Certified Hemodialysis Technologist/Technician Exam Infection Control and Patient Safety in Dialysis 2 — Questions and Answers
Question 1: Catheter-related bloodstream infection (CRBSI) in hemodialysis patients most commonly presents with:
- Exit site redness only
- Fever with or without rigors, often without localizing signs at the catheter site (Correct answer)
- Hypertension and weight gain
- Elevated potassium levels
Correct answer: Fever with or without rigors, often without localizing signs at the catheter site
CRBSI typically presents with fever and chills occurring during or shortly after dialysis, often without obvious local catheter site infection, requiring blood cultures.
Question 2: Which organism is the most common cause of catheter-related bloodstream infections in hemodialysis patients?
- Pseudomonas aeruginosa
- Staphylococcus aureus (Correct answer)
- Escherichia coli
- Candida species
Correct answer: Staphylococcus aureus
Staphylococcus aureus, including MRSA, is the most common cause of CRBSI in hemodialysis patients and is associated with high morbidity and mortality.
Question 3: The recommended approach to CVC exit site care in hemodialysis includes:
- Cleaning only with normal saline, no dressing required
- Cleaning with chlorhexidine or povidone-iodine and applying a sterile dry dressing at each dialysis visit (Correct answer)
- Only cleaning the exit site monthly
- Using antibiotic ointment on all exit sites routinely
Correct answer: Cleaning with chlorhexidine or povidone-iodine and applying a sterile dry dressing at each dialysis visit
Regular antiseptic cleaning and sterile dry dressing application at each dialysis session reduces exit site contamination and catheter-related infection rates.
Question 4: When dialyzing a patient with active pulmonary tuberculosis, which additional precaution is required beyond standard precautions?
- Contact precautions only
- Airborne precautions with N95 respirator and negative-pressure room if available (Correct answer)
- Droplet precautions with surgical mask
- No additional precautions beyond standard
Correct answer: Airborne precautions with N95 respirator and negative-pressure room if available
Active pulmonary tuberculosis requires airborne precautions because M. tuberculosis is transmitted via small airborne particles that remain suspended in air for extended periods.
Question 5: The hepatitis B vaccination series is recommended for which hemodialysis patients?
- Only patients under age 40
- All susceptible (anti-HBs negative) hemodialysis patients (Correct answer)
- Only patients with a history of IV drug use
- Only staff, not patients
Correct answer: All susceptible (anti-HBs negative) hemodialysis patients
All hemodialysis patients who are anti-HBs negative (susceptible to HBV) should receive hepatitis B vaccination regardless of age to prevent facility-acquired hepatitis B.
Question 6: Vascular access care bundles in hemodialysis facilities are designed primarily to reduce:
- Dialysis machine downtime
- Catheter-related bloodstream infections (CRBSI) through standardized aseptic technique (Correct answer)
- Dialyzer reuse frequency
- Patient wait times
Correct answer: Catheter-related bloodstream infections (CRBSI) through standardized aseptic technique
Vascular access care bundles standardize evidence-based aseptic practices for catheter connection and disconnection, significantly reducing CRBSI rates.
Certified Hemodialysis Technologist/Technician Exam Infection Control and Patient Safety in Dialysis 2
Catheter-related bloodstream infection (CRBSI) in hemodialysis patients most commonly presents with: