22 Infection Control, Safety & Professional Role Practice Questions & Answers

1. 1. A technician finishes taping the needles at one station and is immediately called to the next station to answer an alarm. What must the technician do first, before touching anything at the second station?

   • A.Keep the same gloves on, because answering an alarm involves the machine and not contact with the patient's skin
   • B.Rub the gloved hands with alcohol gel, which disinfects the glove surface as well as removing the gloves would
   • C.Remove the gloves, perform hand hygiene, and put on a clean pair before touching the second patient's machine✓ Answer
   • D.Change into a fresh pair of gloves at the second station, since the gloves are the barrier that stops transmission

   Dialysis precautions require both a glove change and hand hygiene between every patient and between every station. Hands are contaminated during glove removal and gloves can carry unseen defects, so swapping gloves without cleaning the hands still moves organisms from one station to the next.

   Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis PatientsReport a problem with this question

2. 2. A technician is ready to remove the needles at the end of a treatment and already has gloves on. What additional protection is most appropriate for this task?

   • A.A gown by itself, because the clothing across the chest is where spattered blood would land during the procedure
   • B.A second pair of gloves pulled over the first, since doubling the glove barrier is what guards against a blood splash
   • C.A face shield, or a mask with eye protection, because blood can spurt or spatter as the needles come out✓ Answer
   • D.No additional protection, since eye and face protection belongs to initiating a treatment rather than ending one

   Gloves alone do not protect the eyes, nose, and mouth. Face protection is required whenever spurting or spattering of blood is anticipated, and needle removal is one of the moments in the treatment when that is most likely.

   Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients; OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030Report a problem with this question

3. 3. A technician carries gauze packets, alcohol pads, and an extra saline flush to a patient's station and uses only some of them. What should be done with the unused items?

   • A.Set them on the shared supply cart in the treatment area for whichever patient needs them next
   • B.Wipe the wrappers with a disinfectant and put them back into the storage bin in the clean room
   • C.Return them to the clean supply cart, since the outer wrappers were never opened and remain clean
   • D.Discard them or leave them dedicated to that patient, because the station is treated as a contaminated area✓ Answer

   Anything taken to a dialysis station must be used for that patient, discarded, or cleaned and disinfected before it goes back to a clean area. Unused supplies are never returned to a common clean supply or medication cart, because the station is treated as contaminated for the whole treatment.

   Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis PatientsReport a problem with this question

4. 4. After drawing up the prescribed dose, a technician sees that medication is still left in the single-dose vial. What should be done with the remainder?

   • A.Discard the vial with the medication still in it, because a single-dose vial is never entered twice✓ Answer
   • B.Keep the vial at the nurses' station and combine the leftovers from several vials into one full dose
   • C.Recap the needle, leave the vial on the medication tray, and use the remainder for that patient next time
   • D.Take the vial back to the clean medication area and label it with the date it was first punctured

   Single-dose vials, including erythropoietin, are punctured once and discarded with whatever is left, and residual doses are never pooled. Re-entering a vial or pooling leftovers has repeatedly caused bloodborne pathogen outbreaks in dialysis units.

   Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis PatientsReport a problem with this question

5. 5. Admission laboratory results show that a new patient is HBsAg positive. Which arrangement must the facility make for his treatments?

   • A.Place him at a corner station behind a privacy curtain, with a gown worn by anyone who enters that space
   • B.Place him in the separate room on a dedicated machine, cared for by staff not assigned to susceptible patients✓ Answer
   • C.Place him on the last shift of the day so that his machine can be disinfected twice before the morning
   • D.Place him at any open station, because routine dialysis precautions already prevent transmission between patients

   Hepatitis B virus is present in blood at very high titer and survives on environmental surfaces, so an HBsAg-positive patient is dialyzed in a separate room on a dedicated machine with dedicated supplies, and the staff caring for him must not care for HBV-susceptible patients on the same shift. His dialyzer is also not reused.

   Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients; CMS ESRD Conditions for Coverage, 42 CFR 494.30Report a problem with this question

6. 6. A patient who has just learned he is hepatitis C antibody positive asks whether he will now be moved into the isolation room like the man down the row. What is the most appropriate response?

