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DAVITA FINAL EXAM 2024
QUESTIONS AND ANSWERS GRADED A+
"When is a pre-treatment assessment by the licensed nurse required? - CORRECT ANSWER ⁃
when it is mandated by state.⁃ when the pct performing a data collection notices abnormal findings⁃ when the patient reports unusual symptoms to the nurse prior to treatment initiation.⁃ when nurse observes initial behavior" "A standing post- treatment blood pressure reading of __is considered an abnormal finding and
should be reported to a licensed nurse - CORRECT ANSWER 140/90 mm Hg or less than 90
mmHg and standing diastolic BP greater than 90 mmHg or less than 50 mmHg"
"Which statement is true regarding the "Reasonable and Prudent" Standard of care? - CORRECT
ANSWER When supervising patient care technicians and other non-licensed personnel it is the
responsibility of the license nurse to ensure these teammates also meet the standard of care" "The maximum ultrafiltration rate should not exceed ___ because it may lead to hypotensive
episodes which increase the risk of organ stunning or mortality. - CORRECT ANSWER UFR >
ml/hr/Kg"
"When the lab receives a laboratory test tube with double labeling: - CORRECT ANSWER The
double labeled specimen will be rejected at the laboratory for patient safety"
"Which statement is true regarding the administration of normal saline? - CORRECT ANSWER
The teammate must remain with the patient to monitor their progress until administration is complete and lines are securely clamp." "Cynthia missed her treatment on Saturday and returns the following Tuesday for her next scheduled treatment. She complains of feeling weakness in her legs. David, a PCT, gets a wheelchair for her, helps her weigh in, and brings her back for the nurse to assess prior to starting her treatment. Which patient complication would the PCT and RN suspect Cynthia is most likely
suffering from? - CORRECT ANSWER Hyperkaliemia"
"You are performing the first chlorine/chloramine testing of the day after the RO has been
running for 10 minutes. Performing the test at this time - CORRECT ANSWER Could result in a
false negative test"
"In optimal nutrition status is evidenced by - CORRECT ANSWER 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 4gm/d" "Unless otherwise directed by the manufacture or state specific pharmacy regulations when must
medications containing a preservative be discarded? - CORRECT ANSWER 28 days after
opening"
"Hemodialysis helps normalize body pH through? - CORRECT ANSWER Diffusion of
biocarbonate from the dialysate into the blood"
How can knowledge of these V tags affect the practice of patient care providers? - CORRECT
ANSWER 1. Provide patient care with in CMS condition for coverage
- Understand rationales for specific regulations as outlined in the interpretive guidance
- Assist in the development of policies and procedures"
"Attempting to remove a large amount of fluid weight gain from the patient - CORRECT
ANSWER Can lead to hypovolemia during the treatment which is associated with an increased
mortality rate"
"For patients with AKI? - CORRECT ANSWER A pre-treatment nursing assessment is always
required?"
"All documentation on machine set up and a pre-treatment patient information - CORRECT
ANSWER Must be entered into the computer before the treatment is initiated"
"You administer 100 ML saline bolus to your patient during the treatment what would be
important to include in your documentation? - CORRECT ANSWER The reason for
administering the Saline and the patient's response"
"What are the most common causes for CKD in the USA? - CORRECT ANSWER Diabetes
Hypertension Polycystic kidney disease"
"What is K? - CORRECT ANSWER Stands for clearance ot urea"
"What treatment factors decrease K? - CORRECT ANSWER Clotting
Low blood flow rate
"If you notice that a patients caregiver is struggling to meet the demands of the patients
treatment regimen you should - CORRECT ANSWER Contact social worker"
"The psychosocial assessment completed by the social worker - CORRECT ANSWER an
evaluation of a persons mental health, social status and functional capacity within the community"
"DaVita Quality Index (DQI) success is achieved - CORRECT ANSWER Encourage continuous
improvement across aboard range of disease management processes (all the above)" "What can be the most likely result if the surveyor sees a patient with a covered vascular access?
