Fresenius Hemodialysis Study Guide
Exam 2025 Complete Verified Questions
and 100% Correct Answers with Detailed
Explanations
Comprehensive Review for Certified Clinical Hemodialysis
Technician (CCHT) Exam Preparation
Updated for 2025/2026 Certification Cycle
Prepared for Dialysis Technicians and Nurses
July 23, 2025
,Contents
1 Introduction 4
2 Dialysis Fundamentals 4
2.1 What are the primary functions of a healthy kidney? . . . . . . . . . . . . . . . 4
2.2 What is hemodialysis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.3 What is the nephron? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.4 What is the role of the glomerulus in the kidney? . . . . . . . . . . . . . . . . 4
2.5 What is the order of urine flow in the urinary system? . . . . . . . . . . . . . . 4
2.6 What is erythropoietins function? . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.7 What is the synthetic form of erythropoietin used in dialysis? . . . . . . . . . . 5
2.8 What is the synthetic form of vitamin D used in dialysis? . . . . . . . . . . . . 5
2.9 What is the role of renin in the body? . . . . . . . . . . . . . . . . . . . . . . . 5
2.10 What are the bodys fluid compartments? . . . . . . . . . . . . . . . . . . . . . 5
2.11 What factors influence diffusion in dialysis? . . . . . . . . . . . . . . . . . . . 5
2.12 What are the types of solutions used in dialysis? . . . . . . . . . . . . . . . . . 5
2.13 What is countercurrent flow in dialysis? . . . . . . . . . . . . . . . . . . . . . 6
2.14 What happens to diffusion when dialyzer fibers clot? . . . . . . . . . . . . . . 6
2.15 What are the compartments of a dialyzer? . . . . . . . . . . . . . . . . . . . . 6
2.16 What is transmembrane pressure (TMP)? . . . . . . . . . . . . . . . . . . . . 6
2.17 How can you detect dialyzer clotting? . . . . . . . . . . . . . . . . . . . . . . 6
2.18 What are the mandatory machine alarms to check before dialysis? . . . . . . . 6
2.19 Why is dextrose added to dialysate? . . . . . . . . . . . . . . . . . . . . . . . 6
2.20 What causes increased arterial and venous pressures? . . . . . . . . . . . . . . 7
3 Patient Care and Monitoring 7
3.1 What is a pre-dialysis evaluation? . . . . . . . . . . . . . . . . . . . . . . . . 7
3.2 Why are pre-dialysis evaluations necessary? . . . . . . . . . . . . . . . . . . . 7
3.3 What are the three Cs in pre-dialysis assessment? . . . . . . . . . . . . . . . . 7
3.4 What should be assessed in a patients ambulation? . . . . . . . . . . . . . . . . 7
3.5 What is assessed in a patients mental status? . . . . . . . . . . . . . . . . . . . 7
3.6 What is checked during a skin assessment? . . . . . . . . . . . . . . . . . . . 7
3.7 Which vital signs are monitored pre-dialysis? . . . . . . . . . . . . . . . . . . 8
3.8 What is Estimated Dry Weight (EDW)? . . . . . . . . . . . . . . . . . . . . . 8
3.9 When is RN assessment required for pre-dialysis weight? . . . . . . . . . . . . 8
3.10 What is the leading cause of chronic renal failure? . . . . . . . . . . . . . . . . 8
3.11 Which foods are high in phosphorus? . . . . . . . . . . . . . . . . . . . . . . 8
3.12 Which foods are high in potassium? . . . . . . . . . . . . . . . . . . . . . . . 8
3.13 What is the technicians role in patient education? . . . . . . . . . . . . . . . . 8
3.14 What PPE is mandatory in the patient care area? . . . . . . . . . . . . . . . . . 9
3.15 What is the purpose of a fistula in dialysis? . . . . . . . . . . . . . . . . . . . 9
3.16 Why check both arms for a fistula before taking blood pressure? . . . . . . . . 9
3.17 What should a PCT do if a patient reports catheter site pain? . . . . . . . . . . 9
3.18 What is the normal body temperature range? . . . . . . . . . . . . . . . . . . . 9
3.19 What should a PCT do if a patient has a pulse of 44 bpm but appears stable? . . 9
4 Infection Control 9
4.1 What is aseptic technique? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
1
, 4.2 Why is dialysis a high-risk area for infections? . . . . . . . . . . . . . . . . . . 10
4.3 What is the main route of hepatitis B transmission in dialysis? . . . . . . . . . 10
4.4 What are universal precautions? . . . . . . . . . . . . . . . . . . . . . . . . . 10
4.5 How long should hands be washed with soap and water? . . . . . . . . . . . . 10
4.6 How long should hands be rubbed with sanitizer? . . . . . . . . . . . . . . . . 10
4.7 What bleach solution is used for surface cleaning? . . . . . . . . . . . . . . . . 10
4.8 What bleach solution is used for large blood spills? . . . . . . . . . . . . . . . 10
4.9 Is hand hygiene required when moving from dirty to clean areas? . . . . . . . . 10
4.10 What should be done after disconnecting bloodlines for a hepatitis B-positive
patient? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
5 Dialysis Procedures and Equipment 11
5.1 What are the two hemodialysis delivery systems? . . . . . . . . . . . . . . . . 11
5.2 What is dialysis adequacy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
5.3 What lab test measures dialysis adequacy? . . . . . . . . . . . . . . . . . . . . 11
5.4 What is Kt/V? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
5.5 What causes inadequate dialysis? . . . . . . . . . . . . . . . . . . . . . . . . . 11
5.6 What is an Online Clearance (OLC) test? . . . . . . . . . . . . . . . . . . . . 11
5.7 What factors affect dialyzer clearance? . . . . . . . . . . . . . . . . . . . . . . 12
5.8 What are the components of a hemodialysis prescription? . . . . . . . . . . . . 12
5.9 What are the components of the extracorporeal circuit? . . . . . . . . . . . . . 12
5.10 What is dialyzer biocompatibility? . . . . . . . . . . . . . . . . . . . . . . . . 12
5.11 What does a larger dialyzer surface area enable? . . . . . . . . . . . . . . . . . 12
5.12 How does TMP affect dialysis? . . . . . . . . . . . . . . . . . . . . . . . . . . 12
5.13 What is the advantage of countercurrent flow? . . . . . . . . . . . . . . . . . . 12
5.14 What is dialyzer clearance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
5.15 When might a patient develop dialyzer sensitivity? . . . . . . . . . . . . . . . 13
5.16 How is a major blood leak treated? . . . . . . . . . . . . . . . . . . . . . . . . 13
5.17 When is hand-cranking the blood pump necessary? . . . . . . . . . . . . . . . 13
5.18 What precautions are needed when hand-cranking? . . . . . . . . . . . . . . . 13
5.19 What should post-dialysis documentation include? . . . . . . . . . . . . . . . 13
5.20 What should acid containers be labeled with? . . . . . . . . . . . . . . . . . . 13
6 Water Treatment and Safety 13
6.1 What is the maximum chlorine level in the water treatment room? . . . . . . . 13
6.2 What is albumins role and target range in dialysis patients? . . . . . . . . . . . 13
6.3 What is the safe pH range for dialysate? . . . . . . . . . . . . . . . . . . . . . 14
6.4 What is the conductivity range for dialysate? . . . . . . . . . . . . . . . . . . . 14
6.5 What causes hemolysis in dialysis? . . . . . . . . . . . . . . . . . . . . . . . . 14
6.6 What causes crenation in dialysis? . . . . . . . . . . . . . . . . . . . . . . . . 14
6.7 What is the maximum machine temperature for dialysis? . . . . . . . . . . . . 14
6.8 What does a dialysate plus filter produce? . . . . . . . . . . . . . . . . . . . . 14
6.9 How often is acid disinfecting of the water system performed? . . . . . . . . . 14
6.10 What are HMIS labels required for? . . . . . . . . . . . . . . . . . . . . . . . 15
7 Additional Questions 15
7.1 What is the purpose of heparin in dialysis? . . . . . . . . . . . . . . . . . . . . 15
7.2 What is the target spKt/V for dialysis adequacy? . . . . . . . . . . . . . . . . . 15
7.3 What is ultrafiltration in dialysis? . . . . . . . . . . . . . . . . . . . . . . . . . 15
