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DAVITA PCT EXAM QUESTIONS
AND ANSWERS ALREADY
GRADED A+| VERIFIED &
UPDATED| 2024
Number 1 & 2 cause of (CKD) chronic kidney disease - Correct answer-1- diabetes 2-hypertension In (AKI) acute kidney injury it is better to keep patients? - Correct answer-too wet, rather than too dry with fluid removal goals 3 sub-groups of ckd? - Correct answer-1-pre-renal-interferes w/ BF to the kidneys, causes-injuries/renal artery clot 2-intra-renal-damages nephron directly, causes- diabetes/hypertension/PKD 3-post-renal-any condition interfering w/ urine leaving the bladder, causes-kidney stones/enlarged prostate Acceptable conductivity range of dialysate? - Correct answer-13-15.5ms +/- 0.
Acceptable PH range of bicarb? - Correct answer-6.9-7.6 PH Hemodialysis (HD) replaces approximately how much of normal kidney function? - Correct answer-15% In patients w/ kidney failure, what is recommended to use if they are having issues w/ their skin, such as dryness? - Correct answer- hyper fatted/super fatted soaps and lotions There is no specific tx for a patient w/ peripheral neuropathy, but it is recommended that a patient should? - Correct answer-not walk barefoot check feet for cuts test bath water to ensure it is not too hot Filtration - Correct answer-fluid passing through a semi-permeable membrane, controlled by hydrostatic pressure EX. coffee filter Ultrafiltration (UF) - Correct answer-controlled fluid removal by manipulation of hydrostatic pressure
normal acid-base balance of the body? - Correct answer-7.35-7.45 PH How do kidneys control blood pressure? - Correct answer-renin- angiotensin system Erythropoiesis - Correct answer-function of the kidneys that control the production of red blood cells 3 functions of normal working kidneys? - Correct answer-1- endocrine system-a. renin-angiotensin-BP regulation b. erythropoiesis-RBC production, activation of vitamin D3 & serum Ca regulation 2-acid concentration- maintain normal body PH, excreting acids & reabsorbing bicarbonates 3-excretory functions- waste removal, acid-base balance, fluid/electrolyte balance Anemia medications? - Correct answer-epogen IV iron 2 most common causes of death for a dialysis patient? - Correct answer- 1-heart attack
2-infection Healthcare-associated infection (HAI) are mainly routed by? - Correct answer-contact transmission of infection hands/surfaces Most common infectious complications among HD patients? - Correct answer-vascular access infections How long can MRSA bacteria remain on a surface? - Correct answer-for days, especially on plastic/vinyl Breakdown product of chlorine that causes hemolysis? - Correct answer- chloramines Hemolysis - Correct answer-the rupture or destruction of red blood cells blood is visibly cherry red kool-aid colored Chlorine + Chloramines = - Correct answer-hemolysis What does the water softener remove? - Correct answer-calcium and magnesium
What are the limits for carbon filter monitoring? - Correct answer- 0.1mg/L or less What does reverse osmosis (RO) remove? - Correct answer- organic/inorganic contaminants bacteria/endotoxins Primary device used for water purification in dialysis? - Correct answer-Reverse Osmosis 3 responses to final water quality alarm? - Correct answer-1-put all machines in bypass mode 2-notify RN, FA, Biomed 3-if water quality cannot be restored, terminate all treatments D.A.R.N. - Correct answer-Desire Ability Reasons Need
W.E. C.A.R.E - Correct answer-Welcome Empathize Connect Actively listen Respect Encourage Fever-when to notify RN - Correct answer-a rise in the temperature of the body greater than 100 degrees F or an increase over baseline of 2 degrees F w/ symptoms Dialysis Disequilibrium Syndrome (DDS) - Correct answer-rare but life threatening complication during initial stage of hemodialysis prevention-slowing rate of HD. HD can lead to excess fluid in brain, cerebral edema signs/symptoms-headache, restlessness, seizure How a patient is to be positioned if they have an air embolism? - Correct answer-left side Trendelenburg NFACT - Correct answer-New fistula assessment and cannulation team
Kt/V - Correct answer-K= clearance T= time V= volume Kt/V goal - Correct answer-equal to 1.2 or higher Factors in Kt/V that influence V (volume)? - Correct answer-height weight sex amputations needle gauge suggested BFR Factors in Kt/V that influence T (time)? - Correct answer-longer blood/dialysate contact time more frequent tx extra tx TX factors that decrease K (volume)? - Correct answer-DFR UF goal BVP adequate anti-coagulation
How do you estimate the blood volume removed (BVR)? - Correct answer-BFR x minutes dialyzed=estimated BVR What is the wait time for heparin bolus prior to starting tx? - Correct answer-3-5 minutes 17g needle - Correct answer-200-250 BFR 16g needle - Correct answer-250-350 BFR 15g needle - Correct answer-350-450 BFR 14g needle - Correct answer->450 BFR Procedure for post BUN lab draw (green top tube) - Correct answer- UF decreased to 50ml place in bypass decrease BFR to 100 ml/pm draw from arterial line
