✅ MCQs – Principles of Hemodialysis (Set 5)
41. The transmembrane pressure (TMP) in hemodialysis represents the pressure gradient across:
A. Dialyzer blood compartment only
B. Arterial and venous bloodlines
C. Dialyzer membrane from blood to dialysate side
D. Arterial access to dialysate flow
➡️ Answer: C. Dialyzer membrane from blood to dialysate side
42. What is the main purpose of bicarbonate in the dialysate solution?
A. To enhance diffusion
B. To remove potassium
C. To buffer blood pH and correct acidosis
D. To increase osmosis
➡️ Answer: C. To buffer blood pH and correct acidosis
43. Which alarm will trigger if venous pressure rises due to an obstruction in the venous line?
A. Arterial pressure alarm
B. TMP alarm
C. Venous pressure alarm
D. Blood leak alarm
➡️ Answer: C. Venous pressure alarm
44. What is the main risk if dialysate conductivity is too low?
A. Hyperkalemia
B. Hypotension and hemolysis
C. Hypertension
D. Blood clotting in the dialyzer
➡️ Answer: B. Hypotension and hemolysis
45. Which component ensures no air enters the bloodstream during dialysis?
A. Blood leak detector
B. Ultrafiltration pump
C. Air bubble detector
D. TMP sensor
➡️ Answer: C. Air bubble detector
46. A dialyzer’s clearance is defined as:
A. Solute concentration in dialysate
B. Dialysate volume per minute
C. The rate at which solute is removed from blood
D. The amount of ultrafiltration
➡️ Answer: C. The rate at which solute is removed from blood
47. High-flux dialyzers are superior in removing:
A. Water only
B. Small molecules like urea
C. Medium to large molecules like β2-microglobulin
D. Only protein-bound toxins
➡️ Answer: C. Medium to large molecules like β2-microglobulin
48. Which one is not a uremic toxin?
A. Urea
B. Creatinine
C. Sodium
D. β2-microglobulin
➡️ Answer: C. Sodium
49. What happens if the blood flow rate is set too low during dialysis?
A. Enhanced ultrafiltration
B. Inefficient solute clearance
C. High blood pressure
D. Blood leak alarm triggers
➡️ Answer: B. Inefficient solute clearance
50. What is the key determinant of diffusion efficiency in dialysis?
A. TMP
B. Solute concentration gradient
C. Blood temperature
D. Arterial pressure
➡️ Answer: B. Solute concentration gradient
51. Which of the following best describes the Sieving Coefficient (SC)?
A. The ratio of dialysate to blood flow
B. The ability of a membrane to remove sodium
C. The ease with which a solute passes through a membrane during convection
D. The blood pressure difference across the dialyzer
➡️ Answer: C. The ease with which a solute passes through a membrane during convection
52. Which of the following factors has the most significant impact on diffusion?
A. TMP
B. Solute size and concentration gradient
C. Arterial pressure
D. Blood temperature
➡️ Answer: B. Solute size and concentration gradient
53. What is the purpose of using a high dialysate flow rate (e.g., 800 mL/min)?
A. Increase convection
B. Maximize ultrafiltration
C. Maximize diffusion gradient
D. Prevent clotting
➡️ Answer: C. Maximize diffusion gradient
54. What is the function of the ultrafiltration pump in the dialysis machine?
A. Pump dialysate to the dialyzer
B. Control blood temperature
C. Control fluid removal volume
D. Pump heparin
➡️ Answer: C. Control fluid removal volume
55. Which statement is true about dialysate composition?
A. Potassium is always higher than plasma
B. Bicarbonate is used to correct metabolic alkalosis
C. Calcium is present to maintain cardiac function
D. Dialysate contains blood thinners
➡️ Answer: C. Calcium is present to maintain cardiac function
56. The main function of the blood pump is to:
A. Regulate dialysate conductivity
B. Ensure constant dialysate flow
C. Move blood through the extracorporeal circuit
D. Detect air bubbles
➡️ Answer: C. Move blood through the extracorporeal circuit
57. During dialysis, a sudden drop in venous pressure may indicate:
A. Dialyzer clotting
B. Disconnection or line leakage
C. Air in the bloodline
D. Patient hypertension
➡️ Answer: B. Disconnection or line leakage
58. Which parameter should be adjusted if a patient cramps during dialysis?
A. Increase dialysate potassium
B. Increase blood flow rate
C. Decrease ultrafiltration rate
D. Increase dialysate bicarbonate
➡️ Answer: C. Decrease ultrafiltration rate
59. What is the likely cause of an arterial pressure alarm showing high negative pressure?
A. Blood clot in dialyzer
B. Kink or clot in arterial line
C. Air detected in venous line
D. High dialysate pressure
➡️ Answer: B. Kink or clot in arterial line
60. The 'first use syndrome' associated with a new dialyzer is mostly caused by:
A. Inadequate heparinization
B. Dialysate contamination
C. Ethylene oxide sterilization
D. Low dialysate temperature
➡️ Answer: C. Ethylene oxide sterilization
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