1
Certified Hemodialysis
Technician (CHT) Exam
Comprehensive Practice
Examination – 150
Multiple-Choice Questions
a well detailed one 2025
/ 2026 written and
graded A+ upgraded
, 2
EXAM OVERVIEW
Certification Body: Board of Nephrology Examiners Nursing and Technology (BONENT)
Exam Format: 150 multiple-choice questions
Time Limit: 3 hours (180 minutes)
Passing Score: Minimum scaled score of 70 out of 100
Content Domains:
• Patient Care – 45%
• Infection Control – 18%
• Water Treatment – 15%
• Machine Technology – 12%
• Education and Professional Development – 10%
Target Audience: Dialysis technicians, nephrology professionals, and candidates preparing for
BONENT CHT certification
Difficulty Level: Advanced / Mixed (conceptual, application-based, and scenario-based
questions)
SECTION 1: PATIENT CARE (Questions 1–68)
Domain Weight: 45%
1. A hemodialysis technician is evaluating a patient prior to treatment. The patient's pre-
dialysis weight is 78.4 kg, and the target dry weight is 75.0 kg. The ultrafiltration rate is set at
800 mL/hr for a 4-hour treatment. What is the total fluid to be removed, and is this
prescription appropriate?
A) 3.2 L to be removed; appropriate for the 4-hour treatment
B) 3.4 L to be removed; exceeds recommended maximum ultrafiltration rate
C) 4.0 L to be removed; exceeds recommended maximum ultrafiltration rate
D) 2.8 L to be removed; appropriate for the 4-hour treatment
- detailed answer 100% correct :- B
, 3
Rationale: The fluid to be removed is calculated as pre-dialysis weight minus target dry weight:
78.4 kg – 75.0 kg = 3.4 kg (3.4 L). At 800 mL/hr for 4 hours, total ultrafiltration is 3.2 L, which is
less than the 3.4 L needed. However, more critically, the ultrafiltration rate of 800 mL/hr
exceeds the generally recommended maximum of 10–13 mL/kg/hr. For a 78.4 kg patient, the
maximum safe UFR would be approximately 780–1,019 mL/hr, making 800 mL/hr at the upper
limit but potentially acceptable. The key issue is that the prescription as written (3.2 L total)
would not remove the full 3.4 L of fluid gained, leaving 0.2 L remaining.
2. A patient receiving hemodialysis suddenly complains of dizziness, nausea, and abdominal
cramping. The technician notes that the patient's blood pressure has dropped from 142/88
mmHg to 98/62 mmHg. What is the MOST appropriate immediate action?
A) Increase the blood flow rate to improve cardiac output
B) Place the patient in Trendelenburg position and decrease the ultrafiltration rate
C) Administer a bolus of normal saline and continue treatment at current settings
D) Terminate the treatment immediately and notify the nurse
- detailed answer 100% correct :- B
Rationale: The patient is experiencing intradialytic hypotension, a common complication. The
priority interventions include placing the patient in Trendelenburg (head-down) position to
improve venous return and decreasing or stopping ultrafiltration to reduce fluid removal stress.
Option A is incorrect because increasing blood flow rate would not address the underlying fluid
shift problem. Option C may be appropriate after positional changes, but continuing at current
settings is inappropriate. Option D is overly aggressive—termination is not the first-line
response unless the patient becomes unresponsive or hypotensive persists despite
interventions.
3. Which of the following findings during vascular access assessment would indicate the
HIGHEST priority for intervention?
A) A bruit and thrill are palpable over the AV fistula
B) The access extremity is slightly warmer than the contralateral extremity
C) Absence of bruit with a high-pitched, continuous bruit heard on auscultation
D) Mild edema of the access extremity that resolves with elevation
- detailed answer 100% correct :- C
, 4
Rationale: A high-pitched, continuous bruit (rather than the normal low-pitched, intermittent
bruit) suggests stenosis or narrowing of the access, which can lead to thrombosis and access
failure. Absence of bruit with a continuous sound indicates turbulent flow through a narrowed
segment. Option A describes a normal, healthy AV fistula. Option B—warmth—may indicate
infection but is less immediately critical than a stenotic access that could clot. Option D—mild
edema—is a common finding that often resolves with elevation and is not immediately
threatening.
4. A technician is preparing to cannulate a patient's AV fistula. The technician observes that
the patient's skin over the access site is erythematous, warm to the touch, and there is
purulent drainage. What should the technician do?
A) Proceed with cannulation using strict aseptic technique
B) Cannulate a different site on the same access
C) Notify the nurse and do NOT cannulate the access
D) Clean the site thoroughly with chlorhexidine and proceed
- detailed answer 100% correct :- C
Rationale: The signs described—erythema, warmth, and purulent drainage—are classic
indicators of an access site infection. Cannulating an infected access can introduce bacteria into
the bloodstream, causing bacteremia or sepsis. The technician must notify the nurse
immediately and not cannulate the infected site. Option A and D ignore the infection risk.
Option B is inappropriate because cannulating elsewhere on the same infected access still poses
risk.
5. During hemodialysis treatment, the venous pressure alarm sounds with a high-pressure
reading. Which of the following is the MOST likely cause?
