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Which of the following pathologies put patients at high risk for acute renal failure?
a) Uncontrolled diabetes
b) Shock
c) Polycystic kidney disease
d) Hypertension
b) Shock
What is continuous ambulatory peritoneal dialysis?
a) A type of dialysis that is performed while walking
b) A mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution
c) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is lowered below the level of an abdominal catheter to fill the abdominal cavity and raised above the level of the abdominal catheter to drain the fluid out
d) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out
d) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out
Patients who dialyze at home are at high risk for what type of infection?
a) Peritonitis
b) Cellulitis
c) Decubitus ulcers
d) Fistula infection
a) Peritonitis
You are attending to an end-stage renal disease (ESRD) patient who has missed dialysis. Which of the following statements is most accurate?
a) You should delay transport if necessary to wait for ALS
b) Patients who have missed dialysis and who become unresponsive and pulseless respond very well to the use of an AED
c) Calling for ALS would not be very helpful because they cannot really do anything that an EMT cannot do in these situations
d) Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED
d) Patients who have missed dialysis and who become unresponsive and pulseless do not respond very well to the use of an AED
Which of the following is the most accurate definition of anemia?
a) A lack of a normal number of red blood cells in the circulation
b) The loss of the kidneys' ability to filter the blood and remove toxins and excess fluid from the body
c) An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure of the red blood cells
d) The process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys
a) A lack of a normal number of red blood cells in the circulation
Which of the following organs may be seriously damaged in sickle cell anemia, subsequently leading to severe infections?
a) Spleen
b) Lungs
c) Liver
d) Kidneys
a) Spleen
What is a cycle of filling and draining of the abdominal cavity during peritoneal dialysis called?
a) Set
b) Trade
c) Rotation
d) Exchange
d) Exchange
You are dispatched to a private residence for a sick person. When you arrive, you are told by the patient that due to the snow storm yesterday he missed his scheduled appointment at the dialysis center and is not feeling well. Your assessment does not reveal anything remarkable outside of the fact that he has missed his dialysis. Which of the steps below would not be part of your care?
a) When you obtain vital signs, obtain a blood pressure on an arm that does not have a fistula
b) Assess the ABCs
c) Administer oxygen at 15 lpm by nonrebreather mask
d) Place the patient in a supine position
d) Place the patient in a supine position
Patients with a history of chronic sickle cell anemia (SCA) may present with which of the following signs and symptoms?
a) Yellowing of the skin and dyspnea on exertion
b) Pale appearance and dyspnea on exertion
c) Bluish discoloration of the skin and shortness of breath
d) Flushed appearance and shortness of breath
a) Yellowing of the skin and dyspnea on exertion
How long does a typical hemodialysis treatment last?
a) 1 to 2 hours
b) 10 to 12 hours
c) 7 to 8 hours
d) 3 to 4 hours
d) 3 to 4 hours
________ patients are at high risk for acquiring the inherited disorder called sickle cell anemia.
a) Hispanic
b) Native American
c) Eastern European
d) African American
d) African American
Approximately how many Americans are currently on some type of dialysis?
a) 200,000
b) 900,000
c) 100,000
d) 450,000
d) 450,000
How frequently is peritoneal dialysis treatment required?
a) Multiple treatments per day
b) Three to five times per week
c) Once a week
d) Once a day
a) Multiple treatments per day
Platelets are actually fragments of larger cells that are crucial to the formation of clots. Clumping (called aggregation) of platelets is the body's most rapid response to stop bleeding from an injured site. However, in some situations the clumping of platelets is not desirable, such as when a plaque in a coronary artery ruptures. In this situation, the rapid clumping of platelets can cause a clot that then completely blocks the coronary artery and results in a heart attack (myocardial infarction). One of the most effective and widely available drugs to prevent the aggregation of platelets is:
a) aspirin
b) acetaminophen
c) hemoglobin
d) plasma
a) aspirin
You are dispatched to a private residence for a sick person. You arrive and find a 47-year-old male patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement. One of the more serious complications of this type of dialysis is a bacterial infection within the peritoneal cavity. What would be the tell-tale sign that this is what is happening in this case?
