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CCHT Exam (2024 / 2025) updated and revised in
2024 - 2025 December
AAMI Chemical Analysis of water used for hemodialysis is tested - ANSWER->annually A dialysis technician observes a drop of blood on the surface of a patient's hemodialysis machine. Which of these actions should the dialysis technician take? - ANSWER->Clean the machine surface immediately A dialysis technician observes all of the below on the treatment floor, which one poses an environment risk? - ANSWER->About one ounce (30 ml) fluid is on the floor A fistula connects - ANSWER->An artery to a vein A marker used to determine the middle molecule clearance of a dialyzer is - ANSWER->Vitamin B A mixed- bed DI tank contains - ANSWER->Cations and anions A nephron is made up of - ANSWER->A glomerulus and a tubule system A patient complains of pain at the venous needle site. The dialysis technician observes there is swelling distal to the venous needle site and that the venous pressure is rising. The dialysis technician should suspect - ANSWER->An infiltration A patient who is to receive their first dialysis treatment is prone to? - ANSWER->Dialysis Disequilibrium Syndrome
A patient tells the technician that the dietician reviewed high potassium foods with her. During the conversation she states she routinely eats the following foods. Which one is highest in potassium? - ANSWER-
bananas A reason why a dialysis technician is to be certified is - ANSWER->It's a new Federal regulation A rise in transmembrane pressure in a low flux dialyzer during hemodialysis is indicative of - ANSWER->Clotting of extracorporeal circuit A teammate asks you to document the normal saline he just gave to Mr. Smith. You would: - ANSWER->Never document something that someone else did A true aneurysm can be dangerous because it - ANSWER->May rupture and cause the patient to bleed profusely A patient's laboratory results indicate that the predialysis BUN level was lower than the post dialysis BUN level. When interpreting these findings the technician should seek the answer to which of these questions? - ANSWER->Was the predialysis sample drawn from the venous port? A rapid pulse of 104 beats/minute would indicate that the patient has: - ANSWER->Tachycardia A patient's dry weight is 154.0 (70kg) and the patient's pre treatment weight is 158.4. (72kg). For a four- hour treatment, how many mL/ hour must the patient lose to reach dry weight? - ANSWER-> 500
Dialysate that is too hot will cause - ANSWER->Hemolysis Dry weight is defined as the - ANSWER->Weight at which the patient has no edema or fluid in the lungs and BP is normal During a hemodialysis treatment the technician responds to a low venous pressure alarm. The most likely cause for this alarm is: - ANSWER->Disconnection of the bloodline Biohazardous waste includes any material exposed to: - ANSWER-
Blood Decreasing the patient's prescribed blood flow rate affects the rate of - ANSWER->Diffusion During a hemodialysis treatment, a patient's venous needle infiltrates. Which of these actions should the dialysis technician take first? - ANSWER->Stop the pump Dialysate pH should be: - ANSWER->Between 7.0 and 7. During hemodialysis, the air detector on Ms. Foster's machine alarms and foam is visible in the venous drop chamber. The immediate action of the dialysis technician should be to: - ANSWER->Clamp the venous line During predialysis data collection, it would be best for the technician to ask the patient which of these questions? - ANSWER->How have you been since your last dialysis treatment? During the hemodialysis treatment, a patient complains of feeling chilled. In addition to getting the patient a blanket, which of these
actions should the technician take? - ANSWER->Take the patient's temperature During the set up of a hemodialysis machine, the alarm test for conductivity fails. Which of these actions should the dialysis technician take? - ANSWER->Notify the equipment technician ESRD specific tests such as BUN, Creatinine, and URR are - ANSWER-
Indicators of the adequacy of the renal replacement therapy Excess fluid is forced out of the blood and into the dialysate during dialysis by which principle - ANSWER->Ultrafiltration Feed conductivity- product conductivity divided by x 100 is the formula calculation of - ANSWER->Percent rejection Fluid to be removed divided by the treatment time tells us - ANSWER- The ultrafiltration rate Germicide rebound occurs due to: - ANSWER->Inadequate dialyzer priming Hives, itching, tightness of the chest and respiratory distress may be signs and symptoms of: - ANSWER->Anaphylaxis (severe allergic reaction) Hyperkalemia can lead to - ANSWER->Cardiac arrest If the extracorporeal circuit clots and it must be discarded, it would be most important to monitor the patient's serum level of: - ANSWER- Hemoglobin
Ms Foster complains of shortness of breath. While calling for the nurse the dialysis technician notices there is air in the extracorporeal circuit she/he should place Ms Foster in: - ANSWER->Trendelenburg position on left side One reason that normal saline is used to rinse and prime the extracorporeal circuit prior to treatment is to remove: - ANSWER->Air Normal body pH is - ANSWER->7.0-7. One disadvantage of a fistula is an increase in - ANSWER->Time to mature One cause of aneurysms and pseudoaneurysms is - ANSWER->Poor rotation of sites The air detector alarms during treatment. If the machine is working properly, the dialysis technician should expect which of these events to have occurred? - ANSWER->Blood pump has stopped Pain at the venous needle site, along with respiratory difficulty and chest pain could be an indicator of: - ANSWER->Sterilant infusion One sign and symptom of fluid overload is - ANSWER->Hypertension Solutions that have a higher similarity than body fluids are called? - ANSWER->Hypo-osmole Symptoms of hyperkalemia (high potassium) may include - ANSWER-
