Dialysis Technician (CHT/CCHT) Certification Exam 2026:
Comprehensive Professional Practice Examination — Dialysis
Patient Care, Haemodialysis Equipment, Water Treatment, Infection
Control, Safety Standards & Technician Responsibilities — 190
Multiple-Choice Questions with Answers & Detailed Rationales
Question 1
A patient arrives for haemodialysis with a pre-treatment weight of 82.3 kg. The established
dry weight is 79.0 kg. The prescribed treatment time is 3.5 hours. What is the hourly
ultrafiltration rate that should be programmed into the machine?
A. 471 mL/hr
B. 943 mL/hr
C. 1,100 mL/hr
D. 822 mL/hr
Correct Answer: B
Explanation: Fluid to remove = 3.3 kg = 3,300 mL; 3,300 ÷ 3.5 = 943 mL/hr. UFR should not
exceed 13 mL/kg/hr for cardiovascular stability.
Question 2
During cannulation of an arteriovenous fistula, the technician advances the needle and
meets resistance. The patient winces and reports sharp pain. What is the most appropriate
immediate action?
,A. Advance the needle further to complete cannulation
B. Withdraw the needle completely and apply pressure
C. Rotate the needle 180 degrees and continue
D. Inject saline to dilate the vessel
Correct Answer: B
Explanation: Resistance with pain indicates the needle tip may be against the vessel wall or
outside the lumen. Withdrawing prevents infiltration and vessel damage.
Question 3
A patient's AV fistula has a palpable thrill but the bruit is high-pitched and discontinuous.
What does this finding most likely indicate?
A. Normal, well-functioning fistula
B. Stenosis downstream from the anastomosis
C. Immediate need for thrombolytic therapy
D. Aneurysm formation at the cannulation site
Correct Answer: B
Explanation: A high-pitched, discontinuous bruit with preserved thrill suggests narrowing
(stenosis). Normal bruits are low-pitched and continuous throughout the cardiac cycle.
,Question 4
A patient receiving hemodialysis develops sudden chills, fever, and hypotension 45 minutes
into treatment. The dialysate appears clear. Which cause should the technician suspect
FIRST?
A. Dialyzer membrane reaction
B. Air embolism
C. Pyrogenic reaction from contaminated dialysate
D. Hemolytic reaction from chloramine exposure
Correct Answer: C
Explanation: Fever with chills and hypotension during treatment suggests pyrogenic
reaction, often from bacterial contamination or endotoxins in the dialysate. Dialysate may
appear clear despite contamination.
Question 5
During treatment, a patient's venous pressure alarm sounds. The technician observes the
venous pressure has risen from 180 mmHg to 280 mmHg over 10 minutes. The blood flow
rate has remained constant. What is the most likely cause?
A. Arterial needle malposition
B. Venous needle infiltration or clotting in the venous chamber
C. Decreased dialysate flow rate
, D. Patient movement causing arterial line kinking
Correct Answer: B
Explanation: Rising venous pressure with stable blood flow indicates increased resistance
after the blood pump, commonly from venous needle issues or clotting in the venous drip
chamber.
Question 6
A patient with a new arteriovenous graft is scheduled for cannulation. How long after
surgical placement should the technician expect the access to be ready for use?
A. 24–48 hours
B. 1–2 weeks
C. 2–3 weeks
D. 3–6 months
Correct Answer: C
Explanation: AV grafts typically require 2–3 weeks for healing and incorporation before
cannulation. AV fistulas require 3–6 months (or longer) for maturation.
Question 7
A patient complains of cramping in the lower extremities during the last hour of dialysis. The
patient's blood pressure is 118/72 mmHg, and the ultrafiltration goal has nearly been
achieved. What is the most appropriate initial intervention?
Comprehensive Professional Practice Examination — Dialysis
Patient Care, Haemodialysis Equipment, Water Treatment, Infection
Control, Safety Standards & Technician Responsibilities — 190
Multiple-Choice Questions with Answers & Detailed Rationales
Question 1
A patient arrives for haemodialysis with a pre-treatment weight of 82.3 kg. The established
dry weight is 79.0 kg. The prescribed treatment time is 3.5 hours. What is the hourly
ultrafiltration rate that should be programmed into the machine?
A. 471 mL/hr
B. 943 mL/hr
C. 1,100 mL/hr
D. 822 mL/hr
Correct Answer: B
Explanation: Fluid to remove = 3.3 kg = 3,300 mL; 3,300 ÷ 3.5 = 943 mL/hr. UFR should not
exceed 13 mL/kg/hr for cardiovascular stability.
Question 2
During cannulation of an arteriovenous fistula, the technician advances the needle and
meets resistance. The patient winces and reports sharp pain. What is the most appropriate
immediate action?
,A. Advance the needle further to complete cannulation
B. Withdraw the needle completely and apply pressure
C. Rotate the needle 180 degrees and continue
D. Inject saline to dilate the vessel
Correct Answer: B
Explanation: Resistance with pain indicates the needle tip may be against the vessel wall or
outside the lumen. Withdrawing prevents infiltration and vessel damage.
Question 3
A patient's AV fistula has a palpable thrill but the bruit is high-pitched and discontinuous.
What does this finding most likely indicate?
A. Normal, well-functioning fistula
B. Stenosis downstream from the anastomosis
C. Immediate need for thrombolytic therapy
D. Aneurysm formation at the cannulation site
Correct Answer: B
Explanation: A high-pitched, discontinuous bruit with preserved thrill suggests narrowing
(stenosis). Normal bruits are low-pitched and continuous throughout the cardiac cycle.
,Question 4
A patient receiving hemodialysis develops sudden chills, fever, and hypotension 45 minutes
into treatment. The dialysate appears clear. Which cause should the technician suspect
FIRST?
A. Dialyzer membrane reaction
B. Air embolism
C. Pyrogenic reaction from contaminated dialysate
D. Hemolytic reaction from chloramine exposure
Correct Answer: C
Explanation: Fever with chills and hypotension during treatment suggests pyrogenic
reaction, often from bacterial contamination or endotoxins in the dialysate. Dialysate may
appear clear despite contamination.
Question 5
During treatment, a patient's venous pressure alarm sounds. The technician observes the
venous pressure has risen from 180 mmHg to 280 mmHg over 10 minutes. The blood flow
rate has remained constant. What is the most likely cause?
A. Arterial needle malposition
B. Venous needle infiltration or clotting in the venous chamber
C. Decreased dialysate flow rate
, D. Patient movement causing arterial line kinking
Correct Answer: B
Explanation: Rising venous pressure with stable blood flow indicates increased resistance
after the blood pump, commonly from venous needle issues or clotting in the venous drip
chamber.
Question 6
A patient with a new arteriovenous graft is scheduled for cannulation. How long after
surgical placement should the technician expect the access to be ready for use?
A. 24–48 hours
B. 1–2 weeks
C. 2–3 weeks
D. 3–6 months
Correct Answer: C
Explanation: AV grafts typically require 2–3 weeks for healing and incorporation before
cannulation. AV fistulas require 3–6 months (or longer) for maturation.
Question 7
A patient complains of cramping in the lower extremities during the last hour of dialysis. The
patient's blood pressure is 118/72 mmHg, and the ultrafiltration goal has nearly been
achieved. What is the most appropriate initial intervention?
