CCHT
MAXE • THCC
CCHT Certified Clinical Hemodialysis Technician
N AT I O N A L N E P H R O LO G Y C E R T I F I C AT I O N O R G A N I Z AT I O N
NNCO CERT
CCHT Certification Examination
CO M P R E H E N S I V E P R A C T I C E E X A M — V E R I F I E D A N S W E R S
CERTIFICATION CCHT — NNCO CREDENTIALING National Nephrology Certification
Organization
PROGRAM Hemodialysis Technician Certification ACADEMIC YEAR
EXAM TITLE CCHT Practice Examination TOTAL QUESTIONS 100+ Questions
DOMAIN Patient Care, Water Treatment, Dialyzer FORMAT Multiple Choice — Select the Single Best
Reprocessing, Infection Control Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise indicated.
▸ Questions cover all CCHT domains: clinical, technical, water treatment, infection control, and professional roles.
▸ Verified answers with rationales are provided for comprehensive certification preparation.
▸ Pay close attention to safety, infection control, and dialysis machine parameters.
CCHT CERTIFICATION — COMPREHENSIVE PRACTICE EXAMINATION Questions 1 – 100+
1. While technical staff are performing duties in the dialysis unit, which team member must always be present?
A. Registered nurse.
B. Medical director for the unit.
C. Lab technician.
CORRECT ANSWER A — Registered nurse
RATIONALE A registered nurse must be present at all times when dialysis treatments are being performed. The RN is
responsible for patient assessment, medication administration, and supervising the care provided by dialysis
technicians. This is a CMS regulatory requirement.
2. Two techs are heatedly discussing a patient care situation. Which team member is responsible for disciplinary
action?
A. Registered practical nurse.
B. Human resource manager.
C. Dialysis nurse manager.
CORRECT ANSWER C — Dialysis nurse manager
RATIONALE The dialysis nurse manager is the direct supervisor responsible for staff discipline, conflict resolution, and
ensuring professional conduct in the dialysis unit. Human resources may be involved but the nurse manager
initiates and manages disciplinary action for clinical staff.
,3. Which credentialing agency for dialysis includes water treatment, dialysate preparation, and complications of
dialysis as part of their practice domains?
A. Board of Nephrology Examiners Nursing in Technology.
B. Nephrology Nursing Certification Commission.
C. National Nephrology Certification Organization (NNCO).
CORRECT ANSWER C — National Nephrology Certification Organization (NNCO)
RATIONALE The NNCO provides CCHT certification covering all domains of hemodialysis technology including water
treatment, dialysate preparation, extracorporeal circuit management, complications of dialysis, and infection
control. It is the primary certification body for dialysis technicians.
4. Prior to starting dialysis, what must the technician and/or nurse verify?
A. That the patient has provided informed written consent for dialysis.
B. That the patient has not eaten any food or beverages for the last six hours.
C. That the patient has a driver to pick him up after dialysis.
CORRECT ANSWER A — That the patient has provided informed written consent for dialysis
RATIONALE Informed consent is a legal and ethical requirement before initiating any medical treatment, including
dialysis. The patient must understand and agree to the procedure in writing. While other preparations are
important, consent verification is mandatory.
5. Which external agencies provide additional guidelines in the areas of infectious disease testing, immunizations,
dialysis treatment safety, and infection control? (Select all that apply.)
A. Centers for Disease Control and Prevention (CDC).
B. Centers for Medicare and Medicaid Services (CMS).
C. Association for the Advancement of Medical Instrumentation (AAMI).
CORRECT ANSWER A, B, C (All of the above)
RATIONALE CDC provides infection control guidelines and disease testing recommendations. CMS establishes conditions
for coverage and reimbursement. AAMI develops technical standards for water quality, dialysate, and
equipment. All three agencies provide essential guidelines for dialysis practice.
6. The Social Security amendments that extended Medicare coverage for almost all patients with ESRD were signed in
what year?
A. 1979, by Jimmy Carter.
B. 1972, by Richard Nixon.
C. 1961, by John F. Kennedy.
CORRECT ANSWER B — 1972, by Richard Nixon
RATIONALE The Social Security Amendments of 1972 (Section 299I) extended Medicare coverage to individuals with end-
stage renal disease (ESRD) regardless of age. This landmark legislation, signed by President Nixon, made
dialysis and transplantation accessible to nearly all Americans with kidney failure.