a) The patient's dialysis fluid appears clear when it is drained from the peritoneal cavity rather than having its normal cloudy appearance
b) The patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance
c) The patient has trouble urinating
d) The patient has swollen ankles
b) The patient's dialysis fluid appears cloudy when it is drained from the peritoneal cavity rather than having its normal clear appearance
Once you encounter uncontrolled bleeding from an AV fistula, which of the following methods would you consider using to control bleeding in addition to direct pressure and elevation?
a) Pressure points
b) Hemostatic dressings
c) Internal wound management
d) Tourniquet
b) Hemostatic dressings
Under which of the following circumstances do the kidneys help the body retain fluid?
a) Urinary tract infection
b) Kidney stones
c) Electrolyte imbalance
d) Dehydration
d) Dehydration
You are dispatched to an unconscious hemodialysis patient. On arrival to the dialysis clinic, the patient is unresponsive, apneic, and pulseless. You secure the ABCs, begin ventilation, and initiate chest compressions. However, the patient's cardiac arrest rhythm is continuously unresponsive to defibrillations with your AED. The best approach is to:
a) begin transporting and contact an ALS intercept. The patient's dysrhythmia may be related to kidney failure
b) continue defibrillating as the monitor recommends. The myocardium becomes increasingly responsive to successive defibrillations
c) call online medical control to terminate the code. The probability of survival is too low to continue resuscitation efforts
d) run a "no-electricity" code in which compressions and ventilation are continued. No additional defibrillations are necessary
a) begin transporting and contact an ALS intercept. The patient's dysrhythmia may be related to kidney failure
What is one of the most common diseases to affect the renal and urinary system?
a) Urinary tract infections
b) Kidney stones
c) End-stage renal disease
d) Acute renal failure
a) Urinary tract infections
A patient with a medical history of sickle cell anemia is complaining of chest pain and shortness of breath. The patient is breathing 26 times per minute in short, shallow respirations. However, the patient's oxygen saturation via pulse oximetry is 100% on room air. The best approach regarding supplemental oxygen is to:
a) do nothing; no supplemental oxygen is necessary
b) place the patient on a simple face mask
c) place the patient on a nonrebreather mask
d) place the patient on a nasal cannula
c) place the patient on a nonrebreather mask
What is the purpose of the red blood cells?
a) They are responsible for the removal of oxygen from the cells
b) They are critical in response to infection and are mediators of the body's immune response
c) They are crucial in the formation of clots
d) They are responsible for the delivery of oxygen to the cells
d) They are responsible for the delivery of oxygen to the cells
Peritoneal dialysis allows patients to dialyze at home through:
a) a dialysis machine
b) an AV fistula
c) the abdomen
d) the urethra
c) the abdomen
There are two main types of dialysis, hemodialysis and peritoneal dialysis. The main difference between them is:
a) hemodialysis is usually done at home and peritoneal dialysis is usually done at a special facility
b) hemodialysis filters the urine and peritoneal dialysis filters the blood
c) hemodialysis filters the blood and peritoneal dialysis filters the urine
d) hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home
d) hemodialysis is usually done at a special facility and peritoneal dialysis is usually done at home
You encounter a patient who has been having diffuse abdominal pain for one week. The patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However, the patient appears pale and complains of generalized weakness and shortness of breath during everyday activities. You suspect the patient is experiencing:
a) chronic anemia
b) acute anemia
c) sickle cell anemia
d) anxiety disorder
a) chronic anemia
Dialysis patients who have missed an appointment may present with signs of ________, which is a similar presentation to ________.
a) neurological disturbances; stroke
b) chest pain; acute myocardial infarction
c) shortness of breath; pneumonia
d) fluid accumulation; congestive heart failure
d) fluid accumulation; congestive heart failure
You suspect a patient who has been having a difficult time controlling the bleeding following a small laceration to the foot may have a history of:
a) high blood pressure
b) taking blood thinners
c) sickle cell anemia
d) poorly controlled diabetes
b) taking blood thinners
Because of abnormally shaped hemoglobin, sickle cell anemia (SCA) patients may occasionally experience ________, causing a blockage of small blood vessels.
