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BONENT Review Exam Questions and
Answers (Rated A+)
W hen the hemodialysis machine detects a blood leak, there will be an audio and visual alarm and the A. blood pump will stop. B. air detector will alarm C. machine will go into bypass D. conductivity alarm will occur - A Management of pericarditis might include all of the following EXPECT? A. Controlled heparinization during dialysis. B. Aggressive blood pressure control. C. Increased frequency of dialysis. D. Use of anti-inflammatory drugs. - B A patient telephones the dialysis unit to complain of shortness of breath. The technician is concerned because she realizes that this symptom is indicative of? A. Cardiac problems B. Disequilibrium syndrome C. Fluid overload D. High serum potassium - C Which of the following organizations is primarily concerned with providing the dialysis unit staff with educational opportunities for continued professional growth and development?
A. Council of nephrology nurses and technicians (CNNT) of the national kidney foundation. B. American society of artificial internal organs (ASAIO) C. American kidney fund. (AKF) D. American society if nephrology (ASN) - A Which of the following is NOT essential to the successful completion of a research project? A. Review of the literature in the problem area B. Publication of results C problem of definition D. Obtaining permission of the unit manager and the study subject. - B Which of the following statements concerning feedback is INCORRECT? A. It should be given as soon after job performance as possible B. It is ineffective when negative C. Is should be specific, description, and clear. D. Is should be given when requested - B When a pyrogenic reaction occurs, the water treatment system should be cultured for A. Viruses B. Gram- negative bacteria C. Spores D gram- positive bacteria - B In the event of a natural disaster (earthquake, fire, flood) the primary responsibility of the technicians in the dialysis setting Is the protection of the?
A. Remove the patients B. Shut off all utilities C. Extinguish the fire D. Pull the fire alarm - A Which of the following had the greatest impact in the efficiency and safety of a hemodialysis treatment? A. Adequate professional supervision and ancillary personnel. B. Adequate personnel ratios, good supervision, and up to date equipment. C. educated and motivated staff and properly maintained equipment. D. Automated modular systems with factory set limitations which can decrease operator error. - C Homeostasis can best be defined as? A The steady state of internal environment B. A holistic approach in medicine C. A balance between nature and man D. The state of physical and psychological wellbeing - A Decreased glomerular filtration rate of the kidney may be due all of the following EXCEPT? A. Shock B. Dehydration C. Fluid overload D. Cardiac decomposition - C Hemolysis of red blood cells will occur if which of the following types of dialyzing fluids is delivered to the dialyzer?
A. Hypertonic B. Hypothermic C hyperthermic D. Hypoglycemic - C The dose of heparin required to achieve anticoagulation varies widely among patients. In general, however the goal of anticoagulation in dialysis is to maintain the degree of anticoagulation at? A. Normal baseline clotting studies B. 1.5-2 times baseline clotting studies C. Five times baseline clotting studies D. Ten times baseline clotting studies - B The normal kidneys compensate for fluid loss by retaining which of the following? A sodium and water B. Urea and creatinine C. Chloride and bicarbonate D. Creatinine and potassium - A The primary reason for anemia in chronic renal failure is? A. Platelet dysfunction B. Increased bleeding tendencies C. Loss of blood during hemodialysis D. Decreased erythropoietin production - D Performance of creatine clearance test requires? A. Spot urine and serum creatinine measurement
C. Offer patients exercise while in hemodialysis D. Regulate instill action and drainage of the dialysis solution - D The best way to define the term anastomosis is? A. Surgical connection B. Ballooning or bulging of a weak spot in a blood vessel C. Opening of a narrowed blood vessel using a catheter and balloon D. Same site cannulation - A In the expression kt/v the "k" stand for? A. Kidney B. Kinetic modeling C. Serum potassium D. Urea clearance of the dialyzer - D A patient’s venous needle falls out. The first thing the technician would do is A. Notify the charge nurse B. Clamp the venous line, reinsert needle and restart treatment. C. Turn off blood pump, clamp venous line, and put pressure on the puncture site. D. Assess the patients’ blood loss and notify the physician - C All of the are potential problems associated with the use of bicarbonate dialysate EXCEPT? A. Increased risk of bacterial growth B. Dangerous electrolyte concentrations due to concentrate mix up C. Precipitation of calcium and magnesium in the delivery system
