REVERSE OSMOSIS WATER TREATMENT

FULL TEXT  CLICK HERE

✅ MCQs: Reverse Osmosis (RO) System in Hemodialysis Water Treatment

1. What is the primary function of the reverse osmosis system in hemodialysis?
A. To warm the dialysate
B. To sterilize the dialyzer
C. To remove chemical and microbial contaminants from water
D. To balance electrolytes
➡️ Answer: C. To remove chemical and microbial contaminants from water

---

2. Which of the following contaminants is most effectively removed by the RO membrane?
A. Chlorine
B. Bacteria
C. Endotoxins
D. Dissolved salts and heavy metals
➡️ Answer: D. Dissolved salts and heavy metals

3. What is the typical rejection rate of solutes by a functioning RO membrane in dialysis water treatment?
A. 30–40%
B. 50–60%
C. 85–95%
D. 99.9%
➡️ Answer: C. 85–95%

---

4. What component is typically placed before the RO unit to remove chlorine/chloramine?
A. Micron filter
B. UV sterilizer
C. Carbon filter
D. Water softener
➡️ Answer: C. Carbon filter

5. Why is chlorine/chloramine removal important before the RO membrane?
A. They improve membrane performance
B. They reduce endotoxin levels
C. They can damage the RO membrane
D. They help sterilize the water
➡️ Answer: C. They can damage the RO membrane

---

6. Which water quality standard is followed for hemodialysis water treatment?
A. FDA
B. WHO
C. AAMI (Association for the Advancement of Medical Instrumentation)
D. CDC
➡️ Answer: C. AAMI

7. What is the recommended frequency for testing product water conductivity from the RO system?
A. Annually
B. Monthly
C. Weekly
D. Continuously during operation
➡️ Answer: D. Continuously during operation

---

8. What does a rise in RO product water conductivity indicate?
A. Better water quality
B. RO membrane damage or failure
C. Chlorine presence
D. UV system failure
➡️ Answer: B. RO membrane damage or failure

9. In a double-pass RO system, water passes through:
A. Two separate dialysis machines
B. The same RO membrane twice
C. Two RO membranes in sequence
D. The carbon filter twice
➡️ Answer: C. Two RO membranes in sequence

---

10. What is the primary purpose of the deionizer (DI) tanks, sometimes used after RO?
A. Kill bacteria
B. Adjust pH
C. Remove organic particles
D. Remove remaining ions and improve purity
➡️ Answer: D. Remove remaining ions and improve purity

11. The recommended maximum allowable level of total chlorine (free + combined) in water used for dialysis is:
A. 0.1 mg/L
B. 0.5 mg/L
C. 1.0 mg/L
D. 4.0 mg/L
➡️ Answer: A. 0.1 mg/L

(AAMI standard – above this may cause hemolysis in patients.)

---

12. The RO membrane should be disinfected:
A. Only when patient infection occurs
B. Once a year
C. As per manufacturer guidelines and at regular intervals
D. When endotoxin levels rise
➡️ Answer: C. As per manufacturer guidelines and at regular intervals

13. Which component is used after the RO unit to ensure microbiological purity of water?
A. Softener
B. UV light
C. Carbon filter
D. Dechlorinator
➡️ Answer: B. UV light

(Helps in microbial and endotoxin reduction post-RO.)

---

14. The correct order of water treatment components is typically:
A. RO → UV → Carbon → Softener
B. Carbon → Softener → RO → UV
C. Softener → UV → RO → Carbon
D. RO → Carbon → UV → Softener
➡️ Answer: B. Carbon → Softener → RO → UV

15. Which of the following is a limitation of RO systems in dialysis water treatment?
A. Cannot remove dissolved solids
B. Cannot remove bacteria
C. Cannot remove volatile gases like chlorine
D. Cannot filter particles
➡️ Answer: C. Cannot remove volatile gases like chlorine

(Carbon filters are needed to remove chlorine/chloramines before RO.)

---

16. When pressure across the RO membrane increases significantly, it usually indicates:
A. Normal operation
B. Membrane fouling or clogging
C. Good flow rate
D. Bacteria growth
➡️ Answer: B. Membrane fouling or clogging

17. According to AAMI standards, how often should endotoxin levels in RO product water be monitored?
A. Daily
B. Weekly
C. Monthly
D. Quarterly
➡️ Answer: C. Monthly

(Or more frequently if system issues occur.)

