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DAVITA FINAL EXAM

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DAVITA FINAL EXAM Per Davita policy, fever and chills is defined as a. Any temperature greater than 99°F or increase over baseline of 1°F with symptoms b. Any temperature greater than 99°F or increase over baseline of 1°F without symptoms c. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms d. Any temperature greater than 100°F or increase over baseline of 2°F without symptoms - answerc. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms Documentation in the medical record a. Includes caregiver opinion. b. Belongs to the patient. c. Is a permanent legal record of the care provided d. Is not subject to review by surveyors - answerc. Is a permanent legal record of the care provided The PCT notes that a patient still has considerable edema in her legs when performing the post-treatment data collection. In addition to informing the nurse, what should the PCT document? a. Leave the data collection entry blank b. Document "RN to assess" c. Document the noted swelling and that the RN was informed d. Document "N/A" since the nurse will assess and document - answerc. Document the noted swelling and that the RN was informed When the patient's calculated UF Goal exceeds the maximum UFR ordered by the nephrologist a. The calculated UF Goal should be entered into Snappy and the UFR adjusted once the patient shows signs of becoming hypotensive b. The patient must give permission to exceed the ordered maximum UFR since fluid overload is harmful and every effort should be made to reach the ordered target weight c. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the reason documented d. The charge nurse must assess the patient prior to treatment initiation to determine a safe UF Goal for the patient - answerc. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the reason documented DQI (Davita Quality Index) is achieved by a. Managing individual patients first and allowing scores to follow b. Knowing each team member's role in improving DQI scores c. Using the CQI process to help identify trends and make improvements d. All of the above - answerd. All of the above Per the CDC, which is the most common factor contributing to bacteremias in dialysis patients? a. Inappropriate skin preparation prior to vascular access needle insertion b. The use of catheters for hemodialysis c. Poor needle site rotation when cannulating an internal vascular access d. Exposing needle insertion sites to unclean environment areas, e.g. contaminated chair side tables during dialysis - answerb. The use of catheters for hemodialysis Which statement is true about sinks used for hand washing? a. Patients may not use sinks that are dedicated for teammate hand washing, but should have their own sinks b. Hand washing sinks may be used to discard clean solution such as left-over normal saline in a sterile bag c. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean d. Hand washing sinks may be used to discard bleach solution since the solution kills germs and has the added benefit of disinfecting the sink - answerc. Hand washing sinks must be dedicated for hand washing purposes only and should remain clean If a patient presents with dialysis associated pericarditis, treatment includes more frequent dialysis and a. Heparin restriction to prevent bleeding into the pericardium and tamponade b. A higher potassium bath to prevent dysrhythmias c. A lower BFR and DFR to prevent dialysis disequilibrium syndrome d. An increased BFR and DFR to increase toxin removal - answera. Heparin restriction to prevent bleeding into the pericardium and tamponade If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be an appropriate patient care assignment a. Caring for HBsAg positive and Hepatitis B immune patients at the same time b. Caring for HBsAg and Hepatitis B susceptible patients at the same time c. Caring for Hepatitis B susceptible patients and those in the process of receiving the vaccination at the same time d. Caring for Hepatitis B immune and susceptible patients at the same time - answerb. Caring for HBsAg and Hepatitis B susceptible patients at the same time The best way to help patients successfully change behaviors is to a. Scare them through describing serious health risks of the current behavior b. Tell them how to accomplish the desired change c. List medically sound reasons why change is necessary d. Inspire behavior change through support, compassion, and empathy - answerd. Inspire behavior change through support, compassion, and empathy Your patient complains of dry itchy skin. You would advise her to a. Take frequent hot showers b. Rub skin completely dry after a bath c. Use hyper-fatted soaps and lotions d. Eat foods rich in fatty acids - answerc. Use hyper-fatted soaps and lotions Which statement is true regarding the stages of grief? a. To come to a place of "Acceptance" one must follow the right way to work through the stages b. Some people can get stuck in a stage c. Once acceptance is achieved even complications like access problems cannot start the grief process anew d. Patients go through a common stepwise progression through each stage of grieving process - answerb. Some people can get stuck in a stage

