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CCHT EXAM 122 Questions with
Answers latest 2025
While technical staff are preforming duties in the dialysis unit which team member must always be present A. Registered nurse B. Medical director for unit C. Lab technician ✔️ A. Registered nurse
Two techs are heatedly discussing pt care situation. Which team member is responsible for disciplinary action A. Registered practical nurse B. Human resource manager C. Dialysis nurse manager ✔️ C. Dialysis nurse manager
Which credentialing agency for dialysis includes items such as water treatment and dialysate preparation and complication 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 ✔️ C. NNCO
Prior to starting dialysis what must the technician and or nurse verify A. That 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 ✔️ A. Consent
Which external agencies provide additional guidelines and standards in the areas of infectious disease testing immunizations dialysis treatment safety and infection control? A. Centers for disease control and prevention B. Centers for Medicare and Medicaid service C. Association for the advancement of medical instrumentation D. Council of nephrology ✔️ A B and C
Prior to passing the Social Security amendments treatment for chronic kidney disease was available only to few who met certain criteria. The amendments extended Medicare coverage for almost all patients who signed the amendment and then what year A. Jimmy Carter in 1979 B. Richard Nixon 1972 C. John f Kennedy 1961
✔️ B. Richard Nixon 1972
Which organization recently approved by CMS to be an independent organization allowed to conduct surveys for Medicare certification fostering faster approval for dialysis clinics A. National kidney foundation B. Medicare bundle dialysis prospective payment system C. National dialysis accreditation commission ✔️ C. NDAC
What is the composition of saline A. 10% salt added to water B. Albumin C. 0.9g of sodium chloride and 100ml of water ✔️ C. 0.9g of sodium and 100ml of h2o
When caring for a patient if the dialysate solution contains two little sodium the water may shift into the patient's blood cells which signs or symptoms would you see A. Hypotension B. Cramping C. Thirst D. Headache ✔️ A and B
Which buffer is the major plasma buffer therefor important during dialysis A. Bicarbonate B. Amino acid C. Protein ✔️ A. Bicarbonate
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% ✔️ C. 40%
How much water is lost through evaporation form lungs every day A. 250-499 ml of water B. 700-1,000 ml of water C. 1500-2000 ml of water ✔️ B.
A patient asks to explain what the normal kidney does in addition to making urine what's the response
✔️ A and D
Patient with chronic kidney disease asks what her goal hemoglobin level should be what level as recommended by the national kidney foundation kidney disease guidelines A. 9% B. 7% C. 11% ✔️ B.7%
Patient with chronic kidney disease arrives at the center after his nephrology visit he relays to the staff that the doctor said he was hardening of the kidneys what is the cause of this condition A. Prolonged severe hypertension B. Daily ingestion of sugar sweetened drinks C. High fat diet D. Too much calcium in the diet along with hypertension ✔️ A.
What is one cause of postrenal failure A. Renal trauma B. Prostrate disease C. Fluid volume shifts D. Kidney infections ✔️ B. Prostate disease
The family member of a dialysis technician has noted blood in his urine the tech also noted the weight loss and rubbing of the flank to ease the cramping pain which disease comes to mind A. Nephrotic syndrome B. Bladder infection C. Kidney stones D. Renal carcinoma ✔️ D. Renal carcinoma
Which integumentary changes are commonly seen in patients with chronic kidney disease A. Brittle nails B. Excessive sweating C. Bruising D. Increase number of moles ✔️ A and C
Monday also patients infection account for about one and 10 fatalities which condition increases a patient's susceptibility to infection A. Diabetes
B. Malnutrition C. Bone abnormalities D. Frequent invasive procedures ✔️ A B and D
Management of renal bone disease requires that ministration of which type of medication with every meal and snack A. Potassium and substitutes B. Antacids C. Phosphate binders ✔️ C. Phosphate binders
Patients with chronic kidney disease are at risk for developing peripheral neuropathy. How may neuropathy present in the patient A. Intolerance to touch B. Burning feet C. Restless legs ✔️ B and C
What are some disadvantages of using hollow-fibers dialyzers A. They're not compliant B. They require meticulous care to remove air or gas from the fiber bundle C. Blood distribution may be uneven at inflow header space D. Higher heparin doses may be needed to prevent clotting in hollow fibers ✔️ B C and D
If a patient is experiencing adverse reactions from the residual toxic products of ethylene oxide sterilization of the hollow fibers what other ways can you sterilize it. A. Gamma radiation B. Pure alcohol flushing C. Electron beam ✔️ A and C
