1
CCHT EXAM ACTUAL 2026/2027 | Certified Clinical
Hemodialysis Technician | Questions & Verified Answers |
Pass Guaranteed - A+ Graded
Section 1: Dialysis Procedures & Treatment Delivery (Questions
1-22)
Question 1
A patient arrives for hemodialysis treatment. The CCHT must set up the hemodialysis
machine. Which is the correct order of steps for priming the dialyzer and bloodlines?
A. Connect arterial line, prime dialyzer, connect venous line, recirculate saline
B. Connect arterial line to dialyzer, prime with saline, connect venous line, check for
air, recirculate, and verify no leaks [CORRECT]
C. Connect both lines simultaneously and prime together
D. Prime the dialyzer first, then attach bloodlines afterward
Rationale: The correct priming sequence is connecting the arterial line to the
dialyzer, priming with saline, connecting the venous line, checking for air bubbles,
recirculating saline, and verifying no leaks to ensure system integrity. Simultaneous
connection or priming the dialyzer separately risks air embolism and inadequate
priming.
Correct Answer: B
Question 2
,2
During priming, the CCHT notices small air bubbles in the venous drip chamber.
Which action is most appropriate?
A. Start treatment; small bubbles will dissipate during blood flow
B. Tap the chamber gently and continue recirculating saline until all air is removed
[CORRECT]
C. Increase the blood pump speed to force air through
D. Ignore the bubbles if they are below the fluid level
Rationale: All air bubbles must be removed before patient connection because air
embolism is a life-threatening complication; tapping the chamber and continuing
recirculation removes trapped air safely. Increasing pump speed or ignoring bubbles
risks embolism.
Correct Answer: B
Question 3
A patient with a 4-hour prescription and a blood flow rate of 400 mL/min is
scheduled for treatment. The dialyzer KoA is 800. Which factor most significantly
affects the delivered dose of dialysis (Kt/V)?
A. The color of the bloodlines
B. The effective blood flow rate and treatment time [CORRECT]
C. The brand of saline used for priming
D. The temperature of the dialysis room
Rationale: Kt/V (dialysis adequacy) is primarily determined by effective blood flow
rate (Qb), treatment time, and dialyzer clearance (KoA); blood flow rate and time are
the controllable variables that directly impact urea removal. Saline brand and room
temperature do not affect clearance.
Correct Answer: B
Question 4
,3
A patient's prescribed dry weight is 72 kg. Pre-treatment weight is 76.5 kg. The
patient gained 1.5 kg since the last treatment 2 days ago. What is the total fluid
removal goal for this treatment?
A. 3.0 kg
B. 4.5 kg [CORRECT]
C. 1.5 kg
D. 6.0 kg
Rationale: Total fluid removal goal equals pre-treatment weight minus dry weight
(76.5 kg - 72 kg = 4.5 kg); this represents the total excess fluid to be removed
regardless of interdialytic weight gain. The 1.5 kg gain since last treatment is a subset
of the total excess.
Correct Answer: B
Question 5
A patient is prescribed 4.0 kg fluid removal over 4 hours. What is the ultrafiltration
rate (UFR) in mL/hour?
A. 500 mL/hour
B. 1,000 mL/hour [CORRECT]
C. 2,000 mL/hour
D. 4,000 mL/hour
Rationale: UFR = total fluid removal (kg) × 1,000 mL/kg ÷ treatment time (hours) =
4.0 × 1,000 ÷ 4 = 1,000 mL/hour. This calculation is essential for monitoring patient
tolerance and preventing intradialytic hypotension.
Correct Answer: B
Question 6
A patient weighs 70 kg dry weight. The nephrologist sets a maximum UFR of 13
mL/kg/hour. What is the maximum safe fluid removal over 4 hours?
, 4
A. 2,800 mL
B. 3,640 mL [CORRECT]
C. 5,200 mL
D. 1,820 mL
Rationale: Maximum UFR = 13 mL/kg/hour × 70 kg = 910 mL/hour; over 4 hours =
910 × 4 = 3,640 mL. Exceeding 13 mL/kg/hour increases risk of intradialytic
hypotension, myocardial stunning, and mortality.
Correct Answer: B
Question 7
The CCHT is preparing to initiate dialysis on a patient with an arteriovenous (AV)
fistula. Which needle insertion technique is correct?
A. Insert both needles in the same direction (antegrade)
B. Insert the arterial needle facing the fistula (antegrade/retrograde per access
anatomy) and the venous needle facing the heart (antegrade), with at least 2 inches
between them [CORRECT]
C. Insert needles immediately adjacent to each other for convenience
D. Insert needles perpendicular to the skin at 90 degrees
Rationale: Needle placement requires the arterial needle facing toward or away from
the fistula depending on access anatomy, the venous needle facing toward the heart
(antegrade), with minimum 2-inch separation to prevent recirculation; perpendicular
insertion increases infiltration risk.
Correct Answer: B
Question 8
Which needle gauge is most appropriate for a patient with a mature AV fistula and a
prescribed blood flow rate of 350 mL/min?
