The Definitive CCHT Practice Test
Bank: Questions, Correct Answers,
and Clinical Rationales for 2026/2027
Patient Assessment & Monitoring
1. A patient arrives for dialysis with a blood pressure of 180/110
mmHg. What is the most appropriate initial action?
A. Begin dialysis immediately to remove fluid and lower blood
pressure
B. Notify the nurse and delay dialysis until blood pressure is evaluated
C. Administer an antihypertensive medication as prescribed
D. Continue with patient assessment and monitor blood pressure
during dialysis
Correct Answer: B
Rationale: A blood pressure of 180/110 mmHg is severely hypertensive
and requires evaluation before dialysis. Dialysis can cause acute blood
pressure drops, and starting treatment with severely elevated pressure can
be dangerous. Only the nurse or physician can determine if dialysis should
proceed, be modified, or if medications are needed first.
2. During dialysis, a patient complains of muscle cramping in the legs.
What should the technician do first?
A. Immediately stop the dialysis treatment
, B. Check the ultrafiltration rate and notify the nurse
C. Give the patient a saline bolus without consulting the nurse
D. Tell the patient to endure the discomfort as it is normal
Correct Answer: B
Rationale: Muscle cramping during dialysis is commonly caused by rapid
fluid removal leading to volume depletion and electrolyte shifts. The
technician should first check the UF rate and notify the nurse, who may
adjust the rate, give saline, or modify treatment parameters. Never give
medications or fluids without nurse direction.
3. What is the most common cause of intradialytic hypotension?
A. Excessive ultrafiltration exceeding vascular refilling capacity
B. Dialyzer membrane reaction
C. Air embolism
D. Hyperkalemia
Correct Answer: A
Rationale: Intradialytic hypotension most commonly occurs when the
ultrafiltration rate exceeds the rate at which fluid can move from the
interstitial space back into the vascular compartment (vascular refilling
rate). This causes acute hypovolemia and dropping blood pressure.
4. A patient's pre-dialysis weight is 72 kg, and their dry weight is 68
kg. How much fluid should be removed during this treatment?
A. 2 liters
B. 4 liters
C. 6 liters
D. 8 liters
,Correct Answer: B
Rationale: The difference between pre-dialysis weight and dry weight
represents excess fluid to be removed. 72 kg - 68 kg = 4 kg, which is
equivalent to 4 liters of fluid (1 kg = 1 L).
5. For patients on hemodialysis, a 1 kg (2.2 lb.) increase in weight in 24
hours is approximately equivalent to fluid retention of which volume?
A. 0.5 L
B. 1.0 L
C. 1.5 L
D. 2.0 L
Correct Answer: B
Rationale: One kilogram of body weight is equivalent to one liter of fluid.
This is a critical concept for monitoring interdialytic weight gain and
determining ultrafiltration goals.
6. When reinforcing education about weight gain, a patient should be
advised that the usual goal for interdialytic weight gain is less than:
A. 0.5 kg/day
B. 1.0 kg/day
C. 1.5 kg/day
D. 2.0 kg/day
Correct Answer: B
Rationale: To prevent complications like cramping, hypotension, and
shortness of breath, patients are typically advised to limit their fluid weight
gain to no more than 1 kilogram (or 1 liter) per day between dialysis
sessions.
, 7. A rapid pulse of 104 beats/minute would indicate that the patient
has:
A. Bradycardia
B. Tachycardia
C. Normal heart rate
D. Arrhythmia
Correct Answer: B
Rationale: Tachycardia is defined as a heart rate greater than 100 beats per
minute in adults. A pulse of 104 beats/minute indicates tachycardia, which
may be caused by fluid overload, anemia, hypotension, or other
cardiovascular issues.
8. Which of the following ethnic groups is most at risk for the
development of kidney failure?
A. Caucasian
B. Asian American
C. African American
D. Hispanic
Correct Answer: C
Rationale: Due to a combination of genetic, environmental, and
socioeconomic factors, including a higher incidence of hypertension and
diabetes, African Americans are at a significantly higher risk for developing
end-stage renal disease (ESRD).
