CHT Domain 1: Patient Care Welcome to your CHT Domain 1: Patient Care 1. CHT: Patient Care A patient undergoing hemodialysis complains of sudden chest pain and shortness of breath. What is the first action you should take? Administer oxygen Start CPR Call for medical assistance Check blood pressure None 2. CHT: Patient Care During hemodialysis, a patient starts exhibiting signs of disequilibrium syndrome. Which of the following is the most appropriate immediate response? Increase the dialysis rate Decrease the dialysis rate Administer hypertonic saline Stop the dialysis treatment None 3. CHT: Patient Care If a hemodialysis patient experiences a hypotensive episode, what is the first step in management? Administer intravenous fluids Decrease the temperature of the dialysate Increase the dialysate flow rate Lower the patient's head and raise their feet None 4. CHT: Patient Care What is the recommended intervention for managing a high venous pressure alarm during hemodialysis? Check for and correct any kinks in the blood tubing Increase the blood flow rate Decrease the dialysate sodium concentration Administer anticoagulants None 5. CHT: Patient Care A patient's blood pressure falls significantly after initiating dialysis. What dietary advice is most appropriate to prevent future episodes? Increase fluid intake before dialysis Decrease potassium-rich foods Increase protein intake Limit pre-dialysis fluid intake None 6. CHT: Patient Care For a patient experiencing muscle cramps during dialysis, which intervention is appropriate? Administer a muscle relaxant Adjust the dialysate calcium level Increase the dialysate temperature Decrease the treatment time None 7. CHT: Patient Care What is the best approach to handling a patient who becomes agitated and confused during dialysis? Sedate the patient Reassure and reorient the patient Immediately discontinue treatment Increase the rate of dialysis None 8. CHT: Patient Care A dialysis patient has a persistent fever with no obvious source of infection. What should be the initial approach to manage this symptom? Start empirical antibiotics Perform a detailed assessment and culture any suspicious sites Increase the frequency of dialysis sessions Adjust the patient's medication regimen None 9. CHT: Patient Care How should hyperkalemia be addressed during a hemodialysis session? Administer glucose and insulin Increase the potassium content in the dialysate Adjust the dialysis membrane surface area Modify the potassium gradient in the dialysate None 10. CHT: Patient Care What is the most appropriate action for managing a hemodialysis patient who develops pruritus (itching)? Administer an oral antihistamine Increase the temperature of the dialysate Prescribe opioid analgesics Apply a topical corticosteroid None 11. CHT: Patient Care During a hemodialysis session, a patient complains of a headache and nausea. What should be the first step? Stop the dialysis session Administer antiemetics Check the dialysate composition Reduce the blood flow rate None 12. CHT: Patient Care For a patient with an AV graft, what is the best practice for needle insertion during hemodialysis? Use the buttonhole technique Rotate the needle insertion sites Always insert at the same site Insert at the highest flow area None 13. CHT: Patient Care If a patient experiences a seizure during dialysis, what is the most appropriate response? Continue the dialysis session while monitoring Administer an intravenous antiseizure medication Stop the dialysis and maintain airway, breathing, and circulation Position the patient upright None 14. CHT: Patient Care Which action is recommended for managing a patient with high interdialytic weight gain? Advise the patient to consume more sodium Encourage strict dietary fluid restrictions Decrease the dialysis session length Increase the dialysate calcium concentration None 15. CHT: Patient Care What is the primary consideration when adjusting the dialysis prescription for a patient with low residual renal function? Increase dialysis duration Decrease the dialysate flow rate Use a high-flux membrane Adjust the anticoagulant dosage None 16. CHT: Patient Care How should a technician respond to a dialysis machine displaying repeated high conductivity alarms? Reset the conductivity meter Check and adjust the dialysate concentrate mixture Increase the water flow rate Replace the conductivity sensor None 17. CHT: Patient Care What is the correct procedure when a patient exhibits signs of an allergic reaction to the dialyzer membrane? Switch to a different type of membrane immediately Administer an