CCHT Exam () Updated
Questions and Verified Answers, 100%
Guarantee Pass Score
Certified Clinical Hemodialysis Technician (CCHT)
Examination Blueprint
Q1. A hemodialysis technician is preparing to cannulate a patient's arteriovenous fistula. Which
assessment finding best indicates that the fistula is mature and suitable for cannulation?
A. A palpable thrill and an audible bruit
B. Redness and warmth surrounding the access site
C. Swelling and bruising near the anastomosis
D. Absence of a pulse distal to the access
Correct Answer: A
Rationale: A mature arteriovenous fistula is characterized by a palpable thrill (a vibration felt on
palpation) and an audible bruit (a whooshing sound heard with a stethoscope). These findings
indicate adequate blood flow through the fistula and suggest the vessel has remodeled sufficiently
for cannulation. Redness and warmth (B) suggest infection or inflammation. Swelling and bruising (C)
may indicate infiltration, hematoma, or recent trauma. Absence of a distal pulse (D) may indicate
steal syndrome, a serious complication requiring immediate evaluation.
Q2. A patient's pre-dialysis weight is 78.5 kg, and the prescribed dry weight is 75.0 kg. The treatment
time is 3.5 hours. What is the required ultrafiltration rate in mL/hour?
A. 500 mL/hr
B. 714 mL/hr
C. 1,000 mL/hr
D. 1,500 mL/hr
Correct Answer: C
Rationale: Fluid to remove equals 78.5 kg minus 75.0 kg, which is 3.5 kg, or 3,500 mL. The treatment
time is 3.5 hours. Ultrafiltration rate equals 3,500 mL divided by 3.5 hours, which equals 1,000
mL/hr. Choice A (500 mL/hr) would remove only half the required fluid. Choice B (714 mL/hr) would
require a treatment time of approximately 4.9 hours to remove 3,500 mL. Choice D (1,500 mL/hr)
would remove 5,250 mL over 3.5 hours, exceeding the prescribed fluid removal.
pg. 1
,Q3. During a hemodialysis treatment, a patient's AV fistula bruit becomes high-pitched and the thrill
feels weak. The technician should suspect which complication?
A. Normal fistula function
B. Stenosis
C. Aneurysm
D. Access infection
Correct Answer: B
Rationale: A high-pitched bruit accompanied by a weak thrill is a classic sign of stenosis, or
narrowing, within the fistula. The narrowed vessel creates turbulent, high-velocity flow that
produces a higher-pitched sound. A normal fistula (A) has a low-pitched bruit and a strong, easily
palpable thrill. An aneurysm (C) typically presents as a bulging, "squishy" area along the access.
Infection (D) presents with redness, warmth, swelling, and possibly purulent drainage.
Q4. A patient receiving hemodialysis suddenly complains of dizziness, nausea, and muscle cramping.
The blood pressure has dropped from 145/85 mmHg to 100/62 mmHg. What is the technician's first
action?
A. Increase the ultrafiltration rate
B. Administer a saline bolus
C. Decrease or stop ultrafiltration
D. Increase the blood flow rate
Correct Answer: C
Rationale: The patient is experiencing intradialytic hypotension, characterized by a significant drop
in blood pressure accompanied by symptoms. The first action is to decrease or stop ultrafiltration,
which reduces the rate of fluid removal and allows the patient's blood pressure to stabilize.
Increasing ultrafiltration (A) would worsen the hypotension by removing more fluid. Administering a
saline bolus (B) may be appropriate but requires a physician's order or standing protocol and is not
the immediate first action. Increasing blood flow rate (D) does not address the underlying volume
depletion.
Q5. The primary function of the water treatment system in a hemodialysis facility is to:
A. Add beneficial minerals to the dialysate
B. Remove contaminants and impurities from the water
C. Increase the temperature of the water for patient comfort
D. Adjust the pH of the dialysate solution
Correct Answer: B
Rationale: The water treatment system removes contaminants and impurities from municipal water
to prevent patient harm during hemodialysis. Contaminants such as chloramines, heavy metals,
bacteria, and endotoxins can cause serious complications including hemolysis, hypotension, and
pyrogenic reactions. Choice A is incorrect because the system removes, not adds, substances.