---

18. The term "product water" in RO systems refers to:
A. Water before carbon filtration
B. Water used to regenerate the softener
C. Water that exits the RO membrane for dialysis
D. Rejected water going to drain
➡️ Answer: C. Water that exits the RO membrane for dialysis

19. The main role of micron prefilters (e.g., 5-micron, 1-micron) is to:
A. Remove chlorine
B. Adjust pH
C. Trap sediments and particulates before reaching the RO membrane
D. Produce dialysate
➡️ Answer: C. Trap sediments and particulates before reaching the RO membrane

---

20. Water that fails RO rejection limits should be:
A. Used for rinsing the dialyzer
B. Used for cleaning dialysis machines only
C. Recycled into the product water tank
D. Rejected and sent to drain
➡️ Answer: D. Rejected and sent to drain

Diet Counselling in ESRD

FULL TEXT :CLICK HERE

✅ MCQs – Diet Counselling in ESRD (Hemodialysis Focus)

1. The main goal of dietary counseling in ESRD patients on dialysis is to:
A. Promote weight gain
B. Prevent muscle cramps
C. Maintain nutritional status and reduce uremic complications
D. Reduce protein intake to zero
➡️ Answer: C. Maintain nutritional status and reduce uremic complications

---

2. Protein recommendation for a stable hemodialysis patient is approximately:
A. 0.6 g/kg/day
B. 0.8 g/kg/day
C. 1.2 g/kg/day
D. 2.0 g/kg/day
➡️ Answer: C. 1.2 g/kg/day

(Higher due to protein loss during dialysis)

3. Which of the following nutrients should be restricted in ESRD patients?
A. Vitamin C
B. Iron
C. Potassium and phosphorus
D. Fiber
➡️ Answer: C. Potassium and phosphorus

---

4. Which of the following foods is high in potassium and usually avoided in ESRD diet?
A. White rice
B. Apples
C. Bananas
D. Chicken breast

➡️ Answer: C. Bananas 

5. Hyperphosphatemia in ESRD patients can lead to:
A. Hair loss
B. Bone disease and vascular calcification
C. Low blood pressure
D. Vitamin C deficiency
➡️ Answer: B. Bone disease and vascular calcification

---

6. Sodium restriction in ESRD helps in controlling:
A. Blood sugar
B. Fluid overload and hypertension
C. Anemia
D. Bone loss
➡️ Answer: B. Fluid overload and hypertension

7. A food label indicates 400 mg of sodium per serving. For ESRD patients, this is considered:
A. Low sodium
B. High sodium
C. Moderate sodium
D. Safe for daily intake
➡️ Answer: B. High sodium

(Low sodium foods typically have <140 mg per serving)

---

8. The daily fluid intake for a patient on hemodialysis is generally restricted to:
A. 1.5–2.0 L/day
B. 500 mL + urine output
C. 3.0–4.0 L/day
D. No fluid restriction
➡️ Answer: B. 500 mL + urine output

9. Which food is safe for a renal diet (low in potassium and phosphorus)?
A. Avocado
B. Watermelon
C. Cauliflower
D. Sweet potatoes
➡️ Answer: C. Cauliflower

---

10. Which of the following is a common nutrition-related complication in ESRD?
A. Hyperglycemia
B. Protein-energy wasting (PEW)
C. Obesity
D. Iron overload
➡️ Answer: B. Protein-energy wasting (PEW)

✅ MCQs – Diet Counselling in ESRD (Set 2)

11. Which phosphate binder is commonly prescribed to control phosphorus levels in ESRD patients?
A. Furosemide
B. Sevelamer
C. Calcium gluconate
D. Sodium bicarbonate
➡️ Answer: B. Sevelamer

---

12. Which of the following fruits is considered low in potassium and suitable in moderation for ESRD patients?
A. Orange
B. Banana
C. Apple
D. Mango
➡️ Answer: C. Apple

13. Why are high-phosphorus foods like nuts and cola discouraged in ESRD?
A. They raise potassium levels
B. They increase blood sugar
C. They can worsen secondary hyperparathyroidism
D. They are high in sodium
➡️ Answer: C. They can worsen secondary hyperparathyroidism

