BONENT CERTIFIED HEMODIALYSIS TECHNOLOGIST/TECHNICIAN CHT
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1. A patient on hemodialysis begins to experience sudden chest pain, shortness of breath,
and hypotension 15 minutes into a treatment. The patient notes that the blood pump
stopped briefly, and upon restarting, the blood lines appeared foamy. Which of the
following complications is most likely occurring?
A. Dialyzer reaction
B. Air embolism
C. First-use syndrome
D. Hemolysis
Foamy blood lines combined with sudden chest pain, dyspnea, and hypotension strongly
indicate an air embolism, which occurs when air enters the vascular system. The blood pump
should be stopped immediately, the patient placed in the Trendelenburg position on the left
side, and emergency medical assistance summoned. The other options do not typically present
with foamy blood lines.
2. During routine machine setup, the hemodialysis technician performs a total chlorine test
on the water treatment system and obtains a result of 0.12 mg/L after the first carbon tank.
What is the appropriate next step?
A. Proceed with treatments because the level is below 0.5 mg/L
B. Test the water after the second carbon tank (post-roughing tank) before initiating any
treatments
C. Immediately bypass the water system and use untreated tap water
D. Shut down the dialysis clinic for the day due to absolute failure
Water treatment systems utilize dual carbon tanks in series (worker and polisher) to remove
chlorine and chloramines. If chlorine is detected after the first tank, the second tank must be
tested immediately to ensure it is effectively protecting the patient from breakthrough
contamination. Treatments cannot safely proceed if chloramines break through both tanks.
3. Which of the following components of the extracorporeal circuit is primarily responsible
for preventing the back-filtration of dialysate contaminants into the patient's blood
stream?
A. Venous line clamp
B. High-flux synthetic membrane with an ultrafiltration control system
C. Blood leak detector
D. Heparin infusion pump
, Advanced synthetic membranes combined with precise ultrafiltration control systems prevent
fluid and particulate movement from the dialysate compartment into the blood compartment.
The blood leak detector senses red blood cells moving in the opposite direction, while the line
clamp stops flow during an alarm.
4. A patient's arteriovenous (AV) graft exhibits a high-pitched, systolic-diastolic bruit and a
pronounced thrill upon palpation. The vascular access coordinator notes a prolonged
bleeding time (>20 minutes) after needle removal during the previous three treatments.
What complication is most likely developing?
A. Anastomotic stenosis leading to increased dynamic venous pressure
B. Complete thrombosis of the outflow vein
C. Localized pseudoaneurysm formation
D. Arterial steal syndrome
A high-pitched, continuous (systolic-diastolic) bruit along with prolonged bleeding after
needle removal is a classic indicator of venous outflow stenosis. The narrowing causes
increased pressure downstream, leading to high resistance and extended hemostasis times.
5. Which water treatment component utilizes a semipermeable membrane operating via
reverse osmosis to remove up to 95-99% of dissolved inorganic ions, bacteria, and
endotoxins?
A. Depth filter
B. Water softener
C. Reverse osmosis (RO) machine
D. Deionization (DI) tank
A reverse osmosis unit forces water under high pressure across a semipermeable membrane,
rejecting the vast majority of dissolved minerals, microorganisms, and pyrogens. Water
softeners remove calcium and magnesium, depth filters capture large particulates, and DI
tanks remove remaining ions through resin beds.
6. A patient receiving hemodialysis complains of circumoral numbness, muscle cramps in
the calves, and lightheadedness. The dialysate calcium concentration is set at 2.5 mEq/L.
Which parameter adjustment is most effective for addressing these symptoms acutely?
A. Increase the dialysate sodium concentration rapidly
B. Administer intravenous calcium chloride or calcium gluconate as ordered and evaluate dialysate
calcium settings
C. Decrease the blood flow rate to zero immediately
D. Increase the ultrafiltration rate to remove excess free water
Circumoral numbness and muscle cramps are classic signs of hypocalcemia or rapid
electrolyte shifts. Administering supplemental intravenous calcium per protocol relieves acute
neuromuscular irritability, and reviewing the dialysate calcium prescription prevents
recurrence.