Temperature control (C) is managed by the dialysis machine, not the water treatment system.
Dialysate pH adjustment (D) occurs at the machine level, not in the water treatment system.
pg. 2
,Q6. According to current AAMI standards, the maximum allowable bacterial count in standard
dialysate is:
A. 50 CFU/mL
B. 100 CFU/mL
C. 200 CFU/mL
D. 1,000 CFU/mL
Correct Answer: B
Rationale: Current AAMI/ISO standards set the maximum allowable bacterial count for standard
dialysate at less than 100 colony-forming units per milliliter (CFU/mL). The endotoxin limit is 0.25
EU/mL. Levels of 200 CFU/mL (C) and 1,000 CFU/mL (D) exceed the acceptable standard and pose a
risk of pyrogenic reactions. Choice A (50 CFU/mL) is below the maximum but is not the established
standard.
Q7. Which component of the water treatment system is responsible for removing dissolved ions and
minerals from the water?
A. Sediment filter
B. Carbon tank
C. Reverse osmosis unit
D. Ultrafilter
Correct Answer: C
Rationale: The reverse osmosis unit removes dissolved ions and minerals by forcing water through a
semipermeable membrane under high pressure. The sediment filter (A) removes particulate matter
such as dirt and rust. The carbon tank (B) removes chlorine and chloramines through adsorption. The
ultrafilter (D) removes bacteria and endotoxins but does not remove dissolved ions.
Q8. During hemodialysis machine setup, the conductivity alarm test fails. What action should the
technician take?
A. Bypass the alarm and continue with setup
B. Notify the biomedical technician for repair
C. Use the machine without completing the alarm test
D. Ignore the alarm since the machine may self-correct
Correct Answer: B
Rationale: If the conductivity alarm test fails, the technician must notify the biomedical technician or
remove the machine from service. Bypassing the alarm (A) or ignoring it (D) would compromise
patient safety, as improper dialysate conductivity can cause hemolysis or inadequate dialysis. Using
the machine without alarm testing (C) violates safety protocols and places the patient at risk.
Q9. The typical dialysate flow rate during standard hemodialysis is:
pg. 3
, A. 200–300 mL/min
B. 500–800 mL/min
C. 1,000–1,500 mL/min
D. 2,000–3,000 mL/min
Correct Answer: B
Rationale: Standard dialysate flow rates during hemodialysis are typically 500–800 mL/min, with 500
mL/min and 800 mL/min being common settings. Higher dialysate flow rates can improve clearance
of small solutes. Choices A, C, and D fall outside the typical clinical range for standard hemodialysis
treatments.
Q10. A patient's pre-dialysis assessment reveals a temperature of 38.3°C (101°F), heart rate of 102
beats per minute, and complaints of chills. The technician should:
A. Proceed with dialysis as ordered
B. Recognize and report signs of possible infection
C. Administer acetaminophen per standing order
D. Increase the dialysate temperature for comfort
Correct Answer: B
Rationale: Fever, tachycardia, and chills are signs of possible infection and must be recognized and
reported to the nurse or physician. Proceeding with dialysis (A) without evaluation could worsen the
patient's condition. Administering medication (C) is outside the technician's scope of practice.
Adjusting dialysate temperature (D) does not address the underlying infection and could mask
symptoms.
Q11. Which of the following best describes the principle of diffusion as it applies to hemodialysis?
A. Movement of fluid across a membrane due to pressure gradient
B. Movement of solutes from higher to lower concentration across a semipermeable membrane
C. Movement of water from lower to higher solute concentration
D. Movement of solutes carried by fluid during ultrafiltration
Correct Answer: B
Rationale: Diffusion is the movement of solutes from an area of higher concentration to an area of
lower concentration across a semipermeable membrane. During hemodialysis, urea, creatinine, and
potassium diffuse from the blood (higher concentration) into the dialysate (lower concentration).
Choice A describes ultrafiltration. Choice C describes osmosis. Choice D describes convection.
