BONENT Certified Hemodialysis Nurse (CHN) Practice Test

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Question: 1
What is the recommended procedure for achieving hemostasis of various internal blood accesses after dialysis?
A. Apply pressure with sterile gauze for 5 minutes
B. Apply a tourniquet above the access site
C. Administer a hemostatic agent
D. Suture the access site closed
Answer: A
Explanation: The recommended procedure for achieving hemostasis of various internal blood accesses after dialysis is to apply pressure with sterile gauze for 5 minutes. Applying pressure helps to promote clot formation and prevent bleeding from the access site. Applying a tourniquet above the access site is not appropriate as it may impede blood flow and cause complications. Administering a hemostatic agent or suturing the access site closed is not typically necessary for achieving hemostasis after dialysis and may increase the risk of infection or other complications.
Question: 2
What are the AAMI Standards for Dialysate Supply Systems?
A. Standards for regulating dialysis fluid flow rate
B. Standards for monitoring dialysis fluid temperature
C. Standards for maintaining dialysate composition and purity
D. Standards for disinfection of dialysis machines
Answer: C Explanation: The AAMI Standards for Dialysate Supply Systems are standards that ensure the maintenance of dialysate composition and purity. These standards define the acceptable ranges for various parameters, such as conductivity, pH, and endotoxin levels, in the dialysate used for hemodialysis.
Question: 3
Which of the following is a disinfectant commonly used for cleaning dialysis machines?
A. Sodium hypochlorite (bleach)
B. Hydrogen peroxide
C. Ethanol
D. All of the above
Answer: D
Explanation: Sodium hypochlorite (bleach), hydrogen peroxide, and ethanol are all commonly used disinfectants for cleaning dialysis machines. These disinfectants help to eliminate bacteria, viruses, and other microorganisms that may be present on the surfaces of the machine.
Question: 4
Which of the following is a correct technique for altering the composition of the dialysis bath?
A. Adding medications directly to the dialysate
B. Adjusting the temperature of the dialysate
C. Modifying the dialysate flow rate
D. Increasing the dialyzer surface area
Answer: A Explanation: Adding medications directly to the dialysate is a correct technique for altering the composition of the dialysis bath. Certain medications or additives may be prescribed for specific patients to address their individual needs during dialysis. Adjusting the temperature of the dialysate is important for maintaining patient comfort but does not directly alter the composition of the bath. Modifying the dialysate flow rate and increasing the dialyzer surface area are not techniques for altering the composition of the dialysis bath.
Question: 5
Which of the following accurately describes the types of dialysis baths used in hemodialysis?
A. Acidic, alkaline, and neutral dialysis baths.
B. Hypotonic, hypertonic, and isotonic dialysis baths.
C. Normal saline, glucose, and electrolyte-based dialysis baths.
D. Bicarbonate-based, acetate-based, and citrate-based dialysis baths.
Answer: D
Explanation: The types of dialysis baths used in hemodialysis treatments can be categorized based on their chemical composition. The most common types are bicarbonate-based, acetate-based, and citrate-based dialysis baths. These baths contain specific concentrations of bicarbonate, acetate, or citrate, which help maintain the acid-base balance, electrolyte levels, and pH of the patient's blood during the dialysis process. The choice of dialysis bath depends on the patient's specific needs and the recommendation of the healthcare provider.
Question: 6
What is the chemical composition of a dialysis bath?
A. Sterile water and electrolytes
B. Saline solution and glucose
C. Distilled water and bicarbonate
D. Sterile water and anticoagulant
Answer: A
Explanation: The chemical composition of a dialysis bath typically consists of sterile water and electrolytes. These electrolytes, such as sodium, potassium, calcium, and bicarbonate, are carefully balanced to create a solution that closely resembles the composition of normal blood plasma.
Question: 7
What is the purpose of monitors and alarms in dialysis fluid delivery systems?