   • A.Explain that he will move to the isolation room at the end of the row and will keep a machine of his own
   • B.Explain that he will be moved to the last shift of the day and will no longer take part in dialyzer reuse
   • C.Explain that a machine will be assigned to him alone, though he can stay at his usual station
   • D.Explain that his station and his machine stay the same, and that the nurse can go over the details with him✓ Answer

   Anti-HCV-positive patients need only the routine dialysis precautions that are used for every patient: no separate room, no dedicated machine, and they may take part in dialyzer reuse. Only hepatitis B surface antigen positive patients require the isolation measures.

   Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis PatientsReport a problem with this question

7. 7. A newly hired technician is offered the hepatitis B vaccine by the employer and decides not to take it. What happens next?

   • A.He signs a declination statement and gives up any further offer of the vaccine for the rest of his employment
   • B.He pays for the vaccine himself if he decides later that he wants it, because he turned down the free offer
   • C.He signs a declination statement and may still receive the vaccine at no cost if he changes his mind later✓ Answer
   • D.He is limited to tasks without exposure risk until he agrees to complete the vaccination series

   The employer must offer the hepatitis B vaccine free of charge to employees with occupational exposure, after training. An employee who declines signs the required declination statement, but the offer stays open and the vaccine must still be provided at no cost whenever the employee later accepts.

   Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030Report a problem with this question

8. 8. A technician has just withdrawn a fistula needle from a patient's arm. What should be done with the needle first?

   • A.Activate the safety device on the needle and drop it into the sharps container at that station✓ Answer
   • B.Recap it with a one-handed scoop technique, then place it in the container at the patient's station
   • C.Walk it uncapped to the sharps container kept at the nurses' station and drop it in from there
   • D.Set it down on the drape until the second needle is out, then discard the pair together at the end

   Contaminated sharps are never bent, sheared, or recapped, and they are not carried around the unit. The engineered safety feature is activated as the needle comes out and the needle goes straight into a puncture-resistant container at the point of use.

   Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030Report a problem with this question

9. 9. A technician sustains a needlestick from a used fistula needle while cleaning up a station. What should be done first?

   • A.Fill in the sharps injury log, then go to employee health at the end of the shift for testing
   • B.Squeeze the site to express blood and apply a disinfectant, then finish the station cleanup
   • C.Report the injury to the charge nurse first, so that the source patient can be identified and tested
   • D.Wash the puncture with soap and water, then report the exposure so evaluation can begin✓ Answer

   First aid comes first: the wound is washed with soap and running water immediately, and only then is the exposure reported so that the confidential medical evaluation, source testing, and any prophylaxis can start without delay. Squeezing the wound is not recommended, and reporting must not wait until the end of the shift.

   Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030Report a problem with this question

10. 10. Blood drips onto the floor beside a chair during needle removal. Gloves are on and the facility's disinfectant is at hand. What is the correct way to clean it up?

    • A.Wipe the area once with a disinfectant-soaked cloth, which cleans and disinfects in a single step
    • B.Pour disinfectant over the spill, let it stand for the labeled time, then dry the floor with a towel
    • C.Cover the spill with an absorbent pad until the treatment ends, then clean and disinfect the floor
    • D.Wipe up the visible blood first, then apply the disinfectant a second time with a fresh cloth✓ Answer

    Mechanical cleaning must come before disinfection, because organic material shields organisms from the germicide. The visible blood is removed first with gloved hands, the used cloth goes into a leakproof container, and the disinfectant is then applied a second time with a fresh cloth, following the label dilution and contact time.

    Source: CDC Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis PatientsReport a problem with this question

11. 11. Before a shift begins, a technician finds that the power cord of a dialysis machine is cracked with bare wire showing near the plug. What should be done first?

    • A.Use the machine for this shift only and submit a repair request at the end of the treatment day
    • B.Remove the machine from service, tag it, and report the damaged cord to the equipment technician✓ Answer
    • C.Wrap the damaged section with electrical tape and run the machine, watching closely for alarms
    • D.Plug the machine into a different outlet, since a fault like this comes from the wall circuit and not the cord

    Equipment must be maintained and operated according to the manufacturer's recommendations, and a frayed cord is an electrocution and fire hazard in a room full of grounded machines and wet floors. The machine is taken out of service and tagged so no one uses it, and only qualified staff repair it.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.60Report a problem with this question

12. 12. A fire alarm sounds and smoke is visible in the corridor outside the treatment area. Six patients are on treatment. What is the first priority?