CORRECT ANSWER immediate jeopardy"
"A surveyor asks you a question. Which of the following statements would be a good answer? -
CORRECT ANSWER I do not know the answer but I will find out."
"A patient with acute kidney injury dialyzes in the out-patient facility. With regards to the patients
target weight, why is being "wet" better that being too dry? - CORRECT ANSWER "
"The excretory function of the kidneys include - CORRECT ANSWER Removing access water,
urea, and metabolic wastes from the blood."
"The endocrine functions of the kidneys are - CORRECT ANSWER Renin and erythropoietin
secretion ,activation of vitamin D"
"Dialysis replaces only ___ percent of normal kidney function. - CORRECT ANSWER 15%"
"The most common infectious complication for hemodialysis patients is - CORRECT ANSWER
central line infections"
"What is one method surveyors used to verify infection control training and education? -
CORRECT ANSWER Patient interview"
"Which infectious disease requires frequent handwashing instead of using alcohol based hand
gels? - CORRECT ANSWER Active Clostridioides difficile infection (C.Diff)"
"Per the Centers for Disease Control and Prevention (CDC), which is the most important route by
which pathogens are transmitted in health care setting including dialysis centers. - CORRECT
ANSWER contact transmission"
"upon completing machine set up and before treatment initiation it is important to verify the
prescription and machine settings: - CORRECT ANSWER both b and c"
"What should be done to the heparin infusion line if a patient does not have maintenance
(hourly)heparin prescribed? - CORRECT ANSWER Clamp and knot the heparin line."
"What type of blood/dialysate flow within the dialyzer increases the rate of diffusion providing
optimal dialysis for patients? - CORRECT ANSWER concurrent flow"
"A PCT greets a patient and the patient reports feeling short of breath. The PCT notices that the
patients lips have a blue hue. The PCT would: - CORRECT ANSWER Complete data collection
and PCT must notify the RN if there are any abnormal findings prior to initiation of tx" "In those states that do not require a nursing assessment to be completed prior to treatment
initiation, the PCT would be required to report abnormal patient data collection findings. -
CORRECT ANSWER Yes"
"The patient is using a central venous catheter for dialysis and has a new arteriovenous fistula (AVF) present in his lower arm,
What observation/assessment should the PCT perform the AVF? - CORRECT ANSWER
Checking for the bruit and thrill every time treatment day" "Can you document patient vital signs under another teammate already signed into the
computer? - CORRECT ANSWER No you cannot"
"What are the three things you should NOT include in a Risk Event Management (REM) report? -
CORRECT ANSWER personal opinions"
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 - CORRECT ANSWER B. This could be indicative of an outflow
stenosis"
"Flipping the arterial vascular access needle - CORRECT ANSWER Is not necessary since all
arterial needles now have a back eye" "The sign that numbing has taken affect and it is time to stop spraying topical anesthetic on the
vascular access cannulation sites is when? - CORRECT ANSWER Blanching of the skin"
"The urea reduction ratio calculates? - CORRECT ANSWER The amount of urea removed
during the dialysis treatment" "Which of the following factors would influence the;
t of the kt/v formula? - CORRECT ANSWER Shortened treatment time"
"Which of the following factors would decrease the; k of the kt/v formula? - CORRECT
ANSWER Inadequate anticoagulation"
"The blood flow rate is reduced to 100 ml-min for ___________ before obtaining post dialysis
blood specimen for kt/v - CORRECT ANSWER 15 seconds"
"Prior to use, how should the medication preparation surface area be disinfected? - CORRECT
ANSWER With 1:100 bleach solution and disposable wipes"
"What must be completed prior to medication preparation? - CORRECT ANSWER All of the
above"
"Water treatment is needed in the dialysis setting to - CORRECT ANSWER Meet renal
networks standards"
"What is the acceptable mg/L or parts per million (ppm) limit for total chlorine in the water
leaving the carbon filter? - CORRECT ANSWER Less than or equal to 0.1mg"
"Which is the primary device for purifying the water used in dialysis? - CORRECT ANSWER
Reverse osmosis"
"What complication would you expect to see if a patient is exposed to chlorine/chloramines? -
CORRECT ANSWER Hemodialysis"
"What time do you perform water harness testing? - CORRECT ANSWER At the end of each
treatment day"
"Left ventricular hypertrophy leads to? - CORRECT ANSWER Hypertension"
"The dialysis team prevents additional blood loss by? - CORRECT ANSWER Providing
appropriate heparin dose per physician order using good cannulation and proper rinse back after tx."