A. To measure patient's blood pressure
B. To monitor dialysis fluid temperature
C. To detect and alert for system errors or malfunctions
D. To regulate the flow rate of dialysis fluid
Answer: C
Explanation: Monitors and alarms in dialysis fluid delivery systems are designed to detect and alert for system errors or malfunctions. They provide important safety features by monitoring various parameters, such as pressure, temperature, and flow rates, and triggering alarms if any abnormalities are detected.
Question: 8
Which of the following accurately describes the purpose of priming and testing procedures for dialyzers?
A. Priming and testing procedures ensure the accurate measurement of blood pressure during dialysis.
B. Priming and testing procedures verify the chemical composition of dialysis fluid before it enters the dialyzer.
C. Priming and testing procedures remove air bubbles and ensure proper functioning of the dialyzer.
D. Priming and testing procedures regulate the flow rate of dialysis fluid through the dialyzer.
Answer: C
Explanation: Priming and testing procedures for dialyzers are critical steps to ensure the optimal functioning of the dialysis process. Priming involves removing air bubbles from the dialyzer and filling it with dialysis fluid. By eliminating air bubbles, priming ensures that the dialyzer can effectively filter the patient's blood. Testing procedures, on the other hand, involve checking for any leaks or malfunctions in the dialyzer before the dialysis treatment begins. These steps help maintain the integrity of the dialysis process and ensure the safety of the patient.
Question: 9
Which of the following accurately describes the purpose of disinfectants in the context of dialysis fluid delivery systems?
A. Disinfectants are used to regulate the flow rate of dialysis fluid.
B. Disinfectants are used to neutralize abnormal functions in dialysis fluid delivery systems.
C. Disinfectants are used to eliminate bacteria and prevent contamination in dialysis fluid.
D. Disinfectants are used to alter the chemical composition of dialysis fluid.
Answer: C
Explanation: Disinfectants are an essential component of dialysis fluid delivery systems. Their primary purpose is to eliminate bacteria and prevent contamination of the dialysis fluid, ensuring the safety and well-being of the patient. By effectively neutralizing potential pathogens, disinfectants help maintain the integrity of the dialysis process and minimize the risk of infection.
Question: 10
Which of the following is a function of dialysis fluid delivery systems?
A. Regulating blood pressure
B. Removing waste products
C. Regulating blood sugar levels
D. Regulating electrolyte balance
Answer: B
Explanation: The function of dialysis fluid delivery systems is to remove waste products from the patient's blood. These systems allow for the exchange of solutes and fluid across a semipermeable membrane, facilitating the removal of waste products and excess fluid from the bloodstream.
Question: 11
What are the potential problems and emergencies associated with the termination of dialysis?
A. Hypotension (low blood pressure)
B. Bleeding at the access site
C. Air embolism
D. All of the above
Answer: D
Explanation: The termination of dialysis can be associated with several potential problems and emergencies. These may include hypotension (low blood pressure), bleeding at the access site, and the risk of air embolism. Hypotension can occur due to rapid fluid removal, bleeding can occur if the access site is not properly managed or if there is a clotting issue, and air embolism can occur if air enters the bloodstream during the disconnection of the dialysis circuit.
Question: 12
Which of the following is not a function of monitors and alarms in dialysis fluid delivery systems?
A. Detecting air in the fluid lines
B. Monitoring the temperature of the dialysate
C. Alerting to excessive pressure in the system
D. Adjusting the flow rate of the dialysate
Answer: D
Explanation: Monitors and alarms in dialysis fluid delivery systems serve various functions to ensure the safety and proper functioning of the system. They detect air in the fluid lines to prevent air embolism, monitor the temperature of the dialysate to ensure it is within the acceptable range, and alert to excessive pressure in the system to prevent damage or injury to the patient. However, adjusting the flow rate of the dialysate is not a function of monitors and alarms. The flow rate is typically set manually by the healthcare provider based on the patient's needs and prescription.