---

14. Which symptom is commonly associated with fluid overload in dialysis patients?
A. Hypotension
B. Shortness of breath
C. Constipation
D. Joint pain
➡️ Answer: B. Shortness of breath

15. ESRD patients are advised to avoid processed and canned foods because they are often:
A. High in vitamins
B. High in sodium and phosphorus additives
C. Contaminated
D. Hard to digest
➡️ Answer: B. High in sodium and phosphorus additives

---

16. A dialysis patient is advised to increase protein intake. Which of the following is a high biological value protein source?
A. Beans
B. Tofu
C. Egg white
D. Brown rice
➡️ Answer: C. Egg white

(High biological value = easily absorbed and utilized proteins)

17. What is the recommended energy intake (calories) for a stable adult ESRD patient on hemodialysis?
A. 15–20 kcal/kg/day
B. 20–25 kcal/kg/day
C. 25–35 kcal/kg/day
D. >40 kcal/kg/day
➡️ Answer: C. 25–35 kcal/kg/day

---

18. A common reason for anorexia in ESRD patients is:
A. Depression
B. Uremic toxins
C. Medication side effects
D. All of the above

➡️ Answer: D. All of the above

19. Which micronutrient may require supplementation in dialysis due to losses during treatment?
A. Iron
B. Vitamin B12
C. Vitamin C
D. Water-soluble vitamins (B complex, C)
➡️ Answer: D. Water-soluble vitamins (B complex, C)

---

20. Which of the following is true regarding potassium restriction in ESRD patients?
A. Cooking vegetables does not reduce potassium
B. Leaching vegetables in water helps reduce potassium content
C. All fruits are safe in unlimited amounts
D. Low potassium intake causes anemia

➡️ Answer: B. Leaching vegetables in water helps reduce potassium content 

Complications During Hemodialysis

FULL TEXT :CLICK HERE

✅ MCQs – Complications During Hemodialysis (Set 1)

1. The most common acute complication during hemodialysis is:
A. Seizures
B. Hypotension
C. Hemolysis
D. Fever
➡️ Answer: B. Hypotension

---

2. Which of the following symptoms suggests a dialyzer reaction?
A. Cough, chest pain, hypotension shortly after initiation
B. Fever 4 hours post-dialysis
C. Severe muscle cramp
D. Numbness in legs
➡️ Answer: A. Cough, chest pain, hypotension shortly after initiation

3. Muscle cramps during dialysis are often associated with:
A. Rapid ultrafiltration
B. High dialysate calcium
C. Hyperkalemia
D. High hemoglobin
➡️ Answer: A. Rapid ultrafiltration

---

4. Which of the following is not a cause of intradialytic hypotension?
A. High ultrafiltration rate
B. Eating during dialysis
C. Excessive dialysate sodium
D. Poor cardiac function
➡️ Answer: C. Excessive dialysate sodium

(Low sodium would cause hypotension; high may cause thirst/hypertension.)

5. The initial step in managing hypotension during dialysis includes:
A. Giving IV iron
B. Lowering the dialysate temperature
C. Trendelenburg position and stop ultrafiltration
D. Continue UF and give oral fluids
➡️ Answer: C. Trendelenburg position and stop ultrafiltration

---

6. Dialysis disequilibrium syndrome is typically caused by:
A. High calcium in dialysate
B. Rapid urea removal in first dialysis
C. Dehydration before dialysis
D. High potassium level
➡️ Answer: B. Rapid urea removal in first dialysis

(Leads to cerebral edema and neurological symptoms.)

7. Signs of dialysis disequilibrium syndrome include all except:
A. Headache
B. Nausea
C. Seizures
D. Hypertension
➡️ Answer: D. Hypertension

(Hypertension is not typical; hypotension may occur.)

---

8. Air embolism during hemodialysis is most likely to occur due to:
A. Disconnected arterial needle
B. Venous line not clamped during disconnection
C. High heparin dose
D. Potassium overload

➡️ Answer: B. Venous line not clamped during disconnection

9. A patient develops chest tightness and back pain during dialysis. You suspect:
A. Hyperkalemia
B. Myocardial infarction
C. Hemolysis
D. Hypoglycemia
➡️ Answer: C. Hemolysis

(Also watch for cherry-red blood, hypotension, and nausea.)