Which manifestation would lead to the tech to suspect the patient is experiencing intradialytic complement A. Anemia B. Intradialytic hypoxemia C. Chest pain D. Back pain ✔️ B C and D
If the bicarbonate concentrate is over mixed what lab values will result A. Increase pH B. Decrease in serum calcium level C. Increase in magnesium level
✔️ All of the above
What modifications to the dialysis procedure can be made to prevent intradialytic complications associated with fluid removal A. Lower the temp of the machine B. Extend treatment times C. Check serum sodium levels every 15 min ✔️ A and B
Which water contaminants may cause methemoglobinemia in which red cell hemoglobin cannot transport oxygen A. Fluoride and Tin B. Nitrates and chloramines C. Zinc and aluminum ✔️ B. Nitrates and chloramine
What is the process utilized when two carbon tanks are used to remove chlorine and chloramine from tank water A. Adsorption B. Absorption C. Diffusion ✔️ A. Adsorption
What type of contaminants are removed from water used in dialysis A. Endotoxins B. Aqueous salts C. Water softeners ✔️ A and B
When preparing for reverse osmosis what type of membranes should the tech be prepared to utilize A. Peritoneum B. Cellulose acetate C. Thin film composites D. Chlorine resistant polysulfone ✔️ B C and D
Which problems may occur when using a deionizer A. It can be hard initially to obtain the maximum flow rate needed B. The service life of a deionizer may be short and essential that the filters be placed downstream C. Resin beds tend to exhaust suddenly in the tanks may need to be exchanged D. If the resin tanks are used to exhaustion previously removed ions may be released ✔️ All of the above
When preparing the water used for the dialysate and reprocessing of dialyzers the CMS require "conventional dialysate" to have a max level of bacteria less than ——— CFU A. 300 B. 100 C. 200 ✔️ C. 200
How often at a minimum is it recommended to cleanse all components of the water treatment system with an approved disinfectant A. Quarterly B. Monthly C. Biweekly ✔️ B. Monthly
What are the most common methods for reducing microbiological contaminants and water use during dialysis A. Infusion of antibiotics in water tank B. Applying a sub micron filter C. Use of a filtration device ✔️ B and C
Which person on the team is responsible for ensuring the quality of water used for dialysis has met the standards A. Registered nurse B. Nurse manager C. Medical director ✔️ C. Medical director
When a dialyzer is prepared to use what actions are required prior to beginning the session A. Prime the dialyzer B. Remove all air in the dialyzer C. Flush the dialyzer with Celine prime to remove all particulate matter D. Remove any disinfectant left behind by rinsing under cold water ✔️ B and C
place the steps for a re-processing/re-using a dialyzer in the correct order A. Disinfect with chemical or heat B. Flush dialyzer to remove most of blood C. Test dialyzer D. Cleanse dialyzer with chemicals and reverse ultrafiltration ✔️ B then D then C then A
According to standard precautions when should gloves be changed and hands washed A. When gloves are contaminated
What are the recommendations for dialysis personnel caring for patients with clostridium difficile colitis A. Wear gloves when treating patient B. Impervious gowns upon entering room C. Wash hands with soap and water ✔️ All of the above
Why is anticoagulation therapy used in dialysis A. To foster good venous blood flow in fingers and toes B. To reduce clotting within the extracorporeal circuit C. To optimize dialyzer efficiency ✔️ B and C
How is heparin commonly administered A. Initial loading dose of heparin is given before tx begins B. Directly into arterial needle C. Administered throughout tx by direct injection ✔️ A. Initial dose
When blood is transfused into at risk patients during heparin free dialysis what complication should the technician be monitoring for A. Fluid removal overload B. Anaphylaxis reaction C. Increased velocity of the blood in the dialyzer ✔️ C. Increased velocity
If a dialysis patient does not have adequate vessels to create an internal fistula what is the remedy A. Veins surgically transferred from other areas of the body B. Wrapping mesh around scarred veins C. Using synthetic grafts ✔️ C. Using synthetic grafts
A patient tells the text that she woke up in the morning with her fistula arm underneath her head and that it has been asleep and feeling funny all day knowing this which complication should the tech assess the patient for prior to assessing her site A. Cervical disc pain resulting in nerve damage B. Thrombosis caused by compression of blood flow C. Aneurysm of the official site due to kinking of the artery ✔️ B.
After the initial skin prep for cannulation the tech is interrupted by a coworker asking a question when she proceeds to cannulation she noticed the skin prep has dried what action should the tech take
A. Proceed with cannulation B. Perform new assessment by palpating the site and then cannulate C. Re-prep the access to ensure the patient has not accidentally touch the site ✔️ C.
