Fresenius Water Treatment Exam /
Fresenius Hemodialysis Study Guide
Types of water sources? Correct Ans - Surface and Ground
Examples of surface water? Correct Ans - lakes, streams, rivers,
reservoirs
Examples of ground water? Correct Ans - Wells, springs
FMC follows water quality standards according to who's standards?
Correct Ans - AAMI
Bone disease can be caused by ________ in product water? Correct Ans -
Aluminum
Aluminum in product water put the patient at risk for ________? Correct
Ans - Anemia
Aluminum, chloramphenicol, copper or zinc may cause _______ when present in
water used for dialysis? Correct Ans - Hemolysis
The presence of bacteria in the bloodstream is? Correct Ans - Sepsis
Parts of a bacteria cell wall, released from dead bacteria is? Correct Ans -
Endotoxin
What are characteristics of bacteria/viruses? Correct Ans - 1. Grows
rapidly
2. Too large to cross an intact dialysis membrane, but can cross a
damaged/torn membrane
3. May produce endotoxins or biofilm
Safe range for total chlorine is? Correct Ans - Less than 0.1 ppm (0.00-
0.09 ppm)
,A serious side effect if chlorine crosses the dialyzer membrane is? Correct
Ans - Hemolysis
Chloramphenicol is a combination of ________ and _________ ? Correct Ans -
Chlorine and Ammonia
Chlorine and chloramphenicol are added to city water for what reason?
Correct Ans - To reduce or eliminate bacteria
A patient complication due to the exposure of blood to chlorine an
chloramines is? Correct Ans - Hemolysis
Examples of the symptoms the patient might experience from Hemolysis.
Correct Ans - 1. Chest pain
2. Shortness of breath
3. Cherry pop red / translucent blood
Where does the water pathway start in the dialysis facility? Correct Ans -
City Water Inlet
The first piece of equipment that the water goes through in the dialysis facility
is the? Correct Ans - Backflow Preventer
What is the function of the backflow preventer? Correct Ans -
Prevents water from flowing back into the city's water suppl.
The recommended water temperature for ideal RO operation is? Correct
Ans - 77 degrees F
What is the function of the water booster pump? Correct Ans - Boosts
incoming city water pressure
What is the function of the Captive Air Tank (bladder tank)? Correct Ans
- Help maintain a minimum pressure
What is the function of the Chemical Feed pump? Correct Ans - Help
adjust the pH level of the water
, What is the function of the Sediment Filters? Correct Ans - Removes
larger particles from the incoming water
What is the function of the multimedia filter? Correct Ans - Removes
particles 10 microns in size or larger
What is the size of particulate matter removed by the multimedia filter?
Correct Ans - 10
What is the function of the Carbon Filter/Tank? Correct Ans - To
remove chlorine and Chloramines and other organic materials.
Carbon filters remove chlorine and chloramines by the process of? Correct
Ans - Adsorbtion
What is the "Empty Bed Contact Time?" Correct Ans - The length of
time that the water is exposed to carbon
AAMI requires a minimum EBCT of __ minutes, FMC requires a minimum EBCT
of __ minutes for new water treatment systems. Correct Ans - 10, 12
RPC Ultra-Low Total Chlorine test strips are used to test for? Correct Ans
- Total Chlorine in the water after GAC #1 and Post RO.
When and at what frequency is routine total chlorine testing performed per
FMS policy? Correct Ans - Prior to the initiation of treatment and at
least every 4 hours.
The reverse osmosis (RO) machine runs for __ minutes before performing any
total chlorine testing. Correct Ans - 15
Total chlorine testing for a central water system must be performed and
documented by __ qualified staff members. Correct Ans - 2
A sample container is always rinsed __ times before a sample is collected for
testing. Correct Ans - 3
___ ml is the correct amount of water to collect for total chlorine testing when
using RPC Ultra-Low Total Chlorine test strips Correct Ans - 100
Fresenius Hemodialysis Study Guide
Types of water sources? Correct Ans - Surface and Ground
Examples of surface water? Correct Ans - lakes, streams, rivers,
reservoirs
Examples of ground water? Correct Ans - Wells, springs
FMC follows water quality standards according to who's standards?
Correct Ans - AAMI
Bone disease can be caused by ________ in product water? Correct Ans -
Aluminum
Aluminum in product water put the patient at risk for ________? Correct
Ans - Anemia
Aluminum, chloramphenicol, copper or zinc may cause _______ when present in
water used for dialysis? Correct Ans - Hemolysis
The presence of bacteria in the bloodstream is? Correct Ans - Sepsis
Parts of a bacteria cell wall, released from dead bacteria is? Correct Ans -
Endotoxin
What are characteristics of bacteria/viruses? Correct Ans - 1. Grows
rapidly
2. Too large to cross an intact dialysis membrane, but can cross a
damaged/torn membrane
3. May produce endotoxins or biofilm
Safe range for total chlorine is? Correct Ans - Less than 0.1 ppm (0.00-
0.09 ppm)
,A serious side effect if chlorine crosses the dialyzer membrane is? Correct
Ans - Hemolysis
Chloramphenicol is a combination of ________ and _________ ? Correct Ans -
Chlorine and Ammonia
Chlorine and chloramphenicol are added to city water for what reason?
Correct Ans - To reduce or eliminate bacteria
A patient complication due to the exposure of blood to chlorine an
chloramines is? Correct Ans - Hemolysis
Examples of the symptoms the patient might experience from Hemolysis.
Correct Ans - 1. Chest pain
2. Shortness of breath
3. Cherry pop red / translucent blood
Where does the water pathway start in the dialysis facility? Correct Ans -
City Water Inlet
The first piece of equipment that the water goes through in the dialysis facility
is the? Correct Ans - Backflow Preventer
What is the function of the backflow preventer? Correct Ans -
Prevents water from flowing back into the city's water suppl.
The recommended water temperature for ideal RO operation is? Correct
Ans - 77 degrees F
What is the function of the water booster pump? Correct Ans - Boosts
incoming city water pressure
What is the function of the Captive Air Tank (bladder tank)? Correct Ans
- Help maintain a minimum pressure
What is the function of the Chemical Feed pump? Correct Ans - Help
adjust the pH level of the water
, What is the function of the Sediment Filters? Correct Ans - Removes
larger particles from the incoming water
What is the function of the multimedia filter? Correct Ans - Removes
particles 10 microns in size or larger
What is the size of particulate matter removed by the multimedia filter?
Correct Ans - 10
What is the function of the Carbon Filter/Tank? Correct Ans - To
remove chlorine and Chloramines and other organic materials.
Carbon filters remove chlorine and chloramines by the process of? Correct
Ans - Adsorbtion
What is the "Empty Bed Contact Time?" Correct Ans - The length of
time that the water is exposed to carbon
AAMI requires a minimum EBCT of __ minutes, FMC requires a minimum EBCT
of __ minutes for new water treatment systems. Correct Ans - 10, 12
RPC Ultra-Low Total Chlorine test strips are used to test for? Correct Ans
- Total Chlorine in the water after GAC #1 and Post RO.
When and at what frequency is routine total chlorine testing performed per
FMS policy? Correct Ans - Prior to the initiation of treatment and at
least every 4 hours.
The reverse osmosis (RO) machine runs for __ minutes before performing any
total chlorine testing. Correct Ans - 15
Total chlorine testing for a central water system must be performed and
documented by __ qualified staff members. Correct Ans - 2
A sample container is always rinsed __ times before a sample is collected for
testing. Correct Ans - 3
___ ml is the correct amount of water to collect for total chlorine testing when
using RPC Ultra-Low Total Chlorine test strips Correct Ans - 100
