NNCC CCHT Certification Exam 180 Questions with Verified Answers
AAMI standard for conventional dialysis requires the total microbial count to be
... [Show More] less than - CORRECT ANSWER 200 CFU/mL
abnormal levels of this electrolyte can cause cardiac arrhythmias and even death - CORRECT ANSWER Potassium
Acceptable interdialytic weight gains are - CORRECT ANSWER 3-5% of TW
The AAMI standard for endotoxin levels in conventional daily's are is - CORRECT ANSWER Less than 2 EU/mL
albumin is an important test that tells about the patient------------status - CORRECT ANSWER nutritional
All of the follow are phosphate binders EXCEPT - CORRECT ANSWER Vitamin B12
numbness and tingling - CORRECT ANSWER Not a sign or symptom of an infected access
Asepsis - CORRECT ANSWER Absence of disease producing organisms
AAMI chemical analysis of water used for hemodialysis is tested - CORRECT ANSWER Annually
A 58- year old patient who is blind comes to treatment accompanied by his wife. What approach should the dialysis tech use when interacting with the patient? - CORRECT ANSWER Describe the activities in the immediate environment
A dialysis technician observed a drop of blood on the surface of a patient's machine. What action should the tech take? - CORRECT ANSWER Clean the machine surface immediately
About one ounce (30 ml) fluid is on the floor - CORRECT ANSWER A dialysis technician observes all of the below on the treatment floor, which one poses an environment risk?
A females dialysis technician has been caring for a male patient for several months. The patient tells the dialysis tech that he is lonely and depressed. He asks the tech to go out to dinner with him. In addition to politely declining the patients invitation, what action should the dialysis technician take? - CORRECT ANSWER Refer the patient to the social worker
A fistula connects - CORRECT ANSWER an artery to a vein
A marker used to determine the middle molecule clearance of a dialyzer is - CORRECT ANSWER Vitamin B12
A mixed bed DI tank contains - CORRECT ANSWER cations and anions
Nephron is made up of - CORRECT ANSWER A glomerulus and a tubule system
A patient complains of pain at venous needle site. The dialysis technician observes there is swelling distal to the venous needle site and that the venous pressure is rising. The tech should suspect - CORRECT ANSWER An infiltration
A patient who is to receive their first dialysis treatment is prone to - CORRECT ANSWER dialysis disequilibrium syndrome
a patient tells the technician that the dietitian reviewed high-potassium foods with her. during the conversation she states she routinely eats the following food. which one is highest in potassium? - CORRECT ANSWER bananas
slow pulse of 54 beats/minute would indicate the patient has: - CORRECT ANSWER bradycardia
A reason why a dialysis technician is to be certified is: - CORRECT ANSWER It's a CMS requirement
A rise in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative of - CORRECT ANSWER clotting in the extracorporeal circuit
A teammate asks you to document the normal saline he just gave to Mr. Smith. You would - CORRECT ANSWER never document something that someone else did
A true aneurysm can be dangerous because it - CORRECT ANSWER may rupture and cause the patient to bleed profusely
A patient's laboratory results indicate that the predialysis BUN level was lower than the post dialysis BUN level. When interpreting these findings the technician should seek the answer to which of these questions. - CORRECT ANSWER Was the post dialysis sample drawn correctly
a rapid pulse of 104 beats/minute would indicate that the patient has: - CORRECT ANSWER tachycardia
A patient's target weight is 154.0 lb (70 kg) and the patient's pre treatment weight is 158.4 lb (72 kg). For a four-hour treatment, how many mL/hour must the patient lose to reach dry weight? - CORRECT ANSWER 500
AAMI standard for conventional dialysate requires the total microbial count be less than - CORRECT ANSWER 100 CFU/mL
abnormal levels of this electrolyte can cause cardiac arrhythmias and even death - CORRECT ANSWER Potassium
Acceptable interdialytic weight gains are - CORRECT ANSWER 3-5% of TW
The AAMI standard for endotoxin levels in conventional dialysate is - CORRECT ANSWER less than two (2) EU/mL
Albumin is an important test that tells about the patients' __________ status. - CORRECT ANSWER nutritional
All of the following are phosphate binders EXCEPT :
Renagel
Phos-Lo
Tums
Vitamin B12 - CORRECT ANSWER Vitamin B12
All of the following may be. signs and symptoms of an infected access EXCEPT :
fever and swelling of the access
numbness and tingling
redness and warmth
tenderness and drainage - CORRECT ANSWER Numbness and tingling
Before a hemodialysis treatment, the technician removes the cap from the fistula needle and accidentally touches the chair with the tip of the needle. Which of these actions should the technician take first? - CORRECT ANSWER discard the needle
Dialysate that is too hot will cause - CORRECT ANSWER hemolysis
Target weight is defined as the - CORRECT ANSWER weight at which the patient has no edema or fluid in the lungs and BP is normal.
