Rdt Cvtc Section 8 Water Treatment

Front 1

The main group(s) of water contaminants is (are):

Back 1

-Microbiological
-Inorganic
-Organic

Front 2

Water can be considered safe for drinking, but not necessarily safe for dialysis treatments because the:

Back 2

Patient exposure to water is 25 times greater

Front 3

Aluminum, fluoride, and chloramine chemicals are added by municipalities to drinking water supplies. True or False

Back 3

True

Front 4

The following are reasons for water treatment in dialysis units:

Back 4

-Impurities and toxins can foul dialysis machines
-Patients are exposed to a large amount of water
-Impurities may enter the blood through the dialyzer and can cause toxicity
Calcium and magnesium can cause a hard water syndrome

Front 5

Chloramine exposure during dialysis may cause:

Back 5

Hemolysis

Front 6

In order to find the volume of supply water having a total hardness of 10 grains/gallon (as CaCo3), which can be softened by a softener having the capacity of 100,000 grains (assume 70% of maximum soften capacity), the following method is used:
100,000 x .70 = 70,000 grains
70,000 grains/10 grains/gal = 7000 gallons
Using the information above, determine the volume of water having a total hardness of 120mg/L (or 7 grains/gal*), which can be softened by a softener having the capacity of 15,000 grains (Assume 70% of maximum soften capacity)
* 1 grain/gal=17.1mg/L

Back 6

1500 gallons

Front 7

Softening is defined as the exchange of calcium and magnesium ions for sodium ions. True or False

Back 7

True

Front 8

During softening, sodium levels are increased in proportion tot eh amount of calcium and magnesium removed. True or False

Back 8

True

Front 9

According to AAMI standards, the total microbial count of water used to prepare dialysate:

Back 9

Shall not exceed 200 cfu/mL

Front 10

According to AAMI standards, the total microbial count for dialysate:

Back 10

Shall not exceed 200 cfu/mL

Front 11

According to AAMI standards, bacteriological testing for water and dialysate should be done:

Back 11

Monthly

Front 12

According to AAMI standards, when water purification devices are used, testing for chemical contaminants in the water should be done at lease

Back 12

Yearly

Front 13

Testing for chloramine levels in a dialysis unit is done by:

Back 13

Subtracting free chloramine from total chlorine

Front 14

Chloroform and reactive agents, such as hypochloride, are the main contaminants removed by carbon absorption. True or False

Back 14

True

Front 15

According to AAMI, to remove chloramines effectively, the minimum empty bed contact time (EBCT) in the carbon tank is at least:

Back 15

10 minutes

Front 16

Cellulose membrane

Back 16

Bleach can be used to disinfect the system

Front 17

Polyamide membrane

Back 17

Tolerance of a wide pH range

Front 18

Thin film composites membrane

Back 18

Subject to degradation by oxidants (such as free chlorine)

Front 19

As the total dissolved solids (TDS) contents of the water increases, the product water recovery:

Back 19

Decreases

Front 20

Bacterial exposure from water may cause which of the following symptoms?

Back 20

Fever, chills

Front 21

The following can be removed by filtration:

Back 21

Bacteria

Front 22

Carbon tanks work on the principle of:

Back 22

Adsorption

Front 23

Bacteria

Back 23

Storage tank

Front 24

Resistivity

Back 24

Deionizer

Front 25

Chlorine

Back 25

Carbon

Front 26

Recent rejection

Back 26

Reverse osmosis

Front 27

Reuse water

Back 27

LAL (Limulus amebocyte lysate)

Front 28

Softener

Back 28

Hardness

Front 29

The filter that removes particulates from the water is called:

Back 29

Multimedia filtration

Front 30

Sediment filtration should have an opaque housing:

Back 30

To inhibit proliferation of algae

Front 31

A minimum flow velocity of 1.5 ft/sec through the feed line is needed to:

Back 31

Discourage bacterial colonization

Front 32

The correct frequency and method of monitoring exhaust levels for DI tanks are:

Back 32

Daily with audio and visual alarms

Front 33

The minimum required resistivity measurement for a DI tank is:

Back 33

1 megohm-cm

Front 34

A mixed-bed deionizer tank contains:

Back 34

Cations and anions

Front 35

One megohm is equivalent to an ionic concentration of:

Back 35

0.500 ppm

Front 36

The minimum amount of endotoxin that will cause a LAL preparation to clot is called the LAL:

Back 36

Sensitivity

Front 37

If the LAL has a sensitivity of 0.25 EU/mL and the unknown sample contains 0.5 EU/mL; a test of the undiluted sample would be positive. If the diluted sample is diluted four fold so that it now contains 1/4 the original endotoxin, the test for the 1:4 dilution result would be:

Back 37

Negative

Front 38

The water sample has a conductance of 25 microSiemens/cm. What is the resistivity of that sample in megohms-cm?

Back 38

0.04

Front 39

The water sample has a conductance of 1200 microSiemens/cm. What is the conductance in ppm?

Back 39

720

Front 40

The chemical restoration of ion exchange resins by treating them with acid and caustic is known as:

Back 40

Regeneration

Front 41

Soft water generally contains less than:

Back 41

1.0 grains/gallon of hardness

Front 42

A reverse osmosis system has a feed water conductivity reading of 300 microSeimens/cm and a permeate conductivity reading of 15 microSiemens/cm. what is the percent salt rejection?

