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CCHT - Certified Clinical Hemodialysis Technician
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1. An AV/V fistula is preferred access for hemodialysis because:
a. There is a lower incidence of complications
b. Surgeons are more experience and prefer creating AV fistulas
c. There is a lower incidence of thrombosis
d. Both A and C
Ans: d. Both A and C
2. The pressure difference between the blood side and the dialysate side ofthe dialyzer
is called
a. Ultrafiltration Factor
b. Dialysate Flow Rate
c. Transmembrane Pressure
d. Urea Reduction Ration
Ans: c. Transmembrane Pressure
3. What is the best way to prepare an access for cannulation
a. Scrub with a gauze or pad soaked with a germicidal agent in a circularmotion
from the outside inward
b. Scrub in a circular motion from the inside to the outside and allow the
recommended time for skin contact before cannulation
c. rub vigorously up and down the area to be cannulated then insert the needle
d. No further preparation is required if the patient has just washed their access
Ans: b. Scrub in a circular motion from the inside to the outside and allow the recommended time for skin contact before cannulation
4. Which of the following statements is not true about the Nephron?
a. the nephron is the functional unit of the kidney
b. nephrons process about 7500 mL of filtrates per hour
c. a nephron is composed of renal tubules and collecting ducts
d. nephrons are located in the bladder
Ans: d. nephrons are located in the bladder
5. Mr. Pitt is always joking. He usually requests to be called "Bob". He presentstoday very
quiet and when you called him "bob" he did not respond. How would you further
Ans: b. <15 Ml
8. Hypernatremia is defined as a plasma sodium concentration of a above146mEQ/L.
It is manifested by:
a. intense thirst, flushed skin, dry mucus membrane
b. headaches, seizures, muscle cramps
c. fever
d. agitation, low body temperature
Ans: a. intense thirst, flushed skin, dry mucusmembrane
9. Which of the following are symptoms of uremia:
a. fatigue, weakness, mental confusion
b. flu like symptoms
c. metallic taste in the mouth
d. all of the above
Ans: d. all of the above
10. Factors to be considered in managing nutrition of ESRD patients are:
a. comorbid conditions
b. laboratory date
c. medications
d. all of the above
Ans: d. all of the above
11. Mr. Peterson experience an episode of hypotension. He is symptomatic. He only has
10 minutes left of his run and the nurse indicates to take him off.The UF goal was 1.4kg and the machine indicates that 1.3kg was removed his weight 0.8 below his dry weight. What is the possible cause(s) for the variance?
d. both a and b
Ans: d. both a and b
14. Which of the follow statements is/are true about transplants?
a. transplant patients have fewer dietary limits than in center hemodialysispatients
b. kidney transplant is a cure for kidney disease
c. anti-rejection drugs may cause high blood pressure, increase of infectionand weight
gain
d. both a and c
Ans: d. both a and c
15. Which of the following complications can happen when removing toomuch
fluid during dialysis?
a. low blood pressure, cramps nausea, and vomiting
b. pruritis, dry and scaly itch
c. bleeding, hematoma, anemia
d. chest pain and shortness of breath
Ans: a. low blood pressure, cramps nausea, andvomiting
16. As a member of the health care team, a dialysis technician can helpimprove
anemia outcomes by:
a. rinsing patient's blood back until the bloodlines are clear
b. reporting to the nurse if a patient complains of bloody stools
c. monitoring access sites for bloodlines separations of exsanguination
d. all of the above
Ans: d. all of the above
17. Your patient is complaining of pain and numbness on the access limb moreso during
dialysis treatment. The patient may be experiencing
a. infiltration
b. steal syndrome
c. infection
d. recirculation
Ans: b. steal syndrome
18. The following statements are true about Hepatitis C (HCV) except:
a. hep c is spread by contact with infected food
b. patients with hep c must be dialyzed in isolation room
c. outbreaks of JCV in dialysis centers have been linked to cross contamina-tion among
patients
d. universal precautions must be observed in all patients, whether or not theyhave HCV
Ans: b. patients with hep c must be dialyzed in isolation room
19. What is the most common cause of transmission of Hep B (HBV) in dialysiscenters?
a. tell the nurse about his symptoms
b. put on your mask and continue his treatment
c. give him acetaminophen to reduce his fever
d. tell him to see his primary physician
Ans: a. tell the nurse about his symptoms
22. About one hour into the treatment, the patients complain of fever, chill, nausea and
vomiting. What condition do you think the patient are experienc-ing?
a. bone disease
b. hemolysis
c. anemia
d. pyrogen reaction
Ans: d. pyrogen reaction
23. Pre-Blood pump arterial pressure alarms are caused by suction on the vascular side
by the blood pump. Increasing negative pressure may indicateall of the following except:
a. flow problem with the access related to the blood pump
b. kinking of the arterial blood tubing between the access and the arterialmonitor
c. increased blood velocity due to ultra filtration
d. hypertension
Ans: d. hypertension
24. When inserting a hemodialysis fistula needle, insert a what angle until aflashback
of blood is observed?