"Fever caused by a pyrogenic reaction will most likely occur at what time during the treatment -
CORRECT ANSWER Within 45 to 75 minutes"
"Per DaVita Policy, fever and chills is defined as: - CORRECT ANSWER Any temperature greater
than 100 or increase over baseline of 2° with symptoms"
"A recommended intervention for muscle cramps is - CORRECT ANSWER Turning the UFR off"
"Which of the following may be, but doesn't have to be a sign of hemolysis - CORRECT
ANSWER Cherry red colored blood in the venous line"
"In the event of a patient experiencing a seizure, the dialysis treatment should be? - CORRECT
ANSWER Discontinued if the seizure is severe or the patient does not respond to treatment"
"The patient position used for a suspected air embolism is? - CORRECT ANSWER
Trendelenburg, on the left side"
"Educational tips for auditory learners? - CORRECT ANSWER Using word associations and
mnemonic"
"Educational tips for visual learners include? - CORRECT ANSWER Selecting quiet
surroundings"
"Diffusion is defined as? - CORRECT ANSWER Particles move from an area of higher solute
concentration to an area of lower solute concentration"
"Osmosis is defined as - CORRECT ANSWER Fluid moves from an area of lower solute
concentration to an area of higher solute concentration"
"The excretory function of the kidney is? - CORRECT ANSWER To normalize electrolytes"
"The acronym DARN stands for? - CORRECT ANSWER Desire, ability, reason, need"
"The three core communication skills used in motivation interviewing are? - CORRECT
ANSWER Asking, listening, informing"
"Summarizing during reflective listening - CORRECT ANSWER Includes the main aspects of
what the patient said during the entire communication"
"The best way to help patient successfully change behaviors is to? - CORRECT ANSWER Inspire
behavior change to support, compassion, and empathy"
"Left ventricular hypertrophy (LVH) is caused by? - CORRECT ANSWER Hypertension"
"What does CKD-MBD lead to? - CORRECT ANSWER Abnormalities in Ca, PO4,PTH and vit D
Metabolism with soft tissue calcification and bone disease"
"Your patient complains of dry itchy skin you would advise her to? - CORRECT ANSWER Use
hyper fatted soaps and lotions" "The tags for CMS survey state specific regulations to be met within a condition such as infection control, provide interpretive guidance for each regulation, and site deficiencies by tag number.
"When sodium loading is present during dialysis treatment? - CORRECT ANSWER It leads to an
increase in theaters in larger fluid weekends between treatments and can contribute to post dialysis hypertension and headaches"
"Target weight is? - CORRECT ANSWER Prescribed and determined by physician order
Modified by physician based on patient tolerance"
"With the patients calculated UF goal exceeds the maximum UFR ordered by the nephrologist? -
CORRECT ANSWER Calculated UF goal must be adjusted to not exceed the ordered maximum
UFR in the reason documented"
"What are three things you should not include in an REM? - CORRECT ANSWER Personal
opinion, speculation, vendettas"
"The clinical pyramid includes? - CORRECT ANSWER The fundamentals, complex programs,
and quality of life" "Which in center hemodialysis patients are at risk of experiencing signs and symptoms of dialysis
disequilibrium syndrome? - CORRECT ANSWER Since who are skipping treatments"
"Which in center hemodialysis patients are at risk of experiencing signs and symptoms of dialysis
disequilibrium syndrome? - CORRECT ANSWER Since who are skipping treatments"
"Interventions for a patient complaining of chest pain/angina include - CORRECT ANSWER
Decrease BFR, decrease UFR, administer oxygen"
"Intradialytic hypotension - CORRECT ANSWER Can have many adverse effects including
impaired tissue perfusion of vital organs and organ injury"
"What is T? - CORRECT ANSWER Stands for time"
"What factors influence T? - CORRECT ANSWER Longer blood dialysate contact time
More frequent or extra treatments"
"the person responsible for implementation, adherence, and training of the facility specific
