ccht practice test 5.0

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c) universal precautions
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1.Which of the following best describes the reason for wearing gloves when handling machine prior to blood? a) patient comfort b) asepsis c) universal precautions d) HIV
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b) needs further rinsing
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2 You test for sterilant levels in a hemodialysis machine prior to patient use. The test is positive for sterilant. This means the machine: a) is sterile & bacteria free b) needs further rinsing c) needs more sterilant d) is in conductivity
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a) creatinine, BUN, & phosphorus are elevated
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3.Choose the correct statement regarding serum abnormalities in renal failure: a) creatinine, BUN, & phosphorus are elevated b) creatinine BUN creatinine, BUN, & phosphorus are depressed c) calcium & bicarbonate are elevated d) calcium & bicarbonate are depressed
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a) vascular access
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4.Hemodialysis requires a means to channel the patient’s blood to the hemodialyzer & then back to the body. It’s called: a) vascular access b) hemodialyzer c) dialyzing fluid delivery system d) infusion pump
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b) usually created in the forearm, near the wrist
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5.Which of the following is correct regarding a fistula? a) usually created in the leg, near the ankle b) usually created in the forearm, near the wrist c) are made of salastic tubing d) none of the above
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c) blood leakage immediately
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6.Blood leak detectors are extremely sensitive & can determine: a) blood type b) amount of blood loss c) blood leakage immediately d) volume changes e) serum potassium levels
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d) bananas, tomatoes, oranges
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7.Which of the following foods are high in potassium? a) milk, ice cream, yogurt b) legumes, cheese, pizza c) chips, colas, canned meat d) bananas, tomatoes, oranges
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a) calcium, phosphorus & PTH
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8.What lab values are monitored for assessing bone disease? a) calcium, phosphorus & PTH b) calcium, phosphorus & albumin c) calcium, phosphorus & potassium d) calcium, phosphorus & magnesium
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a) diabetes
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9.Which is the most common cause of chronic kidney failure in the US? a) diabetes b) hypertension c) polycystic kidney smaller molecular disease d) glomerulonephritis
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b) potassium has a smaller molecular weight
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10.The reason potassium dialyzes and RBC’s do not is: a) potassium has a larger molecular weight b) potassium has a smaller molecular weight c) RBC’s are not water soluble d) RBC’s have a negative charge
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a) less than 0 .1mg/L (ppm)
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11.Acceptable limits for total chlorines in water for hemodialysis are? a) less than 0 .1mg/L (ppm) b) 0.5 mg/L to 1 mg/L(ppm) c) 3.5 mg/L to 5.5 mg/L to 5.5 mg/L(ppm) d) greater than 6.0 mg/L(ppm)
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b) dialysis disequilibrium syndrome
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12.If a new patient starts with a very high BUN, dialysis is purposely made less efficient to prevent: a) rapid decrease in hct b) dialysis disequilibrium syndrome c) cardiac arrhythmia’s d) excessive coagulation
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c) low hematocrit
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13.The following are factors in poor clearance during dialysis except: a) poor dialyzer reuse b) access recirculation c) low hematocrit d) low blood flow rate
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b) osmosis
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14.The movement of water from an area of low solute concentration to an area of high solute concentration is called: a) diffusion b) osmosis c) ultrafiltration d) dialysis
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d) dialyzer
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15.Potting compound, casing, fibers and headers are part of a: a) dialysis machine b) water treatment system c) R. O. system d) dialyzer
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c) 4.0 liters or 4000 ml
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16.Mr. Jones has a dry weight of 72 kg. He weighed 73 kg after last treatment. Today he weighs 75.5 kg. Assume prime and rinse back =500 ml total. What is Mr.Jones’ fluid removal goal for today? a) 2.5 liters or 2500 ml b) 3.0 liters or 3000 ml c) 4.0 liters or 4000 ml d) 4.5 liters or 4500
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c) concentration of red blood cells in the blood
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17.A hematocrit test indicates which of the following? a) concentration of platelets b) concentration of creatinine in the blood c) concentration of red blood cells in the blood d) concentration of white blood cells in the blood
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d) all of the above
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18.What factors should be considered when establishing a patient’s dry weight? a) blood pressure b) patient well being c) evidence of dehydration or fluid overload d) all of the above
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c) appropriately mix the dialysate concentrates with water
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19.In a dialysis machine, the proportioning system does what? a) prepare the dialysate to the proper pH b) warm the dialysate to the proper temperature c) appropriately mix the dialysate concentrates with water d) to monitor the dialysate flow rate
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c) hemolysis
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20.The complication in which blood has a \”cherry pop\”appearance is: a) blood leak b) air embolism c) hemolysis d) none of the above
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d) all of the above
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21.The use of high a sodium dialysate may predispose a patient to: a) fluid overload b) hypertension c) thirst d) all of the above
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a) UF Coefficient
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22.The capability of a dialyzer to remove fluid, expressed as ml/mmHg/hr is: a) UF Coefficient b) clearance c) surface area d) priming volume
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b) resistance to blood flow out of the access through the dialyzer
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23.A pre-pump arterial pressure reading is measuring: a) the pressure required to pump the blood through the dialyzer b) resistance to blood flow out of the access c) pressure within the dialyzer d) none of the above
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d) all of the above
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24.What determines the surface area of a hollow fiber dialyzer? a) number of fibers b) internal diameter of fibers c) length of fibers d) all of the above
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b) increase the rate of waste removal
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25.The purpose of using counter-current flow is to: a) increase the rate of fluid removal b) increase the rate of waste removal c) decrease the amount of dialysate used d) decrease the surface area of the membrane
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b) hemolysis
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26.Chloramine exposure in dialysis can result in: a) hypernatremia b) hemolysis c) pericarditis d) bleeding