antihistamine and continue the session Stop the dialysis and administer epinephrine if severe Reduce the blood flow rate and monitor the patient None 18. CHT: Patient Care When observing a decrease in dialysis efficiency, what should be considered as a possible cause? The patient's diet Inadequate heparinization An increase in patient's physical activity Change in patient's medication None 19. CHT: Patient Care In the case of blood leakage from the dialyzer, what is the most appropriate immediate action? Continue monitoring the leakage Stop the treatment and replace the dialyzer Decrease the blood flow rate Check for leaks in the tubing None 20. CHT: Patient Care What should be done if a patient on hemodialysis develops sudden anaphylactic symptoms after using a new type of heparin? Administer oral antihistamines Discontinue the heparin and administer epinephrine Decrease the dialysis flow rate Apply a cold compress to the site of injection None 21. CHT: Patient Care For patients experiencing frequent hypoglycemic episodes during dialysis, what dietary adjustment is most recommended? Increase protein intake Reduce carbohydrate intake before sessions Increase carbohydrate intake before sessions Eliminate snacks during dialysis None 22. CHT: Patient Care What is the recommended action for a patient who consistently shows elevated blood pressure readings only during dialysis sessions? Adjust antihypertensive medications Evaluate the dry weight setting Increase the sodium content in the dialysate Perform ultrafiltration more frequently None 23. CHT: Patient Care A hemodialysis patient complains of feeling cold during sessions, especially in the extremities. What is the first step to address this? Increase the dialysate temperature Provide additional blankets Check for blood access issues Reduce the blood flow rate None 24. CHT: Patient Care How should a technician address a situation where a patient's vascular access begins to show signs of thrombosis? Apply a warm compress Immediately schedule for surgical evaluation Administer a thrombolytic agent at the site Increase heparin dosage during dialysis None 25. CHT: Patient Care What is the best approach when a patient on hemodialysis reports persistent insomnia? Recommend over-the-counter sleep aids Refer to a sleep specialist for evaluation Increase dialysis frequency Adjust the timing of dialysis sessions None 26. CHT: Patient Care When noticing a gradual decrease in a patient's hematocrit levels during consecutive dialysis sessions, what is the most likely action needed? Initiate iron supplementation Reduce heparin dosage Increase erythropoietin administration Decrease dialysis frequency None 27. CHT: Patient Care What intervention is appropriate for a hemodialysis patient who develops pedal edema? Reduce fluid intake between sessions Increase fluid intake between sessions Decrease dialysis duration Administer diuretics None 28. CHT: Patient Care In cases where a patient develops a fever during dialysis, what is the initial step that should be taken? Stop the dialysis session and assess the patient Increase the flow rate of the dialysate Administer antipyretics immediately Continue the session while monitoring temperature None 29. CHT: Patient Care What should be done if a patient experiences severe pain at the dialysis catheter site? Adjust the catheter position Prescribe pain medication Schedule an immediate X-ray Apply a topical antibiotic None 30. CHT: Patient Care A hemodialysis patient presents with elevated phosphorus levels despite dietary restrictions. What is the next best step in management? Increase dialysis session length Administer phosphate binders Decrease dialysate calcium Prescribe calcium supplements None 31. CHT: Patient Care When a patient complains of sudden dizziness and tinnitus during hemodialysis, what should be considered first? Ear infection Disequilibrium syndrome Hypoglycemia Medication side effect None 32. CHT: Patient Care What is the appropriate response if a patient on hemodialysis has consistently low post-dialysis potassium levels? Decrease the potassium in the dialysate Increase the potassium in the dialysate Administer potassium supplements orally Reduce the frequency of dialysis sessions None 33. CHT: Patient Care For a patient experiencing xerostomia (dry mouth) during dialysis, which intervention is most appropriate? Provide sugar-free candies or gum Increase fluid intake during dialysis Prescribe anticholinergic medications Administer intravenous fluids None 34. CHT: Patient Care In the case where a dialysis patient experiences post-dialysis