    • A.Return every patient's blood before anything else, so that no circuit of blood is lost
    • B.Take an extinguisher into the corridor and try to put the fire out before it reaches the unit
    • C.Move anyone in immediate danger away from the fire, and make sure the alarm has been activated✓ Answer
    • D.Close the doors of the treatment area so the smoke is contained before anyone is moved out

    Fire response follows rescue, alarm, contain, extinguish. People in immediate danger are moved first and the alarm is raised, because containing the smoke or fighting the fire matters only after the people nearest the fire are out of harm's way.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.60; NFPA Life Safety Code, ambulatory health care occupanciesReport a problem with this question

13. 13. The unit must be evacuated at once and a patient is still on treatment. What is the fastest safe way to get that patient away from the machine?

    • A.Disconnect her from the machine and take the machine along so treatment can continue outside
    • B.Rinse her blood back with saline at a slow rate, then disconnect and walk her to the exit
    • C.Leave the needles and lines connected and push the chair with the machine attached to the exit
    • D.Clamp the bloodlines, disconnect or cut them as the emergency procedure directs, and move her out✓ Answer

    In an emergency evacuation there is no time to rinse blood back. The lines are clamped and then disconnected or cut according to the facility's emergency termination procedure, the needle sites are held or dressed, and the patient leaves with the staff. Losing the blood in the circuit is acceptable when lives are at risk.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.62Report a problem with this question

14. 14. A weak patient must be moved from the dialysis chair to a wheelchair at the end of treatment. What should the technician do?

    • A.Lock both chairs, ask for help, keep her close to the body, and bend at the knees to lift✓ Answer
    • B.Bend at the waist with the legs kept straight and lift smoothly, which keeps the back muscles working
    • C.Reach across the chair and lift under her arms, twisting to set her down into the wheelchair
    • D.Have her stand on her own first and catch her under the arms if her knees begin to buckle

    Safe transfer starts with locking the wheels of both chairs and getting a second person, then lifting with the legs while the load is held close to the trunk. Bending at the waist, reaching, and twisting are the movements that produce most of the back injuries reported by dialysis staff.

    Source: OSHA guidance on safe patient handling and ergonomics; Core Curriculum for the Dialysis Technician, workplace safetyReport a problem with this question

15. 15. A patient waiting for his chair asks the technician why the man in the closed room always dialyzes by himself. How should the technician answer?

    • A.Say that the room is for patients who need closer monitoring, so no diagnosis is revealed
    • B.Say that he should ask the man himself, since a patient may share his own health information
    • C.Say that the man has an infection that requires a room to himself, without naming the infection
    • D.Say that information about other patients cannot be shared, and offer to answer his own questions✓ Answer

    Every patient has a right to privacy and confidentiality in all aspects of treatment, so nothing about another patient's status may be disclosed, not even a partial hint such as the word infection. Redirecting the conversation to the questioner's own care answers him without breaching anyone's confidentiality.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.70, patients' rightsReport a problem with this question

16. 16. A patient tells the technician she is stopping her treatment forty-five minutes early because her ride is waiting. What should the technician do?

    • A.Take her off right away without telling anyone, since a patient may refuse treatment at any time
    • B.Inform the nurse right away, then document the patient's decision and the team's response✓ Answer
    • C.Talk her out of it by describing what the missed time will do to her laboratory results
    • D.Explain that treatment cannot be stopped once it has started and keep her connected for the full time

    A patient has the right to refuse or discontinue treatment, so the technician cannot force her to stay, but the decision is a clinical event that belongs to the nurse. The technician reports it immediately so the nurse can talk with her and terminate safely, and then documents what she said and what was done.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.70, patients' rightsReport a problem with this question

17. 17. A patient complains to the technician about a staff member but says he is afraid of being treated badly if he files anything. What is the best response?

    • A.Tell him you will pass the concern along informally so no formal grievance has to be filed
    • B.Tell him a grievance may be filed anonymously and that the facility cannot retaliate for it✓ Answer
    • C.Tell him a complaint has to be in writing and signed before the facility can look into it
    • D.Tell him to write to the ESRD Network instead, because internal complaints always reach the person named

    Patients may file grievances internally or externally, in person, anonymously, or through a representative, and the facility may not retaliate or withhold services because a grievance was filed. Telling him the process is anonymous and reprisal-free removes the barrier without steering him away from the internal process.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.70, patients' rightsReport a problem with this question

18. 18. A patient arrives with bruises at different stages of healing and pulls away when her adult son comes near. She asks the technician to say nothing. What should the technician do?