---

10. What is the first action if blood leak is detected during dialysis?
A. Continue dialysis and notify doctor
B. Clamp bloodlines and stop the machine
C. Increase heparin
D. Ignore unless patient is unstable

➡️ Answer: B. Clamp bloodlines and stop the machine

11. Which of the following is a common cause of fever during or after hemodialysis?
A. Dialyzer reaction
B. Volume overload
C. Bacterial contamination of dialysate or access infection
D. Hypoglycemia
➡️ Answer: C. Bacterial contamination of dialysate or access infection

---

12. An ESRD patient on dialysis presents with arrhythmia during treatment. Which electrolyte is most likely involved?
A. Calcium
B. Potassium
C. Phosphate
D. Magnesium
➡️ Answer: B. Potassium

(Both hyperkalemia and hypokalemia can cause arrhythmias.)

13. If a patient becomes restless, confused, and has a headache during dialysis, you should suspect:
A. Hypernatremia
B. Air embolism
C. Dialysis disequilibrium syndrome
D. Vascular access clotting
➡️ Answer: C. Dialysis disequilibrium syndrome

---

14. Chest pain during dialysis could be due to all EXCEPT:
A. Angina
B. Dialyzer incompatibility
C. Hypokalemia
D. Hemodialysis disequilibrium
➡️ Answer: D. Hemodialysis disequilibrium

(This mainly causes neurological symptoms.)

15. A sudden drop in venous pressure during dialysis may indicate:
A. Hypoglycemia
B. Dislodged venous needle or line leak
C. Kink in arterial line
D. Dialyzer clotting
➡️ Answer: B. Dislodged venous needle or line leak

---

16. During dialysis, the nurse notices red or pink-colored dialysate. This most likely indicates:
A. Sepsis
B. Hemolysis
C. Blood leak
D. Dislodged arterial needle
➡️ Answer: C. Blood leak

---

17. Which of the following is not a common cause of hemolysis during dialysis?
A. Hypotonic dialysate
B. Kinked blood tubing
C. Disinfectant in dialysate
D. High dialysate sodium

➡️ Answer: D. High dialysate sodium

18. What immediate action should be taken if an air embolism is suspected during dialysis?
A. Stop dialysis and place the patient in Trendelenburg and left lateral position
B. Give hypertonic saline
C. Raise the patient’s head
D. Flush the line with saline
➡️ Answer: A. Stop dialysis and place the patient in Trendelenburg and left lateral position

(This helps trap the air in the right atrium.)

---

19. A patient complains of itching and restlessness during dialysis. Which is most likely the cause?
A. Hyperkalemia
B. Uremia or inadequate dialysis
C. Hypoglycemia
D. Vascular access infection

➡️ Answer: B. Uremia or inadequate dialysis

20. Which of the following is NOT typically a cause of hypertension during dialysis?
A. Volume overload
B. Renin-angiotensin activation
C. Pain or anxiety
D. Excessive ultrafiltration
➡️ Answer: D. Excessive ultrafiltration

(Excessive UF usually leads to hypotension.) 

21. What is the most appropriate response to a severe muscle cramp during dialysis?
A. Continue dialysis at same rate
B. Give saline bolus and stop ultrafiltration
C. Increase dialysate sodium
D. Administer glucose
➡️ Answer: B. Give saline bolus and stop ultrafiltration

---

22. A rise in transmembrane pressure (TMP) during dialysis usually indicates:
A. High blood pressure
B. Filter clotting
C. Dialyzer membrane rupture
D. Blood leak
➡️ Answer: B. Filter clotting

23. What is the most frequent cause of seizures during hemodialysis?
A. Hypoglycemia
B. Dialysis disequilibrium syndrome
C. Hypernatremia
D. Infection
➡️ Answer: B. Dialysis disequilibrium syndrome

---

24. Intradialytic nausea and vomiting are most commonly due to:
A. High ultrafiltration rate and hypotension
B. Low potassium dialysate
C. Excess sodium
D. Slow blood flow
➡️ Answer: A. High ultrafiltration rate and hypotension

