Download DAVITA (RN) Final Exam: Questions and Answers for Dialysis Nursing and more Exams Health sciences in PDF only on Docsity!
FINAL EXAM DAVITA (RN)
QUESTIONS AND ANSWERS GRADED A+ BY EXPERTS
"the transport mechanism when particles move from an area of higher solute concentration to an
area of lower solute concentration is called - CORRECT ANSWER diffusion"
"during dialysis, the movement of bicarb from the dialysate into the blood - CORRECT
ANSWER helps normalize body pH"
"the kidneys excretory functions include - CORRECT ANSWER normalizing electrolytes"
"what distance should be observed between needle tips and away from each other when
cannulating an internal vascular access? - CORRECT ANSWER 1.5 inches"
"what is the appropriate intervals for total chlorine testing? - CORRECT ANSWER prior to the
first patient shift and within every 4 hours"
"which condition may impair a patient's increase in pulse rate as a response to hypovoilemia -
CORRECT ANSWER autonomic neuropathy"
"a patient's protein status is affected by nutritional and non-nutritional factors. what can you do
to prevent a drop in your patient's albumin? - CORRECT ANSWER prevent HAIs"
"Calciphylaxis (soft tissue calcification) is a consequence of which out or range labs? - CORRECT
ANSWER Ca, PTH, Phosphorus"
"Why must you wait 3-5 minutes after administering the initial heparin bolus before initiating
treatment? - CORRECT ANSWER takes 3-5 minutes for heparin to become systemic"
"Bicarb lasts for how long once opened? - CORRECT ANSWER 24 hours"
"Acid lasts for how long when opened? - CORRECT ANSWER 30 days
if additives discard after treatment"
"Why is drawing the correct amount for blood cultures improtant - CORRECT ANSWER too
much blood may create a false positive"
"When do we test Hep B - CORRECT ANSWER need to have it every 28 days drawn for negative
and susceptible, if negative and immune every 365 days. if unknown draw patient"
"what is S/S of hemolysis - CORRECT ANSWER anxiety, restlessness, n/v, dyspenea, chest
tightness, hyperkalemia, blood will look cranberry"
"what do we do for hemolysis - CORRECT ANSWER stop treatment, clamp lines, DO NOT
RETURN BLOOD, assess patient, draw labs, obtain samples for hypotonic dialysate, check dialysate temp, give o2"
"what are s/s of air embolism - CORRECT ANSWER dyspnea, coughing, chest tightness/pain,
cyanosis, confusion, visual disturbances"
"Intervention for hypotension - CORRECT ANSWER take BP, minimum UFR, give NS, elevate
feet, supine position" "CKD can have its orgin pre-renal , intra-renalm or post renal. Which of the following conditions is
an intra-renal cause of CKD - CORRECT ANSWER HTN"
"Knowing what caused your patient's CKD - CORRECT ANSWER is important because the
underlying disease could cause health complications that can impact the dialysis treatment"
"When a patient has an irregular heartbeat, - CORRECT ANSWER the automatic BP reading
may not be accurate"
"Which of the following is a data collection - CORRECT ANSWER HR 72"
"at what time should the post treatment data collection be completed - CORRECT ANSWER
after the treatment has been completed"
"the A in smart communication stands for - CORRECT ANSWER actual- just report the facts"
"using the __________ approach is one way to fill out an REM - CORRECT ANSWER SBAR"
"What is your main priority when returning a patient's blood with the hand crank during a power
outage? - CORRECT ANSWER you must be vigilant in watching for air in the blood lines"
"which is the primary device for purifying the water used in dialysis - CORRECT ANSWER the
RO"
"What is a likely cause for dysrhythmias? - CORRECT ANSWER Hypotension, heart disease, or
rapid changes in K"
"In what position should you place a patient who experiences intradialytic hypotension? -
CORRECT ANSWER Supine"
"Preventing hypotensive episodes during dialysis treatment is important because they are
associated with - CORRECT ANSWER a higher mortality rate"
"The mortality risk for patient who experience two or more episodes of intradialytic hypotension
per week increases to - CORRECT ANSWER 70%"
"When do you take PO4 binders? - CORRECT ANSWER with meals and snacks"
"#1 thing we do - CORRECT ANSWER patient safety"
"Conductivity acceptable rrange - CORRECT ANSWER 13-15.5 and +/- 0.4 of the machine"
"pH of dialysate - CORRECT ANSWER 6.9-7.6"
"blood pH - CORRECT ANSWER 7.35-7.45"
"When is the RO checked? - CORRECT ANSWER before the first patient and every 4 hours
afterwards"
"lifespan of a RBC for dialysis patient - CORRECT ANSWER 60 days"
"Ultrafiltration - CORRECT ANSWER fluid passing thru a membrane"
"Convetion - CORRECT ANSWER solute being dragged across the semipermeable membrane"
"Diffusion - CORRECT ANSWER particles from high to low concentrations"
"Osmosis - CORRECT ANSWER fluid from lower to higher concentration"
"How much air can cause a patient harm? - CORRECT ANSWER 10mL"
"What is the solution of bleach to clean up a spill? - CORRECT ANSWER 1:10"
"2 independent nursing functions - CORRECT ANSWER patient care and technical skills"
