CCHT Patient Assessment 2

Question 1

What is the primary purpose of weighing a dialysis patient before and after each treatment?

Accepted Answer

To calculate fluid removal (UF) goal and assess post-treatment dry weight achievement

Answer

To monitor for weight gain from increased muscle mass

Answer

To determine if the patient is eating adequately

Answer

To adjust EPO dosing based on body weight

Question 2

During pre-treatment assessment, a patient reports taking a new herbal supplement for kidney health. What is the most appropriate response?

Accepted Answer

Document the supplement, inform the charge nurse, and ask the patient not to take it until cleared by the nephrologist

Answer

Tell the patient herbal supplements are safe and not to worry

Answer

Advise the patient that all natural supplements are safe for dialysis patients

Answer

Ignore the information as it is not medically relevant

Question 3

When assessing a patient's vascular access before cannulation, which finding requires withholding cannulation and notifying the charge nurse?

Accepted Answer

A large, firm, non-compressible hematoma directly over the intended needle sites

Answer

A palpable thrill extending along the fistula

Answer

Mild warmth of the skin overlying the fistula

Answer

A faint bruit heard on auscultation

Question 4

What does a positive Tinel's sign at the wrist suggest in a long-term hemodialysis patient with an upper arm access?

Accepted Answer

Carpal tunnel syndrome, commonly caused by beta-2 microglobulin amyloid deposits

Answer

Good arterial blood flow through the fistula

Answer

Normal neurological function

Answer

Early signs of vascular access stenosis

Question 5

A patient on dialysis has a serum albumin of 2.8 g/dL. What does this value indicate and why is it clinically significant?

Accepted Answer

Malnutrition with poor prognosis; requires nutritional intervention and dietary consultation

Answer

Normal albumin; no intervention needed

Answer

Excessive protein intake requiring dietary restriction

Answer

Fluid overload diluting albumin levels only

Question 6

During assessment, a patient's blood pressure is 185/110 mmHg pre-dialysis. What information is most important to collect before proceeding?

Accepted Answer

Current medications taken that day, compliance with antihypertensives, and comparison to baseline BP

Answer

Patient's dietary sodium intake from the previous day

Answer

The type of blood pressure cuff used

Answer

Patient's most recent Kt/V value