a) sludging
b) aggregation
c) clumping
d) clotting
a) sludging
Certain drugs are commonly referred as "blood thinners" or drugs that inhibit clotting. Which of the following would not be considered such a drug?
a) Aspirin
b) Lovenox (enoxaparin)
c) Prilosec
d) Coumadin (warfarin)
c) Prilosec
How many times per week do the majority of American hemodialysis patients receive treatment?
a) Three
b) Seven
c) One
d) Five
a) Three
Hemodialysis is used to help the kidneys filter ________ and remove excess ________.
a) urine; poisons
b) electrolytes; hormones
c) toxins; fluids
d) blood; cholesterol
c) toxins; fluids
The sensation felt when palpating an arterial-venous fistula or shunt is known as a:
a) fluttering
b) bruit
c) frill
d) thrill
d) thrill
Approximately what percentage of United States dialysis patients treat themselves at home?
a) 16 percent
b) 25 percent
c) 50 percent
d) 8 percent
d) 8 percent
The medications that transplant patients need to take for the rest of their lives to prevent organ rejection also often lead to high susceptibility of:
a) renal failure
b) congestive heart failure
c) ulcers
d) infection
d) infection
One of the more serious diseases of the body is renal failure. Renal failure occurs when the:
a) kidneys fail to function as required
b) liver fails to function properly
c) adrenal glands stop working
d) pancreas stops working
a) kidneys fail to function as required
You are dispatched to a private residence for a 52-year-old African American male sitting in his living room complaining of chest pain. During your assessment, he discloses that he has the sickle cell trait. Because of this you should:
a) monitor for signs of inadequate respiration
b) treat the patient as any other 52-year-old with chest pain
c) administer high-concentration oxygen
d) be prepared to treat for shock if he also has a high fever
b) treat the patient as any other 52-year-old with chest pain
You are dispatched to a sick call. The patient was just extricated from a bathtub where he was trapped under the shower door for 2 days. The 72-year-old male had limited access to water from the bathtub faucet. The patient is complaining of disorientation, nausea, and vomiting. What do you think is the underlying cause for the illness?
a) Chronic renal failure
b) Acute renal failure
c) End-stage renal disease
d) Gastrointestinal infection
b) Acute renal failure
Which of the following abbreviations is not correct?
a) CAPD for continuous acute peripheral disease
b) RBC for red blood cells
c) SCA for sickle cell anemia
d) WBC for white blood cells
a) CAPD for continuous acute peripheral disease
The correct terminology used for patients whose kidneys are damaged to the point where they require dialysis to survive is:
a) end-stage renal disease
b) acute renal failure
c) terminal kidney disease
d) hepatic failure
a) end-stage renal disease
The kidney's major function(s) include(s):
a) balancing electrolytes
b) maintaining blood volume
c) excreting urea
d) All of the above
d) All of the above
The blood has many functions critical to a patient's health. Which of the following is not a function of the blood?
a) Removal and delivery of waste products to organs that provide filtration and removal, such as the kidneys and liver
b) Control of bleeding by clotting
c) Removal of carbon monoxide from the cells
d) Delivery of oxygen to the cells
c) Removal of carbon monoxide from the cells
Two chronic medical conditions that dialysis patients frequently have in addition to kidney failure are ________ and ________.
a) high cholesterol; cerebral aneurysms
b) heart failure; stroke
c) blood clots; COPD
d) hypertension; diabetes
d) hypertension; diabetes
Which of the following medications does not interfere with the blood-clotting process?
a) Aspirin
b) Acetaminophen
c) Clopidogrel
d) Warfarin
b) Acetaminophen
The most frequently transplanted organ is the:
a) pancreas
b) liver
c) kidney
d) heart
c) kidney
A patient with renal disease who is currently on dialysis and missed an appointment may present with dangerously high levels of the electrolyte:
a) potassium
b) sodium
c) calcium
d) phosphorous
a) potassium