DaVita PCT Final Exam Review 2022/2023
1. Abnormalities in calcium, phosphorus, parathyroid hormone and Vitamin D metabolism with soft tissue
... [Show More] calcification and bone disease.(answer) CKD-MBD (p. 171)
2. These meds are taken with all meals and snacks(answer) Phosphate binders
3. S/S of excess sodium intake(answer) Increased thirst & hypertension
4. Eating foods high in causes extreme muscle weakness & abnormal heart rhythm(answer) Potassium
5. This protein is essential for growth, maintenance, preventing infection and anemia(answer) Albumin
6. Recommended distance between needle tips(answer) 1.5 inches
7. This best practice prevents the formation of aneurysms & pseudoa- neurysms(answer) Good needle site rotation
8. The 3 steps in a vascular access assessment(answer) Look, Listen, Feel
9. This technique causes bleeding at needle sites during dialysis(answer) Flipping or over-manipulating needles
10. This cannulator has at least 6 months of AV access cannulation experi- ence and at least 10 successful cannulations on established fistulae(answer) NFACT intermediate cannulator (p. 315)
11. Stretching the affected muscle is an appropriate intervention for ?(answer) muscle cramps
12. how to position the patient to treat air embolism(answer) left side trendelenburg
13. This HD complication is associated w/ increased mortality rate(answer) Hypoten- sion during treatment
14. Patients who are skipping treatments are at risk for this(answer) Dialysis Disequi- librium Syndrome
15. Pain at the venous needle site, tingling around the lips and difficulty breathing are symptoms of ?(answer) disinfectant infusion
16. The best way to help patients successfully change behaviors(answer) Inspire change through support, compassion and empathy
17. The degree to which individuals understand basic health information is called ?(answer) Health Literacy
18. Dealing with the consequences of illness rather than just the physical disease is a basic principle of ?(answer) patient self management
19. The automatic intervention of a healthcare practitioner who observes a patient doing something detrimental to his health(answer) Righting Reflex
20. Use word associations and mnemonics for this type of learner(answer) auditory learner
21. The most common infection in dialysis patients(answer) Access infection
22. The most common route by which pathogens are transmitted in health- care settings(answer) Contact transmission
23. The single most important intervention in preventing HAIs in healthcare-
(answer) Handwashing
24. This bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival(answer) Viable MRSA bacteria
25. This test is performed monthly on patients susceptible for Hepatitis B(answer) HbsAg
26. The time the RO must be running prior to performing the first chlo- rine/chloramine test(answer) 15 minutes
27. Works only with a sufficient amount of salt pellets(answer) water softener
28. First response to a Final Water Quality alarm(answer) Place all machines in BY- PASS
29. A complication when patient's blood is exposed to chlorine/chloramines-
(answer) Hemolysis
30. These tanks produce highly dangerous water when exhausted(answer) DI tanks
31. Being "wet" is better than being too dry in patients with this type of kidney disease(answer) The target weight in a patient with AKI
32. The acronym for the 5 rights of medication administration(answer) TRAMP Time, Route, Amount, Medication, Patient
33. Davita policy allows PCTs to administer these 3 medications(answer) 0.9% Sodi- um Chloride, Heparin & Lidocaine
34. The method used to protect against infection by pathogenic microorgan- isms when preparing and administering medications(answer) Aseptic technique
35. Medications containing a preservative must be discarded at this time after opening(answer) 28 days
36. The time frame during which single dose medications should be prepared and administered per DaVita P&P(answer) 4 hours
37. The most common methods used to prevent clotting while the blood is in the extracorporeal circuit(answer) Anticoagulation with Heparin
38. Waiting time after administration of initial heparin loading dose prior to initiation of HD(answer) 3-5 minutes
39. Clotting in the dialyzer causes this change in venous pressure(answer) A de- crease
40. This acid concentrate contains a small amount of anticoagulant & can be used for patients in whom Heparin is contraindicated(answer) Citrasate or CitraPure
41. A frequent cause of prolonged bleeding post-dialysis(answer) Outflow stenosis
42. Method to ascertain needle is not in blood vessel when administering intradermal lidocaine(answer) Pulling back on the plunger
43. topical skin anesthetic patients apply at home(answer) EMLA cream
44. Method prior to cannulation to prevent access infections when a patient has applied topical EMLA cream at home(answer) Wiping off EMLA cream completely
45. The appropriate time to clean the VA cannulation sites when using a topical anesthetic spray(answer) Before applying the spray
46. The sign that numbing has taken effect and it is time to stop spraying topical anesthetic onto VA cannulation sites(answer) When there is blanching of the skin
47. Stimulates bone marrow to produce RBCs(answer) Epogen
48. This med supports the formation of RBCs(answer) Venofer (IV Iron)
49. Medication indicated for the prevention of excessive PTH production in dialysis patients(answer) Vitamin D (Hectorol, Zemplar, Calcitriol)
50. Medication used to treat thrombosis-related CVC occlusion(answer) Cathflo Acti- vase
51. Antibiotic that should be administered over a period of at least 60 min- utes(answer) Vancomycin
52. Patients should take this vitamin after dialysis to prevent meds that are water soluble from being dialyzed out(answer) Nephrocaps (vitamins)
53. This med is taken with meals(answer) Phosphorus binders
54. This med is used to increase the clotting time in patients with arrhyth- mias, prosthetic valves or clotting disorders(answer) Coumadin
