DAVITA FINAL EXAM QUESTIONS & ANSWERS GRADED A+ VERIFIED & UPDATED 2023/2024, Exams of Nursing

Download DAVITA FINAL EXAM QUESTIONS & ANSWERS GRADED A+ VERIFIED & UPDATED 2023/2024 and more Exams Nursing in PDF only on Docsity! DAVITA FINAL EXAM QUESTIONS & ANSWERS GRADED A+ VERIFIED & UPDATED 2023/2024 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 – answer c. 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 – answer c. 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 – answer c. 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 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 The acronym DARN stands for a. Desire, Ability, Reason, Need b. Deficiency, Ambition, Rationality, Neediness c. Design, Aspiration Requirement, Negativity d. To normalize electrolytes - answerd. To normalize electrolytes Unless otherwise directed by the manufacturer or state specific pharmacy regulations, when must medications containing a preservative be discarded? a. At 28 days after opening b. At 25 days after opening c. At 23 days after opening d. At 21 days after opening - answera. At 28 days after opening Educational tips for visual learners include a. Providing soft background music b. Selecting quiet surroundings c. Using lively hand gestures when delivering long lectures d. Allowing plenty of time for the patient to talk - answerb. Selecting quiet surroundings An optimal nutrition status is evidenced by a. An appropriate amount of energy, ability to sleep well at night, serum potassium of no greater than 5.5 mEq/L, and a BUN of 60-80 mg/dl b. A 30 minute exercise tolerance, calcium 8.4-10.2 mg/dl, phosphorus 3-5.5 mg/dl and PTH intact 150-600 pg/ml c. Patient report of feeling well, no excess fluid weight gains, bringing appropriate snacks to dialysis, and taking phosphate binders with every meal d. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl - answerd. A stable, desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake, and a serum albumin of equal to or greater than 4 gm/dl When comparing the FMC dialysis machine's conductivity reading to your manual reading, policy states that the difference between these two readings is to be d. Provides guidelines for use of a tunneled CVC - answera. Provides guidelines for use of a new AV fistula During cannulation of all AV fistulas a. A tourniquet is to be applied to increase vein engorgement and stabilize vessel b. A tourniquet may be applied to increase vein engorgement if deemed necessary by the cannulator c. A tourniquet to increase vein engorgement is not necessary if the AVF is well developed d. Tourniquets should not be applied to decrease the risk of AVF clotting - answera. A tourniquet is to be applied to increase vein engorgement and stabilize vessel At what time do you perform water hardness testing? a. At the beginning of each day prior to the first treatment b. About halfway through your treatment day c. Every four hours d. At the end of the treatment day - answerd. At the end of the treatment day Why should the patient be in a comfortable supine position when you perform pre-dialysis CVC care? a. The supine position allows easier visualization of the CVC exit site b. The supine position decreases blood flow through the catheter and diminishes the risk of hemorrhage c. The supine position prevents clean barriers from dropping off d. The supine position increases pressure within central veins and diminishes the risk of an air embolism - answerd. The supine position increases pressure within central veins and diminishes the risk of an air embolism What is your immediate response to a final water quality alarm on the treatment floor? a. Place all machines into bypass b. Terminate treatments c. Notify your biomed technician d. Perform manual water testing to verify results - answera. Place all machines into bypass What complication would you expect to see if a patient is exposed to chlorine/chloramines? a. Bone disease b. Hemolysis c. Hypertension d. Muscle weakness - answerb. Hemolysis The nephrologist has ordered the use of hemostatic sponges, such as SureSeal, for your patient. What is the correct procedure when using these sponges? will remove more potassium - answerb. You explain to the patient that the potassium in food eaten during dialysis is not dialyzed off A new AV fistula has received its post op exam, meets the criteria listed in the KDOQI Rule of 6s and the nephrologist writes orders to begin cannulation. Which teammates can cannulate the AVF? a. The NFACT Beginner Cannulator b.The NFACT Intermediate Cannulator c. The NFACT Advanced Cannulator d. Any teammate who has completed vascular access cannulation training - answerc. The NFACT Advanced Cannulator Which