D. Carbon dioxide levels in the bicarbonate dialysate becoming dangerously high - D A patient who has gone on high-efficiency dialysis now dialyzes for 3 hours per session instead of 4. Which of the following findings would indicate that the current prescription is inadequate? A. an increased sense of well-being, a kt/v value less < or equal to 1.1 a midweek bun value < or equal to 75 blood pressure= 128/84 mm Hg, and a PCR value of 1.0. ' B. a decrease in the midweek BUN value from 85 to 70 decreased incidence of cramps, and a decreased estimated dry weight. C. a lean weight gain of 2.0 kg absence of edema, blood pressure 238/70mm Hg and a calculated PCR value of 0.75. D. A kt/v value = 0.8 routine Qb = 400 cc/mm absence of edema and increased hematocrit value. - D. The role of the renal dietician is best described as? A. preparing list of food patients need to avoid. B. preparing a strict diet and making sure the patients follow it. C. Counseling patients on the optimum diet for their needs assisting them in following good dietary habits. D. Supplying a list of area grocery stores, where patients should food shop. - C The half-life of heparin is 40-90 minutes. The elimination of heparin in dialysis patients is similar to that of the nonuremic populations. Which of the following is true regarding the effect of heparin in a dialysis patient? A. hemodialysis patients may exhibit increased bleeding tendencies for up to 24 hours post dialysis. B. The rebound effect, of heparin metabolism increases the incidence of bleeding in this population. C. platelet aggregation in the dialysis population is markedly increased placing patients at risk for bleeding. D. Diabetic dialysis patients exhibit a heparin half-life up to three times longer than non-diabetic dialysis patients. - B Constipation is a common problem for dialysis patients. The primary reason for this is?
The technician is setting up a dialyzer. The test for a residual sterilant is positive after 500 cc normal saline has been infused by recirculation. The technician should find this as? A. normal nothing needs to be done. B. abnormal the test should be repeated with a fresh test strip C. abnormal the dialyzer should be discarded D. abnormal rinsing and retesting should be continued per protocol. - D Which subclavian catheters poor blood flow can be caused by all of the following EXCEPT? A. vascular spasms B. an incorrect cannula lumen size C. blood pump set higher than 150 ml/mm D. incorrect placement of the cannula within the host vessel - C The procedure most likely ordered after placement of a subclavian catheter is? A. Chest X-ray to verify catheter placement B. CAT scan to rule out pulmonary embolism. C. Echocardiogram to verify catheter placement. D. Pulmonary scan to assess degrees of recirculation in the new access. - A Complications associated with arteriovenous fistula for hemodialysis access included which of the following? A. infections, aneurysm, hypovolemia, hypoxia B. stenosis, thrombosis, hypovolemia, hypoxia C. Thrombosis, infection, stenosis, arterial steal syndrome D. Arterial steal syndrome, infection, epistaxis, hyperkalemia. - C
The total pressure in the blood circuit is a result of all the following EXCEPT the? A. rate of dialysis fluid flow B. blood flow rate controlled by the blood pump. C. resistance to flow is the blood circuit D. diameter of the fistula needle. - A Minimal heparinization should be considered in patients who have a history of all of the following EXCEPT? A. cataracts B. Menstrual flow C. pericarditis D. active ulcer - A For a patient treatment session, the blood pump is set at 250 ml/mm The technician notices that the bloodlines appear to be "jumping' The pre pump arterial monitor reads - 250 mm Hg, In this situation the technician should A. Administer hypertonic saline because the patient is hypotensive. B. Turn off the pump and apply pressure because the needles have infiltrated C. Administer a bolus of saline because volume depletion has caused the arterial system to collapse. D. Reposition the needle and adjust the blood flow downward because of excessive negative pressure on the arterial portion of the circuit. - C The dextrose load from peritoneal dialysis solution can cause A. hyperglycemia B. hypoglycemia C. weight loss D. hypocalcemia - A
D. hemorrhage - D Uremic pericarditis presents as A. Bounding pulses, Hyperkalemia, and uremia B. Pulmonary emboli, Hypokalemia, and uremia C. decreased cardiac size and hypertension D. dyspnea, chest pain, pericardial friction rub, and uremia - D The most effective treatment for muscle cramping during dialysis treatment is to inject a bolus of A. hypertonic saline into the injection port on the venous blood line. B. hypertonic saline into the blood line through the arterial injection port. C. dextrose 26% into the bloodline through the venous injection port D. dextrose 25% into the blood line thought the arterial injection port - A Chloride is the primary anion in which body fluid compartment? A. humoral B. interstitial C. intracellular D. extracellular - D Two hours into a dialysis treatment a 34 - year-old female patient suddenly complains of chest pain and difficulty breathing. Which of the following procedures should the technician preform immediately? A. administer normal saline B. Draw a hemoglobin and hematocrit stat C. manually check the dialysate temperature