Q12. A patient's arteriovenous graft has a palpable pulse but no thrill or bruit. The technician should:
A. Proceed with cannulation since a pulse is present
B. Recognize this as a potential access failure and report immediately
C. Apply warm compresses to the access site
D. Document the finding and continue with routine care
pg. 4
Questions and Verified Answers, 100%
Guarantee Pass Score
Certified Clinical Hemodialysis Technician (CCHT)
Examination Blueprint
Q1. A hemodialysis technician is preparing to cannulate a patient's arteriovenous fistula. Which
assessment finding best indicates that the fistula is mature and suitable for cannulation?
A. A palpable thrill and an audible bruit
B. Redness and warmth surrounding the access site
C. Swelling and bruising near the anastomosis
D. Absence of a pulse distal to the access
Correct Answer: A
Rationale: A mature arteriovenous fistula is characterized by a palpable thrill (a vibration felt on
palpation) and an audible bruit (a whooshing sound heard with a stethoscope). These findings
indicate adequate blood flow through the fistula and suggest the vessel has remodeled sufficiently
for cannulation. Redness and warmth (B) suggest infection or inflammation. Swelling and bruising (C)
may indicate infiltration, hematoma, or recent trauma. Absence of a distal pulse (D) may indicate
steal syndrome, a serious complication requiring immediate evaluation.
Q2. A patient's pre-dialysis weight is 78.5 kg, and the prescribed dry weight is 75.0 kg. The treatment
time is 3.5 hours. What is the required ultrafiltration rate in mL/hour?
A. 500 mL/hr
B. 714 mL/hr
C. 1,000 mL/hr
D. 1,500 mL/hr
Correct Answer: C
Rationale: Fluid to remove equals 78.5 kg minus 75.0 kg, which is 3.5 kg, or 3,500 mL. The treatment
time is 3.5 hours. Ultrafiltration rate equals 3,500 mL divided by 3.5 hours, which equals 1,000
mL/hr. Choice A (500 mL/hr) would remove only half the required fluid. Choice B (714 mL/hr) would
require a treatment time of approximately 4.9 hours to remove 3,500 mL. Choice D (1,500 mL/hr)
would remove 5,250 mL over 3.5 hours, exceeding the prescribed fluid removal.
pg. 1
,Q3. During a hemodialysis treatment, a patient's AV fistula bruit becomes high-pitched and the thrill
feels weak. The technician should suspect which complication?
A. Normal fistula function
B. Stenosis
C. Aneurysm
D. Access infection
Correct Answer: B
Rationale: A high-pitched bruit accompanied by a weak thrill is a classic sign of stenosis, or
narrowing, within the fistula. The narrowed vessel creates turbulent, high-velocity flow that
produces a higher-pitched sound. A normal fistula (A) has a low-pitched bruit and a strong, easily
palpable thrill. An aneurysm (C) typically presents as a bulging, "squishy" area along the access.
Infection (D) presents with redness, warmth, swelling, and possibly purulent drainage.
Q4. A patient receiving hemodialysis suddenly complains of dizziness, nausea, and muscle cramping.
The blood pressure has dropped from 145/85 mmHg to 100/62 mmHg. What is the technician's first
action?
A. Increase the ultrafiltration rate
B. Administer a saline bolus
C. Decrease or stop ultrafiltration
D. Increase the blood flow rate
Correct Answer: C
Rationale: The patient is experiencing intradialytic hypotension, characterized by a significant drop
in blood pressure accompanied by symptoms. The first action is to decrease or stop ultrafiltration,
which reduces the rate of fluid removal and allows the patient's blood pressure to stabilize.
Increasing ultrafiltration (A) would worsen the hypotension by removing more fluid. Administering a
saline bolus (B) may be appropriate but requires a physician's order or standing protocol and is not
the immediate first action. Increasing blood flow rate (D) does not address the underlying volume
depletion.
Q5. The primary function of the water treatment system in a hemodialysis facility is to:
A. Add beneficial minerals to the dialysate
B. Remove contaminants and impurities from the water
C. Increase the temperature of the water for patient comfort
D. Adjust the pH of the dialysate solution
Correct Answer: B
Rationale: The water treatment system removes contaminants and impurities from municipal water
to prevent patient harm during hemodialysis. Contaminants such as chloramines, heavy metals,
bacteria, and endotoxins can cause serious complications including hemolysis, hypotension, and
pyrogenic reactions. Choice A is incorrect because the system removes, not adds, substances.