of the following is a basic principle of patient self-management? a. Focusing primarily on dialysis prescription and adherence to treatment b. Taking on responsibility of the medical management of the illness c. Dealing with the consequences of illness, rather than just the physical disease d. Allowing care providers to help with the day-to-day management of the disease - answerc. Dealing with the consequences of illness, rather than just the physical disease Diffusion is defined as a. Particles move from an area of higher solute concentration to an area of lower solute concentration b. Controlled fluid removal by manipulation of hydrostatic pressure c. Solutes are dragged across the semipermeable membrane along with fluid d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration - answera. Particles move from an area of higher solute concentration to an area of lower solute concentration Attention to infection control, proper hand hygiene, cleaning and disinfection procedures are of utmost importance in the dialysis setting. Which of the following statement is true? a. Only items taken to a clean dialysis station prior to initiation of a patient treatment can be returned to a common clean area without being disinfected b. If a hemodialysis patient performs self-care at the facility, common supply carts used to store clean supplies may be placed within the patient's reach c. Viable MRSA bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival d. Red disposal bags are to be closed with a tight "dog eared" knot to prevent leakage of fluid from the bag - answerc. Viable MRSA bacteria can remain on surfaces for days with plastic and vinyl being most favorable to their survival Teammates decrease the risk of infection when working with a central venous catheter (CVC) by: a. Wearing a facemask b. Washing hands and wearing clean gloves c. Avoiding touching dirty surfaces when providing CVC care d. All of the above - answerd. All of the above Your immediate intervention for a patient experiencing an anaphylactic reaction is a. Discontinue the medication, administer a saline bolus to prevent hypotension b. Discontinue the medication and the treatment, return the blood c. Discontinue the medication, decrease BFR, administer oxygen d. Stop the blood pump, discontinue the treatment, do not return the blood - answerd. Stop the blood pump, discontinue the treatment, do not return the blood How do you verify that the patient is stable and safe for discharge after the dialysis treatment? a. Evaluate the effectiveness of the treatment by comparing data to pre-dialysis findings b. PCTs notify the nurse if there are any unusual findings c. Nurses perform a post treatment assessment as required d. All of the above - answerd. All of the above Knowing what caused your patient's renal failure a. Is not necessary because it does not affect the dialysis treatment itself b. Is only important of the underlying disease causes additional health problems c. Is important to inquire about possible problems during data collection and assessment d. Is recommended to decide on the best treatment modality for the patient - answerc. Is important to inquire about possible problems during data collection and assessment Which in-center hemodialysis patients are at risk of experiencing signs and symptoms of dialysis disequilibrium syndrome? a. Patients who are eating a diet rich in meats b. Patients with severe mineral and bone disorder c. Patients who are fluid overloaded d. Patients who are skipping treatments - answerd. Patients who are skipping treatments Mr. Simon complains of shortness of breath and back pain. Upon inspection, the blood lines look like cherry Kool-Aid. What is this complication and what should you do? a. This is an infection and the patient should be given an antibiotic b. This is hemolysis and the hemodialysis treatment should be stopped without returning the patient's blood c. This is an anaphylactic reaction and the patient should be given Benadryl and kept on dialysis d. This is hemolysis, the patient's blood should be returned and dialysis treatment ended - answerb. This is hemolysis and the hemodialysis treatment should be stopped without returning the patient's blood Waiting only 5 Seconds between lowering the blood pump speed and drawing the post-treatment blood sample would a. An air embolus b. A disinfectant infusion c. Impending cardiac arrest d. A dialyzer reaction - answerb. A disinfectant infusion In states that do not mandate a pre-dialysis patient assessment by the registered nurse a. The nurse should always perform the pre-treatment assessment for patient safety b. The PCT must inform the nurse of unusual data collection findings prior to