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d) the dialyzer fibers are free of leaks
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27.Part of the reuse process involves the reuse machine testing the dialyzer to verify: a) the dialyzer is free of sterilant b) the dialyzer is free of bacteria c) the dialyzer is free of endotoxins d) the dialyzer fibers are free of leaks
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c) 200 CFU’s
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28.According to AAMI RD52, what is the maximum allowable level of bacteria in dialysate? a) 1,000 CFU’s b) 50 CFU’s c) 200 CFU’s d) 500 CFU’s
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b) monthly
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29.According to AAMI RD52, how often should bacterial cultures be sampled? a) weekly b) monthly c) quarterly d) annually
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a) 50 CFU’s
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30.According to AAMI RD52, what is the action level for bacteria in dialysate? a) 50 CFU’s b) 75 CFU’s c) 100 CFU’s d) 200 CFU’s
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b) fever/chills
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31.Bacterial exposure from water may cause which of the following symptoms? a) hemolysis b) fever/chills c) bone disease d) hypotension
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a) Scribner and Quinton
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32.Who developed the first permanent blood access, the \”Shunt\”? a) Scribner and Quinton b) Kolff c) Brescia and Cimino d) Turner
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b) mm/Hg
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33.Venous pressure meters are calibrated in: a) PSI b) mm/Hg c) mL/hour d) mg%
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b) mm/Hg
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34.TPM is measured as: a) mL/hr b) mm/Hg c) mL/min d) none of the above
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c) pH and conductivity
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35.The hemodialysis machine continuously monitors many parameters. Which of these parameters must be verified by an external measuring device? a) blood flow b) dialysate flow c) pH and conductivity d) temperature and transmembrane pressure
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b) chlorine and chloramine
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36.Prior to each patient shift, it would be essential to perform a water quality check for which of these substances? a) calcium and magnesium b) chlorine and chloramine c) organic contaminants d) inorganic contaminants
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b) hydrogen ions
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37.The term pH is a measurement of the concentration of: a) all ions in solution b) hydrogen ions c) bicarbonate ions d) acetate ions
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c) determine the patient’s learning needs
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38.The technician’s role in patient teaching should be to: a) assess the patient\”s barriers to learning b) check the patient’s readiness to learn new information c) determine the patient’s learning needs d) Reinforce teaching that the patient has received from other team members
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d) all of the above
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39.What can dialysis staff do to reduce the risk of being infected with a blood borne pathogen? a) proper hand washing b) universal precautions c) proper sharps disposal d) all of the above
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d) all of the above
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40.Which of the following are ways to handle chemicals safely? a) wash hands before eating or drinking b) wear protective clothing c) don’t eat or drink in the work area d) all of the above
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b) 25-35 degrees
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41.What is the correct angle in which to cannulate a fistula? a) 10-15 degrees b) 25-35 degrees c) 35-45 degrees d) it dosen’t matter
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d) all of the above
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42.Which of the following affects access recirculation? a) distance between the tips of the needles b) presence of stenosis c) direction of needles d) all of the above
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a) salt
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43.The technician observes that the hardness reading after the water softener isabove the acceptable limit. The technician should check the softener tank’s level of: a) salt b) chlorine c) carbon d) sand
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c) about one ounce (30 ml) of fluid is on the floor
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44. A technician observes all of the following in the hemodialysis unit. Which one poses an environmental risk? a) the wheels of the hemodialysis machines are locked b) charts are lying on bedside tables c) about one ounce (30 ml) of fluid is on the floor d) a patient’s family member is present during treatment
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a) Material Safety Data Sheet (MSDS)
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45. When preparing a bleach solution for cleaning equipment, the technician accidentally spills undiluted bleach on the floor. Which of these resources will provide the technician with information about how to properly handle spill of the chemical? a) Material Safety Data Sheet (MSDS) b) Centers for Disease Control & Prevention (CDC) c) Association for the Advancement of Medical Instrumentation (AAMI) d) State Department of Health (DOH)
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d) the dialyzer was bypassed
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46. A conductivity alarm sounds during a hemodialysis treatment. The technician should expect which of these events to have occurred? a) the blood pump has stopped b) the dialysate flow rate has increased c) the electrical power source was interrupted d) the dialyzer was bypassed
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c) obtain a sample after the second
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47. During routine water testing, the technician notes that the chloramine level after the first carbon tank is 0.2mg/L. Which of these actions should the technician take next? a) bypass the carbon tanks b) descale the reverse osmosis membranes c) obtain a sample after the second d) immediately terminate hemodialysis treatments
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a) refer the patient to the social worker
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48. A female technician has been caring for a male patient for several months. The patient tells the technician that he is lonely and depressed. He asks the technician to go out to dinner with him. In addition to politely declining the patient’s invitation, which of these actions, if any, should be taken: a) refer the patient to the social worker b) recommend an over-the-counter mood stimulant, such as St. John’s wort c) share the patient’s need for socialization with other patients d) no further action is needed
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d) left-sided trendelenberg
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49. A hemodialysis technician suspects that a patient who is receiving a hemodialysistreatment has an air embolus. After stopping the blood pump, the patient should be placed in which of these positions? a) low-fowlers b) high-fowlers c) right-sided trendelenberg d) left-sided trendelenberg
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b) call for help
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50. During hemodialysis a patient goes into cardiac arrest. Which of these actions shouldbe taken first? a) apply a precordial thump to the patient b) call for help c) return the patient’s blood d) stop ultrafiltration

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