During a hemodialysis treatment the technician responds to a low venous pressure alarm. The most likely cause for this alarm is: - CORRECT ANSWER Disconnection of the bloodline
During a hemodialysis treatment, a patient says to the technician, 'Three hours of time have passed according to the clock on the wall, but the machine shows that only 2.5 hours have passed. What could be the problem?' The technician should understand that the - CORRECT ANSWER machine was in bypass for 30 minutes
Biohazardous waste includes any material exposed to: - CORRECT ANSWER blood
Decreasing the patient's prescribed blood flow rate affects the rate of - CORRECT ANSWER diffusion
During a hemodialysis treatment, a patient's venous needle infiltrates. Which of these actions should the dialysis technician take first? - CORRECT ANSWER stop the blood pump
During hemodialysis a patient goes into cardiac arrest. The first action for the dialysis technician is - CORRECT ANSWER Call for assistance
Dialysate pH should be - CORRECT ANSWER Between 6.9 and 7.6
During hemodialysis, the air detector on Ms. Foster's machine alarms and foam is visible in the venous drip chamber. The immediate action of the dialysis technician should be to: - CORRECT ANSWER Clamp the venous line
during predialysis data collection, it would be best for the technician to ask the patient which of these questions? - CORRECT ANSWER How have you been since your last dialysis treatment?
During the hemodialysis treatment, a patient complains of feeling chilled. In addition to getting the patient a blanket, which of these actions should the technician take? - CORRECT ANSWER take the patient's temperature
during the set-up of a hemodialysis machine, the alarm test for conductivity fails. which of these actions should the dialysis technician take? - CORRECT ANSWER Notify the equipment technician
ESRD specific tests such as BUN, Creatinine, and URR are - CORRECT ANSWER indicators of the adequacy of the renal replacement therapy
excess fluid is forced out of the blood and into the dialysate during dialysis by which principle? - CORRECT ANSWER ultrafiltration
Feed conductivity minus product conductivity divided by feed conductivity X 100 is the formula for calculating - CORRECT ANSWER percent resistivity
Fifteen minutes before the end of a hemodialysis treatment, a patient complains of dizziness and nausea. These symptoms are most likely due to: - CORRECT ANSWER hypotension
Fluid to be removed divided by the treatment time tells us - CORRECT ANSWER the ultrafiltration rate
Germicide rebound occurs due to - CORRECT ANSWER Inadequate dialyzer priming
A semipermeable membrane is a porous barrier that: - CORRECT ANSWER Allows for only certain sized particles to cross
Mrs. Smith's target weight is 62 kg. Her pretreatment weight when she came in for treatment on Monday was 67 kg. The priming saline amount is 240 mL, the rinseback amount is 200 mL, fluid from medications is 100 mL, and she is not allowed any fluids during treatment. What is the total amount of fluid weight to be removed during her treatment? - CORRECT ANSWER 5,540 mL
Based on Mrs. Smith's total amount of fluid to be removed, what is the ultrafiltration rate per hour (mL/hr) for her 4-hour treatment? - CORRECT ANSWER 1,385 ml/hr
Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of - CORRECT ANSWER anaphylaxis (severe allergic reaction)
Hyperkalemia can lead to - CORRECT ANSWER cardiac arrest
if a patient develops an infection post transplant, the largest contributing factor would most likely be: - CORRECT ANSWER immunosuppressive medication
If the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient's serum level of - CORRECT ANSWER hemoglobin
During dialyzer reprocessing, the blood compartment is tested to - CORRECT ANSWER Check dialyzer for total cell volume
Infection control protocols for hemodialysis equipment should include which of these actions by the caregiver? - CORRECT ANSWER using gloves when touching the machine
Lidocaine is administered - CORRECT ANSWER intradermally
Low albumin levels in the dialysis patient have been linked with - CORRECT ANSWER Higher hospitalization and death rates
A medication that dialyzes off easily is - CORRECT ANSWER Digoxin
Mr. jones demonstrates how to wash his access. this is a an example of which adult learning principle - CORRECT ANSWER psychomotor
Mr. jones suffers from constipation. he goes to the drug store to buy a laxative. Mr. jones should avoid which medication? - CORRECT ANSWER milk of magnesia
