DaVita Final exam answered (LATEST)
Per Davita policy, fever and chills is defined as
a. Any temperature greater than 99°F or increase over
... [Show More] baseline of 1°F with symptoms
b. Any temperature greater than 99°F or increase over baseline of 1°F without symptoms
c. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms
d. Any temperature greater than 100°F or increase over baseline of 2°F without symptoms - Ans-c. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms
Documentation in the medical record
a. Includes caregiver opinion.
b. Belongs to the patient.
c. Is a permanent legal record of the care provided
d. Is not subject to review by surveyors - Ans-c. Is a permanent legal record of the care provided
The PCT notes that a patient still has considerable edema in her legs when performing the posttreatment data collection. In addition to informing the nurse, what should the PCT document? a. Leave the data collection entry blank
b. Document "RN to assess"
c. Document the noted swelling and that the RN was informed
d. Document "N/A" since the nurse will assess and document - Ans-c. Document the noted swelling and that the RN was informed
When the patient's calculated UF Goal exceeds the maximum UFR ordered by the nephrologist
a. The calculated UF Goal should be entered into Snappy and the UFR adjusted once the patient shows signs of becoming hypotensive
b. The patient must give permission to exceed the ordered maximum UFR since fluid overload is harmful and every effort should be made to reach the ordered target weight
c. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the reason
documented
d. The charge nurse must assess the patient prior to treatment initiation to determine a safe UF Goal for the patient - Ans-c. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the reason documented
DQI (Davita Quality Index) is achieved by
a. Managing individual patients first and allowing scores to follow
b. Knowing each team member's role in improving DQI scores
c. Using the CQI process to help identify trends and make improvements
d. All of the above - Ans-d. All of the above
Per the CDC, which is the most common factor contributing to bacteremias in dialysis patients?
a. Inappropriate skin preparation prior to vascular access needle insertion
b. The use of catheters for hemodialysis
c. Poor needle site rotation when cannulating an internal vascular access
d. Exposing needle insertion sites to unclean environment areas, e.g. contaminated chair side tables during dialysis - Ans-b. The use of catheters for hemodialysis
Which statement is true about sinks used for hand washing?
a. Patients may not use sinks that are dedicated for teammate hand washing, but should have their own sinks
b. Hand washing sinks may be used to discard clean solution such as left-over normal saline in a sterile bag
c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean
d. Hand washing sinks may be used to discard bleach solution since the solution kills germs and has the added benefit of disinfecting the sink - Ans-c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean
If a patient presents with dialysis associated pericarditis, treatment includes more frequent dialysis and
a. Heparin restriction to prevent bleeding into the pericardium and tamponade
b. A higher potassium bath to prevent dysrhythmias
c. A lower BFR and DFR to prevent dialysis disequilibrium syndrome
d. An increased BFR and DFR to increase toxin removal - Ans-a. Heparin restriction to prevent bleeding into the pericardium and tamponade
If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be an appropriate patient care assignment
a. Caring for HBsAg positive and Hepatitis B immune patients at the same time
b. Caring for HBsAg and Hepatitis B susceptible patients at the same time
c. Caring for Hepatitis B susceptible patients and those in the process of receiving the vaccination at the same time
d. Caring for Hepatitis B immune and susceptible patients at the same time - Ans-b. Caring for HBsAg and Hepatitis B susceptible patients at the same time
The best way to help patients successfully change behaviors is to
a. Scare them through describing serious health risks of the current behavior
b. Tell them how to accomplish the desired change
c. List medically sound reasons why change is necessary
d. Inspire behavior change through support, compassion, and empathy - Ans-d. Inspire behavior change through support, compassion, and empathy
Your patient complains of dry itchy skin. You would advise her to
a. Take frequent hot showers
b. Rub skin completely dry after a bath
c. Use hyper-fatted soaps and lotions
d. Eat foods rich in fatty acids - Ans-c. Use hyper-fatted soaps and lotions
Which statement is true regarding the stages of grief?
a. To come to a place of "Acceptance" one must follow the right way to work through the stages b. Some people can get stuck in a stage
c. Once acceptance is achieved even complications like access problems cannot start the grief process anew
d. Patients go through a common stepwise progression through each stage of grieving process - Ans-b. Some people can get stuck in a stage
The acronym DARN stands for
a. Desire, Ability, Reason, Need
b. Deficiency, Ambition, Rationality, Neediness
c. Design, Aspiration Requirement, Negativity
d. Demand, Accomplishment, Requisite, Necessary - Ans-a. Desire, Ability, Reason, Need
Convection is defined as
a. Solutes are dragged across the semipermeable membrane along with fluid
b. Controlled fluid removal by manipulation of hydrostatic pressure
c. Particles move from an area of higher solute concentration to an area of lower solute concentration
d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration - Ans-a. Solutes are dragged across the semipermeable membrane along with fluid
The three core communication skills used in motivational interviewing are
a. Monitoring, persuading, advising
b. Explaining, comprehending, adapting
c. Asking, listening, informing
d. Inquiring, directing, informing - Ans-c. Asking, listening, informing
hemodialysis helps normalize body pH through
a. Diffusion of acids from the blood into the dialysate
b. Convection of bicarbonate during backfiltration
c. Diffusion of bicarbonate from the dialysate into the blood
d. Stimulation of the respiratory system to increase exhalation of acids - Ans-c. Diffusion of bicarbonate from the dialysate into the blood
The excretory function of the kidney is:
a. Erythropoietin production
b. To bind to phosphorus
c. To absorb vitamins
d. To normalize electrolytes - Ans-d. To normalize electrolytes
Unless otherwise directed by the manufacturer or state specific pharmacy regulations, when must medications containing a preservative be discarded?