Back 42

95

Front 43

Water moves the fastest in the middle of the pipe. True or False

Back 43

True

Front 44

Laminar flow is faster than turbulent flow. True or False

Back 44

False

Front 45

Pressure drops continuously along a pipe in the direction of fluid movement. True or False

Back 45

True

Front 46

if the diameter of a pipe is doubles, the amount of flow it will allow also doubles. True or False

Back 46

True

Front 47

if the pyrogenic reaction is suspected, the water should be cultured for:

Back 47

Gram negative bacteria

Front 48

Granular activated carbon is acid washed to accomplish all of the following:

Back 48

-To remove the ash
-To increase the porosity
-To increase the adsorbency

Front 49

During the process of water softening:

Back 49

Calcium and magnesium ions are exchanged for sodium ions

Front 50

If the level of aluminum in water exceeds the maximum allowable level, the patient may experience:

Back 50

Encephalopathy

Front 51

If the level of copper in water exceeds the maximum allowable level, the patient may experience:

Back 51

Anemia

Front 52

If the level of lead in water exceeds the maximum allowable level, the patient may experience

Back 52

Osteomalacia

Front 53

To test for residual chlorine in a home hemodialysis water treatment system, the patient is taught to collect the water sample after it has passed through the:

Back 53

Carbon filter

Front 54

In a water purification process, reverse osmosis is accomplished by:

Back 54

Ultrafiltration under high pressure against a concentration gradient

Front 55

A flushed sensation, headache, profound thirst and vomiting are all symptoms indicating that the dialysate water is high in:

Back 55

Sodium

Front 56

In dialysis, the continuous use of untreated water with high concentrations of calcium causes which one of the following problems?

Back 56

Hard water syndrome

Front 57

What are the toxic effects or symptoms of chloramines in dialysis water?

Back 57

hemolysis, anemia, and methemoglobinemia

Front 58

Chloramines are MOST effectively removed by which one of the following components of a water treatment system?

Back 58

Activated carbon

Front 59

According to AAMI and the American National Standards Institute (ANSI), the manufacturer of the water treatment system for dialysis is responsible for:

Back 59

Ensuring that the water produced by the system is below the maximum allowable chemical contaminant levels at the time of installation

Front 60

When a deionizer system is used to prepare water for dialysate, it should be monitored continuously to produce water of:

Back 60

1MegOhm-cm or greater specific resistivity at 25* C

Front 61

What element, when present at excessive levels in water used in dialysis, can induce nausea, vomiting, hypertension and muscular weakness in the dialysis patient?

Back 61

Calcium

Front 62

Mechanical filtration of suspended particulate matter includes all of the following:

Back 62

-Membrane filters
-Cartridge filters
-Sand and gravel filters

Front 63

A system of water treatment that removes pyrogens as well as solutes is called:

Back 63

Reverse Osmosis

Front 64

In the water treatment system, a semipermeable membrane and pressure process that removes both organic matter and electrolytes form processed water is:

Back 64

Reverse Osmosis

Front 65

The primary purpose of carbon prefiltration of water is:

Back 65

Removal of chlorine and chloramine

Front 66

Shortly after the Monday morning dialysis shift begins, three patients on one side of the unit develop fever, chills, and malaise. The nurse in charge suspects bacterial contamination of the water treatment system and immediately pages the physician on call. The technician should:

Back 66

Put all machines in bypass, draw blood cultures and take samples for cultures form the dialysate and the water

Front 67

May municipal water treatment facilities reduce bacterial levels through addition of what chemical to treated water?

Back 67

Chloramine

Front 68

During the process of deionization:

Back 68

Cations are exchanged for hydrogen ions and anions for hydroxyl ions

Front 69

During reverse osmosis:

Back 69

Solvents are removed from a mixture of solutes and solvents

Front 70

The water distribution system is a dialysis unit keeps bacterial levels low by:

Back 70

-Proper system design and installation
-Periodic maintenance and disinfection
-Maintaining a minimum flow velocity of 1.5 ft/sec

Front 71

Exchange cations for hydrogen ions and anion for hydroxly ions

Back 71

Deionization

Front 72

Exchange calcium and magnesium ions for sodium ions.

Back 72

Softening

Front 73

Involves removal of solutes by filtration

Back 73

Reverse osmosis

Front 74

Exchange chloramines for calcium ions

Back 74

None of the above

Front 75

An LAL test is

Back 75

An assay for endotoxin

Front 76

Aluminum =

Back 76

Encephalopathy

Front 77

Iron =

Back 77

Anemia

Front 78

Lead =

Back 78

Neurological disease

Front 79

Copper =

Back 79

Liver

Front 80

Fluoride =

Back 80

Osteomalacia

Front 81

Calcium/Magnesium

Back 81

Hard water syndrome

Front 82

Endotoxin

Back 82

Fever/Chills

Front 83

Many municipal water treatment facilities reduce bacterial levels through addition of what chemical to treated water?

Back 83

Chloramines

Front 84

What are the toxic effects or symptoms of chloramines in dialysis water?

Back 84

Hemolysis, anemia, and methemoglobinemia

Front 85

Testing for chloramine levels in a dialysis unit is done by:

Back 85

Subtracting free chloramines from total chlorine

Front 86

Chloramine exposure during hemodialysis may cause:

Back 86

Hemolysis

Front 87

Testing the effluent for chlorine/chloramines breakthrough should be done:

Back 87

Before every patient

Front 88

The difference between "free chlorine" and "total chlorine" is the

Back 88

Chloramine content

Front 89

In order to remove chlorine and chloramine effectively, the recommended "iodine number" of a GAC (granular activated carbon) should be at least:

Back 89

900

Front 90

The AAMI standards have established a maximum allowable level for free chlorine at:

Back 90

0.5 mg/L

Front 91

The AAMI standards have established a maximum allowable level for chloramines at:

Back 91

0.1 mg/L

Front 92

When chlorine combines with ammonia from decomposing vegetation, it forms:

Back 92

Chloramines

Front 93

The new action level for endotoxin concentration in the product water is:

Back 93

0.125 EU/ml