CCHT Exam Part A 91 Questions with Verified Answers,100% CORRECT

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CCHT Exam Part A 91 Questions with Verified Answers What are some of the responsibilities and requirements of the medical director of a dialysis facility? - CORRECT ANSWERBeing knowledgeable of a... nd responsible for the integrity of the water treatment system in the facility Prior to beginning dialysis, what must the physician order include? - CORRECT ANSWERSpecific dialyzer, BFR, Duration To sit for the CCHT-A exam, the tech must have what? - CORRECT ANSWERHold another national certification such as CCHT, and have worked at least 5,000 hours as a hemo tech What abilities are required of a dialysis tech? - CORRECT ANSWERSome understanding of anat/phy and pathophys of CKD, full understanding of the principles of dialysis and tx complications, math skills What certification program offers the dialysis tech the most cognitive content related to water tx principles? - CORRECT ANSWERCert biomedical nephrology technology What consents are needed for dialysis? - CORRECT ANSWER1 for treatment, 1 for access procedures If a patient decides to terminate dialysis, what should the staff do? - CORRECT ANSWERRealize it is well within the pts right to choose termination. Who was the first person to use the term 'dialysis'? - CORRECT ANSWERThomas Graham What was the primary anticoagulant used in the first artificial kidney? - CORRECT ANSWERHirudin Dr Kolff created the first bio-compatible (rotating drum) dilyzer. What material was used to construct the hollow tubes? - CORRECT ANSWERcellophane The first AV shunt for CKD was placed... - CORRECT ANSWERexternally, using Teflon tubes Which US President signed the bill that allowed Medicare coverage for CKD tx? - CORRECT ANSWERNixon In 1989, the FDA approved a drug that diminished the need for blood transfusions in CKD - CORRECT ANSWEREpogen (mircera) An electrolyte is a substance that dissolves in water to form - CORRECT ANSWERIonized particles What happens to a pt is the dialysate contains too much sodium? - CORRECT ANSWERFluid leaves the cells and they shrivel, the pt will get hypotensive, thirsty and get a headache With osmosis, water moves from areas of.. - CORRECT ANSWERlow concentration to areas of high concentration of solutes Buffers minimize the pH changes when an acid or a base is added to a solution. What is the major plasma buffer in the body? - CORRECT ANSWERBicarbonate Kidney failure causes retention of hydrogen ions. What is the result? - CORRECT ANSWERMetabolic acidosis Which of these pt populations has the lowest proportion of body water? - CORRECT ANSWERAdult females The vasa recta capillaries surrounds the loop of Henle nephrons and play a major role in... - CORRECT ANSWERConcentration of urine as it moves through the tubules In the formation of urine, what action is occurring in step 2? - CORRECT ANSWERWater and other dissolved substances move from the tubules into the blood in the peritubular capillaries. The GFR is the amount of filtrate produced by the kidneys per minute. What is GFR dependent on? - CORRECT ANSWERSufficient blood circulation to the glomerulus , and maintenance of normal filtration pressures Blood urea levels are influenced by many factors. Decreased levels may result from: - CORRECT ANSWERLow dietary protein intake, overhydration At the conference 'Kidney Disease: Improving Global Outcomes on CKD' it was recommended that stage 3 be divided into 3a and 3b. What is the recommended GFR for 3b? - CORRECT ANSWER30-44mL/min/1.73m^2 The NKF recommends that all individuals be assessed for increased risk for developing CKD. Which of these laboratory values should be included in said eval? - CORRECT ANSWERCreatinine When is a pt considered to be in stage 5 CKD? - CORRECT ANSWERWhen the pt requires maintenance dialysis for survival A patient with a diagnosis of nephrosclerosis may exhibit... - CORRECT ANSWERBlood in urine, proteinuria, uncontrolled hypertension What is a common clinic manifestation of renal cell carcinoma? - CORRECT ANSWERBlood in urine