Clinical Annual Competency Exam - Fresenius 2023 with 100% questions and answers

Inadequate Heparinization The adequacy of a dialysis treatment may be compromised by Post reinfusion and prior to disconnection Routine post dialysis treatment documentation on the patients dialysis treatment record should include patients blood pressure and temperature both Chemical content Individual acid containers should be labeled with Notify the RN The patient complains of pain at the catheter exit site. What would the PCT do first? Hemosafe is in place and secure on the arterial line (hemosafe clamp should be secured on the venous line) Which of these findings noted on a safety check would indicate that an intervention is needed. Notify the RN The patient presents to the dialysis center with a pulse rate of 44/bpm but doesn't appear to be in distress. What should be the dialysis technicians immediate action? Assessment for possible clotting in the dialyzer Documentation and interpretation of the KECN (clearance effective by conductivity) results can assist the staff member in Circulation of water during the day only Which of the following would minimize bacterial growth in the water treatment system? Pressure A major factor affecting ultrafiltration is Palpating for a thrill Pre-treatment evaluation of an internal vascular access includes Hypotension A patient having a dialysis treatment complains of feeling dizzy, and begins to yawn. These symptoms are most likely to indicate that the patient has Check the dialysate effluent with a blood leak test indicator If a blood leak detector alarms a second time and no visible blood is noted, what should the PCT do next? Surface area of the dialyzer Which has the most impact on dialyzer clearance? Turn the blood pump off, clamp the venous line. The patient exhibits signs of hemolysis. What is the appropriate action to take? Calcium and magnesium Softener tanks remove Technical must perform a functional test on the machine. During dialysis a patient has a cardiac arrest. Which action should be completed on the dialysis machine before the machine is used by another patient? Low clearance, hold heparin dose The following KECN's are noted: the results indicate a Time KECN. TIME KECN 00:15. 268. 01:45. 243 00:45. 254. 02:15. 240 01:15. 242. 02:45. 238 Either with or against the flow of blood The arterial needle is placed Priming the dialyzer venous end up An important factor in achieving adequacy during machine set up is Ultra Care The FMC program that utilizes technology to improve our patient care is Bicarbonate The component of the dialysate that helps treat acidosis is Check the patient blood pressure The PCT notices the patient yawning toward the end of treatment. The PCT should take which action immediately Presence of endotoxins in the dialysate Several patients with normal pre-dialysis temperatures develop sudden chills and a spike in temperature. This situation is most likely caused by 150 ml/min What is the correct blood flow rate for priming the dialyzer Use of a tourniquet is optional when cannulating a new AVF What is NOT true when cannulating a new AVF? Weekly If bicarbonate concentrate jugs are used, the frequency for disinfecting jugs is Aid in fluid removal Using the sodium variation module during the dialysis treatment will To improve nutritional status and ensure compliance with oral intake and reduce the risk of morbidity and mortality Oral nutrition supplements are given to FMS in-center dialysis patients who are malnourished while they are at the dialysis facility for what reason? Elevated potassium levels may cause changes in heart rhythm When instructing patients with CKD, who are receiving dialysis, the RN should include the fact that Sitting blood pressure followed by the standing blood pressure One way to establish a patient has orthostatic hypotension is to obtain a patients Albumin, Hgb, Phosphorous, Adequacy, Catheter Rate The QSR is a monthly report detailing quality outcomes as primary or secondary. Primary quality outcomes are those that have the highest impact on patient survival. These include Clamp the venous line Dialysis has been initiated on a patient using a right internal jugular catheter, as the blood pump is turned up to 200 ml/min, foam begins to accumulate in the lines. The patient begins to wheeze, and becomes short of breath. The care givers FIRST action would be to Disinfect with 1:100 bleach water and rinse with RO water until negative for bleach If the bicarbonate jugs have been in storage and are needed for emergency use, what action must be taken prior to use? Less than 0.10 ppm According to FMS policy, the safe level for total chlorine is Bananas, orange juice, and salt substitute What has the highest potassium content Remote Total Dissolved Solids (TDS) alarms in treatment room What notification process would alert the staff of poor water quality during the dialysis treatment After the completion of the last patient treatment Following FMC policy, when should the second hardness test be completed 10 minutes According to AAMI standards the required exposure time of water to the carbon filters to effectively remove chlorine and chloramine is Notify the RN in charge to stop treatment If the second GAC (carbon) filter exceeds the acceptable limit for total chlorine, what is the next step? Hypotension Excessive fluid removal during dialysis, combined with the patients taking an anti hypertension medication may result in the patient having Should be engaged before removing the needle from the patient access When removing needles from an internal access the needles safety device Turn off ultrafiltration rate To properly collect a post BUN sample, it is necessary to Gloves, full face shield or mask and protective eyewear with side shield and fluid resistant gown What PPE is required when performing venipuncture? Solution to conduct an electrical current Conductivity is best described as the ability of a (n) Inspect the dialysate effluent for pink or red tinged color The patients blood leak detector alarms. After verifying the blood pump has stopped, what should the PCT do next? Total Dissolved Solids (TDS) What reading on the reverse osmosis (RO) machine indicates the level of water quality? 0.10 ppm Which total chlorine reading is UNACCEPTABLE? The patient does not respond to verbal questioning and vital signs are trending down. The PCT observes a patient at the 30 minute safety check. What signs or symptoms will prompt the tech to wake the patient for further evaluation? Hemolysis A patient begins to experience shortness of breath, chest pain, and sudden hypotension, the blood is bright red and translucent. The complication most likely occurring is The top level of the salt pellets in the brine tank must be maintained above the level of the brine solution in the tank What is the correct level for salt in the brine tank? Examine both patient arms for the presence of an access Prior to applying the blood pressure cuff on a new patient, the PCT should Chlorine and chloramines The carbon tank removes Hazardous materials identification system (HMIS) labels Individual bicarbonate containers must be labeled with Received from the water supplier to make product water for dialysis Source water is Dialyzer primed at 300 ml/min What factor is most likely to affect dialysis adequacy Kink or obstruction after the dialyzer If the arterial pressure changes from -200 mmHg to -250 mmHg from the initiation of treatment, what would be a possible cause? 15 minutes How long must the reverse osmosis machine (RO) run prior to collecting samples for water testing? Hemolysis Blood pump occlusion and kinked lines would most likely cause which complication during hemodialysis? 1:10 bleach water solution What solution should be used to disinfect a large blood spill area (greater than 10 mLs)