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DAVITA FINAL EXAM


Per Davita policy, fever and chills is defined as

a. Any temperature greater than 99°F or increase over baseline of 1°F with symptoms

b. Any temperature greater than 99°F or increase over baseline of 1°F without symptoms

c. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms

d. Any temperature greater than 100°F or increase over baseline of 2°F without symptoms -
answerc. Any temperature greater than 100°F or increase over baseline of 2°F with symptoms



Documentation in the medical record

a. Includes caregiver opinion.

b. Belongs to the patient.

c. Is a permanent legal record of the care provided

d. Is not subject to review by surveyors - answerc. Is a permanent legal record of the care provided



The PCT notes that a patient still has considerable edema in her legs when performing the
post-treatment data collection. In addition to informing the nurse, what should the PCT
document?

a. Leave the data collection entry blank

b. Document "RN to assess"

c. Document the noted swelling and that the RN was informed

d. Document "N/A" since the nurse will assess and document - answerc. Document the noted
swelling and that the RN was informed



When the patient's calculated UF Goal exceeds the maximum UFR ordered by the nephrologist

a. The calculated UF Goal should be entered into Snappy and the UFR adjusted once the patient
shows signs of becoming hypotensive

b. The patient must give permission to exceed the ordered maximum UFR since fluid overload is

,harmful and every effort should be made to reach the ordered target weight

c. The calculated UF Goal must be adjusted to not exceed the ordered maximum UFR and the
reason documented

d. The charge nurse must assess the patient prior to treatment initiation to determine a safe UF
Goal for the patient - answerc. The calculated UF Goal must be adjusted to not exceed the ordered
maximum UFR and the reason documented



DQI (Davita Quality Index) is achieved by

a. Managing individual patients first and allowing scores to follow

b. Knowing each team member's role in improving DQI scores

c. Using the CQI process to help identify trends and make improvements

d. All of the above - answerd. All of the above



Per the CDC, which is the most common factor contributing to bacteremias in dialysis patients?

a. Inappropriate skin preparation prior to vascular access needle insertion

b. The use of catheters for hemodialysis

c. Poor needle site rotation when cannulating an internal vascular access

d. Exposing needle insertion sites to unclean environment areas, e.g. contaminated chair side
tables during dialysis - answerb. The use of catheters for hemodialysis



Which statement is true about sinks used for hand washing?

a. Patients may not use sinks that are dedicated for teammate hand washing, but should have their
own sinks

b. Hand washing sinks may be used to discard clean solution such as left-over normal saline in a
sterile bag

c. Hand washing sinks must be dedicated for hand washing purposes only and should remain
clean

d. Hand washing sinks may be used to discard bleach solution since the solution kills germs and
has the added benefit of disinfecting the sink - answerc. Hand washing sinks must be dedicated
for hand washing purposes only and should remain clean

, If a patient presents with dialysis associated pericarditis, treatment includes more frequent
dialysis and

a. Heparin restriction to prevent bleeding into the pericardium and tamponade

b. A higher potassium bath to prevent dysrhythmias

c. A lower BFR and DFR to prevent dialysis disequilibrium syndrome

d. An increased BFR and DFR to increase toxin removal - answera. Heparin restriction to prevent
bleeding into the pericardium and tamponade



If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be an
appropriate patient care assignment

a. Caring for HBsAg positive and Hepatitis B immune patients at the same time

b. Caring for HBsAg and Hepatitis B susceptible patients at the same time

c. Caring for Hepatitis B susceptible patients and those in the process of receiving the vaccination
at the same time

d. Caring for Hepatitis B immune and susceptible patients at the same time - answerb. Caring for
HBsAg and Hepatitis B susceptible patients at the same time



The best way to help patients successfully change behaviors is to

a. Scare them through describing serious health risks of the current behavior

b. Tell them how to accomplish the desired change

c. List medically sound reasons why change is necessary

d. Inspire behavior change through support, compassion, and empathy - answerd. Inspire behavior
change through support, compassion, and empathy



Your patient complains of dry itchy skin. You would advise her to

a. Take frequent hot showers

b. Rub skin completely dry after a bath

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