2
Exam 2025 Complete Verified Questions
and 100% Correct Answers with Detailed
Explanations
Comprehensive Review for Certified Clinical Hemodialysis
Technician (CCHT) Exam Preparation
Updated for 2025/2026 Certification Cycle
Prepared for Dialysis Technicians and Nurses
July 23, 2025
,Contents
1 Introduction 4
2 Dialysis Fundamentals 4
2.1 What are the primary functions of a healthy kidney? . . . . . . . . . . . . . . . 4
2.2 What is hemodialysis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.3 What is the nephron? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.4 What is the role of the glomerulus in the kidney? . . . . . . . . . . . . . . . . 4
2.5 What is the order of urine flow in the urinary system? . . . . . . . . . . . . . . 4
2.6 What is erythropoietins function? . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.7 What is the synthetic form of erythropoietin used in dialysis? . . . . . . . . . . 5
2.8 What is the synthetic form of vitamin D used in dialysis? . . . . . . . . . . . . 5
2.9 What is the role of renin in the body? . . . . . . . . . . . . . . . . . . . . . . . 5
2.10 What are the bodys fluid compartments? . . . . . . . . . . . . . . . . . . . . . 5
2.11 What factors influence diffusion in dialysis? . . . . . . . . . . . . . . . . . . . 5
2.12 What are the types of solutions used in dialysis? . . . . . . . . . . . . . . . . . 5
2.13 What is countercurrent flow in dialysis? . . . . . . . . . . . . . . . . . . . . . 6
2.14 What happens to diffusion when dialyzer fibers clot? . . . . . . . . . . . . . . 6
2.15 What are the compartments of a dialyzer? . . . . . . . . . . . . . . . . . . . . 6
2.16 What is transmembrane pressure (TMP)? . . . . . . . . . . . . . . . . . . . . 6
2.17 How can you detect dialyzer clotting? . . . . . . . . . . . . . . . . . . . . . . 6
2.18 What are the mandatory machine alarms to check before dialysis? . . . . . . . 6
2.19 Why is dextrose added to dialysate? . . . . . . . . . . . . . . . . . . . . . . . 6
2.20 What causes increased arterial and venous pressures? . . . . . . . . . . . . . . 7
3 Patient Care and Monitoring 7
3.1 What is a pre-dialysis evaluation? . . . . . . . . . . . . . . . . . . . . . . . . 7
3.2 Why are pre-dialysis evaluations necessary? . . . . . . . . . . . . . . . . . . . 7
3.3 What are the three Cs in pre-dialysis assessment? . . . . . . . . . . . . . . . . 7
3.4 What should be assessed in a patients ambulation? . . . . . . . . . . . . . . . . 7
3.5 What is assessed in a patients mental status? . . . . . . . . . . . . . . . . . . . 7
3.6 What is checked during a skin assessment? . . . . . . . . . . . . . . . . . . . 7
3.7 Which vital signs are monitored pre-dialysis? . . . . . . . . . . . . . . . . . . 8
3.8 What is Estimated Dry Weight (EDW)? . . . . . . . . . . . . . . . . . . . . . 8
3.9 When is RN assessment required for pre-dialysis weight? . . . . . . . . . . . . 8
3.10 What is the leading cause of chronic renal failure? . . . . . . . . . . . . . . . . 8
3.11 Which foods are high in phosphorus? . . . . . . . . . . . . . . . . . . . . . . 8
3.12 Which foods are high in potassium? . . . . . . . . . . . . . . . . . . . . . . . 8
3.13 What is the technicians role in patient education? . . . . . . . . . . . . . . . . 8
3.14 What PPE is mandatory in the patient care area? . . . . . . . . . . . . . . . . . 9
3.15 What is the purpose of a fistula in dialysis? . . . . . . . . . . . . . . . . . . . 9
3.16 Why check both arms for a fistula before taking blood pressure? . . . . . . . . 9
3.17 What should a PCT do if a patient reports catheter site pain? . . . . . . . . . . 9
3.18 What is the normal body temperature range? . . . . . . . . . . . . . . . . . . . 9
3.19 What should a PCT do if a patient has a pulse of 44 bpm but appears stable? . . 9
4 Infection Control 9
4.1 What is aseptic technique? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