Numbness and tingling
The accuracy of lab results depends on adherence to proper lab draw technique. You must ensure that labs are drawn: - ANSWER->Before treatment, after treatment, and after giving heparin Short frequent hemodialysis treatments in patient's with high BUN (blood Urea Nitrogen) are performed to prevent: - ANSWER->Dialysis Disequilibrium Syndrome Prior cannulation a technician notices the skin over the patient's fistula is reddened and warm to touch. These symptoms are most likely due to: - ANSWER->An infection A medication used to treat anemia is - ANSWER->Epogen The most important monitor in the dialysis setting is: - ANSWER-
Teammate The most frequent cause of death in the first year post transplant is: - ANSWER->Infection The normal range of resting respirations in an adult is - ANSWER-> 12 - 20 breaths per min The leading cause of chronic kidney disease for adults in the United States: - ANSWER->Diabetes The minimum dwell time to achieve sterilization with the chemical Renalin is - ANSWER->24 hours The most important intervention to prevent the spread of infection is - ANSWER->Cleansing of the hands
The organization that sets the standards for dialysis water quality is called - ANSWER->AAMI Total cell volume (TCV) is an indirect measure of the: - ANSWER-
Performance of the dialyzer Total chlorine levels in the water are tested - ANSWER->Before each patient shift or every four hours The purpose of using counter-current flow is to - ANSWER->Increase the rate of waste removal Water moves across a membrane from an area of lower solute concentration to an area of higher solute concentration by which principle - ANSWER->Osmosis The water softener - ANSWER->Operates on the principle of ion exchange The TCV should be no less than - ANSWER->80% What are the typical signs of fluid overload - ANSWER->Edema and shortness of breath To determine the latency of an arteriovenous vascular access, the dialysis technician should initially feel for the presence of - ANSWER->A thrill Ultrafiltration is influenced by - ANSWER->Transmembrane pressure Waste products are removed during dialysis by which principle - ANSWER->Diffusion
The water softener removes - ANSWER->Calcium and magnesium The reprocessed dialyzer is carefully rinsed prior to patient use to remove - ANSWER->Residual Sterilant The part of the cell wall of bacteria that, when released, can cause fever in hemodialysis patient's is: - ANSWER->Endotoxin The venous needle in an AV fistula - ANSWER->Should point in the direction of the blood flow The total pressure that exists across the dialyzer membrane is called - ANSWER->Transmembrane pressure The substance that may be added to the municipal drinking water to make it clearer is: - ANSWER->Aluminum Which of the following is the most accurate measure of dialysis adequacy? - ANSWER->Kt/V Which of the following component in dialysate is used to correct metabolic acidosis? - ANSWER->Bicarbonate Which of the following is most likely to cause a high venous pressure alarm? - ANSWER->Kinking of the venous blood line What lab tests are used to monitor anemia in the ESRD patient? - ANSWER->Hemoglobin/Hematocrit Which learning domain is knowledge based? - ANSWER->Cognitive Which of the following is the classic sign of hemolysis? - ANSWER-
Cranberry juice colored blood in the venous line
Which of the following symptoms would indicate a need to increase the estimated dry weight (EDW)? - ANSWER->Hypotension and cramping Your patient is to receive 2000 units of heparin. The vial you are using is 1000 u/ml heparin. How many mls will you draw up for this patient? - ANSWER->2. Which of these types of vascular accesses has the fewest complications? - ANSWER->An arteriovenous fistula Which of the following is used to prevent air in the bloodlines? - ANSWER->Tighten all connections Which organization set the standards and recommendations for dialyzer reprocessing? - ANSWER->AAMI Which of the following would cause a high venous pressure alarm? - ANSWER->Venous needle is against the wall of the vessel Which of the following might indicate a need to increase heparin? - ANSWER->Clotting in the extracorporeal circuit Which of the following might indicate a need to decrease the heparin dose? - ANSWER->The patient just had surgery yesterday Which of these technician activities contributes to data collection used to measure quality outcomes? - ANSWER->Ensuring accurate documentation You have documented incorrectly on a patient's chart. How do you correct this? - ANSWER->Draw one line through it, date, time, signature/credentials, with the words "error"