A) Needle infiltration
B) Clotting in the venous drip chamber
C) Kinking of the arterial blood line
D) Patient hypotension
- detailed answer 100% correct :- B
Rationale: High venous pressure alarms indicate increased resistance in the venous return
circuit. The most common causes include clotting in the venous drip chamber, venous needle
malposition, stenosis of the venous access, or kinking of the venous blood line. Option A
Certified Hemodialysis
Technician (CHT) Exam
Comprehensive Practice
Examination – 150
Multiple-Choice Questions
a well detailed one 2025
/ 2026 written and
graded A+ upgraded
, 2
EXAM OVERVIEW
Certification Body: Board of Nephrology Examiners Nursing and Technology (BONENT)
Exam Format: 150 multiple-choice questions
Time Limit: 3 hours (180 minutes)
Passing Score: Minimum scaled score of 70 out of 100
Content Domains:
• Patient Care – 45%
• Infection Control – 18%
• Water Treatment – 15%
• Machine Technology – 12%
• Education and Professional Development – 10%
Target Audience: Dialysis technicians, nephrology professionals, and candidates preparing for
BONENT CHT certification
Difficulty Level: Advanced / Mixed (conceptual, application-based, and scenario-based
questions)
SECTION 1: PATIENT CARE (Questions 1–68)
Domain Weight: 45%
1. A hemodialysis technician is evaluating a patient prior to treatment. The patient's pre-
dialysis weight is 78.4 kg, and the target dry weight is 75.0 kg. The ultrafiltration rate is set at
800 mL/hr for a 4-hour treatment. What is the total fluid to be removed, and is this
prescription appropriate?
A) 3.2 L to be removed; appropriate for the 4-hour treatment
B) 3.4 L to be removed; exceeds recommended maximum ultrafiltration rate
C) 4.0 L to be removed; exceeds recommended maximum ultrafiltration rate
D) 2.8 L to be removed; appropriate for the 4-hour treatment
- detailed answer 100% correct :- B
, 3
Rationale: The fluid to be removed is calculated as pre-dialysis weight minus target dry weight:
78.4 kg – 75.0 kg = 3.4 kg (3.4 L). At 800 mL/hr for 4 hours, total ultrafiltration is 3.2 L, which is
less than the 3.4 L needed. However, more critically, the ultrafiltration rate of 800 mL/hr
exceeds the generally recommended maximum of 10–13 mL/kg/hr. For a 78.4 kg patient, the
maximum safe UFR would be approximately 780–1,019 mL/hr, making 800 mL/hr at the upper
limit but potentially acceptable. The key issue is that the prescription as written (3.2 L total)
would not remove the full 3.4 L of fluid gained, leaving 0.2 L remaining.
2. A patient receiving hemodialysis suddenly complains of dizziness, nausea, and abdominal
cramping. The technician notes that the patient's blood pressure has dropped from 142/88
mmHg to 98/62 mmHg. What is the MOST appropriate immediate action?
A) Increase the blood flow rate to improve cardiac output
B) Place the patient in Trendelenburg position and decrease the ultrafiltration rate
C) Administer a bolus of normal saline and continue treatment at current settings
D) Terminate the treatment immediately and notify the nurse
- detailed answer 100% correct :- B
Rationale: The patient is experiencing intradialytic hypotension, a common complication. The
priority interventions include placing the patient in Trendelenburg (head-down) position to
improve venous return and decreasing or stopping ultrafiltration to reduce fluid removal stress.
Option A is incorrect because increasing blood flow rate would not address the underlying fluid
shift problem. Option C may be appropriate after positional changes, but continuing at current
settings is inappropriate. Option D is overly aggressive—termination is not the first-line
response unless the patient becomes unresponsive or hypotensive persists despite
interventions.
3. Which of the following findings during vascular access assessment would indicate the
HIGHEST priority for intervention?
A) A bruit and thrill are palpable over the AV fistula
B) The access extremity is slightly warmer than the contralateral extremity
C) Absence of bruit with a high-pitched, continuous bruit heard on auscultation
D) Mild edema of the access extremity that resolves with elevation
- detailed answer 100% correct :- C
, 4
Rationale: A high-pitched, continuous bruit (rather than the normal low-pitched, intermittent
bruit) suggests stenosis or narrowing of the access, which can lead to thrombosis and access
failure. Absence of bruit with a continuous sound indicates turbulent flow through a narrowed
segment. Option A describes a normal, healthy AV fistula. Option B—warmth—may indicate
infection but is less immediately critical than a stenotic access that could clot. Option D—mild
edema—is a common finding that often resolves with elevation and is not immediately
threatening.
4. A technician is preparing to cannulate a patient's AV fistula. The technician observes that
the patient's skin over the access site is erythematous, warm to the touch, and there is
purulent drainage. What should the technician do?
A) Proceed with cannulation using strict aseptic technique
B) Cannulate a different site on the same access
C) Notify the nurse and do NOT cannulate the access
D) Clean the site thoroughly with chlorhexidine and proceed
- detailed answer 100% correct :- C
Rationale: The signs described—erythema, warmth, and purulent drainage—are classic
indicators of an access site infection. Cannulating an infected access can introduce bacteria into
the bloodstream, causing bacteremia or sepsis. The technician must notify the nurse
immediately and not cannulate the infected site. Option A and D ignore the infection risk.
Option B is inappropriate because cannulating elsewhere on the same infected access still poses
risk.
5. During hemodialysis treatment, the venous pressure alarm sounds with a high-pressure
reading. Which of the following is the MOST likely cause?
A) Needle infiltration
B) Clotting in the venous drip chamber
C) Kinking of the arterial blood line
D) Patient hypotension
- detailed answer 100% correct :- B
Rationale: High venous pressure alarms indicate increased resistance in the venous return
circuit. The most common causes include clotting in the venous drip chamber, venous needle
malposition, stenosis of the venous access, or kinking of the venous blood line. Option A