25. Which of the following should be monitored closely during dialysis to detect complications early?
A. Blood pressure
B. Venous and arterial pressure
C. Temperature and heart rate
D. All of the above
➡️ Answer: D. All of the above

---

26. When should a dialysis nurse suspect clotting in the extracorporeal circuit?
A. Rising venous pressure and falling blood flow
B. Low TMP and low venous pressure
C. Patient vomiting
D. Clear dialysate fluid
➡️ Answer: A. Rising venous pressure and falling blood flow

27. What is the best prevention method for intradialytic hypotension?
A. Cold dialysate and slow ultrafiltration rate
B. High UF rate at start
C. High sodium bath
D. Post-dialysis fluid loading
➡️ Answer: A. Cold dialysate and slow ultrafiltration rate

---

28. What action should be taken if a patient loses consciousness during dialysis?
A. Increase ultrafiltration rate
B. Clamp bloodlines and call emergency team
C. Continue dialysis and monitor
D. Turn off the dialysis machine
➡️ Answer: B. Clamp bloodlines and call emergency team

29. The most likely cause of hypercalcemia during dialysis is:
A. High calcium dialysate
B. Excess fluid removal
C. Uremia
D. Infection
➡️ Answer: A. High calcium dialysate

---

30. Which of the following is true regarding chest pain during dialysis?
A. It should be ignored unless severe
B. Always indicates heart failure
C. May indicate angina, air embolism, or hemolysis
D. Is a normal finding in some patients
➡️ Answer: C. May indicate angina, air embolism, or hemolysis

Patient Monitoring During Dialysis and Laboratory Test

FULL TEXT :CLICK HERE

✅ MCQs – Patient Monitoring During Dialysis & Lab Tests (Set 1)

1. Which of the following should be monitored and recorded at least every 30 minutes during a hemodialysis session?
A. Hemoglobin level
B. Blood pressure and pulse
C. Serum potassium
D. Blood glucose
➡️ Answer: B. Blood pressure and pulse

---

2. Which lab test is most commonly used to assess dialysis adequacy?
A. Serum albumin
B. KT/V
C. Hemoglobin
D. C-reactive protein
➡️ Answer: B. KT/V

3. Which lab parameter indicates anemia of chronic kidney disease (CKD) in dialysis patients?
A. Low WBC count
B. Low Hemoglobin (Hb)
C. Low Platelet count
D. High Calcium
➡️ Answer: B. Low Hemoglobin (Hb)

---

4. When should the dialysis nurse document pre-dialysis weight?
A. After connecting the patient to the machine
B. Before starting dialysis
C. During dialysis
D. Only if hypotension occurs
➡️ Answer: B. Before starting dialysis

5. A sudden rise in venous pressure during dialysis may indicate:
A. Venous needle dislodgement
B. Dialyzer clotting or access stenosis
C. Hypotension
D. Low TMP
➡️ Answer: B. Dialyzer clotting or access stenosis

---

6. Which of the following laboratory results would require immediate action before starting dialysis?
A. Potassium 5.2 mmol/L
B. Hemoglobin 10.5 g/dL
C. Potassium 7.2 mmol/L
D. Albumin 3.5 g/dL
➡️ Answer: C. Potassium 7.2 mmol/L

7. Which clinical sign should be checked before needling an AV fistula?
A. Hematoma
B. Presence of thrill and bruit
C. Blood pressure
D. Dialysate conductivity
➡️ Answer: B. Presence of thrill and bruit

---

8. The most important pre-dialysis lab value to assess for cardiac arrhythmia risk is:
A. Hemoglobin
B. Serum albumin
C. Serum potassium
D. Serum creatinine
➡️ Answer: C. Serum potassium

9. A decreasing trend in serum albumin in a dialysis patient suggests:
A. Improved nutrition
B. Hemodialysis adequacy
C. Poor nutritional status or chronic inflammation
D. Low phosphate intake
➡️ Answer: C. Poor nutritional status or chronic inflammation

---

10. Which monthly lab test is essential to guide erythropoiesis-stimulating agent (ESA) therapy?
A. Phosphorus
B. Creatinine
C. Hemoglobin
D. Uric acid
➡️ Answer: C. Hemoglobin

11. Post-dialysis weight is important to determine:
A. Serum calcium level
B. Interdialytic weight gain
C. Residual renal function
D. Anemia management
➡️ Answer: B. Interdialytic weight gain