CCHT EXAM ACTUAL 2026/2027 | Certified Clinical
Hemodialysis Technician | Questions & Verified Answers |
Pass Guaranteed - A+ Graded
Section 1: Dialysis Procedures & Treatment Delivery (Questions
1-22)
Question 1
A patient arrives for hemodialysis treatment. The CCHT must set up the hemodialysis
machine. Which is the correct order of steps for priming the dialyzer and bloodlines?
A. Connect arterial line, prime dialyzer, connect venous line, recirculate saline
B. Connect arterial line to dialyzer, prime with saline, connect venous line, check for
air, recirculate, and verify no leaks [CORRECT]
C. Connect both lines simultaneously and prime together
D. Prime the dialyzer first, then attach bloodlines afterward
Rationale: The correct priming sequence is connecting the arterial line to the
dialyzer, priming with saline, connecting the venous line, checking for air bubbles,
recirculating saline, and verifying no leaks to ensure system integrity. Simultaneous
connection or priming the dialyzer separately risks air embolism and inadequate
priming.
Correct Answer: B
Question 2
,2
During priming, the CCHT notices small air bubbles in the venous drip chamber.
Which action is most appropriate?
A. Start treatment; small bubbles will dissipate during blood flow
B. Tap the chamber gently and continue recirculating saline until all air is removed
[CORRECT]
C. Increase the blood pump speed to force air through
D. Ignore the bubbles if they are below the fluid level
Rationale: All air bubbles must be removed before patient connection because air
embolism is a life-threatening complication; tapping the chamber and continuing
recirculation removes trapped air safely. Increasing pump speed or ignoring bubbles
risks embolism.
Correct Answer: B
Question 3
A patient with a 4-hour prescription and a blood flow rate of 400 mL/min is
scheduled for treatment. The dialyzer KoA is 800. Which factor most significantly
affects the delivered dose of dialysis (Kt/V)?
A. The color of the bloodlines
B. The effective blood flow rate and treatment time [CORRECT]
C. The brand of saline used for priming
D. The temperature of the dialysis room
Rationale: Kt/V (dialysis adequacy) is primarily determined by effective blood flow
rate (Qb), treatment time, and dialyzer clearance (KoA); blood flow rate and time are
the controllable variables that directly impact urea removal. Saline brand and room
temperature do not affect clearance.
Correct Answer: B
Question 4
,3
A patient's prescribed dry weight is 72 kg. Pre-treatment weight is 76.5 kg. The
patient gained 1.5 kg since the last treatment 2 days ago. What is the total fluid
removal goal for this treatment?
A. 3.0 kg
B. 4.5 kg [CORRECT]
C. 1.5 kg
D. 6.0 kg
Rationale: Total fluid removal goal equals pre-treatment weight minus dry weight
(76.5 kg - 72 kg = 4.5 kg); this represents the total excess fluid to be removed
regardless of interdialytic weight gain. The 1.5 kg gain since last treatment is a subset
of the total excess.
Correct Answer: B
Question 5
A patient is prescribed 4.0 kg fluid removal over 4 hours. What is the ultrafiltration
rate (UFR) in mL/hour?
A. 500 mL/hour
B. 1,000 mL/hour [CORRECT]
C. 2,000 mL/hour
D. 4,000 mL/hour
Rationale: UFR = total fluid removal (kg) × 1,000 mL/kg ÷ treatment time (hours) =
4.0 × 1,000 ÷ 4 = 1,000 mL/hour. This calculation is essential for monitoring patient
tolerance and preventing intradialytic hypotension.
Correct Answer: B
Question 6
A patient weighs 70 kg dry weight. The nephrologist sets a maximum UFR of 13
mL/kg/hour. What is the maximum safe fluid removal over 4 hours?
, 4
A. 2,800 mL
B. 3,640 mL [CORRECT]
C. 5,200 mL
D. 1,820 mL
Rationale: Maximum UFR = 13 mL/kg/hour × 70 kg = 910 mL/hour; over 4 hours =
910 × 4 = 3,640 mL. Exceeding 13 mL/kg/hour increases risk of intradialytic
hypotension, myocardial stunning, and mortality.
Correct Answer: B
Question 7
The CCHT is preparing to initiate dialysis on a patient with an arteriovenous (AV)
fistula. Which needle insertion technique is correct?
A. Insert both needles in the same direction (antegrade)
B. Insert the arterial needle facing the fistula (antegrade/retrograde per access
anatomy) and the venous needle facing the heart (antegrade), with at least 2 inches
between them [CORRECT]
C. Insert needles immediately adjacent to each other for convenience
D. Insert needles perpendicular to the skin at 90 degrees
Rationale: Needle placement requires the arterial needle facing toward or away from
the fistula depending on access anatomy, the venous needle facing toward the heart
(antegrade), with minimum 2-inch separation to prevent recirculation; perpendicular
insertion increases infiltration risk.
Correct Answer: B
Question 8
Which needle gauge is most appropriate for a patient with a mature AV fistula and a
prescribed blood flow rate of 350 mL/min?