9. Albumin is an important test that tells about the patient's:
A. Nutritional status
B. Fluid status
C. Infection status
Bank: Questions, Correct Answers,
and Clinical Rationales for 2026/2027
Patient Assessment & Monitoring
1. A patient arrives for dialysis with a blood pressure of 180/110
mmHg. What is the most appropriate initial action?
A. Begin dialysis immediately to remove fluid and lower blood
pressure
B. Notify the nurse and delay dialysis until blood pressure is evaluated
C. Administer an antihypertensive medication as prescribed
D. Continue with patient assessment and monitor blood pressure
during dialysis
Correct Answer: B
Rationale: A blood pressure of 180/110 mmHg is severely hypertensive
and requires evaluation before dialysis. Dialysis can cause acute blood
pressure drops, and starting treatment with severely elevated pressure can
be dangerous. Only the nurse or physician can determine if dialysis should
proceed, be modified, or if medications are needed first.
2. During dialysis, a patient complains of muscle cramping in the legs.
What should the technician do first?
A. Immediately stop the dialysis treatment
, B. Check the ultrafiltration rate and notify the nurse
C. Give the patient a saline bolus without consulting the nurse
D. Tell the patient to endure the discomfort as it is normal
Correct Answer: B
Rationale: Muscle cramping during dialysis is commonly caused by rapid
fluid removal leading to volume depletion and electrolyte shifts. The
technician should first check the UF rate and notify the nurse, who may
adjust the rate, give saline, or modify treatment parameters. Never give
medications or fluids without nurse direction.
3. What is the most common cause of intradialytic hypotension?
A. Excessive ultrafiltration exceeding vascular refilling capacity
B. Dialyzer membrane reaction
C. Air embolism
D. Hyperkalemia
Correct Answer: A
Rationale: Intradialytic hypotension most commonly occurs when the
ultrafiltration rate exceeds the rate at which fluid can move from the
interstitial space back into the vascular compartment (vascular refilling
rate). This causes acute hypovolemia and dropping blood pressure.
4. A patient's pre-dialysis weight is 72 kg, and their dry weight is 68
kg. How much fluid should be removed during this treatment?
A. 2 liters
B. 4 liters
C. 6 liters
D. 8 liters
,Correct Answer: B
Rationale: The difference between pre-dialysis weight and dry weight
represents excess fluid to be removed. 72 kg - 68 kg = 4 kg, which is
equivalent to 4 liters of fluid (1 kg = 1 L).
5. For patients on hemodialysis, a 1 kg (2.2 lb.) increase in weight in 24
hours is approximately equivalent to fluid retention of which volume?
A. 0.5 L
B. 1.0 L
C. 1.5 L
D. 2.0 L
Correct Answer: B
Rationale: One kilogram of body weight is equivalent to one liter of fluid.
This is a critical concept for monitoring interdialytic weight gain and
determining ultrafiltration goals.
6. When reinforcing education about weight gain, a patient should be
advised that the usual goal for interdialytic weight gain is less than:
A. 0.5 kg/day
B. 1.0 kg/day
C. 1.5 kg/day
D. 2.0 kg/day
Correct Answer: B
Rationale: To prevent complications like cramping, hypotension, and
shortness of breath, patients are typically advised to limit their fluid weight
gain to no more than 1 kilogram (or 1 liter) per day between dialysis
sessions.
, 7. A rapid pulse of 104 beats/minute would indicate that the patient
has:
A. Bradycardia
B. Tachycardia
C. Normal heart rate
D. Arrhythmia
Correct Answer: B
Rationale: Tachycardia is defined as a heart rate greater than 100 beats per
minute in adults. A pulse of 104 beats/minute indicates tachycardia, which
may be caused by fluid overload, anemia, hypotension, or other
cardiovascular issues.
8. Which of the following ethnic groups is most at risk for the
development of kidney failure?
A. Caucasian
B. Asian American
C. African American
D. Hispanic
Correct Answer: C
Rationale: Due to a combination of genetic, environmental, and
socioeconomic factors, including a higher incidence of hypertension and
diabetes, African Americans are at a significantly higher risk for developing
end-stage renal disease (ESRD).
9. Albumin is an important test that tells about the patient's:
A. Nutritional status
B. Fluid status
C. Infection status