emergency management plan (EMP) and applicable policy and procedures is - CORRECT
ANSWER Fa or designee"
"Teammates MUST be able to readily identify patients who may require additional assistance in the event of an emergency evacuation. This will include patients who need help with or are
unable to - CORRECT ANSWER both b and c"
"Per physician order and based on individual patient needs, Chronic Kidney Disease Mineral and
Bone Disorder (MBD) is treated with - CORRECT ANSWER Phosphate binders
Vitamin D (Hectorol), and Cinacalcet"
"Poor wound healing is directly related to - CORRECT ANSWER Low (albumin) protein intake"
"Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is
the best time to take them? - CORRECT ANSWER With a meal"
"The Clinical Pyramid includes: - CORRECT ANSWER The Fundamentals: Immunizations, Iron,
Dialysis Access, Calcium, Phosphorus, Hb, Kt/V, Target Weight, Access,PTH, etc.• Complex Programs: Fluid Management, Infection Management, Diabetes Management, Med Management, CVCManagement, Palliative / EOL Care, Infection Surveillance, Transition of Care, CKDEducation, Depression, Missed Treatments, etc.• Measures of Effectiveness • Mortality, Hospitalization /Re-hospitalization, Patient Experience of Care• What Matters Most • Our patient's health-related Quality of Life"
"Intra-renal causes of AKI - CORRECT ANSWER Ischemic ATN, Sepsis, SIRS, Septic Shock,
Anaphylaxis Drugs, Goodpasture Syndrome, Acute Glomerulonephritis, Trauma, Open Heart Surgery"
"Knowing what caused your patients kidney failure - CORRECT ANSWER can cause
complications to treatment"
"Acid concentrate replaces the excretory function of normal kidney function by - CORRECT
ANSWER Hemodialysis removes urea, salts, and excess water from the blood normalizing
electrolytes, removes metabolic acidosis"
"Ultrafiltration is defined as? - CORRECT ANSWER Controlled fluid removed by manipulation
of hydrostatic pressure"
"V-tags cite deficiencies, provide interpretive guidance, and provide a condition that must be met
for each regulation. How can knowledge of V-tags affect the practice of patient care providers? -
CORRECT ANSWER all of the above"
"Why is meticulous hand hygiene so important in healthcare? - CORRECT ANSWER its the
single most important intervention in preventing HAI's" "If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be
appropriate patient care assignment - CORRECT ANSWER Caring for HBsAG positive and
hepatitis B susceptible patients at the same time" "Per The centers for disease control prevention, which is the most common factor contributing to
bacterial infections in dialysis patients? - CORRECT ANSWER The use of catheters for
hemodialysis"
"For patients with Acute Kidney Injury (AKI)which statement is correct? - CORRECT ANSWER A
nursing assessment prior to tx initiation is always required" "How do you verify that the patient is stable and safe for discharge after the dialysis treatment?
CORRECT ANSWER Evaluate the effectiveness of the treatment by comparing data to pre-
dialysis findings PCT's notify the nurse if there are any unusual findings" "The pct notes that a patient still has considerable in edema in her legs when performing the post
treatment data collection, in addition to informing the nurse, what should the pct document? -
CORRECT ANSWER Document the swelling and that RN was informed."
"To prevent the formation of aneurisms and pseudo aneurysms the following should be
practiced? - CORRECT ANSWER Good needle site rotation and complete needle site clotting
techniques" "The nephrologist has ordered the use of hemostatic sponges, SureSeal, for your patient. what is
the correct procedure when using these sponges? - CORRECT ANSWER Remove the
hemostatic sponge after hemostasis has been achieved and dress the needle site with sterile gauge or band-aid." "When a patient is prescribed topical anesthetic spray, the appropriate time to clean the
cannulation site is? - CORRECT ANSWER Is prior to applying spray"
