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61 Cards in this Set
- Front
- Back
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The concentration of the mixed Renalin used in the Renatron should be:
a) 10% b) 33% c) 0.9% d) 21% |
c) 0.9%
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Dialyzer caps should be soaked in Renalin at a concentration of:
a) 5% b) 1% c) 25% d) 21% |
b) 1%
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The following are risks and hazards of reprocessing.
I. Sepsis, infection II. Pyrogenic reaction III. Reactions to reprocessing chemicals IV. Altered immune system V. Infusion of particulate VI. Increased dialyzer blood leak a) I and II only b) I, II, and III only c) I, II, IV, and VI only d) All of the above |
d) All of the above
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The purpose of disconnecting the used dialyzer form the blood tubing and capping both blood ports is (are) to:
a) Avoid introduction of bacteria b) Avoid introduction of air into the blood compartment c) Prevent contamination of the unit d) All of the above |
b) Avoid introduction of air into the blood compartment
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All of the following solutions are commonly used to clean residual blood from the dialyzer EXCEPT:
a) Hydrogen peroxide b) Bleach c) Peracetic acid d) Formaldehyde |
d) Formaldehyde
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Measurement of the total cell volume (TCV) is used to determine:
a) Performance of the dialyzer b) Blood leak c) Contaminants d) Residual chemicals |
a) Performance of the dialyzer
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A 20% decrease in total cell volume (TCV) results in a drop in dialyzer clearance of:
a) 5% b) 10% c) 20% d) 25% |
b) 10%
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The total cell volume must be no less than:
a) 20% b) 50% c) 80% d) 100% |
c) 80%
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The blood path integrity is tested to prevent the possibility of a blood leak. The drop in pressure should not exceed:
a) 5 mmHg b) 10mmHg c) 20 mmHg d) 25 mmHg |
b) 10mmHg
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A positive or negative change in the ultrafiltration rate (Kuf) of the dialyzer should not exceed:
a) 10% b) 20% c) 25% d) 50% |
a) 10%
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Any dialyzer that does not pass the TCV/leak test is a failed dialyzer and must be discarded.
a) True b) False |
a) True
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Reprocessing records are considered medical records and should be maintained in a complete, legible, and secure manner.
a) True b) False |
a) True
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Erythropoietin is known to reduce the effective clearances of reused dialyzers as a result of an increase in the hematocrit.
a) True b) False |
a) True
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In order to avoid cross contamination in Hepatitis B antigen positive patients, reprocessing of their dialyzers should not be performed.
a) True b) False |
a) True
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Which of the following actions should be taken if a wrong dialyzer is used for a patient?
I. The patient's virology samples should be drawn II. Discontinue dialysis immediately III. The staff who put the patient on dialysis should be interviewed a) I and II only b) II and III only c) I and III only d) All of the above |
d) All of the above
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Reprocessing polysulfone dialyzers with bleach will result in:
I. A steady increase in B2 microglobulin removal over the usage II. Comlement activation and leukopenia occur as with the first use III. An increase in albumin loss a) I and II only b) II and III only c) I and III only d) All of the above |
d) All of the above
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The main purpose of completely disinfecting the O ring and header of a disassembled dialyzer before it is reassembled is:
a) To prevent bacterial growth where the disinfectant does not penetrate b) To lubricate the O ring c) To soften the O ring for assembly d) All of the above |
a) To prevent bacterial growth where the disinfectant does not penetrate
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If dialysis is not commenced immediately following an acceptable residual germicide test, the following will occur EXCEPT:
a) Concentrations of germicide in the blood compartment increase b) Dialyzer clearance diminishes c) Re-equilibrium occurs between the potting compound and the saline in the blood compartment d) The patient may exhibit symptoms of acute toxicity when dialysis is started. |
b) Dialyzer clearance diminishes
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Germicide rebound is avoided by:
I. Adequate rinsing of the dialyzer II. Performance of a residual germicide test III. Delaying dialysis for one hour IV. Discarding the priming saline when initiating dialysis a) I, II, and III only b) II, III, and IV only c) I, II, and IV only d) All of the above |
c) I, II, and IV only
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Endotoxins are not only released when bacteria are killed; living bacteria also release endotoxins during reproduction and growth.