55. Over-the-counter laxative that can cause severe toxicity in dialysis pa- tients(answer) Milk of Magnesia
56. Two meds that treat secondary hyperparathyroidism by increasing the sensitivity of calcium sensing receptors(answer) Cinacalcet and Parsabiv
57. Vaccination series consists of four 40mcg doses at 0, 1, 2 and 6 months-
(answer) Engerix B (Hep B vaccine)
58. What defines immunity after Hepatitis B vaccination?(answer) Hepatitis B Surface Antibody of equal or greater than 10mlU/mL
59. Indicated for active immunization against 23 serotypes contained in the vaccine(answer) Pneumovax 23 (pneumonia vaccine)
60. Required for patients whose HBsAb falls below the level sufficient to be immune(answer) Booster dose
61. Required for patients failing to develop sufficient HBsAb after one full series of vaccine(answer) Revaccination with an additional series
62. Which class of meds does not require a physician order but should be approved by the Nephrologist(answer) Over-the-counter medications
63. Sepsis, shock, hemorrhage, burns, renal artery stenosis are considered which type of AKI?(answer) PRERENAL causes of AKI
64. Nephritis, ATN, ingestion of antifreeze, IV contrast, chemotherapy are considered which type of AKI?(answer) INTRARENAL causes of AKI
65. Prostate disease, kidney stones, spinal cord injury, bladder cancer are considered which type of AKI?(answer) POSTRENAL causes of AKI
66. S/S(answer) UOP < 400mL/day, increased BUN/creatinine, hyperkalemia, metabol- ic acidosis(answer) S/S of AKI
67. How are NSAIDs, aspirin, IV contrast, amphotericin B related to AKI(answer) -
Things to avoid w/AKI
68. Difference b/t AKI and CKD(answer) AKI...sudden & short term CKD...slow & long
69. Diabetes, HTN, polycystic kidney disease are causes of what disease?(answer) -
Causes of CKD
70. Definition of K in Kt/V(answer) CLEARANCE of urea from the blood in Kt/V
71. Definition of t in Kt/V(answer) Length of TIME of dialysis treatment in Kt/V
72. Definition of V in Kt/V(answer) Total VOLUME of patient's body water in which urea is distributed in Kt/V
73. BFR for 17G needle(answer) 200-250
74. BFR for 16G needle(answer) 250-350
75. BFR for 15G needle(answer) 350-450
76. BFR for 14G needle(answer) >450
77. Decrease these 3 settings prior to drawing post-BUN(answer) UFR, DFR, BFR
UFR...50
DFR...300
BFR...100
78. How long to wait before drawing Post-BUN?(answer) 15 seconds
79. Kt/V will be falsely DECREASED if...(answer) You wait longer than 15 seconds to draw
Post-BUN
80. Kt/V will be falsely INCREASED if you...(answer) 1.) Draw the Post-BUN while the blood pump stays at prescribed rate
2.) DrawPost-BUN from venous bloodline 3.) Wait only 5 seconds to draw sample
81. Adequacy of dialysis is represented by...(answer) Kt/V
82. When to chart in medical record(answer) Change in baseline assessment or pt. condition
Procedure or Treatment Medication administration Patient Teaching
Care Plan
83. How often to chart during treatment(answer) Every 30 minutes
84. The 6 items charted for medication administration(answer) Name of medication Route of administration
Reason for administration Dose of medication
Date & time given Patient response
85. Acronym used when communicating(answer) SMART Simple
Meaningful Actual Read Teach
86. The 5 W's used to complete an AOR(answer) Who, What, When, Where, Witness
87. What not to include in an AOR(answer) Personal opinion Speculation
Vendettas
88. S/S of which complication? Ischemia to organs
Loss of renal function
Increased mortality rate(answer) Hypovolemia
89. Germ causing most infections in HD patients(answer) Staph/MRSA
90. This association requires employers to provide workers with a safe work- place and mandates P&P(answer) OSHA
91. This association is concerned with patient care and safety(answer) CMS
92. Strategies to decrease CVC infections(answer) Use surgical masks Wear clean gloves & don't touch exposed surfaces
Minimize the time CVC lumens and exit site are exposed
93. What conditions warrant an HBsAg screen?(answer) If hepatitis B surface antibody is <10 and surface antigen is negative
94. When to give Hep B booster dose(answer) When HBsAb is <10
95. How often HBsAg screen is done(answer) Monthly
96. How often HBsAb screen is done(answer) Annually
97. Sign of Inflow stenosis(answer) "Water-hammer" sound over AVF
98. Sign of outflow stenosis(answer) Whistling sound in AVF
99. Signs of thrombosis(answer) High venous pressure, high recirculation rate, increased TMP
100. When do you perform machine ALARM test(answer) Before the initiation of treat- ment
101. How long can you recirculate a dialyzer?(answer) Not more than 2 hours
102. What is the range that MANUAL CONDUCTIVITY must be with machine conductivity?(answer) +/- 0.4
13.0-15.5
103. How to prepare 1(answer)100 bleach solution(answer) 1 part bleach to 99 parts water
104. What happens when bleach and paracetic acid are mixed?(answer) A toxic chlo- rine gas is produced
105. When is residual bleach testing done(answer) After bleach disinfection and prior to use
106. Dialysate pH range(answer) 6.9-7.6
107. Why is "strikethrough" of a transducer important?(answer) Bc a wet transducer could cause AP & VP to be inaccurate
108. When to use 1(answer)10 bleach solution(answer) Visible or gross blood spills
109. The 3 processes that make up the water treatment system(answer) Pre treatment, Water Purification, Distribution
110. Pre treatment water samples for chlorine testing are collected after the RO has operated for at least how many minutes?(answer) 15 minutes
111. What happens if Total Chlorine is collected before the minimum time the RO should be operating?(answer) Results could be falsely negative
112. What do you do if the result of Total Chlorine testing from the primary carbon filter is >0.1ppm?(answer) Perform test after the secondary carbon filter [Show Less]