Mr. Roberts verbalizes how to hand crank his blood pump in the event of an emergency. this is an example of which adult principle? - CORRECT ANSWER cognitive
Mrs. pruitt's temperature is elevated post-hemodialysis treatment. which of these actions should the dialysis technician take? - CORRECT ANSWER Notify the nurse
Mrs. smith arrives for dialysis treatment complaining of shortness of breath. her pre-dialysis weight is 4.7 kilograms above the last post-treatment weight. the dialysis technician reweighed and verified the weight. which of the actions should the dialysis technician take next? - CORRECT ANSWER notify the nurse of the need for an assessment
Ms. Foster complains of shortness of breath. While calling for the nurse the dialysis technician notices there is air in the extracorporeal circuit she/he should place Ms. Foster in - CORRECT ANSWER trendelenburg position on left side
One reason that normal saline is used to prime and perform recirculation for the extracorporeal circuit prior to treatment is to remove - CORRECT ANSWER Air
Normal body pH - CORRECT ANSWER 7.35-7.45
One disadvantage of a fistula is an increase in - CORRECT ANSWER Time to mature
One cause of aneurysms and pseudoaneurysms is: - CORRECT ANSWER Poor rotation of sites
the air detector alarms during treatment. if the machine is working properly, the dialysis technician should expect which of these events to have occurred - CORRECT ANSWER blood pump has stopped
pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of - CORRECT ANSWER sterilant infusion
Patient exposure to chloramines during the hemodialysis treatment may cause - CORRECT ANSWER hemolysis
One sign and symptom of fluid overload is - CORRECT ANSWER hypertension
Solutions that have a higher osmolarity than body fluids are called? - CORRECT ANSWER hypertonic
Sam's TW is 70 kilograms (kg). He arrives for treatment today at a weight of 70 kg. He complains of shortness of breath and you notice his ankles are swollen. You notify the charge nurse. What do you think will be the plan for Sam's treatment today? - CORRECT ANSWER The nurse will get an order to increase the TW
Symptoms of hyperkalemia may include - CORRECT ANSWER numbness and tingling
The accuracy of the lab results depends on adherence to proper lab draw technique. You must ensure that labs are drawn? - CORRECT ANSWER at the right time, right site, and right order
Short frequent hemodialysis treatments in patients with high BUN (blood urea nitrogen) are performed to prevent - CORRECT ANSWER dialysis disequilibrium syndrome
prior to cannulation a technician notices the skin over the patient's fistula is reddened and warm to touch. these symptoms are most likely due to - CORRECT ANSWER infection
The medication used to treat anemia is - CORRECT ANSWER Epogen
The most important monitor in the dialysis setting is - CORRECT ANSWER teammate
The extracorporeal circuit consists of the - CORRECT ANSWER blood lines and the dialyzer
The normal range of resting respirations in an adult is - CORRECT ANSWER 12-20 breaths per minute
the dextrose used in the dialysate for peritoneal dialysis can cause - CORRECT ANSWER hyperglycemia
The leading cause of chronic kidney disease for adults in the United States - CORRECT ANSWER diabetes
The organization that has as a goal to 'improve the care and outcomes of all individuals with kidney disease' is called - CORRECT ANSWER KDOQI
the dialysis technician's role in patient education is to - CORRECT ANSWER reinforce educational information provided
The most important intervention to prevent the spread of infection - CORRECT ANSWER Perform hand hygiene
The movement of fluid from the tissues toward a higher concentration of sodium in the blood is and example of - CORRECT ANSWER Osmosis
The functional unit of the kidney, or the structure in the kidneys that does the work is the... - CORRECT ANSWER Nephron
The bruit in a AV fistula or graft is detected by - CORRECT ANSWER Listening with a stethoscope
The national standard, based on the KDOQI guidelines for the urea reduction rate (URR) is a ratio greater than - CORRECT ANSWER 65%
KDOQI - CORRECT ANSWER Kidney Disease Outcomes Quality Initiative
The most important member of the patient care team is the - CORRECT ANSWER patient
The medication used to improve calcium absorption is - CORRECT ANSWER Zemplar
How do you know if a patient can safely disconnect themselves in an emergency - CORRECT ANSWER Let the patient show you after a treatment