a) True b) False |
b) False
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Pyrogens are any agent that cause fever when injected into humans.
a) True b) False |
a) True
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Salmonella typhosa needs to reach 1 ng/kg before crossing the threshold and Excherichia coli only needs about 0.1 ng/kg to cause a pyrogenic response.
a) True b) False |
a) True
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The use of new membranes with greater permeability to large molecules (4000-5000 Daltons) never has any effect on the transfer of bacterial proteins and other noxious byproducts int he dialysate to the patient.
a) True b) False |
b) False
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Short dialysis time is associated with a greater post dialysis urea rebound.
a) True b) False |
a) True
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Germicide
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A chemical that destroys bacteria
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Total cell volume
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A measure of how much fluid the dialyzer can hold on the blood side
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Automated reprocessing
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A machine to rinse, clean, and test dialyzers
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Composite reimbursement
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The fees paid by Medicare for each dialysis
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Cellulose
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A fiber that forms cell walls of many plants
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To make sodium hypochlorite (Clorox Bleach 5.25%) 100ppm, and 2.0 ml to 1000 cc of water. To make 10 ppm of bleach solution add ___ ml of bleach to 1000 cc of water.
a) 2.0 b) 0.2 c) 0.02 d) 0.002 |
b) 0.2
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To make 2% formalin (37% formaldehyde), add 54.0 mL in 1000 mL of water. to make 3% formalin solution add ___ mL of formaldehyde to 1000 mL of water.
a) 108.0 b) 7.6 c) 81.0 d) 10.8 |
c) 81.0
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An acid of vinegar rinse helps:
a) Disinfect the hydraulic system b) Prevent precipitation c) Sterilizing the equipment d) All of the above |
b) Prevent precipitation
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Dialyzer reprocessing requires:
a) Water trace analysis b) Bacteria testing c) Endotoxin testing d) All of the above |
d) All of the above
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The minimum standard for the level of disinfection to be used on a blood compartment and contacting surface is:
a) Low level disinfection b) High level disinfection c) Sterilization d) None of the above |
b) High level disinfection
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Clots are removed from the fibers during the DRS4 reprocessing procedure during the:
a) Reverse ultrafiltration cycle b) Back filtration cycle c) Rinse cycle d) Performance tests |
a) Reverse ultrafiltration cycle
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Your center reprocesses dialyzers. What are some possible clinical indications of decreasing efficiency that would alert the caregiver?
a) An unusual rise in predialysis plasma urea or creatinine b) General deterioration of the patient's clinical condition c) An unanticipated deviation of the post dialysis weight, if a conventional fluid removal system was used. d) All of the above |
a) An unusual rise in predialysis plasma urea or creatinine
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The number of times of dialyzer is reused is determined by:
a) Reprocessing procedures b) Dialyzer priming procedures c) Proper heparinization d) All of the above |
d) All of the above
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Patient have the right to refuse dialyzer reprocessing.
a) True b) False |
a) True
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The term 510(K) is:
a) Larger than a 401K b) An FDA approval for a medical device c) Not needed for hemodialysis equipment d) Non of the above |
b) An FDA approval for a medical device
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The State Department of Health can:
a) Recommend a dialysis facility follow a procedure b) Close the facility until they are compliant c) Start legal action d) All of the above |
d) All of the above
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The steps, in order, for reprocessing dialyzers are:
a) Test, rinse, clean, documentation, disinfect, statistical analysis b)Rinse, test, clean disinfect, documentation, statistical analysis c) Documentation, clean, rinse, test, disinfect, statistical analysis d) Rinse, disinfect, clean, test, documentation, statistical analysis |
b)Rinse, test, clean disinfect, documentation, statistical analysis
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Part of the rinse process during reprocessing is:
a) Ultrafiltration b) Reverse ultrafiltration c) Blood side rinse d) B and C only |
d) B and C only
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After the disinfect cycle, the dialyzer should be tested for:
a) Residual disinfectant b) Total cell volume c) Leak test d) Presence of disinfectant |
d) Presence of disinfectant
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Before a patient is treated on a reprocessed dialyzer, the dialysis caregiver should perform a:
a) Test for presence of disinfectant b) Leak test c) Test for residual disinfectant d) B and C only |
d) B and C only
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Total cell volume equals:
a) Fiber bundle volume b) Blood cap volume c) Dialysate compartment volume d) A and B |
d) A and B
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A reprocessed dialyzer can be used:
a) On any patient b) On the same patient c) Once and discarded d) Up to one year |
b) On the same patient
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Water used for reprocessing dialyzers must meet:
a) Local municipal water standards b) AAMI standards c) ANSI standards d) Facility preference |
b) AAMI standards
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Verification of the test for residual disinfectant should be performed by:
a) The practitioner initiating dialysis b) The patient c) The charge nurse d) Two individuals |
d) Two individuals
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The reuse technician is the only factor in the reuse average.
