CHT Patient Assessment and Monitoring in Dialysis 3

Question 1

Which clinical presentation is most characteristic of dialysis disequilibrium syndrome?

Accepted Answer

Headache, nausea, confusion, and possible seizures

Answer

Severe hyperkalemia with peaked T-waves on electrocardiogram

Answer

Fever, rigors, and hypotension suggesting bacteremia

Answer

Sudden severe hypotension with immediate loss of consciousness

Question 2

What is the normal oxygen saturation (SpO2) range for a healthy adult as measured by pulse oximetry?

Accepted Answer

95–100%

Answer

85–90%

Answer

75–85%

Answer

90–94%

Question 3

During hemodialysis, a sudden drop in the venous pressure alarm most likely indicates which problem?

Accepted Answer

Needle dislodgment or disconnection in the venous return line

Answer

High blood flow rate causing circuit overpressure

Answer

Dialyzer fiber clotting increasing circuit resistance

Answer

Air bubbles accumulating in the venous blood line

Question 4

Before cannulating a patient's arteriovenous fistula, which assessment must ALWAYS be performed first?

Accepted Answer

Inspect and palpate the access site for thrill, bruit, redness, swelling, and pain

Answer

Measure blood pressure in the arm that contains the fistula

Answer

Draw blood cultures from the fistula to screen for active infection

Answer

Irrigate the fistula site with heparinized saline solution

Question 5

A patient develops muscle cramps during hemodialysis. What is the most likely underlying cause?

Accepted Answer

Rapid or excessive fluid removal causing hypovolemia and reduced muscle perfusion

Answer

Hyperglycemia caused by glucose in the dialysate solution

Answer

Dialysate temperature programmed above recommended levels

Answer

Blood flow rate set above the prescribed level for the patient

Question 6

A patient reports new-onset chest pain during hemodialysis. What is the technician's FIRST action?

Accepted Answer

Notify the nurse immediately while remaining with the patient and monitoring vital signs

Answer

Stop the blood pump and initiate a normal saline bolus immediately

Answer

Apply oxygen via nasal cannula per standing protocol orders

Answer

Reduce the blood flow rate by half and continue monitoring

Question 7

A hemodialysis patient develops a fever (temperature >38°C) during treatment. What is the most likely cause?

Accepted Answer

Bacteremia or a pyrogenic reaction from contaminated water or inadequately reprocessed dialyzer

Answer

Dialysate temperature set below the recommended range causing vasoconstriction

Answer

Hypoglycemia triggering an adrenergic sympathetic stress response

Answer

Excessive ultrafiltration rate causing hemodynamic instability