, 7. What is the composition of saline?
A. 10% salt added to water.
B. Albumin.
C. 0.9 grams of sodium chloride in 100 mL of water.
CORRECT ANSWER C — 0.9 grams of sodium chloride in 100 mL of water
RATIONALE Normal saline (0.9% NaCl) contains 0.9 grams of sodium chloride per 100 mL of water. It is isotonic with
human plasma (approximately 308 mOsm/L) and is the standard solution used for priming the extracorporeal
circuit and managing intradialytic hypotension.
8. When caring for a patient, if the dialysate solution contains too little sodium, which signs or symptoms would you
see?
A. Hypotension and cramping.
B. Thirst.
C. Headache.
CORRECT ANSWER A — Hypotension and cramping
RATIONALE When dialysate sodium concentration is too low (hyponatremic dialysate), water shifts from the blood into
cells and tissues by osmosis, causing intravascular volume depletion. This results in hypotension (from
decreased blood volume) and muscle cramping (from cellular edema and electrolyte shifts).
9. Which buffer is the major plasma buffer and therefore important during dialysis?
A. Bicarbonate.
B. Amino acid.
C. Protein.
CORRECT ANSWER A — Bicarbonate
RATIONALE Bicarbonate (HCO₃⁻) is the major extracellular buffer system in the body, maintaining normal blood pH. In
dialysis, bicarbonate is added to the dialysate to correct the metabolic acidosis that occurs in kidney failure.
The bicarbonate buffer system is essential for acid-base homeostasis.
10. While reviewing the body weight for a dialysis patient, the tech knows that ___ of the total amount of water is
contained in the intracellular fluid compartment.
A. 20%.
B. 30%.
C. 40%.
CORRECT ANSWER C — 40%
RATIONALE Total body water is approximately 60% of body weight. Of this, about 40% is intracellular fluid (ICF) — water
inside cells. The remaining 20% is extracellular fluid (ECF), which includes interstitial fluid (15%) and plasma
(5%). This distribution is crucial for understanding fluid removal during dialysis.
MAXE • THCC
CCHT Certified Clinical Hemodialysis Technician
N AT I O N A L N E P H R O LO G Y C E R T I F I C AT I O N O R G A N I Z AT I O N
NNCO CERT
CCHT Certification Examination
CO M P R E H E N S I V E P R A C T I C E E X A M — V E R I F I E D A N S W E R S
CERTIFICATION CCHT — NNCO CREDENTIALING National Nephrology Certification
Organization
PROGRAM Hemodialysis Technician Certification ACADEMIC YEAR
EXAM TITLE CCHT Practice Examination TOTAL QUESTIONS 100+ Questions
DOMAIN Patient Care, Water Treatment, Dialyzer FORMAT Multiple Choice — Select the Single Best
Reprocessing, Infection Control Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise indicated.
▸ Questions cover all CCHT domains: clinical, technical, water treatment, infection control, and professional roles.
▸ Verified answers with rationales are provided for comprehensive certification preparation.
▸ Pay close attention to safety, infection control, and dialysis machine parameters.
CCHT CERTIFICATION — COMPREHENSIVE PRACTICE EXAMINATION Questions 1 – 100+
1. While technical staff are performing duties in the dialysis unit, which team member must always be present?
A. Registered nurse.
B. Medical director for the unit.
C. Lab technician.
CORRECT ANSWER A — Registered nurse
RATIONALE A registered nurse must be present at all times when dialysis treatments are being performed. The RN is
responsible for patient assessment, medication administration, and supervising the care provided by dialysis
technicians. This is a CMS regulatory requirement.
2. Two techs are heatedly discussing a patient care situation. Which team member is responsible for disciplinary
action?
A. Registered practical nurse.
B. Human resource manager.
C. Dialysis nurse manager.
CORRECT ANSWER C — Dialysis nurse manager
RATIONALE The dialysis nurse manager is the direct supervisor responsible for staff discipline, conflict resolution, and
ensuring professional conduct in the dialysis unit. Human resources may be involved but the nurse manager
initiates and manages disciplinary action for clinical staff.
,3. Which credentialing agency for dialysis includes water treatment, dialysate preparation, and complications of
dialysis as part of their practice domains?