Which of the following may be a cause of postrenal acute renal failure? - CORRECT ANSWERObstruction in the ureter or the uthera What is the target blood pressure in pts with CKD recommended by the JNCPDETHBP? - CORRECT ANSWER< 130/80 A pt presents to the nephrologist office with c/o chest pain, fever, and chills. Dr hears a pericardial friction rub during auscultation. Echocardiogram confirms a pericardial tamponade. What procedure is likely next? - CORRECT ANSWERA pericardiocentesis where a needle is inserted into the pericardial space to remove fluid. What are integumentary changes commonly seen in pts with chronic CKD? - CORRECT ANSWERBrittle nails, ecchymosis Dialysis pts are at higher risk of infection. What increases their susceptibility? - CORRECT ANSWERDiabetes, malnutrition, frequent invasive procedures The CDC recommends that DPC staff be annually tested for what infection control? - CORRECT ANSWERHand hygiene, CVC dressing change, vascular access technique What are the causes of anemia in CKD pts? - CORRECT ANSWERDecreased production of erythropoietin, impaired intake of iron from food, loss of blood through the GI What are two of the s/s of anemia in CKD pts? - CORRECT ANSWERDyspnea and fatigue What is the recommended tx for osteodystrophy in CKD pts? - CORRECT ANSWERAdministration of phosphate binding agents Most pts who have been on dialysis for more than __ have dialysis amyloidosis - CORRECT ANSWER10 years CKD pts are at risk for developing peripheral neuropathy. How does it manifest? - CORRECT ANSWERBurning feet, restless legs What are the advantages of hollow fiber dialyzers? - CORRECT ANSWERThe UF is precisely controlled, they can be reused. Pts sensitive to ethylene oxide sterilization techniques may benefit from having their dialyzer cleaned by ____ which contains no chem or radioactive materials - CORRECT ANSWERElectronic beam or e-beam What are three disadvantages from using a synthetic membrane? - CORRECT ANSWERThey're expensive, require manual UF control, they absorb proteins Long term exposure to bio-incompatible membranes can cause: - CORRECT ANSWERIncreased incidence of infection and malignancy, impaired nutritional status Bicarbonate is... - CORRECT ANSWERvery susceptible to bacterial contamination What happens when the bicarb is overmixed? - CORRECT ANSWERDecrease in serum calcium levels. Which test is used to detect and quantify bacterial endotoxins? - CORRECT ANSWERLimulus amebocyte lysate During a dialysis session, a temp ____ will cause hemolysis - CORRECT ANSWEROver 41 degrees What should be done if the blood leak alarm goes off, but there doesn't appear to be contamination? - CORRECT ANSWERTest dialysate with an approved blood leak test strip Where are the two places air can enter the lines? - CORRECT ANSWERAt loose connections, and empty fluid containers What does high efficiency dialysis require? - CORRECT ANSWERHighly permeable cellusoc membrane with a surface Dialysis techs working with pts on tx should watch for bacterial infection. Why is blood contamination a problem with high-flux dialysis? - CORRECT ANSWERHigh flux membranes readily pass particles of 2,000-10,000 daltons in size How does flow rate affect the removal of toxins? - CORRECT ANSWERThe greater the flow rate, the greater the removal of solutes. To achieve an optimal concentration gradient, what direction should blood and dialysate flow? - CORRECT ANSWERIn opposite directions During UF, what happens when positive pressure is applied to the blood side of the dialyzer? - CORRECT ANSWERPlasma fluid will be pushed out If reverse filtration occurs and dialysate get into the blood, with might the pt experience? - CORRECT ANSWERA pyrogen reaction; AKA fever What principle is used to increase tx tolerance and decrease complications d/t fluid removal? - CORRECT ANSWERUF profiling A pt is on a Crit-Line. If the fluid removal is greater than the pt can shift into the intravascular space, what can occur? - CORRECT ANSWERHypovolemia What is the most common impurity in tap water? - CORRECT ANSWERCalcium carbonate What chemicals can cause