---

12. What does a high arterial pressure alarm during dialysis usually indicate?
A. Venous needle dislodgement
B. Bloodline kink or clot before the pump
C. Low blood flow rate
D. Machine malfunction
➡️ Answer: B. Bloodline kink or clot before the pump

13. What is the normal target range for hemoglobin in a stable hemodialysis patient?
A. 8–9 g/dL
B. 9–10 g/dL
C. 10–11.5 g/dL
D. >13 g/dL
➡️ Answer: C. 10–11.5 g/dL

(Per KDIGO guidelines, aim is typically 10–11.5 to avoid both anemia and cardiovascular risk.)

---

14. Why is serum calcium and phosphorus monitoring important in ESRD patients?
A. To prevent anemia
B. To reduce infection risk
C. To monitor mineral bone disorder and vascular calcification
D. To adjust sodium bath
➡️ Answer: C. To monitor mineral bone disorder and vascular calcification

15. What does a consistently low KT/V (<1.2) suggest?
A. Excellent dialysis clearance
B. Overhydration
C. Inadequate dialysis dose
D. Low phosphorus levels
➡️ Answer: C. Inadequate dialysis dose

---

16. Which of the following must be assessed before giving IV iron or ESA during dialysis?
A. Creatinine and BUN
B. Ferritin and transferrin saturation (TSAT)
C. Calcium and phosphate
D. Potassium
➡️ Answer: B. Ferritin and transferrin saturation (TSAT)

17. An increase in pre-dialysis blood pressure may suggest:
A. Improved fluid control
B. Excessive ultrafiltration
C. Volume overload or non-compliance with fluid restrictions
D. Normal variation
➡️ Answer: C. Volume overload or non-compliance with fluid restrictions

---

18. Which lab test is most useful to assess long-term dialysis adequacy and uremic control?
A. Serum urea
B. Creatinine
C. Bicarbonate
D. KT/V or URR
➡️ Answer: D. KT/V or URR (Urea Reduction Ratio)

19. What is the purpose of checking conductivity and dialysate temperature during dialysis?
A. To ensure sodium and bicarbonate levels are balanced
B. To prevent air embolism
C. To check blood pressure
D. To measure hemoglobin
➡️ Answer: A. To ensure sodium and bicarbonate levels are balanced

---

20. Which symptom requires immediate monitoring during dialysis?
A. Mild headache
B. Yawning
C. Chest pain
D. Mild thirst
➡️ Answer: C. Chest pain

PRINCIPLES OF HEMODIALYSIS

FULL TEXT :CLICK HERE

✅ MCQs – Principles of Hemodialysis (Set 1)

1. The primary mechanism of solute removal during hemodialysis is:
A. Filtration
B. Secretion
C. Diffusion
D. Absorption
➡️ Answer: C. Diffusion

---

2. Which of the following substances is most efficiently removed by diffusion during dialysis?
A. Albumin
B. Sodium
C. Urea
D. Hemoglobin
➡️ Answer: C. Urea

(Small molecules like urea diffuse easily across the dialysis membrane.)

3. The movement of water across the dialysis membrane due to pressure gradient is called:
A. Convection
B. Filtration
C. Ultrafiltration
D. Osmosis
➡️ Answer: C. Ultrafiltration

---

4. The dialysate in hemodialysis serves the purpose of:
A. Acting as an anticoagulant
B. Removing red blood cells
C. Creating a concentration gradient for solute exchange
D. Increasing blood pressure

➡️ Answer: C. Creating a concentration gradient for solute exchange

5. In hemodialysis, convection is the process by which:
A. Solutes move with water flow
B. Large molecules bind to membranes
C. Blood clots are filtered
D. Heat is transferred to the dialysate
➡️ Answer: A. Solutes move with water flow

(Also called "solvent drag")

---

6. Which of the following best describes a semipermeable membrane used in dialysis?
A. Allows all particles to pass through
B. Prevents the passage of both solutes and water
C. Allows selective passage of water and small solutes
D. Is impermeable to gases only

➡️ Answer: C. Allows selective passage of water and small solutes

7. Dialysis is typically needed when GFR falls below:
A. 90 mL/min
B. 45 mL/min
C. 30 mL/min
D. 15 mL/min
➡️ Answer: D. 15 mL/min

(Usually considered the threshold for ESRD.)