a. At 28 days after opening
b. At 25 days after opening
c. At 23 days after opening
d. At 21 days after opening - Ans-a. At 28 days after opening
Educational tips for visual learners include
a. Providing soft background music
b. Selecting quiet surroundings
c. Using lively hand gestures when delivering long lectures
d. Allowing plenty of time for the patient to talk - Ans-b. Selecting quiet surroundings
An optimal nutrition status is evidenced by
a. An appropriate amount of energy, ability to sleep well at night, serum potassium of no greater than
5.5 mEq/L, and a BUN of 60-80 mg/dl
b. A 30 minute exercise tolerance, calcium 8.4-10.2 mg/dl, phosphorus 3-5.5 mg/dl and PTH intact 150-
600 pg/ml
c. Patient report of feeling well, no excess fluid weight gains, bringing appropriate snacks to dialysis, and taking phosphate binders with every meal
d. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl - Ans-d. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl
When comparing the FMC dialysis machine's conductivity reading to your manual reading, policy states that the difference between these two readings is to be
a. No greater than +/- 0.4
b. No greater than +/- 0.3
c. No greater than +/- 0.2
d. No greater than +/- 0.1 - Ans-a. No greater than +/- 0.4
Which statement is true regarding the "Reasonable and Prudent" Standard of Care?
a. The Standard of Care is based on providing highly specialized care after a caregiver is certified
b. Caregivers who are doing it "their way" without regard to DaVita P&P can easily defend their actions in the event of an adverse patient outcome
c. The Standard of Care only includes actions a nephrology nurse would do, but not those the nurse would avoid doing
d. When supervising patient care technicians an other non-licensed personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the Standard of Care - Ans-d. When supervising patient care technicians an other non-licensed personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the Standard of Care
What is an important action prior to returning a patient's blood using the hand crank in the event of a power failure?
a. Take the patient's blood pressure
b. Check for a blood leak
c. Place the machine into bypass
d. Remove the venous line from the line clamp - Ans-d. Remove the venous line from the line clamp
The KDOQI (Kidney Disease Outcomes Quality) Rule of 6s
a. Provides guidelines for use of a new AV fistula
b. Provides guidelines for use of a new AV graft
c. Provides guidelines for use of a new AV fistula and a new AV graft
d. Provides guidelines for use of a tunneled CVC - Ans-a. Provides guidelines for use of a new AV fistula
During cannulation of all AV fistulas
a. A tourniquet is to be applied to increase vein engorgement and stabilize vessel
b. A tourniquet may be applied to increase vein engorgement if deemed necessary by the cannulator
c. A tourniquet to increase vein engorgement is not necessary if the AVF is well developed
d. Tourniquets should not be applied to decrease the risk of AVF clotting - Ans-a. A tourniquet is to be applied to increase vein engorgement and stabilize vessel
At what time do you perform water hardness testing?
a. At the beginning of each day prior to the first treatment
b. About halfway through your treatment day
c. Every four hours
d. At the end of the treatment day - Ans-d. At the end of the treatment day
Why should the patient be in a comfortable supine position when you perform pre-dialysis CVC care?
a. The supine position allows easier visualization of the CVC exit site
b. The supine position decreases blood flow through the catheter and diminishes the risk of hemorrhage
c. The supine position prevents clean barriers from dropping off
d. The supine position increases pressure within central veins and diminishes the risk of an air embolism - Ans-d. The supine position increases pressure within central veins and diminishes the risk of an air embolism
What is your immediate response to a final water quality alarm on the treatment floor? a. Place all machines into bypass
b. Terminate treatments
c. Notify your biomed technician
d. Perform manual water testing to verify results - Ans-a. Place all machines into bypass
What complication would you expect to see if a patient is exposed to chlorine/chloramines? a. Bone disease
b. Hemolysis
c. Hypertension
d. Muscle weakness - Ans-b. Hemolysis
The nephrologist has ordered the use of hemostatic sponges, such as SureSeal, for your patient. What is the correct procedure when using these sponges?
a. Apply a sterile band aid over the hemostatic sponge to keep it in place
b. Tape a folded sterile gauge over the hemostatic sponge to create a pressure dressing
c. Remove the hemostatic sponge after hemostasis has been achieved and dress the needle sites with sterile gauge or band aid
d. After hemostasis has been achieved, observe the needle site for 5 minutes. If no further bleeding is noted, advise the patient to remove the hemostatic sponge at home - Ans-c. Remove the hemostatic sponge after hemostasis has been achieved and dress the needle sites with sterile gauge or band aid
Why do we measure the pH of the dialysis solution?
a. To verify its conductivity is within the acceptable range
b. To verify the correct amount of dialysis quality water has been added
c. To verify its acid-base balance within the acceptable range
d. To verify no residual disinfectant is present - Ans-c. To verify its acid-base balance within the acceptable range
You listen to your patient's AV graft and hear a whistling sound
a. This could be inactive of an inflow stenosis
b. This could be indicative of an outflow stenosis
c. This could be indicative of advanced access thrombosis
d. This is a normal sounding bruit - Ans-b. This could be indicative of an outflow stenosis
Your patients pull out her snack during dialysis. As she savors the first bite of her banana she smiles and tells you she always waits to eat food in high in potassium during dialysis so it won't harm her. What is your appropriate response?
a. You congratulate the patient on her understanding that too much potassium can be dangerous
b. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off
c. You ask the patient if she remembered to bring her phosphate binders too
d. You ask the Charge RN to change the amount of potassium in the dialysate to a lower level so it will remove more potassium - Ans-b. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off [Show Less]