methemoglobenemia, in which red cell hgb can't transport oxygen? - CORRECT ANSWERNitrates and chloramines In order to remove smaller solutes, such as endotoxins, which filter should be used? - CORRECT ANSWERUF What is the proper procedure regarding the removal of chlorine and chloramines in a two tank system? - CORRECT ANSWERIf sampling reveals there is a chlormaine >0.1ppm leaving first tank, second tank must be sampled Polymade membranes used for RO: - CORRECT ANSWERHave a wide pH tolerance, are very susceptible to degredation by free chlorine What is an advantage of RO water treatment? - CORRECT ANSWERRejects bacteria, viruses, and pyrogenic material if membrane is intact What type of water is produced by deionozers? - CORRECT ANSWERWater of high ionic purity How is UV light used in treating water? - CORRECT ANSWERTo destroy microorganisms The max level of endotoxins in water used to prepare dialysate must not exceed: - CORRECT ANSWER2 EU/mL If water quality standards are not met, who may be cited as the negligent party? - CORRECT ANSWERMD When preparing a dialyzer for pt use, the tech must ensure: - CORRECT ANSWERThere is no air in the dialyzer What is the order in which the dialyzer is primed? - CORRECT ANSWER1) prime normal saline into the dialyzer from bottom 2) run the bloodlines to the dialyzer, dialyzer upside down 3) run saline through arterial bloodline, through dialyzer then to the venous bloodline 4) tap dialyzer to get all air out How much saline is needed to prime dialyzer? - CORRECT ANSWER500-1000mL When would a reused dialyzer be rejected? - CORRECT ANSWERRenalin exposure was 4 hours total Two people must verify that __ and that __ before using a reprocessed dialyzer: - CORRECT ANSWERthe dialyzer is correct for the specific pt, the disinfectant is negative Name two guidelines concerning hand washing: - CORRECT ANSWER1) when decontaminating hands via alcohol, rub until dry 2) clinics must have dedicated 'clean' sinks for handwashing only Hep B: - CORRECT ANSWER1) highly transmissible 2) live on a surface for a week How is a pt who is Hep B + safely dialyzed? - CORRECT ANSWERUsing an isolation room with dedicated machine, and using dedicated supplies If a staff member is immune to Hep B d/t vaccines, what will the labs show? - CORRECT ANSWERAnti HBc - and Anti- HBs + A staff member tests positive for IgM to Hep B. What does that mean? - CORRECT ANSWERHe has had a recent infection w/ Hep B What is the CDC recommendation for Hep C screening? - CORRECT ANSWERMonitoring all pts for liver enzyme elevation How can pts with antibiotics resistant infections be safely treated? - CORRECT ANSWERFollowing standard precautions, and making sure all reusable equipment is sanitized before reuse When a dialysis pt is infected with CRC, what type of precautions should be used? - CORRECT ANSWERContact iso What solution is used to clean machines, chairs, IV pumps, etc? - CORRECT ANSWERBleach, 1:100 or 1:10 After heparin is given, what adverse event is more common? - CORRECT ANSWERBleeding How long is the half life of heparin? - CORRECT ANSWER90 minutes When citrasate acid is used: - CORRECT ANSWERhypocalcemia is no longer a concern, anti-coagulation is improved What is the preferred access for ESRD pts? - CORRECT ANSWERRadial cephalic arteriovenous AV fistula What precautions should pts with stage 4 or 5 follow? - CORRECT ANSWERWear a medical bracelet that discourages use of vessels that may be needed for dialysis What are the advantages of having a proximal radial artery AV fistula placed? - CORRECT ANSWERGood for pts with advanced arteriosclerosis and inhibit steal syndrome What are two advantages of a graft vs a fistula? - CORRECT ANSWERQuicker healing time, easier to cannulate What is the most common complication of AV fistulas? - CORRECT ANSWERThrombosis When a pt is dilayzed at a high BFR with a small needles, what may result? - CORRECT ANSWERHemolysis of RBCs What are the s/s of severe re-circulation by stenosis? - CORRECT ANSWERpH below 7 and very dark blood [Show More]

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