treatment initiation c. The nurse can perform the patient assessment as time permits d. A patient assessment is not necessary as long as the PCT does a thorough data collection - answerb. The PCT must inform the nurse of unusual data collection findings prior to treatment initiation For patients' with AKI a. No nursing assessment is required b. A pre-treatment nursing assessment is always required c. Treatment and prescription is the same as if diagnosed with end stage kidney disease d. No labs are drawn - answerb. A pre-treatment nursing assessment is always required Intradialytic hypotension a. Is common during the hemodialysis treatment and can easily be corrected with saline infusion b. Is only of concern if it happens on a regular basis, e.g. once every treatment c. Can have many adverse effects including impaired tissue perfusion of vital organs and organ injury d. Has no adverse effects unless the systolic blood pressure drops below 60 mmHg - answerc. Can have many adverse effects including impaired tissue perfusion of vital organs and organ injury The nephrologist orders a BFR of 300 for a patient with a two-month-old AV fistula. What needle gauge would be appropriate for this BFR? a. 17 gauge b. 16 gauge c. 15 gauge d. 14 gauge - answerb. 16 gauge V-tags for CSM surveys state specific regulations to be met within a condition such as Infection Control, provide interpretive guidance for each regulation, and cite deficiencies by tag number. How can knowledge of these V-tags affect the practice of patient care providers? a. Provide patient care within CMS Conditions for Coverage b. Understand rationales for specific regulations as outlined in the interpretive guidance c. Assist in the development of policies and procedures d. All of the above - answerd. All of the above c. Malnutrition d. Blood loss related to dialysis - answera. Hypertension What does CKD-MBD lead to? a. Abnormalities in gastrointestinal mucosa interfering with adequate nutrition b. Abnormalities in erythropoiesis with pallor, weakness, and fatigue c. Abnormalities in the peripheral nervous system with muscle weakness, burning feet and decreased sensation d. Abnormalities in Ca, PO4, PTH, and Vitamin D metabolism with soft tissue calcification and bone disease - answerd. Abnormalities in Ca, PO4, PTH, and Vitamin D metabolism with soft tissue calcification and bone disease Ultrafiltration is defined as a. Solutes are dragged across the semipermeable membrane along with fluid b. Controlled fluid removal by manipulation of hydrostatic pressure c. Particles move from an area of higher solute concentration to an area of lower solute concentration d. Fluid moves from an area of lower solute concentration to an area of higher solute concentration - answerb. Controlled fluid removal by manipulation of hydrostatic pressure Osmosis is defined as a. Controlled fluid removal by manipulation of hydrostatic pressure b. Fluid moves from an area of lower solute concentration to an area of higher solute concentration c. Solutes are dragged across the semipermeable membrane along with fluid d. Particles move from an area of higher solute concentration to an area of lower solute concentration - answerb. Fluid moves from an area of lower solute concentration to an area of higher solute concentration The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is a. 4-6 minutes b. 3-5 minutes c. 1-2 minutes d. No waiting is needed - answerb. 3-5 minutes Educational tips for auditory learners include a. Using word associations and mnemonics b. Providing loud background music of the patient's choice c. Incorporating the patient's secondary learning style d. Minimizing use of written materials - answera. Using word associations and mnemonics When an AV access is cannulated via the rope ladder method, cannulated sites are rotated with each treatment to allow healing and increase longevity of the access. How long does it take for a cannulation site to heal? a. One week b. Two weeks c. Three weeks d. Four weeks - answerb. Two weeks The two types of peritoneal dialysis are: a. Drain and Fill b. CAPD and CCPD c. Solo and Conventional d. None of the above - answerb. CAPD and CCPD Educational tips for kinesthetic learners include a. Allowing the patient to doodle during long lectures b. Using outlines, pictures, graphs, charts, and diagrams whenever possible c. Letting the patient watch videos d. Taking short breaks and allowing your patient to get up and walk around - answerd. Taking short breaks and allowing your patient to get up and walk around A patient with hyperkalemia will present with a. Hypotension and dizziness b. Nausea/vomiting and fatigue c. Extreme muscle weakness and an abnormal heart rhythm