Temperature control (C) is managed by the dialysis machine, not the water treatment system.
Dialysate pH adjustment (D) occurs at the machine level, not in the water treatment system.
pg. 2
,Q6. According to current AAMI standards, the maximum allowable bacterial count in standard
dialysate is:
A. 50 CFU/mL
B. 100 CFU/mL
C. 200 CFU/mL
D. 1,000 CFU/mL
Correct Answer: B
Rationale: Current AAMI/ISO standards set the maximum allowable bacterial count for standard
dialysate at less than 100 colony-forming units per milliliter (CFU/mL). The endotoxin limit is 0.25
EU/mL. Levels of 200 CFU/mL (C) and 1,000 CFU/mL (D) exceed the acceptable standard and pose a
risk of pyrogenic reactions. Choice A (50 CFU/mL) is below the maximum but is not the established
standard.
Q7. Which component of the water treatment system is responsible for removing dissolved ions and
minerals from the water?
A. Sediment filter
B. Carbon tank
C. Reverse osmosis unit
D. Ultrafilter
Correct Answer: C
Rationale: The reverse osmosis unit removes dissolved ions and minerals by forcing water through a
semipermeable membrane under high pressure. The sediment filter (A) removes particulate matter
such as dirt and rust. The carbon tank (B) removes chlorine and chloramines through adsorption. The
ultrafilter (D) removes bacteria and endotoxins but does not remove dissolved ions.
Q8. During hemodialysis machine setup, the conductivity alarm test fails. What action should the
technician take?
A. Bypass the alarm and continue with setup
B. Notify the biomedical technician for repair
C. Use the machine without completing the alarm test
D. Ignore the alarm since the machine may self-correct
Correct Answer: B
Rationale: If the conductivity alarm test fails, the technician must notify the biomedical technician or
remove the machine from service. Bypassing the alarm (A) or ignoring it (D) would compromise
patient safety, as improper dialysate conductivity can cause hemolysis or inadequate dialysis. Using
the machine without alarm testing (C) violates safety protocols and places the patient at risk.
Q9. The typical dialysate flow rate during standard hemodialysis is:
pg. 3
, A. 200–300 mL/min
B. 500–800 mL/min
C. 1,000–1,500 mL/min
D. 2,000–3,000 mL/min
Correct Answer: B
Rationale: Standard dialysate flow rates during hemodialysis are typically 500–800 mL/min, with 500
mL/min and 800 mL/min being common settings. Higher dialysate flow rates can improve clearance
of small solutes. Choices A, C, and D fall outside the typical clinical range for standard hemodialysis
treatments.
Q10. A patient's pre-dialysis assessment reveals a temperature of 38.3°C (101°F), heart rate of 102
beats per minute, and complaints of chills. The technician should:
A. Proceed with dialysis as ordered
B. Recognize and report signs of possible infection
C. Administer acetaminophen per standing order
D. Increase the dialysate temperature for comfort
Correct Answer: B
Rationale: Fever, tachycardia, and chills are signs of possible infection and must be recognized and
reported to the nurse or physician. Proceeding with dialysis (A) without evaluation could worsen the
patient's condition. Administering medication (C) is outside the technician's scope of practice.
Adjusting dialysate temperature (D) does not address the underlying infection and could mask
symptoms.
Q11. Which of the following best describes the principle of diffusion as it applies to hemodialysis?
A. Movement of fluid across a membrane due to pressure gradient
B. Movement of solutes from higher to lower concentration across a semipermeable membrane
C. Movement of water from lower to higher solute concentration
D. Movement of solutes carried by fluid during ultrafiltration
Correct Answer: B
Rationale: Diffusion is the movement of solutes from an area of higher concentration to an area of
lower concentration across a semipermeable membrane. During hemodialysis, urea, creatinine, and
potassium diffuse from the blood (higher concentration) into the dialysate (lower concentration).
Choice A describes ultrafiltration. Choice C describes osmosis. Choice D describes convection.
Q12. A patient's arteriovenous graft has a palpable pulse but no thrill or bruit. The technician should:
A. Proceed with cannulation since a pulse is present
B. Recognize this as a potential access failure and report immediately
C. Apply warm compresses to the access site
D. Document the finding and continue with routine care
pg. 4