fatigue regularly, what should be evaluated? The adequacy of dialysis clearance The patient's sleep quality The patient's caloric intake All of the above None 35. CHT: Patient Care A hemodialysis patient reports severe back pain only during dialysis sessions. What is the most likely cause? Poor posture during treatment Dialysate temperature too low Underlying kidney disease Dialysis catheter displacement None 36. CHT: Patient Care When a patient's blood tests show consistently elevated bicarbonate levels post-dialysis, what adjustment should be made? Increase the bicarbonate in the dialysate Decrease the bicarbonate in the dialysate Increase the dialysis frequency Administer acidifying medications None 37. CHT: Patient Care What is the best practice for a technician when a patient expresses anxiety about needle insertion for AV fistula access? Use a smaller gauge needle Provide psychological counseling Use a numbing cream prior to insertion All of the above None 38. CHT: Patient Care How should a dialysis technician respond when a high-efficiency particulate air (HEP filter alarm sounds on a dialysis machine? A) Reset the machine Replace the HEPA filter immediately Check and clean the air intake system Continue the session and monitor the patient None 39. CHT: Patient Care What is the correct action if a patient experiences a venous pressure alarm during hemodialysis? Increase the blood flow rate Decrease the blood flow rate Check for kinks in the venous line Administer a bolus of saline None 40. CHT: Patient Care What is the appropriate action when a hemodialysis patient shows symptoms of air embolism? Increase the blood flow rate Place the patient in a supine position Administer supplemental oxygen and place in the Trendelenburg position Apply a warm compress to the access site None 41. CHT: Patient Care A dialysis patient exhibits signs of hypercalcemia. What is the most likely adjustment needed in their treatment protocol? Increase the calcium content in the dialysate Reduce the calcium content in the dialysate Administer calcium supplements Decrease the dialysis frequency None 42. CHT: Patient Care For a patient experiencing excessive bleeding at the vascular access site post-dialysis, what is the first course of action? Apply pressure and elevate the limb Administer a coagulant Perform a vascular surgery consultation Reduce anticoagulant dose for the next session None 43. CHT: Patient Care What is the appropriate intervention if a patient develops pericarditis as a complication of end-stage renal disease? Increase fluid removal during dialysis Initiate anti-inflammatory medication Adjust the dialysate pH Schedule an echocardiogram and start appropriate medication None 44. CHT: Patient Care How should a technician manage a patient who becomes increasingly lethargic and disoriented during a dialysis session? Decrease the dialysate temperature Test blood glucose levels and manage accordingly Increase the blood flow rate Administer a stimulant None 45. CHT: Patient Care When encountering a high arterial pressure alarm during hemodialysis, what should be the technician's first response? Check for arterial line obstructions Increase the anticoagulant dosage Decrease the blood flow rate Administer hypertensive medication None 46. CHT: Patient Care A patient on hemodialysis develops gout. What dietary recommendation is most appropriate? Increase protein intake Decrease consumption of high-purine foods Increase fluid intake between sessions Increase calcium intake None 47. CHT: Patient Care What is the correct procedure if a patient reports burning sensation at the dialysis catheter site during treatment? Discontinue the session immediately Apply a topical anesthetic Flush the catheter with saline Check for signs of infection and inflammation None 48. CHT: Patient Care How should hypernatremia be managed during hemodialysis? Increase sodium in the dialysate Reduce sodium in the dialysate Administer sodium bicarbonate Increase fluid intake during dialysis None 49. CHT: Patient Care What is the most effective way to handle a situation where the patient feels claustrophobic during dialysis sessions? Administer anxiolytics Use distraction techniques such as music or television Provide a private room Shorten the dialysis sessions None 50. CHT: Patient Care What is the recommended protocol for managing hypocalcemia detected during a hemodialysis session? Administer intravenous calcium Decrease the dialysate calcium level Increase phosphate binders Administer oral calcium supplements after the session None 1 out of 50 Time is Up! Time's up