How should the needles be positioned A. Please the needles in the same general area during each treatment B. To achieve best blood flow placed the arterial needle near the anastomosis keeping the tip no closer than 1 1/2 to 2 inches from the anastomosis C. placed the arterial needle point in the direction of the flow D. Space the needles at least 1 inch apart ✔️ B C and D
What care should be provided for official arm between dialysis treatments A. Maintain adequate pressure over the puncture site for 10 to 20 minutes after the needles been removed B. Allow the skin over the access site to breathe by removing dressings after the bleeding has stopped C. Clean the fistula arm daily with soap ✔️ A and C
In patients with stage four or five chronic kidney disease which access site should be avoided to prevent risk of stenosis and thrombosis A. Fistula B. Subclavian vein catheter C. Peripherally Inserted central catheter ✔️ B and C
Immediately after insertion of a jugular catheter which complication should be assessed in the newly diagnosed stage five chronic kidney disease patient A. Slurred speech B. Collapsed lung C. Chest pain ✔️ B. Collapsed lung
According to KDOQI guidelines on goals of therapy for CKD patient on dialysis which post dialysis blood pressure goal is recommended A. Less than 140/ B. Less than 130/ C. Less than 150/ ✔️ B
According to the centers for Medicare and Medicaid what is the maximum amount of fluid that can be safely removed during a standard treatment A. 30% of fluid way as long as the pressure is normal
✔️ B and C
According to KDOQI which pre-dialysis albumin level should be the outcome goal for dialysis patient A. Equal to or greater than the normal range of four B. Equal to or greater than the normal range of three C. Equal to or greater than the normal range of one ✔️ A.
A 73-year-old dialysis patient is discussing with the tech her desire to convert to a total plant-based diet which statement is important for the tech to share A. There is no way to satisfy a patient's protein needs with a total plant-based diet B. Plant proteins are low biological value proteins and need to be combined to get all building blocks her body needs C. No plant protein foods are considered high proteins so it will be hard for her to satisfy her protein needs ✔️ B.
For a patient with stage 5 CKD phosphorus intake should be limited to what level A. 400 to 800 B. 1200 to 1600 C. 800 to 1200 ✔️ C.
A patient with CKD is having difficulty controlling her phosphorus intake why is control of phosphorus challenging A. Phosphorus is abundant in fresh food such as vegetables and fruit B. Phosphorus is found in high amounts of coffee and tea C. Phosphorus additives are commonly found in best-selling processed foods ✔️ C.
A patient with stage 5CKD has C Dash reactive protein level of 25 what does this level suggest A. Early onset diabetes B. Inflammation in the body C. Heart attack ✔️ B.
Parathyroid hormone helps to regulate calcium and phosphorus levels low serum calcium levels stimulate secretion of parathyroid hormone this results in which change of the body A. Increase calcium absorption from small intestine B. Calcium loss in the urine is minimize C. Movement of calcium out of the bones D. Creation of a urinary buffer for acid base balance
✔️ A B and C
How can a dialysis procedure be modified for a CKD patient with severe elevated blood urea nitrogen level A. Shorten dialysis time B. Increase blood flow rate C. Increased time rinsing the equipment D. Use a larger dialyzer ✔️ B and D
Which asymptomatic patient meet the criteria for testing for diabetes or prediabetes A. African-American and Latino or Native American B. Triglyceride level of 150 MG/DL C. Patient is on antihypertensive medication ✔️ A and C
A pts lab results revealed a significant drop in hemoglobin. Which med would the tech expect the nurse to administer to the pt A. Calcitrol B. Erythropoietin C. Vancomycin ✔️ B.
Which of the following practices helps to build a pts immunity to hep B A. Isolation B. Vaccination C. Sequestration ✔️ B
The tech is unsure which one of a patient's arteriovenous graft is arterial and which one is Venus in order to differentiate what do you do A. Cannulate both sides and observe the color B. Apply a tourniquet to the arm and feel for venous resistance C. Compressed a graft in the middle and palpate each side ✔️ C.
At the end of a patient's treatment which of these findings is observed by the tech should be reported A. Pulse rate of 55 B. Temp of 98 C. Weight loss of 6. ✔️ A.