---

8. What is the typical blood flow rate during conventional hemodialysis?
A. 30–50 mL/min
B. 100–200 mL/min
C. 300–500 mL/min
D. 600–800 mL/min

➡️ Answer: C. 300–500 mL/min

9. Dialysate typically flows in which direction relative to blood flow?
A. Parallel flow
B. Countercurrent flow
C. Crossflow
D. Static mode
➡️ Answer: B. Countercurrent flow

(Maximizes diffusion gradient efficiency.)

---

10. The clearance of a solute during dialysis depends on all of the following EXCEPT:
A. Membrane surface area
B. Blood flow rate
C. Dialysate flow rate
D. Patient’s blood pressure

➡️ Answer: D. Patient’s blood pressure

11. The term "Kuf" (ultrafiltration coefficient) of a dialyzer refers to:
A. The maximum blood flow rate
B. The ability of the membrane to allow protein movement
C. The amount of water removed per hour per mmHg of TMP
D. The dialysate sodium concentration
➡️ Answer: C. The amount of water removed per hour per mmHg of TMP

---

12. Which type of transport is primarily responsible for removal of middle molecules (e.g., β2-microglobulin)?
A. Diffusion
B. Osmosis
C. Convection
D. Active transport

➡️ Answer: C. Convection

13. What is the normal range of dialysate flow rate in standard hemodialysis?
A. 100–200 mL/min
B. 300–800 mL/min
C. 1–2 L/min
D. 500–800 mL/min
➡️ Answer: D. 500–800 mL/min

---

14. Transmembrane pressure (TMP) is the pressure difference between:
A. Arterial and venous blood lines
B. Dialysate and blood compartments
C. Dialysate inflow and outflow
D. Blood flow rate and dialysate rate

➡️ Answer: B. Dialysate and blood compartments

15. The ability of a dialyzer to remove urea is measured by:
A. Hematocrit
B. KT/V
C. TMP
D. Serum albumin
➡️ Answer: B. KT/V

---

16. The principle that governs solute movement from higher to lower concentration in hemodialysis is:
A. Ultrafiltration
B. Filtration
C. Diffusion
D. Reabsorption

➡️ Answer: C. Diffusion

17. A high-flux dialyzer differs from a low-flux dialyzer by having:
A. A thicker membrane
B. Smaller surface area
C. Greater permeability to large molecules
D. No ability to remove water
➡️ Answer: C. Greater permeability to large molecules

---

18. What does URR (Urea Reduction Ratio) measure?
A. Percentage of urea removed during dialysis
B. Amount of blood processed
C. Dialysate sodium concentration
D. Dialyzer protein leakage

➡️ Answer: A. Percentage of urea removed during dialysis

19. Which factor most directly affects the efficiency of solute clearance?
A. Dialysate color
B. Dialysis nurse’s experience
C. Surface area of the dialyzer membrane
D. Patient’s height
➡️ Answer: C. Surface area of the dialyzer membrane

---

20. What does “dry weight” refer to in dialysis patients?
A. Weight after fasting
B. Post-dialysis weight without excess fluid
C. Target body weight after meals
D. Weight of the patient including edema

➡️ Answer: B. Post-dialysis weight without excess fluid 

BASIC LIFE SUPPORT

FULL TEXT :CLICK HERE

Hemodialysis Machine _Dialysis Circuit Review (Alarms)

 

FULL TEXT : CLICK HERE

✅ MCQs – Hemodialysis Machine: Circuit & Alarm System

1. Which of the following is most likely to trigger a venous pressure high alarm?
A. Bloodline disconnected
B. Kink in the venous line
C. Low blood flow rate
D. Arterial needle dislodgement
➡️ Answer: B. Kink in the venous line

---

2. A low arterial pressure alarm may be caused by:
A. Clot in dialyzer
B. Venous needle infiltration
C. Disconnection or air in arterial line
D. Saline flush
➡️ Answer: C. Disconnection or air in arterial line

3. The air detector alarm is usually located:
A. Before the blood pump
B. In the arterial line
C. After the venous drip chamber
D. In the dialysate line
➡️ Answer: C. After the venous drip chamber