a. 15 b. 90 c. choose the angle of insertion based on the depth of the vein, in generalabout 45* d. 60* Ans: c.** choose the angle of insertion based on the depth of the vein, in generalabout 45*
25. The following lab values are monitored at least monthly except:
a. blood urea nitrogen
b. zinc
c. calcium
d. potassium
Ans: b. zinc
26. John Adam dialyzes 3 hours on a F180 dialyzer using an AV fistula in hisleft
forearm. His Urea Reduction ration (URR) this month is 62% and Kt/V is 1.0. These lab values indicate:
c. Recalculate the fluid removal calculation on the treatment record for accu-racy.
d. all of the above
Ans: d. all of the above
29. During the treatment the patient's needle starts to bleed slowly around theinsertion
site. You should:
a. change the blue pad beneath the patients arm
b. flip the needle to stop the bleeding
c. reposition the arm
d. place a pressure dressing over the site to control the bleeding
Ans: d. place apressure dressing over the site to control the bleeding
30. All of the following are causes of air in the blood except
a. pre-blood pump tubing collapsing related to the inadequate blood flow fromthe arterial
needle
b. kinked venous bloodline
c. low levels in the drip chambers
d. not removing all air during dialyzer primer
Ans: b. kinked venous bloodline
31. which would not be a sign or system of exsanguination
a. pain in the access extremity
b. hypotension
c. arterial and or venous pressure alarms
d. visual observation of blood
Ans: a. pain in the access extremity
32. which vital signs must be assessed before and after every dialysis treat-ment
a. blood pressure
b. temperature
c. pain level
d. all of the above
Ans: d. all of the above
33. Mrs. Mantel arrives to dialysis with a complaint of feeling cold, her temper-ature pre
dialysis is 97.8% and her blood pressure is 160/80. She dialyzes witha tunneled permacath which has been in place for there months. Shorty afterinitiation of dialysis she stated having chills and her temperature is no 99 F,B/P is 100/60. You would suspect:*
a. Mrs. Mantel is experiencing a reaction to the dialyzer
36. Mr. rice's dialyzer has cleared poorly. What may be a factor affecting hisdialyzer
rinse back:
a. the blood flow rate is reduced
b. he has not dialyzed the prescribed length of treatment on several occasions
c. with a catheter he should receive hourly infusions of heparin via a heparinpump or
pushed every hour. The amount of heparin he is getting hourly mayneed to be increased
d. both a and c
Ans: d. both a and c
37. Prior to returning the patient's blood , what following things should bedone?
a. check pulse
b. check blood pressure
c. check temperature
d. all of the above
Ans: d. all of the above
38. Mr. Tate is planning on going to the casino after dialysis today. He is anxious for you
to terminate treatment so he can go, after you return the bloodyou request for him to stand for a blood pressure prior to pulling his needles.He gets very upset and says "no one makes me do that". How would you bestrespond to this?
a. "Well, i do not care what other technicians do"
b. "okay whatever you want "
c. " Mr. Tate, taking a standing blood pressure is very important and it's foryour safety.
I want to ensure that your blood pressure remains stable whenyou begin to ambulate"
d. Call the nurse over and let her or him deal with it
Ans: c. " Mr. Tate, taking a standingblood pressure is very important and it's for your safety. I want to ensure that your blood pressure remains stable when you begin to ambulate"
39. When removing fistula needles, what is the most important things to keepin mind?
a. be sure to completely remove the needle prior to holding pressure to theskin
b. be sure to hold pressure as you are pulling the needle out of the skin
c. just ask the patient to remove his/her own needles
d. none above
Ans: a. be sure to completely remove the needle prior to holding pressureto the skin
d. both b and c
Ans: d. both b and c
43. Mrs. Hit has just completed her treatment. You note the following on her post
assessment, Hypotension, light headaches, cramping even after rinse-back and nausea. What are these signs and symptoms?
a. Patient at the their prescribed weight
b. Patient below their dry weight
c. Patient above their dry weight
d. Hypoglycemia
Ans: b. Patient below their dry weight
44. You're training a new technician. You ask him or her to recite a sign of toomuch
heparin. What is the correct answer?
a. blood clots noted in the venous chamber
b. shortness of breath
c. prolonged bleeding from the puncture sites
d. both a and b
Ans: c. prolonged bleeding from the puncture sites
45. You are aware the Mr. Brown had a severe episode with cramping and
hypotension the previous treatment. Today he is assigned to you. He statesthat he feels tired with some cramping yesterday and reports to you that he felt poorly after his last dialysis treatment. As a patient care technician, you report this to the nurse. She reviews the treatment records, but finds n documentation to support the previous treatment's episode. Knowing that allmedical records can be called into court, what would the previous treatmentrecord, with no documentation, show to the lawyer?
a. The run sheet would not be admissible to court
b. Nothing, if symptoms were not admissible in court
c. Mr. Brown lied about the previous treatment
d. both A and C
Ans: b. Nothing, if symptoms were not admissible in court
46. All of the following are reasons that the patients records are kept except:
a. legal document admissible in court
b. data for research and quality assurance
c. to get other technicians in trouble
d. a way for the staff to communicate and share patient information; createcontinuity