a) True b) False |
b) False
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If the reuse average is low for one week in a clinic, the reuse technician should:
a) Be dismissed b) Be retrained immediately c) Notify the charge nurse that there is a problem with the priming procedure d) Understand that this is a normal fluctuation of a process |
d) Understand that this is a normal fluctuation of a process
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Dialyzers that are primed and pass the test for residual may fail the test if dialysate flow and blood side recirculation is not maintained.
a) True b) False |
a) True
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Germicide rebound is thought to occur because of:
a) Residual germicide in the O ring b) Germicide bound to the dialyzer casing c) Inadequate dialyzer priming process d) Leaching from the potting compound |
c) Inadequate dialyzer priming process
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According to federal law, the reused dialyzer MUST be labeled with the:
a) Patients name, the number of previous uses and the date of the last reprocessing b) Patient's name, the ultrafiltration co-efficient and the patient's social security number c) Patient's name, social security number and diagnosis d) Patient's social security number, pressure test results and blood typr |
a) Patients name, the number of previous uses and the date of the last reprocessing
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Careful rinsing of a re-used dialyzer prior to its being used for a patient is done primarily to remove:
a) Residual disinfectant solution b) Residual blood c) Bacteria d) Cellular deposits |
a) Residual disinfectant solution
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Dialyzer reuse is effected by:
a) Reprocessing procedures b) Dialyzer priming procedures c) Heparinization d) All of the above |
d) All of the above
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K-DOQI recommends measuringt the TCV of every reuse dialyzer prior to its' first use, for all of the following reasons EXCEPT:
a) TCV can vary by 8% to 10% from the TCV stated by the manufacturer b) There is lot to lot variability and hemodialyzer to hemodialyzer variability within a single lot c) Measurement of TCV prior to hemodialyzer use provides a baseline value for subsequent monitoring and evaluation of the performance of each individual dialyzer d) TCV measurement will predict the blood leak of the dialyzer |
d) TCV measurement will predict the blood leak of the dialyzer
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The OSHA Environmental exposure limits for glutaraldehyde are:
a) 0.2 ppm b) 10 ppm c) 1 ppm d) 2 ppm |
a) 0.2 ppm
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A toxic substance produced and held with the cell walls of bacteria until they die or are destroyed, whereupon it may be released.
a) Pseudomonas b) LAL c) E. Coli d) Endotoxin |
d) Endotoxin
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A measure of how much fluid a dialyzer can hold on the blood side is the:
a) Total cell volume b) Dialyzer clearance c) Ultrafiltration rate d) Residual test |
a) Total cell volume
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The OSHA Environmental exposure limits for formaldehyde are:
a) 0.2 ppm b) 5 ppm TWA c) 0.75 ppm TWA and 0.5 ppm action level d) 1 ppm TWA |
c) 0.75 ppm TWA and 0.5 ppm action level
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With regard to evaluation the reusability of a hollow fiber dialyzer, which one of the following statements is correct?
a) Cell volume correlates with surface area which in turn correlates with dialyzer effectiveness b) Compliance correlates with cell membrane volume which in turn correlates with patient symptoms c) Surface area correlates with ultrafiltration which in turn correlates with reusability d) Dialyzer effectiveness correlates with priming volume which in turn correlates with patient symptoms |
a) Cell volume correlates with surface area which in turn correlates with dialyzer effectiveness
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