---

4. A continuous blood leak alarm likely indicates:
A. Kink in blood tubing
B. Rupture of dialyzer fibers
C. Air in venous line
D. Overheated dialysate
➡️ Answer: B. Rupture of dialyzer fibers

5. Which of the following will not trigger a machine alarm?
A. Blood flow drops below set value
B. Patient moves during treatment
C. Dialysate temperature drifts outside range
D. Venous pressure line gets disconnected
➡️ Answer: B. Patient moves during treatment

---

6. The conductivity alarm alerts staff to:
A. Blood clotting in circuit
B. Incorrect dialysate concentration
C. Blood-air interface
D. Machine temperature overheating
➡️ Answer: B. Incorrect dialysate concentration

7. A TMP (transmembrane pressure) alarm high is most commonly caused by:
A. Low blood flow
B. Blocked ultrafiltration pump
C. Dialyzer clotting or fiber clogging
D. Low dialysate flow
➡️ Answer: C. Dialyzer clotting or fiber clogging

---

8. When the heparin pump fails, what is the potential risk?
A. Electrolyte imbalance
B. Dialysate contamination
C. Blood clotting in extracorporeal circuit
D. Blood pressure drop
➡️ Answer: C. Blood clotting in extracorporeal circuit

9. A temperature alarm on the machine typically indicates:
A. Room temperature fluctuation
B. Blood warmer malfunction
C. Dialysate out of safe range (35–37°C)
D. Patient has fever
➡️ Answer: C. Dialysate out of safe range (35–37°C)

---

10. What is the first action when a venous pressure low alarm occurs?
A. Increase ultrafiltration
B. Reset the alarm
C. Check for line disconnection or infiltration
D. Administer saline
➡️ Answer: C. Check for line disconnection or infiltration

11. If the blood pump stops during treatment, the most immediate concern is:
A. Infection
B. Electrolyte imbalance
C. Clotting in the extracorporeal circuit
D. Low dialysate flow
➡️ Answer: C. Clotting in the extracorporeal circuit

---

12. A blood leak detector alarm activates. The next step is to:
A. Increase blood flow
B. Flush with saline
C. Stop treatment and return blood if safe
D. Continue dialysis and observe
➡️ Answer: C. Stop treatment and return blood if safe

13. What could trigger a dialysate flow alarm?
A. Loose arterial connection
B. Power failure
C. Obstruction in dialysate lines or pump failure
D. Patient cramping
➡️ Answer: C. Obstruction in dialysate lines or pump failure

---

14. A venous pressure high alarm could indicate:
A. Arterial needle dislodgement
B. Venous needle infiltration or clot
C. Dialysate too cold
D. Conductivity too low
➡️ Answer: B. Venous needle infiltration or clot

15. Which alarm is designed to detect the risk of hemolysis?
A. Blood leak detector
B. Temperature alarm
C. Conductivity alarm
D. Air detector
➡️ Answer: C. Conductivity alarm

(Drastic changes in dialysate conductivity can lead to hemolysis.)

---

16. A TMP high alarm occurs due to:
A. Air in the circuit
B. Excessive ultrafiltration pressure
C. Normal blood flow rate
D. Low venous pressure
➡️ Answer: B. Excessive ultrafiltration pressure

17. What causes a low venous pressure alarm in a functioning circuit?
A. Venous needle dislodgement
B. Blood pump too fast
C. High TMP
D. Dialysate pump failure
➡️ Answer: A. Venous needle dislodgement

---

18. Which of the following actions is most appropriate if the air detector alarm activates?
A. Increase blood flow
B. Clamp the venous line and stop the pump
C. Silence the alarm and continue
D. Recalibrate the machine
➡️ Answer: B. Clamp the venous line and stop the pump

---

19. A low arterial pressure alarm is most commonly caused by:
A. High blood viscosity
B. Patient coughing
C. Kinked or occluded arterial needle/tubing
D. Dialysate flow too high
➡️ Answer: C. Kinked or occluded arterial needle/tubing

20. The UF (ultrafiltration) error alarm means:
A. Blood leak detected
B. UF volume not matching programmed settings
C. Dialysate conductivity too high
D. Blood pressure is low
➡️ Answer: B. UF volume not matching programmed settings