"2 common routes for CVC infection - CORRECT ANSWER into cath via contact of the insertion
site and via cath lumen- scrub the hub for 60 seconds each limb"
"Most common cause for CKD in USA - CORRECT ANSWER DM"
"What is the percent of kidney function lost before going on dialysis - CORRECT ANSWER 75%"
"HD replaces what percent of kidney function - CORRECT ANSWER 15%"
"What is the direct result of intravascular fluid overload - CORRECT ANSWER HTN"
"Patient with cardiac disease are 10x more likely to develop intra HTN - CORRECT ANSWER
LVH"
"Offer a patient of this is an example of oral sodium loading - CORRECT ANSWER broth"
"this electrolyte is often elevated with patients with severe itching - CORRECT ANSWER
phosphorus"
"kidneys regulate BO by realeasing - CORRECT ANSWER renin"
"hormone stimulated in bone marrow production - CORRECT ANSWER erythropoeitin"
"Excess of this electrolyte causes slowing of the hearts electrical system - CORRECT ANSWER
k"
"the vitamin converts vit d into which hormone - CORRECT ANSWER Calictrol"
"what is a fever - CORRECT ANSWER temp >100 or increase in 2 degrees from baseline"
"what will hyperkalemic patients have - CORRECT ANSWER peaked T waves"
"what do we do for pericarditis patients - CORRECT ANSWER more frequent dialysis"
"what do we avoid with pericarditis patients - CORRECT ANSWER heparin"
"what is the K bath we give for digoxin patients - CORRECT ANSWER 2k"
"heparin is considered what - CORRECT ANSWER systemic"
"vitamins should be given when? - CORRECT ANSWER post treatment so they dont dialyze
out"
"what is the half life of heparin - CORRECT ANSWER 30-90 minutes"
"How long should Vanc be administered? - CORRECT ANSWER over 60 minutes"
"UF profiling - CORRECT ANSWER MD must order"
"Linear profile - CORRECT ANSWER fluid gainers, fluid overload, patients have hypotension
toward the end of treatment"
"Stepped profile - CORRECT ANSWER hypotension happens midway may start at 800 then
reduce down"
"intermittent - CORRECT ANSWER up and down approach"
"Weight gain over 5% of patient's target weight is - CORRECT ANSWER fluid excess"
"what medication must be given on an IV pump - CORRECT ANSWER IV Fe"
"What happens with mannitol? - CORRECT ANSWER It dialyzes off"
"how long do you scrub the hub of a CVC? - CORRECT ANSWER 60 seconds each limb"
"Platelets should be adminstered how - CORRECT ANSWER thru venous med lock on the
venous drip chamber using an IV pump"
"how often do you rotate sites? - CORRECT ANSWER every 14 days"
"How often do you draw Hepatitis B - CORRECT ANSWER draw every 28 days they are good for
30 days" “When dialyzing a patient with acute kidney injury, one task of the patient care teammates is to
monitor blood pressure and weight closely. Why is it important? - CORRECT ANSWER
hypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys"
"When a PCT documents the extent of a patient's edema, for example as +3 - CORRECT
ANSWER the PCT is preforming an assessment which is not allowed legally"
"which of the following events is defined as a near miss - CORRECT ANSWER the wrong
dialyzer was set up and primed for a patient, but it was caught before dialysis was initiated and the dialyzer was replaced" "you are dialyzing a patient and the only available HPB surveillance test is a HBsAb of 8. What are
the machine disinfection requirements after dialyzing this patient? - CORRECT ANSWER the
machine must be heat disinfected at the end of each day"
"What is the most common factor contributing to bacteremia in dialysis patients? - CORRECT
ANSWER use of catheters for HD"
"which may cause a decrease in the hemoglobin of a patient with ESRD - CORRECT ANSWER
infection/inflammation" "the licensed nurse has delegated a specific task to a PCT, but the PCT gets called away before
performing this task. Can the PCT asek another PCT to take over? - CORRECT ANSWER no, a
task delegated by the licensed nurse to a non-licenced teammate cannot be re-delegated by this teammate"
"what is the inflammation aroudn the heart called - CORRECT ANSWER pericarditis"
"restless leg syndrome is a complication of - CORRECT ANSWER peripheral neropathy"
"measures the RBC by weight - CORRECT ANSWER HgB"
"what is the diminished quality and quality of RBC - CORRECT ANSWER anemia"
"what is classified as bone disease associated with renal failure - CORRECT ANSWER CKD-
MBD"
"Why is the order of lab draw important - CORRECT ANSWER samples in subsequent tubes are
not contaminated with additives from the previous"
"what do you want the level of albumin to be - CORRECT ANSWER >4"
"if drawing labs during dialysis how do you label them? - CORRECT ANSWER DRAWING
DURING DIALYSIS"
"BUN lab draws post dialysis - CORRECT ANSWER turn off or decrease UR to 50
decrease DFR to 300 or place machine in bypass reduce BFR to 100 wait 15 seconds for AVG/AVF and CVC (WAIT 15 seconds!!) Obtain from A Line"
"hypotension - CORRECT ANSWER a drop in BP by 20
decrease in MAP by 10 if pre SBP less than 90 drop of 10 with symptoms"