Why are pts more likely to become infected with germs like MRSA A. Their diet is restricted
B. eGGR for Values below 90 mL/min C. Fasting glucose < ✔️ A and B
A child who has in just a large amount of poison is brought to the emergency room the tech is preparing the child for dialysis for it to remove the poison the poison must have which characteristic A. High degree of Protein binding B. Water solubility C. Low molecular weight ✔️ B and C
While reviewing the latest information on hypertension the dialysis tech notes that a blood pressure of 130/80 mmHg or higher is considered hypertension in which people A. Those with diabetes B. Those with CKD C. Those this cardiovascular disease ✔️ A and B
A dialysis patient regularly experiences intradialytic hypotension which medication may be given 15 to 30 minutes before dialysis for blood pressure support A. Amlodipine calcium channel blocker B. Losartan angiontensin receptor blocker C. Midodrine a vasopressor ✔️ C.
A dialysis patient asked the technician why am I taking Velphoro what medication does this fall under A. Phosphate binders B. Calcium channel blocker C. Cation exchange resin ✔️ A.
A patient has been diagnosed with acute kidney injury what symptoms might the family notice A. Listlessness B. Dark circles under eyes C. Confusion D. Fatigue ✔️ A c and D
What are some of the most common indications for acute dialysis A. Elevated BUN level B. Symptomatic Hypokalemia C. Weakness in one side of body
D. Acute pulmonary edema ✔️ A and D
A patient with first used syndrome is experiencing severe symptoms including breathing difficulty and cardiac rhythm abnormalities as the tech working which action should be implemented A. Return the blood to patient as quickly as possible B. Ask the RN to dispense Benadryl C. Discard the dialyzer ✔️ C.
If a patient is receiving acute dialysis what adjustment to the dialysis machine will help the patient with hypertension lower it to relatively normal reading A. Infusion of normal saline B. Ultrafiltration C. Transfuse one unit of packed cells ✔️ B.
Which action by the dialysis staff will help prevent or minimize disequilibrium A. Decrease flow rate B. Implement isolated ultrafiltration to remove fluid C. Utilize a small dialyzer with lower clearance properties D. Lower heparin dose to 250 units/hour ✔️ A and C
The emergency department is sending a patient to the dialysis unit due to a drug overdose which condition should the dialysis tech be aware of prior to patient arrival A. Hypertension B. Respiratory apnea C. Severe acid base in balance ✔️ B and C
A new client with CKD asks the tech what does nocturnal intermittent peritoneal dialysis mean how do you answer A. The initial volume will be small but will increase to a total volume infused every morning B. The machine will provide 3 to 5 exchanges every night but only minimal or no dwelling during the day C. You will receive dialysis 3 to 4 times a week with dry periods In between treatments ✔️ B.
The patient has had an expected progression of CKDN needs urgent start peritoneal dialysis what problems may be present in the patient who has been prescribed urgent start A. Fluid volume overload
A. High potassium level B. Acidosis C. Low magnesium levels ✔️ A and B
Transplant patient who is undergoing dialysis for hyperkalemia asks which vaccination should I avoid after I have this new kidney which one should be avoided A. Flu shot B. Small pox vaccine C. Bacillus calmette-guerin ✔️ B and C
Which diagnostic indicator leads to the staff to suspect the patient is experiencing rejection of her transplant kidney A. Low hemoglobin level B. Elevated serum BUN C. Elevated serum creatinine ✔️ C.
In a two year old which serum creatinine level would indicate kidney failure A. 0. B. 1. C. 0. ✔️ B 1.
Which dialyzer is appropriate and pediatric hemodialysis A. Dialyzer surface area should approximate the child's body surface area B. Regular adult dialyzer will work on pediatric patient C. Any dialyzer will work as long as ultrafiltration is kept at a low level ✔️ A.
What precaution should be address when restraining a pediatric patient for needle insertion A. All children under 10 must be restrained during assessing their fistula B. Children weighing less than 15 KG should be swaddled C. No matter the type of restraint a medical order should be written and refreshed with each dialysis treatment ✔️ C.
When would it be appropriate to isolate a child during hemodialysis treatment session A. Experiencing a runny nose and itchy eyes B. Exposed to chickenpox and now running a fever and has a red bumpy rash C. Confirmed lab test positive for blood-borne pathogen's ✔️ B and C
If a 13-year-old child has a blood pressure of 140/90 for three days in a row what blood pressure category/stage would this child be diagnosed with A. Normal blood pressure B. Stage two hypertension C. Stage one hypertension ✔️ B.
Which child is at high risk for developing latex allergy A. Young child born with spina bifida B. Child with allergies to cats and dogs and most grasses C. Child with urologic problems who requires frequent catheter placement ✔️ A and C