1
, 4.2 Why is dialysis a high-risk area for infections? . . . . . . . . . . . . . . . . . . 10
4.3 What is the main route of hepatitis B transmission in dialysis? . . . . . . . . . 10
4.4 What are universal precautions? . . . . . . . . . . . . . . . . . . . . . . . . . 10
4.5 How long should hands be washed with soap and water? . . . . . . . . . . . . 10
4.6 How long should hands be rubbed with sanitizer? . . . . . . . . . . . . . . . . 10
4.7 What bleach solution is used for surface cleaning? . . . . . . . . . . . . . . . . 10
4.8 What bleach solution is used for large blood spills? . . . . . . . . . . . . . . . 10
4.9 Is hand hygiene required when moving from dirty to clean areas? . . . . . . . . 10
4.10 What should be done after disconnecting bloodlines for a hepatitis B-positive
patient? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
5 Dialysis Procedures and Equipment 11
5.1 What are the two hemodialysis delivery systems? . . . . . . . . . . . . . . . . 11
5.2 What is dialysis adequacy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
5.3 What lab test measures dialysis adequacy? . . . . . . . . . . . . . . . . . . . . 11
5.4 What is Kt/V? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
5.5 What causes inadequate dialysis? . . . . . . . . . . . . . . . . . . . . . . . . . 11
5.6 What is an Online Clearance (OLC) test? . . . . . . . . . . . . . . . . . . . . 11
5.7 What factors affect dialyzer clearance? . . . . . . . . . . . . . . . . . . . . . . 12
5.8 What are the components of a hemodialysis prescription? . . . . . . . . . . . . 12
5.9 What are the components of the extracorporeal circuit? . . . . . . . . . . . . . 12
5.10 What is dialyzer biocompatibility? . . . . . . . . . . . . . . . . . . . . . . . . 12
5.11 What does a larger dialyzer surface area enable? . . . . . . . . . . . . . . . . . 12
5.12 How does TMP affect dialysis? . . . . . . . . . . . . . . . . . . . . . . . . . . 12
5.13 What is the advantage of countercurrent flow? . . . . . . . . . . . . . . . . . . 12
5.14 What is dialyzer clearance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
5.15 When might a patient develop dialyzer sensitivity? . . . . . . . . . . . . . . . 13
5.16 How is a major blood leak treated? . . . . . . . . . . . . . . . . . . . . . . . . 13
5.17 When is hand-cranking the blood pump necessary? . . . . . . . . . . . . . . . 13
5.18 What precautions are needed when hand-cranking? . . . . . . . . . . . . . . . 13
5.19 What should post-dialysis documentation include? . . . . . . . . . . . . . . . 13
5.20 What should acid containers be labeled with? . . . . . . . . . . . . . . . . . . 13
6 Water Treatment and Safety 13
6.1 What is the maximum chlorine level in the water treatment room? . . . . . . . 13
6.2 What is albumins role and target range in dialysis patients? . . . . . . . . . . . 13
6.3 What is the safe pH range for dialysate? . . . . . . . . . . . . . . . . . . . . . 14
6.4 What is the conductivity range for dialysate? . . . . . . . . . . . . . . . . . . . 14
6.5 What causes hemolysis in dialysis? . . . . . . . . . . . . . . . . . . . . . . . . 14
6.6 What causes crenation in dialysis? . . . . . . . . . . . . . . . . . . . . . . . . 14
6.7 What is the maximum machine temperature for dialysis? . . . . . . . . . . . . 14
6.8 What does a dialysate plus filter produce? . . . . . . . . . . . . . . . . . . . . 14
6.9 How often is acid disinfecting of the water system performed? . . . . . . . . . 14
6.10 What are HMIS labels required for? . . . . . . . . . . . . . . . . . . . . . . . 15
7 Additional Questions 15
7.1 What is the purpose of heparin in dialysis? . . . . . . . . . . . . . . . . . . . . 15
7.2 What is the target spKt/V for dialysis adequacy? . . . . . . . . . . . . . . . . . 15
7.3 What is ultrafiltration in dialysis? . . . . . . . . . . . . . . . . . . . . . . . . . 15
2