'Dwell time' in peritoneal dialysis is defined as: - CORRECT ANSWER The amount of time the peritoneal fluid remains in the abdomen
Dialysate conductivity measures - CORRECT ANSWER the total electrical charge of a solution
name two compartments of the dialyzer - CORRECT ANSWER blood and dialysate
Which statement is true about kidney transplantation - CORRECT ANSWER The is a shortage of available kidney donors
The usual fluid allowance for a person with kidney failure is - CORRECT ANSWER 1.0 to 1.5 liters daily
The scale says a patient weights 70kg this is the same as weighing how many pounds - CORRECT ANSWER 154
The organization that sets the standards for dialysis water quality is called - CORRECT ANSWER AAMI
total cell volume (TCV) is a indirect measure of the - CORRECT ANSWER performance of the dialyzer
Total chlorine levels in the water are tested - CORRECT ANSWER before each patient shift or every four hour
The purpose of using counter currant flow is to - CORRECT ANSWER Increase the rate of waste removal
water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle - CORRECT ANSWER osmosis
water softener - CORRECT ANSWER Operates on the principle of ion exchange
What are the typical signs of fluid overload - CORRECT ANSWER edema and shortness of breath
The usual heparin sodium concentration for anticoagulation during hemodialysis is - CORRECT ANSWER 1,000 u/mL
To determine the patency of an arteriovenous vascular access, the dialysis technician should initially fell for the presence of - CORRECT ANSWER A thrill
Ultrafiltration is influenced by - CORRECT ANSWER Transmembrane pressure
Waste products are removed during dialysis by which principle - CORRECT ANSWER Ultrafiltration
The water softener removes - CORRECT ANSWER calcium and magnesium
The reprocessed dialyzer is carefully rinsed prior to patient use to remove - CORRECT ANSWER Residual germicide
The part of the cell wall of bacteria that, when released m, can cause fever in hemodialysis patients is - CORRECT ANSWER Endotoxin
the venous needle in an AV fistula - CORRECT ANSWER Should be placed antegrade
The total pressure that exists across the dialyzer membrane is called - CORRECT ANSWER Transmembrane pressure
The substance that may be added to the municipal drinking water to make it clearer - CORRECT ANSWER Alum
What is the most accurate measure of dialysis adequacy - CORRECT ANSWER Kt/V
Which component in dialysis is used to correct metabolic acidosis - CORRECT ANSWER Bicarbonate
What is most likely to cause high venous pressure alarm - CORRECT ANSWER Kinking of the venous blood line
What lab tests are used to monitor anemia in the ESKD patients - CORRECT ANSWER Hemoglobin/ hematocrit
which learning domain is knowledge based - CORRECT ANSWER cognitive
What is the desired outcome when the patient performs fistula exercises - CORRECT ANSWER Enlargement of the vein
What is a classic sign of hemolysis - CORRECT ANSWER Cranberry juice colored blood in the venous line
Which food is highest in phosphorus - CORRECT ANSWER Ice cream
when fluid replacement is necessary during the hemodialysis treatment, which of the following solution is used? - CORRECT ANSWER 0.9% normal saline
What is not a symptom of uremia - CORRECT ANSWER elevated hematocrit
What is a cause of hypotension during and after dialysis treatment - CORRECT ANSWER Removing too much fluid
What is not a possible cause of an increased temperature pre dialysis - CORRECT ANSWER The patient has fluid overload
What is considered to be safe water for dialysis - CORRECT ANSWER Dialysis quality water
What is the largest needle gauge - CORRECT ANSWER 18 gauge
What actions would increase diffusion during dialysis - CORRECT ANSWER Using a bath that will provide a greater concentration gradient
Fluid - CORRECT ANSWER Diffuses from the patients blood during dialysis
hand hygiene - CORRECT ANSWER the most important technique used in preventing and controlling transmission of infection
What learning domain is behavioral - CORRECT ANSWER Affective
when cannulating, the tips of the needles should be at least - CORRECT ANSWER 1.5" or the width of 2 fingers apart
What symptoms would indicate a need to increase the target weight - CORRECT ANSWER Hypotension and cramping
Your patient is to receive 2000 units of heparin. The vile you are using is 1000u/ml heparin. How many mls will you draw up for this patient - CORRECT ANSWER 2.0
What type vascular access has the fewest complications - CORRECT ANSWER arteriovenous fistula
What is used to prevent air in bloodlines - CORRECT ANSWER Tighten all connections
