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Certified Hemodialysis Nurse Practice Test

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Nursing
BONENT-CHN
BONENT Certified Hemodialysis Nurse (CHN)
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Question: 762
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?
A. Assess for signs of infection at the access site
B. Offer the patient a snack to Excellerate energy levels
C. Notify the healthcare provider immediately
D. Encourage the patient to engage in conversation
Answer: C
Explanation: A change in mental status may indicate serious complications
such as uremic encephalopathy or electrolyte imbalances, requiring prompt
notification of the healthcare provider for further evaluation and intervention.
Question: 763
In managing a patient with a central venous catheter, what is the most effective
method for ensuring that the catheter remains patent and free from occlusions?
A. Keeping the catheter capped at all times
B. Flushing with saline and heparin regularly
C. Avoiding any movement of the catheter
D. 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.
Question: 764
In the context of kidney transplantation, which immunosuppressive agent is
commonly used to prevent acute rejection during the initial post-operative
period?
A. Tacrolimus
B. Mycophenolate mofetil
C. Prednisone
D. Azathioprine
Answer: A
Explanation: Tacrolimus is commonly used as part of the immunosuppressive
regimen to prevent acute rejection in the initial post-operative period due to its
potent immunosuppressive effects on T lymphocytes.
Question: 765
When evaluating the effectiveness of unit policies related to personnel
management, which of the following metrics would be most indicative of
success in a hemodialysis unit?
A. The number of patient complaints received
B. Staff retention rates and job satisfaction surveys
C. The frequency of patient treatments administered
D. 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.
Question: 766
Which of the following aseptic techniques is critical when initiating
hemodialysis to prevent infection during the cannulation process?
A. Using a single-use tourniquet
B. Performing hand hygiene before accessing the vascular access
C. Prepping the skin with alcohol alone
D. Cannulating the access site without a mask
Answer: B
Explanation: Performing hand hygiene before accessing the vascular access is
essential to minimize the risk of infection. It is a key component of aseptic
technique. Using a single-use tourniquet and preparing the skin with antiseptic
solutions are also important, but hand hygiene is the foremost step.
Question: 767
During a safety meeting, a nurse learns that some staff members are not
familiar with the fire evacuation plan. What should the nurse do to address this
knowledge gap effectively?
A. Organize a comprehensive review session
B. Assume they will learn during drills
C. Provide them with written copies of the plan
D. 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.
Question: 768
In the context of professional literature, which of the following statements best
describes the importance of peer-reviewed journals in nursing practice?
A. They are primarily used for advertising new products in the healthcare
industry
B. They provide a platform for nurses to publish their personal experiences
C. They focus solely on the historical aspects of nursing and do not present
current data
D. They ensure that the information disseminated is based on rigorous scientific
methods and validated research
Answer: D
Explanation: Peer-reviewed journals are essential in nursing practice as they
ensure that published studies undergo rigorous evaluation by experts, thereby
providing reliable, evidence-based information that practitioners can apply in
their clinical decision-making.
Question: 769
In a hemodialysis setting, what is the primary reason for monitoring the pH of
the dialysate?
A. To ensure adequate clearance of toxins
B. To maintain patient comfort
C. To facilitate the removal of excess fluid
D. 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.
Question: 770
In assessing a patient with a newly placed arteriovenous graft, which symptom
would be most concerning for the nurse indicating potential graft failure?
A. Warmth at the site
B. Slow capillary refill
C. Slight redness
D. Absence of a palpable thrill
Answer: D
Explanation: The absence of a palpable thrill indicates potential graft failure or
thrombosis, which is a critical finding that requires immediate investigation.
Question: 771
In the context of biological agents, which of the following routes of
transmission poses the highest risk for healthcare workers in a hemodialysis
setting, particularly when handling contaminated blood?
A. Parenteral route
B. Airborne transmission
C. Fecal-oral route
D. 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.
Question: 772
In the event of a blood leak detected during dialysis, which of the following
actions should the nurse prioritize?
A. Clamp the blood lines and notify the physician
B. Increase the blood flow rate
C. Continue dialysis and monitor the patient
D. Flush the lines with saline
Answer: A
Explanation: Clamping the blood lines and notifying the physician is crucial to
prevent further complications from the blood leak.
Question: 773
In a situation where a hemodialysis patient presents with hypotension during
treatment, which of the following medications might be considered for acute
management of this condition?
A. Calcium gluconate
B. Ferrous sulfate
C. Midodrine
D. Furosemide
Answer: C
Explanation: Midodrine is an oral medication that can help increase blood
pressure in patients who experience hypotension during hemodialysis.
Question: 774
In the scientific method, which step is crucial for ensuring that the data
collected during research is valid and can be replicated by others?
A. Hypothesis formulation
B. Data analysis
C. Research design
D. Literature review
Answer: C
Explanation: A well-structured research design is vital as it outlines the
methodology, including how data will be collected and analyzed, ensuring that
the study can be replicated and the results validated.
Question: 775
When conducting the priming procedure for a new dialyzer, which of the
following actions is essential to prevent air embolism during the initiation of
dialysis?
A. Connect the dialyzer to the patient before completely priming it.
B. Use a roller clamp to occlude the blood line during priming.
C. Prime the dialyzer with the dialysis bath only, avoiding saline.
D. Ensure that the dialyzer is filled with saline before connecting to the patient.
Answer: D
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.
Question: 776
During a safety audit, a nurse finds that personal protective equipment (PPE) is
not being used consistently by staff. What is the most effective strategy to
improve compliance?
A. Monitor staff more closely during procedures
B. Increase the availability of PPE in the unit
C. Implement regular training sessions on PPE usage
D. Provide written reminders about PPE policies
Answer: C
Explanation: Implementing regular training sessions on PPE usage is essential
to Excellerate understanding and compliance, ensuring staff are aware of the
importance of PPE in infection control.
Question: 777
Which record-keeping format is most effective for tracking the reuse and
cleaning status of dialyzers in a clinical setting?
A. Spreadsheet
B. Handwritten logs
C. Calendar entries
D. Electronic health records
Answer: D
Explanation: Electronic health records provide an efficient and organized
method for tracking the reuse and cleaning status of dialyzers, enhancing
accessibility and compliance.
Question: 778
Which of the following medications is contraindicated in patients with a history
of hypersensitivity reactions and should be carefully monitored in hemodialysis
patients?
A. Iron sucrose
B. Calcium supplements
C. Aminoglycosides
D. Vancomycin
Answer: D
Explanation: Vancomycin can cause severe hypersensitivity reactions,
including anaphylaxis, making monitoring essential in patients with a history of
such reactions.
Question: 779
What is the primary rationale for using multiple immunosuppressive agents in
the management of kidney transplant recipients?
A. To reduce costs of treatment
B. To minimize the risk of opportunistic infections
C. To simplify the medication regimen
D. To enhance drug efficacy and prevent acute rejection
Answer: D
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.
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