, 7. When evaluating the conductivity of the dialysate mixture during a treatment
preparation, the technician notices the machine displays a conductivity alarm and enters
bypass mode. What does this safety mechanism prevent?
A. Delivery of incorrectly mixed acid and bicarbonate concentrates that could cause hemolysis or
severe electrolyte imbalances
B. Excessive ultrafiltration of patient plasma volume
C. Air entering the venous blood tubing line
D. Blood clotting within the hollow-fiber dialyzer fibers
The conductivity monitor measures the total ionic concentration of the dialysate. If
conductivity falls outside safe physiological limits, the machine automatically diverts fluid
away from the dialyzer (enters bypass mode) to protect the patient from hypertonic or
hypotonic solutions.
8. Which of the following blood-borne pathogens represents the highest risk of
occupational transmission to healthcare personnel via a needlestick injury in a
hemodialysis setting if universal precautions are breached?
A. Hepatitis C virus (HCV)
B. Hepatitis B virus (HBV)
C. Human immunodeficiency virus (HIV)
D. Cytomegalovirus (CMV)
Hepatitis B has a significantly higher infectivity rate and environmental stability compared to
HIV and HCV, making vaccination and strict barrier precautions mandatory for all dialysis
personnel and patients.
9. During a hemodialysis treatment, the venous pressure monitor suddenly alarms,
indicating a high venous pressure limit breach. Which of the following conditions could
cause this alarm?
A. Kinking or occlusion of the venous blood tubing line downstream from the monitoring site
B. Separation of the blood tubing line from the access needle
C. A significant drop in the blood pump speed
D. Infiltration of the arterial access needle
An obstruction (such as a kink, clamp, or clotting) in the venous line between the pressure
monitor and the patient causes blood to back up, sharply increasing pressure. Conversely,
needle separation or a downstream disconnection causes a drop in pressure.
10. A technician is priming an extracorporeal blood circuit and dialyzer with normal
saline. What is the minimum volume of saline that must be infused through the system to
ensure complete removal of residual sterilants and air before connecting the patient?
A. 100 mL
B. 300 mL
C. 500 mL to 1,000 mL per manufacturer guidelines
EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST| DOWNLOAD
INSTANT PDF
1. A patient on hemodialysis begins to experience sudden chest pain, shortness of breath,
and hypotension 15 minutes into a treatment. The patient notes that the blood pump
stopped briefly, and upon restarting, the blood lines appeared foamy. Which of the
following complications is most likely occurring?
A. Dialyzer reaction
B. Air embolism
C. First-use syndrome
D. Hemolysis
Foamy blood lines combined with sudden chest pain, dyspnea, and hypotension strongly
indicate an air embolism, which occurs when air enters the vascular system. The blood pump
should be stopped immediately, the patient placed in the Trendelenburg position on the left
side, and emergency medical assistance summoned. The other options do not typically present
with foamy blood lines.
2. During routine machine setup, the hemodialysis technician performs a total chlorine test
on the water treatment system and obtains a result of 0.12 mg/L after the first carbon tank.
What is the appropriate next step?
A. Proceed with treatments because the level is below 0.5 mg/L
B. Test the water after the second carbon tank (post-roughing tank) before initiating any
treatments
C. Immediately bypass the water system and use untreated tap water
D. Shut down the dialysis clinic for the day due to absolute failure
Water treatment systems utilize dual carbon tanks in series (worker and polisher) to remove
chlorine and chloramines. If chlorine is detected after the first tank, the second tank must be
tested immediately to ensure it is effectively protecting the patient from breakthrough
contamination. Treatments cannot safely proceed if chloramines break through both tanks.
3. Which of the following components of the extracorporeal circuit is primarily responsible
for preventing the back-filtration of dialysate contaminants into the patient's blood
stream?
A. Venous line clamp
B. High-flux synthetic membrane with an ultrafiltration control system
C. Blood leak detector
D. Heparin infusion pump
, Advanced synthetic membranes combined with precise ultrafiltration control systems prevent
fluid and particulate movement from the dialysate compartment into the blood compartment.
The blood leak detector senses red blood cells moving in the opposite direction, while the line
clamp stops flow during an alarm.