A. Board of Nephrology Examiners Nursing in Technology.
B. Nephrology Nursing Certification Commission.
C. National Nephrology Certification Organization (NNCO).
CORRECT ANSWER C — National Nephrology Certification Organization (NNCO)
RATIONALE The NNCO provides CCHT certification covering all domains of hemodialysis technology including water
treatment, dialysate preparation, extracorporeal circuit management, complications of dialysis, and infection
control. It is the primary certification body for dialysis technicians.
4. Prior to starting dialysis, what must the technician and/or nurse verify?
A. That the patient has provided informed written consent for dialysis.
B. That the patient has not eaten any food or beverages for the last six hours.
C. That the patient has a driver to pick him up after dialysis.
CORRECT ANSWER A — That the patient has provided informed written consent for dialysis
RATIONALE Informed consent is a legal and ethical requirement before initiating any medical treatment, including
dialysis. The patient must understand and agree to the procedure in writing. While other preparations are
important, consent verification is mandatory.
5. Which external agencies provide additional guidelines in the areas of infectious disease testing, immunizations,
dialysis treatment safety, and infection control? (Select all that apply.)
A. Centers for Disease Control and Prevention (CDC).
B. Centers for Medicare and Medicaid Services (CMS).
C. Association for the Advancement of Medical Instrumentation (AAMI).
CORRECT ANSWER A, B, C (All of the above)
RATIONALE CDC provides infection control guidelines and disease testing recommendations. CMS establishes conditions
for coverage and reimbursement. AAMI develops technical standards for water quality, dialysate, and
equipment. All three agencies provide essential guidelines for dialysis practice.
6. The Social Security amendments that extended Medicare coverage for almost all patients with ESRD were signed in
what year?
A. 1979, by Jimmy Carter.
B. 1972, by Richard Nixon.
C. 1961, by John F. Kennedy.
CORRECT ANSWER B — 1972, by Richard Nixon
RATIONALE The Social Security Amendments of 1972 (Section 299I) extended Medicare coverage to individuals with end-
stage renal disease (ESRD) regardless of age. This landmark legislation, signed by President Nixon, made
dialysis and transplantation accessible to nearly all Americans with kidney failure.
, 7. What is the composition of saline?
A. 10% salt added to water.
B. Albumin.
C. 0.9 grams of sodium chloride in 100 mL of water.
CORRECT ANSWER C — 0.9 grams of sodium chloride in 100 mL of water
RATIONALE Normal saline (0.9% NaCl) contains 0.9 grams of sodium chloride per 100 mL of water. It is isotonic with
human plasma (approximately 308 mOsm/L) and is the standard solution used for priming the extracorporeal
circuit and managing intradialytic hypotension.
8. When caring for a patient, if the dialysate solution contains too little sodium, which signs or symptoms would you
see?
A. Hypotension and cramping.
B. Thirst.
C. Headache.
CORRECT ANSWER A — Hypotension and cramping
RATIONALE When dialysate sodium concentration is too low (hyponatremic dialysate), water shifts from the blood into
cells and tissues by osmosis, causing intravascular volume depletion. This results in hypotension (from
decreased blood volume) and muscle cramping (from cellular edema and electrolyte shifts).
9. Which buffer is the major plasma buffer and therefore important during dialysis?
A. Bicarbonate.
B. Amino acid.
C. Protein.
CORRECT ANSWER A — Bicarbonate
RATIONALE Bicarbonate (HCO₃⁻) is the major extracellular buffer system in the body, maintaining normal blood pH. In
dialysis, bicarbonate is added to the dialysate to correct the metabolic acidosis that occurs in kidney failure.
The bicarbonate buffer system is essential for acid-base homeostasis.
10. While reviewing the body weight for a dialysis patient, the tech knows that ___ of the total amount of water is
contained in the intracellular fluid compartment.
A. 20%.
B. 30%.
C. 40%.
CORRECT ANSWER C — 40%
RATIONALE Total body water is approximately 60% of body weight. Of this, about 40% is intracellular fluid (ICF) — water
inside cells. The remaining 20% is extracellular fluid (ECF), which includes interstitial fluid (15%) and plasma
(5%). This distribution is crucial for understanding fluid removal during dialysis.