Question: 13
What are the techniques for altering the composition of the dialysis bath?
A. Adjusting the concentration of electrolytes
B. Adding medications or supplements
C. Changing the pH of the solution
D. All of the above
Answer: D
Explanation: Techniques for altering the composition of the dialysis bath may include adjusting the concentration of electrolytes, adding medications or supplements, and changing the pH of the solution. These techniques allow for customization of the dialysis treatment to meet the specific needs of the patient.
Question: 14
If hemolysis occurs during the patient's dialysis treatment, which of the following interventions would not be correct?
A. Continue the dialysate flow
B. Check the patient’s hematocrit
C. Transfuse blood if needed.
D. Stop the dialysate flow
Answer: A
Explanation: Continuing the dialysate flow would not be the correct intervention if hemolysis occurs during the patient's dialysis treatment. Hemolysis refers to the breakdown of red blood cells, which can lead to the release of hemoglobin into the bloodstream. If hemolysis occurs, it is important to stop the dialysate flow to prevent further damage to the patient's blood cells and to assess the situation. Checking the patient's hematocrit (the percentage of red blood cells in the blood) is a valid intervention to evaluate the extent of hemolysis. If severe hemolysis has occurred and the patient's blood volume is significantly reduced, transfusing blood may be necessary to restore the blood volume and prevent complications. However, the first step should be to stop the dialysate flow and assess the situation before determining the appropriate course of action.
Question: 15
Which of the following accurately describes the role of AAMI Standards for Dialysate Supply Systems?
A. AAMI Standards provide guidelines for the use of disinfectants in dialysate supply systems.
B. AAMI Standards define the chemical composition of dialysate used in hemodialysis.
C. AAMI Standards regulate the types of monitors and alarms used in dialysate supply systems.
D. AAMI Standards establish safety and quality standards for the design and operation of dialysate supply systems.
Answer: D
Explanation: AAMI Standards for Dialysate Supply Systems play a crucial role in ensuring the safety and quality of dialysis treatments. These standards set guidelines for the design, installation, operation, and maintenance of dialysate supply systems. By adhering to AAMI Standards, healthcare facilities can establish protocols that minimize the risk of complications and ensure consistent delivery of high-quality dialysis treatments.
Question: 16
What are the corrective actions for abnormal functions of dialysis fluid delivery systems?
A. Adjusting the flow rate
B. Checking for leaks
C. Calibrating sensors
D. All of the above
Answer: D
Explanation: Corrective actions for abnormal functions of dialysis fluid delivery systems may include adjusting the flow rate, checking for leaks in the system, and calibrating sensors. These actions help ensure the proper functioning of the system and accurate delivery of dialysis fluid to the patient.
Question: 17
Which of the following is a recommended disinfectant for cleaning dialysis machines?
A. Bleach (sodium hypochlorite)
B. Rubbing alcohol (isopropyl alcohol)
C. Hydrogen peroxide
D. Ammonia
Answer: A
Explanation: Bleach (sodium hypochlorite) is a recommended disinfectant for cleaning dialysis machines. It is effective against a wide range of microorganisms and is commonly used in healthcare settings for surface disinfection. Rubbing alcohol (isopropyl alcohol) and hydrogen peroxide are also commonly used disinfectants, but they are not typically recommended for cleaning dialysis machines due to their potential to damage certain components of the machine. Ammonia is not an appropriate disinfectant for dialysis machines.
Question: 18
What are dialyzers?
A. Devices used to measure blood pressure during dialysis
B. Filters used for removing waste products during dialysis
C. Monitors used to detect air bubbles in the dialysis circuit
D. Devices used to warm the dialysis fluid before it enters the patient
Answer: B
Explanation: Dialyzers are filters used for removing waste products from the blood during dialysis. They consist of a semipermeable membrane that allows the passage of small molecules, such as waste products and excess fluid, while retaining larger molecules, such as proteins and blood cells.

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