What organization establishes the standards and recommendations for dialyzer reprocessing - CORRECT ANSWER AAMI
What would cause a high venous pressure alarm - CORRECT ANSWER Venous needle is against the wall of the vessel
What might indicate a need to decrease the heparin dose? - CORRECT ANSWER The patient just had surgery yesterday
What might indicate the need to increase heparin? - CORRECT ANSWER clotting in the extracorporeal circuit
What technician activities contributes to data collection used to measure quality outcomes - CORRECT ANSWER Ensuring accurate documentation
A decrease in transmembrane pressure in a high flux dialyzer during hemodialysis is indicative of - CORRECT ANSWER Clotting of the extra corporeal circuit
You have documented incorrectly on a patient's chart. How do you correct this? - CORRECT ANSWER Draw one line through it, date, time, sign, with the words "error"
What practice helps build a patients immunity to hepatitis B - CORRECT ANSWER Vaccination
A patient asks the technician " what does uremia mean?" The technicians response should be based on the understanding that uremia is - CORRECT ANSWER An increase of wastes in the blood
A central venous catheter may be used as a vascular access when a - CORRECT ANSWER Patient has inadequate blood vessels in the limbs
Before a dialysis treatment, the patient tells the technician "yesterday, I felt terrible and vomited up some blood. I feel much better today" the technician can expect the patients treatment will be modified by - CORRECT ANSWER Decreasing the heparin does
The technician is unsure which one of a patients AV grafts anastomoses is arterial and which is venous. In order to differentiate between the two the technician should - CORRECT ANSWER Compress the graft in the middle and palpate each side
At the end of a patient's treatment, which of these findings, if observed by the technician, should be reported to the nurse ? - CORRECT ANSWER A pulse rate of 55 beats per minute
A patient asks the dialysis technician "why am I getting vitamin D therapy?" What should the tech tell the patient - CORRECT ANSWER Vitamin d is needed for healthy bones
Why are dialysis patients more likely to become infected with germs like MSRA - CORRECT ANSWER They have weak immune systems
Legally, if a treatment was performed but not charted in the patient's record, it was - CORRECT ANSWER not done
The most common cause of a low conductivity alarm during hemodialysis is - CORRECT ANSWER An exhausted concentrate supply
A patient who has diabetes mellitus should be observed for signs of low blood sugar which include - CORRECT ANSWER Anxiety and confusion
A patient asks the technician why a high venous pressure alarm is sounding. The technician should explain that a high venous pressure alarm might indicate a - CORRECT ANSWER Clotting of the blood in the access
In hemodialysis the term "reuse" refers to the cleaning and disinfecting of - CORRECT ANSWER Dialyzers
A 30 year old male new to hemodialysis, is scheduled for treatments at 6:00 AM three times a week. He tells the technician "I've walked a mile every morning for years. I guess I'll have to give that up now." Which of these responses by the technician would be best - CORRECT ANSWER
If a patient is exposed to bleach or germicide, what will you be expected to do? - CORRECT ANSWER Stop treatment, clamp venous blood line, take samples for analysis
Who may be able to tell you if a patient has gained or lost really weight? - CORRECT ANSWER The patient
What is the first step in a chair to chair or stand and pivot transfer? - CORRECT ANSWER Lock the wheels on the wheelchair
What is dialysis related amyloidosis - CORRECT ANSWER A build up of waxy protein that forms fibrils that deposit in tissues
If a patients own family is not supportive what can you do as a dialysis tech - CORRECT ANSWER Encourage the patient to reach out, ask what they need, and be their cheerleader
What is the first step in the cdc's scrub the hub protocol for cvc - CORRECT ANSWER Wash hands put on clean gloves
What must occur to stop the process of diffusion or osmosis - CORRECT ANSWER Equilibrium; the solutes or water level are the same on both sides of a membrane
Getting enough protein is important for people on dialysis because protein helps them to - CORRECT ANSWER Maintain muscle and tissues. Patient lose protein at each treatment
What are the key components of a water softener - CORRECT ANSWER A resin bed and sodium ions [Show Less]