    • A.Respect her request and stay silent, because confidentiality covers what a patient discloses
    • B.Report the bruising and her request to the nurse, and document exactly what was observed✓ Answer
    • C.Ask the son how the bruises happened so his explanation can be entered into the record
    • D.Wait until the next treatment to see whether new bruises appear before telling anyone

    Confidentiality protects information from being shared outside the care team; it does not allow suspected abuse to go unreported inside it. The technician stays within scope by reporting the objective observations and the patient's words to the nurse and charting them, and the nurse and social worker carry out the assessment and any required reporting.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.70 and 42 CFR 494.150, responsibilities of the patient care dialysis technicianReport a problem with this question

19. 19. At the end of a treatment a patient hands the technician fifty dollars and asks her to accept his friend request on social media. What should she do?

    • A.Accept both and tell the charge nurse afterward so the gift and the contact are on the record
    • B.Accept the money as a thank-you and share it with the rest of the staff in the break room
    • C.Thank him, decline the money and the online request, and explain the policy on staff and patients✓ Answer
    • D.Turn down the cash but accept the online request, since a friend request costs him nothing

    Professional boundaries keep the relationship therapeutic rather than personal. Accepting money creates an expectation of favoritism, and a social media connection moves a clinical relationship into a private setting where confidential information is easily exposed, so both are declined and the reason is explained kindly.

    Source: NNCC CCHT content outline, Role Responsibilities, maintaining appropriate caregiver and patient relationshipsReport a problem with this question

20. 20. A technician realizes she wrote a blood pressure reading on the wrong patient's flow sheet. How should she correct the entry?

    • A.Draw a single line through the entry, write the correction, and add her initials and the date✓ Answer
    • B.Leave the entry alone and write a note at the bottom saying that the whole sheet may be unreliable
    • C.Cover the entry with correction fluid and then record the reading on the right patient's sheet
    • D.Erase the entry so the sheet stays readable and write the correct reading in the same space

    The medical record is a legal document, so an error is corrected in a way that leaves the original entry readable and shows who changed it and when. Erasing or covering an entry destroys the original and looks like an attempt to hide something, which undermines the credibility of the whole record.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.170, medical recordsReport a problem with this question

21. 21. During treatment a patient asks the technician to turn the blood pump up so he can finish sooner. What should the technician do?

    • A.Make a small increase that stays inside the range the machine allows and note it on the flow sheet
    • B.Shorten the treatment by the same amount instead, since the total blood processed comes out even
    • C.Explain that the settings come from his prescription and pass the request along to the nurse✓ Answer
    • D.Tell him the machine is locked and that no part of a treatment can be changed once it has started

    Treatment parameters are part of the physician's prescription, and the technician works under the direction of the nurse without altering that prescription. The correct action is to say plainly where the settings come from and hand the request to the nurse, who can involve the physician if a change is appropriate.

    Source: CMS ESRD Conditions for Coverage, 42 CFR 494.150, responsibilities of the patient care dialysis technicianReport a problem with this question

22. 22. A patient starting her first hemodialysis treatment grips the arms of the chair and says she is frightened. What is the most appropriate response?

    • A.Give her privacy to settle down and come back once the treatment has been running a while
    • B.Sit down at eye level, ask what worries her most, and stay with her as the treatment begins✓ Answer
    • C.Explain in detail how the machine filters her blood so the science takes her mind off the fear
    • D.Reassure her that there is nothing to be frightened of, because a first treatment is always easy

    Sitting at eye level, asking an open-ended question, and staying present are therapeutic techniques that let the patient name the specific fear so it can be addressed or referred. False reassurance such as saying there is nothing to fear closes the conversation and tells the patient her feelings are not being taken seriously.

    Source: NNCC CCHT content outline, Role Responsibilities, verbal and nonverbal communicationReport a problem with this question

Practice questions based on the NNCC CCHT content outline, CDC recommendations for hemodialysis settings, and the OSHA Bloodborne Pathogens Standard. Not affiliated with or endorsed by NNCC, and not medical advice. Machine settings, dialysate composition, flow rates, alarm thresholds, water-quality limits and laboratory targets are deliberately never the answer to a question here — those are set by your machine's manufacturer, your facility's protocol and the physician's prescription. Always follow your facility's policies and your patient's prescribed treatment. About the CCHT exam (NNCC) →