D. check the extracorporeal circuit for the presence of air - D Hemodialysis is accomplished by which combination of processes? A. filtration, osmosis, dilution B. osmosis, filtration, diffusion C. osmosis, diffusion, ultrafiltration D. ultrafiltration, filtration, dilution - C which of the following is true regarding With them Kalf? A. He introduced the technique of renal biopsy B. he discovered the flow of urine from the bladder C. he designed and applied the first clinically successful artificial kidney D. he first described uremia and did fundamental studies on nutrition in renal disease - C The best way to establish hemostasis after dialysis is to apply? A. moderate pressure over the puncture site B. a pressure dressing for 30 minutes C. enough pressure to occlude the vessel D. firm pressure proximal to the puncture site - A The BEST way to ensure that the technician’s documentation on the patients flow sheet is complete and accurate is to A. chart as soon as possible B. document promptly at the end of the shift C. keep notes at the patient’s bedside and chat them at the end of the patients treatment
D. gloves, eye shields, respirators, (when appropriate) and impervious aprons - D Pyrogen reactions usually occur within 45 to 75 minutes after the start of dialysis. The initial patient complaint is? A. chills B. fever C. hypotension D. vomiting - A Water used for preparation of dialysate should be analyzed for levels of all chemicals A. dialysis B. weekly C. at least monthly D. at least weekly - D Shortly after the Monday morning dialysis shift begins, three patients on one side of the unit develop fevers, chills and malaise. The nurse in charge suspects bacterial contamination of the water treatment system and immediately pages the physician om call. The technician should be instructed to A. discontinue dialysis by discarding the blood lines and dialyzer B. return the patients’ blood and send blood C. administer two Tylenol tablets and a bolus of normal saline to each affected patient D. put all machines into bypass, draw blood cultures, and take samples for cultures from the dialysate and the water - D Which of the following organizations is primarily concerned with testing the competency of dialysis nurses and technicians in their chosen specialty? A. American kidney fund
B. American society of artificial internal organs C. board of nephrology examiners nursing and technology (BONENT) D. counsel of nephrology nurses and technicians (CNNT) of the national kidney foundation - C Key steps in the research process include all of the following EXCEPT? A. analyzing data B. identifying the problem C. developing the study design D. eliminating unusual variation - B The best method of disinfecting dialysis machines to prevent heavy bacterial growth and buildup in the blood detector, pressure reducer and blood pump is to? A. heat to 80 degrees for 60 minutes B. rinse the unit 30-60 minutes C. use ultraviolet irradiation for 30-60 minutes D. use proper concentrations of disinfecting agents over recommended periods of time - D Which of the following recommended by the centers for disease control A. universal isolation practices and segregation of patients positive for hepatitis b antigen B. quarterly screening of health care personal for HBsAg and HIV C. discard disposables, including dialyzers, used for all patients positive for HBsAg and HIV D. universal isolation practices and segregation of patients with AIDS and ARC - A system of water treatment that removes pyrogens as well as solutes is called? A. sediment filtration B. reverse osmosis
D. maintain adequate supply levels - C The ultimate responsibility for maintaining water purity levels for water used for hemodialysis lies with the A. head nurse B. water system supplier C. technician D. medical director - D in selecting a dialyzer for a hemodialysis patient, which of the following is LEAST important A. ultrafiltration B. BUN and creatinine clearances C. priming volume D. patients age - C The JCAHO requires that dialysis personnel review which of the following annually A. electrical safety, fire safety, and hemodialysis water quality B. reuse procedures, fire safety, and levels of hazardous vapors C. evacuation procedures, fire safety and CPR techniques D. venipuncture techniques, infection control procedures, and staffing ratios - C Air detectors monitor for the presence of air in the A. dialysate lines B. venous blood line C. arterial blood line D. concentrate line - B
One of the dialysates monitoring devices is a conductivity meter or probe that continuously monitors to indicate dialysate A. flow B. pressure C. ionic concentration D. temperature - C To prevent hemolysis, the thermal sensor and regulator of the dialysate delivery system should be maintained to keep the dialysate within that temperature range? A. 35 c + 10 c B. 37 c + 1 c C. 37 c +5 c D. 42 c + 2 c - B prior to each treatment, it is essential to check the sensitivity of the A. venous pressure alarm B. temperature alarm C. conductivity alarm D. blood leak alarm - D The dextrose concentration of a dialysate solution does NOT add to the total ionic content because it A. only ionizes when concentrated B. in only expressed in mg/dl C. is not ionized D. has a positive electrical charge - C