d. Severe itching and irritability - answerc. Extreme muscle weakness and an abnormal heart rhythm The centrifuge to spin blood samples must be balanced to avoid shaking and the centrifuge losing its balance. To balance the centrifuge a. A glass tube that is filled to the same level as a plastic tube may be placed opposite each other b. A dummy plastic tube filled with slightly more water than a glass specimen tube can be placed opposite each other c. Placing tubes of the same kind and size opposite each other is more important than the fill level d. Only tubes of the same kind, size, and fill level should be placed opposite each other - answerd. Only tubes of the same kind, size, and fill level should be placed opposite each other Summarizing during reflective listening a. Recalls the patient's resistance statements to change and summarizes reasons for change b. Summarizes strategies for change based on the practitioner's expertise The endocrine functions of the kidneys are a. Excreting acids and reabsorbing bicarbonates b. Elimination of waste products c. Normalizing electrolytes d. Renin and erythropoietin secretion, activation of vitamin D - answerd. Renin and erythropoietin secretion, activation of vitamin D Peripheral neuropathy is a complication in chronic renal failure which affects sensory and motor nerve fibers. If your patient complains of a burning sensation in the feet, you should advise him a. That short cold foot baths once or twice a day numb the feet and provide relief from the burning b. Not to walk barefoot, be careful with foot care, and check the bath water temperature with thermometer c. Not wearing socks or shoes at home might make him more comfortable as long as he is walking on soft carpet d. To take two or three short brisk walks each day to strengthen the affected nerves in the feet - answerb. Not to walk barefoot, be careful with foot care, and check the bath water temperature with thermometer What problem will cause a more negative pre-pump arterial pressure? a. Separation of blood tubing from arterial access b. Kinking of the arterial blood line between the vascular access and arterial monitor c. Increase in blood pump speed d. Arterial needle properly positioned - answerb. Kinking of the arterial blood line between the vascular access and arterial monitor Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them? a. 60 minutes prior to a meal b. 30 minutes prior to a meal c. With a meal d. 60 minutes after a meal - answerc. With a meal A surveyor asks you a question. Which of the following statements would be a good answer? a. This is the way we have always done it b. Nobody showed me how to do this c. I do not know the answer but I will find out d. This is a faster way - answerc. I do not know the answer but I will find out What complication occurs if blood is exposed to dialysate that is too hot? a. Hypersensitivity reaction b. Seizures Target weight is: a. Prescribed and determined by physician order b. Modified by physician based on patient tolerance c. Modified by the nurse based on patient tolerance d. d. Both a & b - answerd. d. Both a & b What are three things you should NOT include in an REM? a. Teammates' actions, visitor behaviors, patient response b. Personal opinions, speculation, vendettas c. Who, what, where d. Date, time, place - answerb. Personal opinions, speculation, vendettas All documentation on machine setup and pre-treatment patient information a. Must be entered into the computer before the treatment is initiated b. Must be entered into the computer at the time the treatment is initiated c. Must be entered into the computer within five minutes after the treatment is initiated d. Must be entered into the computer before the treatment is terminated - answera. Must be entered into the computer before the treatment is initiated Interventions for a patient complaining of chest pain/angina include a. Place patient in flat supine position, place machine into bypass b. Decrease BFR, decrease UFR, administer oxygen c. Place patient in Trendelenburg position, administer a saline bolus d. Immediately return the blood, administer oxygen - answerb. Decrease BFR, decrease UFR, administer oxygen A patient with Acute Kidney Injury (AKI) is at increased risk for: a. Hypertension and Hypervolemia b. Hypotension and Hypovolemia c. Anemia and MBD d. Receiving too much dialysis time - answerb. Hypotension and Hypovolemia Post treatment data collection and assessment is performed a. Within five minutes prior to terminating the treatment b. During rinseback c. As time permits immediately prior to or right after treatment termination d. After the treatment was terminated - answerd. After the treatment was terminated