4. A patient's arteriovenous (AV) graft exhibits a high-pitched, systolic-diastolic bruit and a
pronounced thrill upon palpation. The vascular access coordinator notes a prolonged
bleeding time (>20 minutes) after needle removal during the previous three treatments.
What complication is most likely developing?
A. Anastomotic stenosis leading to increased dynamic venous pressure
B. Complete thrombosis of the outflow vein
C. Localized pseudoaneurysm formation
D. Arterial steal syndrome
A high-pitched, continuous (systolic-diastolic) bruit along with prolonged bleeding after
needle removal is a classic indicator of venous outflow stenosis. The narrowing causes
increased pressure downstream, leading to high resistance and extended hemostasis times.
5. Which water treatment component utilizes a semipermeable membrane operating via
reverse osmosis to remove up to 95-99% of dissolved inorganic ions, bacteria, and
endotoxins?
A. Depth filter
B. Water softener
C. Reverse osmosis (RO) machine
D. Deionization (DI) tank
A reverse osmosis unit forces water under high pressure across a semipermeable membrane,
rejecting the vast majority of dissolved minerals, microorganisms, and pyrogens. Water
softeners remove calcium and magnesium, depth filters capture large particulates, and DI
tanks remove remaining ions through resin beds.
6. A patient receiving hemodialysis complains of circumoral numbness, muscle cramps in
the calves, and lightheadedness. The dialysate calcium concentration is set at 2.5 mEq/L.
Which parameter adjustment is most effective for addressing these symptoms acutely?
A. Increase the dialysate sodium concentration rapidly
B. Administer intravenous calcium chloride or calcium gluconate as ordered and evaluate dialysate
calcium settings
C. Decrease the blood flow rate to zero immediately
D. Increase the ultrafiltration rate to remove excess free water
Circumoral numbness and muscle cramps are classic signs of hypocalcemia or rapid
electrolyte shifts. Administering supplemental intravenous calcium per protocol relieves acute
neuromuscular irritability, and reviewing the dialysate calcium prescription prevents
recurrence.
, 7. When evaluating the conductivity of the dialysate mixture during a treatment
preparation, the technician notices the machine displays a conductivity alarm and enters
bypass mode. What does this safety mechanism prevent?
A. Delivery of incorrectly mixed acid and bicarbonate concentrates that could cause hemolysis or
severe electrolyte imbalances
B. Excessive ultrafiltration of patient plasma volume
C. Air entering the venous blood tubing line
D. Blood clotting within the hollow-fiber dialyzer fibers
The conductivity monitor measures the total ionic concentration of the dialysate. If
conductivity falls outside safe physiological limits, the machine automatically diverts fluid
away from the dialyzer (enters bypass mode) to protect the patient from hypertonic or
hypotonic solutions.
8. Which of the following blood-borne pathogens represents the highest risk of
occupational transmission to healthcare personnel via a needlestick injury in a
hemodialysis setting if universal precautions are breached?
A. Hepatitis C virus (HCV)
B. Hepatitis B virus (HBV)
C. Human immunodeficiency virus (HIV)
D. Cytomegalovirus (CMV)
Hepatitis B has a significantly higher infectivity rate and environmental stability compared to
HIV and HCV, making vaccination and strict barrier precautions mandatory for all dialysis
personnel and patients.
9. During a hemodialysis treatment, the venous pressure monitor suddenly alarms,
indicating a high venous pressure limit breach. Which of the following conditions could
cause this alarm?
A. Kinking or occlusion of the venous blood tubing line downstream from the monitoring site
B. Separation of the blood tubing line from the access needle
C. A significant drop in the blood pump speed
D. Infiltration of the arterial access needle
An obstruction (such as a kink, clamp, or clotting) in the venous line between the pressure
monitor and the patient causes blood to back up, sharply increasing pressure. Conversely,
needle separation or a downstream disconnection causes a drop in pressure.
10. A technician is priming an extracorporeal blood circuit and dialyzer with normal
saline. What is the minimum volume of saline that must be infused through the system to
ensure complete removal of residual sterilants and air before connecting the patient?
A. 100 mL
B. 300 mL
C. 500 mL to 1,000 mL per manufacturer guidelines