Waiting only 5 Seconds between lowering the blood pump speed and drawing the post-treatment blood sample could cause the Kt/V reading to be? - Correct answer-falsely too high Waiting longer than 15 seconds between lowering the blood pump speed and drawing the post-treatment blood sample could cause the Kt/V reading to be? - Correct answer-falsely too low If a tube in the centrifuge breaks while spinning, what should you do? - Correct answer-Remove the sleeve it is inside of, remove the opposite tube/sleeve to create the correct weight balance If a patient wants to take OTC medications, what should they do first? - Correct answer-consult their physician When is the best time for a patient to take their phosphate binders? - Correct answer-w/ meals, first bite of their food sometimes taken w/ snacks When should renal vitamins be taken? - Correct answer-after a dialysis tx
CKD-MBD? - Correct answer-abnormalities in Ca, PO4, PTH, & Vitamin D metabolism w/ soft tissue calcification & bone disease Increase sodium intake causes? - Correct answer-increased thirst, hypotension What does overindulging in foods w/ high potassium cause? - Correct answer-extreme muscle weakness & abnormal heart rhythm Albumin - Correct answer-essential for growth, maintenance, preventing infection & anemia Prevents the formation of aneurysms & pseudoaneurysms - Correct answer-good needle site rotation 3 steps in the complete access assessment? - Correct answer-Look, listen, feel Symptoms of disinfectant infusion? - Correct answer-Pain at the venous needle site, tingling around the lips, & difficulty breathing
D.A.R.N - Correct answer-Desire Ability Reason Need Educational tip for auditory learners? - Correct answer-using word associations & mnemonics What is HbsAg? - Correct answer-test to be performed monthly on patients susceptible for Hepatitis B What is 15 minutes? - Correct answer-The time the RO must be running prior to performing the first chlorine/chloramine test? Water softener - Correct answer-works only w/ a sufficient amount of salt pellets Why would you place all machines into bypass? - Correct answer- how you would respond to a final quality alarm What do DI tanks do? - Correct answer-produces highly dangerous water when exhausted
What is the target weight in a patient w/ AKI? - Correct answer-being "wet" is better than being too dry R.U.L.E - Correct answer-Resist Understand Listen Empower 5 stages of grief - Correct answer-1. Denial 2.Anger 3.Bargaining 4.Depression 5.Acceptance 3 learning styles - Correct answer-visual, auditory, kinesthetic/tactile What do you do if a patient wants to get off early? - Correct answer- Educate, document, draw labs, notify RN Role of PCT prior to treatment? - Correct answer-Data collection 4 reasons to document for medical records - Correct answer-1-proof care was rendered 2-provides data continuity/planning of patient care
4-communication tool Post treatment data collection is done? - Correct answer-after tx, not during rinse back What is a URR & what is this used for? - Correct answer-urea reduction rate, percentage of urea removed during a tx Why is protein intake so important? - Correct answer-maintains health, helps fight infection, prevents anemia, maintains muscle, heals wounds Purpose of DQI & how is it achieved? - Correct answer-to encourage continuous improvement across a broad range of disease management. managing patients first, scores will follow Why is hand hygiene important? - Correct answer-prevent the spread of infection what does sodium loading contribute to? - Correct answer-increased thirst, large fluid gains, more ischemic events during tx, hypertension, headaches
What can cause DDS? - Correct answer-Urea transfers slowly from the blood to the brain, causes fluid in the brain, which causes it to swell How do you care for a patient who is having a seizure? - Correct answer-protect pts. access, treat hypotension, DDS, hypoglycemia, administer oxygen, provide airway support, discontinue tx if unresponsive How do you initially care for anaphylactic reaction? - Correct answer- stop meds, blood pump, and tx. Do not return the blood, notify RN, call EMS Signs, symptoms, & intervention of disinfectant reaction? - Correct answer-pain at venous needle site, itching, restless, back pain, tingling around lips, respiratory distress. interventions-discard bicarb/rinse mixer, no tx until all tests are negative What does intradialytic hypotension cause? - Correct answer-organ stunning Signs, symptoms, & intervention for an air embolism? - Correct answer- visible air in venous line, chest pain, coughing confusion, cyanosis,
