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BONENT Certified Hemodialysis Nurse (CHN)
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During a routine assessment of a patient in hemodialysis, the nurse notes a change in the patient's mental status. Which of the following interventions should the nurse prioritize?
ssess for signs of infection at the access site
ffer the patient a snack to improve energy levels otify the healthcare provider immediately ncourage the patient to engage in conversation
wer: C
anation: A change in mental status may indicate serious complications as uremic encephalopathy or electrolyte imbalances, requiring prompt ication of the healthcare provider for further evaluation and interventi
anaging a patient with a central venous catheter, what is the most effe od for ensuring that the catheter remains patent and free from occlusi
eeping the catheter capped at all times ushing with saline and heparin regularly
A O N E Ans Expl such notif on. In m ctive meth ons? K Fl Avoiding any movement of the catheter Reducing the frequency of dressing changes Answer: B Explanation: Regular flushing with saline and heparin is the most effective method for maintaining catheter patency and preventing occlusions. In the context of kidney transplantation, which immunosuppressive agent is commonly used to prevent acute rejection during the initial post-operative period? ycophenolate mofetil rednisone zathioprine wer: A anation: Tacrolimus is commonly used as part of the immunosuppress men to prevent acute rejection in the initial post-operative period due t nt immunosuppressive effects on T lymphocytes. When evaluating the effectiveness of unit policies related to personnel agement, which of the following metrics would be most indicative of ess in a hemodialysis unit? he number of patient complaints received Tacrolimus M P A Ans Expl ive regi o its pote man succ T Staff retention rates and job satisfaction surveys The frequency of patient treatments administered The overall cost of staffing for the unit Answer: B Explanation: Staff retention rates and job satisfaction surveys are key indicators of effective personnel management and a positive work environment, directly impacting patient care quality. Which of the following aseptic techniques is critical when initiating hemodialysis to prevent infection during the cannulation process? sing a single-use tourniquet erforming hand hygiene before accessing the vascular access repping the skin with alcohol alone annulating the access site without a mask wer: B anation: Performing hand hygiene before accessing the vascular acces ntial to minimize the risk of infection. It is a key component of aseptic nique. Using a single-use tourniquet and preparing the skin with antise ions are also important, but hand hygiene is the foremost step. ng a safety meeting, a nurse learns that some staff members are not liar with the fire evacuation plan. What should the nurse do to address wledge gap effectively? U P P C Ans Expl s is esse tech ptic solut Duri fami this kno Organize a comprehensive review session Assume they will learn during drills Provide them with written copies of the plan Rely on senior staff to guide them Answer: A Explanation: Organizing a comprehensive review session ensures that all staff members understand the fire evacuation plan fully, enhancing safety preparedness in the unit. ribes the importance of peer-reviewed journals in nursing practice? hey are primarily used for advertising new products in the healthcare stry hey provide a platform for nurses to publish their personal experience hey focus solely on the historical aspects of nursing and do not presen nt data hey ensure that the information disseminated is based on rigorous scie ods and validated research wer: D anation: Peer-reviewed journals are essential in nursing practice as the re that published studies undergo rigorous evaluation by experts, there iding reliable, evidence-based information that practitioners can apply clinical decision-making. In the context of professional literature, which of the following statements best desc T indu T s T t curre T ntific meth Ans Expl y ensu by prov in their In a hemodialysis setting, what is the primary reason for monitoring the pH of the dialysate? To ensure adequate clearance of toxins To maintain patient comfort To facilitate the removal of excess fluid To prevent metabolic acidosis or alkalosis Answer: D Explanation: Monitoring the pH of the dialysate is essential for preventing metabolic acidosis or alkalosis, which can have significant effects on the patient's overall health during hemodialysis. sessing a patient with a newly placed arteriovenous graft, which symp d be most concerning for the nurse indicating potential graft failure? armth at the site ow capillary refill ight redness bsence of a palpable thrill wer: D anation: The absence of a palpable thrill indicates potential graft failu mbosis, which is a critical finding that requires immediate investigatio context of biological agents, which of the following routes of Que In as tom woul W Sl Sl A Ans Expl re or thro n. In the transmission poses the highest risk for healthcare workers in a hemodialysis setting, particularly when handling contaminated blood? Parenteral route Airborne transmission Fecal-oral route Vector-borne transmission Answer: A Explanation: The parenteral route, particularly exposure to contaminated blood through needlesticks, is the most significant risk for healthcare workers in a hemodialysis setting. event of a blood leak detected during dialysis, which of the followin ns should the nurse prioritize? lamp the blood lines and notify the physician crease the blood flow rate ontinue dialysis and monitor the patient lush the lines with saline wer: A anation: Clamping the blood lines and notifying the physician is cruci ent further complications from the blood leak. ituation where a hemodialysis patient presents with hypotension duri ment, which of the following medications might be considered for acu Question: 772 In the g actio C In C F Ans Expl al to prev In a s ng treat te management of this condition? Calcium gluconate Ferrous sulfate Midodrine Furosemide Answer: C Explanation: Midodrine is an oral medication that can help increase blood pressure in patients who experience hypotension during hemodialysis. cted during research is valid and can be replicated by others? ypothesis formulation ata analysis esearch design iterature review wer: C anation: A well-structured research design is vital as it outlines the odology, including how data will be collected and analyzed, ensuring tudy can be replicated and the results validated. When conducting the priming procedure for a new dialyzer, which of the wing actions is essential to prevent air embolism during the initiation sis? In the scientific method, which step is crucial for ensuring that the data colle H D R L Ans Expl meth that the s follo of dialy Connect the dialyzer to the patient before completely priming it. Use a roller clamp to occlude the blood line during priming. Prime the dialyzer with the dialysis bath only, avoiding saline. Ensure that the dialyzer is filled with saline before connecting to the patient. Explanation: Filling the dialyzer with saline before connecting to the patient is crucial to prevent air embolism, as it ensures there are no air bubbles in the blood path. eing used consistently by staff. What is the most effective strategy to ove compliance? onitor staff more closely during procedures crease the availability of PPE in the unit mplement regular training sessions on PPE usage rovide written reminders about PPE policies wer: C anation: Implementing regular training sessions on PPE usage is essen mprove understanding and compliance, ensuring staff are aware of the rtance of PPE in infection control. ch record-keeping format is most effective for tracking the reuse and ning status of dialyzers in a clinical setting? During a safety audit, a nurse finds that personal protective equipment (PPE) is not b impr M In I P Ans Expl tial to i impo Whi clea Spreadsheet Handwritten logs Calendar entries Electronic health records Explanation: Electronic health records provide an efficient and organized method for tracking the reuse and cleaning status of dialyzers, enhancing accessibility and compliance. ypersensitivity reactions and should be carefully monitored in hemodi nts? on sucrose alcium supplements minoglycosides ancomycin wer: D anation: Vancomycin can cause severe hypersensitivity reactions, ding anaphylaxis, making monitoring essential in patients with a histo reactions. is the primary rationale for using multiple immunosuppressive agent anagement of kidney transplant recipients? Which of the following medications is contraindicated in patients with a history of h alysis patie Ir C A V Ans Expl inclu ry of such What s in the m To reduce costs of treatment To minimize the risk of opportunistic infections To simplify the medication regimen To enhance drug efficacy and prevent acute rejection Explanation: The primary rationale for using multiple immunosuppressive agents is to enhance efficacy and minimize the risk of acute rejection by targeting different mechanisms of the immune response.Que
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