What's the normal lab value? - ANSWER->Phosphorus, potassium, and calcium What is diffusion? - ANSWER->The movement of particles across a semipermeable membrane from an area of higher solute concentration to an area of lower solute concentration, until the concentration on both sides of the membrane is equal What is filtration? - ANSWER->The process of passing fluid through a filter or semipermeable membrane What is epogen? - ANSWER->A medication(synthetic erythropoietin) used to stimulate production of red blood cells How long can a used dialyzer sit out before reprocessing? - ANSWER-> 2 hours How long can a reprocessed dialyzer sit out to dry before use? - ANSWER->11 hours What is a reused dialyzer shelf life? - ANSWER->14 days What is a reuse dialyzer (TCV) percentage - ANSWER->80% What does AAMI stand for? - ANSWER->Association for the Advancement of Medical Instrumentation The base used to maintain an acceptable dialysate pH(acid/base balance). A buffer - ANSWER->Bicarbonate What is BUN? - ANSWER->Blood urea nitrogen, the end product of protein metabolism
A protein that carries oxygen from the lung to the body tissue and transports carbon dioxide from the tissues to the lungs. - ANSWER-
Hemoglobin (HB) What is the rupture of red blood cells? ( lysis is cell rupture) - ANSWER- Hemolysis The cessation of bleeding due to clotting. In dialysis, hemostasis refers to the cessation of bleeding from a needle site. - ANSWER->Hemostasis An excess of potassium in the blood caused by dietary indiscretion, certain medications, internal bleeding, cellular injury or blood transfusion. - ANSWER->hyperkalemia What are symptoms of hyperkalemia? - ANSWER->Muscle weakness, nausea, and vomiting High blood pressure is signs of? - ANSWER->Hypertension What is infiltration? - ANSWER->Movement of blood from a needle site into the surrounding tissue that occurs when the needle pierces the vessel wall. Symptoms of infiltration? - ANSWER->Swelling around the insertion site and pain What is kt/v? - ANSWER->A mathematical measurement of the adequacy or dialysis treatment, which considers protein intake and the
amount of urea removed from the patient. The functional unit of the kidney - ANSWER->Nephron
The movement of fluid across a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration. Movement occurs until equilibrium is reached: - ANSWER->Osmosis The measure of the acid-base status of a solution. PH stands for potential of hydrogen - ANSWER->pH What is phosphorus? - ANSWER->An electrolyte necessary for bone formation, energy transfer, andneuromuscular function What is semipermeable membrane? - ANSWER->Very thin flexible sheets of material, such as cellophane, with pores that allow smaller particles or molecules to pass through while blocking larger ones. What is steal syndrome? - ANSWER->A condition caused when the surgical diversion of the arterial blood supply through the vascular access deprives the distal portion of the access extremity of oxygenated blood. What is stenosis? - ANSWER->A narrowing of blood vessels due to the build up of hypertrophic tissue, anatomical narrowing if the vessels, or surgical technique problems. What is Tachycardia? - ANSWER->Rapid heart beat What is ultrafiltration? - ANSWER->Controlled fluid removal achieved by increasing or decreasing the amount of fluid moves across a semipermeable membrane by controlling hydrostatic pressure What is urea? - ANSWER->A waste product of protein metabolism affected by dietary intake.
The reprocessed dialyzer is carefully rinsed prior to patient use to remove: - ANSWER->Residual Sterilant The patient's machine alarms blood leak, where would you draw the sample from to determine if there is a blood leak? - ANSWER->Box port behind the machine What causes symptoms of fever and chills? - ANSWER->Pyrogen Reaction Which of the following types of vascular access has the lowest incidence of infection? - ANSWER->arteriovenous (AV) fistula During Mrs. King's hemodialysis treatment, she starts actively yawning. The technician suspects she may be experiencing - ANSWER-
Hypotention While performing the end-of-day water hardness check, the technician notes that the hardness exceeds the allowable limit. In addition to notifying the equipment technician, the technician should check which component of the water system? - ANSWER->Salt level in brine tank Chloramine levels in treated water that are in excess of the standards of the Association for the Advancement of Medical Instrumentation (AAMI) could result in - ANSWER->A life-threatening condition A patient is experiencing large weight gains between hemodialysis treatments. The technician should remind the patient that the best dietary measure to control weight gain is to decrease the intake of - ANSWER->Salt When doing a routine patient check, the technician notices a puddle of clear liquid underneath a dialysis machine. After wiping it up, which of
these actions, if any, should the technician take? - ANSWER->Notify the equipment technician A patient has an arteriovenous (AV) fistula in his lower left arm. When choosing a cannulation site, the technician observes where previous needles were placed and chooses to use alternate sites for arterial and venous needle insertion. This practice is an example of - ANSWER-
Rope and ladder technique A solution with higher osmolarity than body fluid? - ANSWER- Hypertonic If during a set up, a machine test fails what would be the next step after re-testing? - ANSWER->Call the bio-med What does the water softener do? - ANSWER->Operates in the principle of ion exchange Shortened frequent treatments in patient's with high BUN prevent? - ANSWER->Dialysis Equilibrium Syndrome What is the ratio for bleach wipes? - ANSWER->1: What is the ratio for bleach clamps? - ANSWER->1: What ratio do you use for blood spills? - ANSWER->1: What is the ratio for bleach water? - ANSWER->1:1 0 Symptoms of hyperkalemia? - ANSWER->Numbness and tingling What part of the cell wall when released can cause fever in hemodialysis patients? - ANSWER->Endotoxins
