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CCHT Exam Review 106 Questions with
Answers latest 2025
The functional unit of the kidney, or the structure in the kidney that does the work, is the: ✔️ Nephron
A nephron is made up of: ✔️ A glomerulus and a tubule
The endocrine functions of the kidney includes: ✔️ Making erythropoietin and the active form of vitamin D
The leading cause of End-Stage Renal Disease for adult in the United States is: ✔️ Diabetes
Patients with kidney failure often complain of itching, which is likely to be caused by: ✔️ Hyperphosphatemia
Why do kidney patients often have bone disease? ✔️ Kidneys stop producing calcitriol
Symptoms that a patient may need more dialysis time include: ✔️ Anorexia, fatigue, swelling
A semipermeable membrane is a porous barrier that: ✔️ Allow for only certain sized particles to cross
Diffusion is movement of particles: ✔️ From an area of higher concentration
Negative pressure is pressure created when: ✔️ Fluid is pulled through a restriction
During dialysis, ultrafiltration occurs when: ✔️ Water is removed from blood because there is a pressure gradient between blood and dialysate
At which point in the extracorporeal circuit is the blood usually under negative pressure? ✔️ The arterial line section before the blood pump
Which of the following will increase the amount of solutes that will diffuse across the semipermeable membrane?
✔️ High concentration gradients
The components of the dialysate treatment that affect clearance includes: ✔️ Dialysate flow, time of treatment, dialyzer size, blood flow rate
Two things that affect the dialyzer's ability to remove wastes from the body include: ✔️ Surface area and molecular weight cutoff
Dialysate is the fluid that help remove waiste products from the body. It contains a number of substances. What are the substances that might be prescribed for a dialysate solution? ✔️ Bicarbonate, Sodium, Potassium
What is the most important safety monitor during a dialysis treatment ✔️ The dialysis technician
Dialysate conductivity measures: ✔️ The total electrical charge of a solution
Dialysate that has too much sodium may cause patient injury. Too much sodium or hypernatremia can cause: ✔️ Headache, high BP, and shriveling of RBCs (crenation)
Dialysate that has too much calcium can cause: ✔️ Vomiting, confusion, irritability
Dialysate that has too little sodium can cause: ✔️ Low BP, cramping, and bursting of RBCs (hemolysis)
Things that affect dialysis adequacy are: ✔️ -Treatment time -BFR -DFR -Dialyzer clotting/inadequate heparinization
Normal body temp. taken orally is: ✔️ 98.6 degrees F
_______ is the instrument use to measure blood pressure ✔️ Sphygmomanometer
A rapid pulse of 104 beats/min would indicate that the patient has: ✔️ Tachycardia
✔️ -Tachycardia -Hypertension -Dyspnea
"First use syndrome" is a hypersensitivity reaction to a dialyzer. It characterized by: ✔️ -Back pain -Anxiety -Tachycardia -Wheezing -Circulatory collapse
Dialyzer performance can be affected by reuse. The sets of potential problem that may be related to reuse are: ✔️ -Reduce dialyzer performance -Plugged hollow fibers -Changed fiber bundle volume
AAMI standards recommend quality control activities before a reprocessed dialyzer is used on a patient. How many people must check the dialyzer to verify quality control information? ✔️ Two people, one of whom should be the patient
Which of the following is NOT a symptom of chemical reaction due to incomplete rinsing of germicide from a reprocessed dialyzer:
-Burning in the access site -Numbness in the access arm -Blurred vision -Diarrhea ✔️ Diarrhea
Dialyzer are processed before use to rinse out manufacturing residues and to: ✔️ Establish the original fiber bundle volume of the dialyzer and check for leaks
Two criteria for rejecting a reprocessed dialyzer ✔️ 1) Less than 80% of original fiber bundle volume
- aesthetic appearance
The AAMI (Association for the Advancement of Medial Instrumentation) ✔️ The AAMI recommends voluntary standards for dialysis water treatment
According to AAMI standards, bacteriologic testing for water and dislysate should take place: ✔️ Monthly
According to AAMI standards, the total microbial count of water used to prepare dialysate shall not exceed: ✔️ 200 CFU/mL
Stenosis is a major cause of access failure, which unless corrected, can lead to thrombosis and other complications. What are the signs of stenosis? ✔️ Changes in the thrill and bruit
Describe 4 types of anastomosis for an arteriovenous fistula ✔️ Artery-side to vein-side anastomosis Artery-end to vein-end anastomosis Artery-end to vein-side Artery-side to vein-end
What is an infiltration? ✔️ A needle tip that punctures a vessel and goes out the other side, allowing blood to seep into the surrounding tissue
What is the preferred insertion site for both temporary and long term catheters? ✔️ Internal jugular vein
Why is artrivenous fistula preferable as the vascular access of choice whenever possible? ✔️ They have the lowest rate of primary failure of all known accesses
Example of an indication of a break in the integrity of the extracorporeal circuit (ECC)? ✔️ Appreance of air or foam in any bloodline
During dialysis, patients should be monitored for the following complications (list all that apply):
a. Separation of bloodlines or rupture of an access b. The presence of air or foam in the lines c. Bleeding around needle or catheter exit sites d. Sudden change in blood flow, or venous pressure, or line collapse ✔️ All letters
a. Separation of bloodlines or rupture of an access b. The presence of air or foam in the lines c. Bleeding around needle or catheter exit sites d. Sudden change in blood flow, or venous pressure, or line collapse
Poor blood flow during dialysis in patient with catheters is often due to which of the following factors? (List all that apply)
✔️ FEWER
-Infections -Missed needle insertions -Hematomas -Infiltrations
Steps for creating the buttonhole: ✔️ -Remove the scab -Cannulate the same site at the same angle, by the same caregiver with sharp needles for 3-4 weeks to create a tunnel
The venous pressure on a dialysis machine starts to rise but the venous needle is not infiltrated, which might be the reason? ✔️ -Clotting of the venous line -Venospasm
Factors that affect peritoneal membrane permeability include: ✔️ Peritonitis infection
Anastomosis: ✔️ Sugical connection between 2 blood vessels
Bruit: ✔️ Buzzing, swooshing sound in a fistula or graft
Stenosis: ✔️ Narrowing of a blood vessel
Thrombosis: ✔️ Blood clotting
Aneurysm: ✔️ Ballooning of a weak spot in a blood vessel wall
Thrill: ✔️ Vibration from pulse of blood in a dialysis vascular access
What term indicates a solution that has the same concentration of solutes as blood? ✔️ Isotonic
For patients on hemodialysis, a 1 kg (2.2 lb) increase in weight in 24 hours is approximately equivalent to fluid retention of: ✔️ 1.0 L
(1 kg = 1 L)
Which of the following is the most common cause of hypotension developing during hemodialysis?
a. Eating/drinking during treatment b. Removing excessive volume of fluid c. Anemia d. Dialyzer reaction ✔️ b. Removing excessive volume of fluid
When washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least ✔️ 15 seconds
With an AV fistula, cannulation should usually be done at an angle of ✔️ 25° to 35°
What percentage of water that is filtered out of the blood by the glomeruli is excreted as urine? ✔️ 1%
Which of the following needle sizes has the largest lumen (diameter)?
a. 17 gauge b. 16 gauge c. 15 gauge d. 14 gauge ✔️ d. 14 gauge
How frequently should patients and staff members of a dialysis center have tuberculosis skin tests? ✔️ Once a year
How often should colony counts and limulus amebocyte lysate tests be conducted on the water feeding the bicarbonate mixer? ✔️ Monthly
Which of the following is an extracorporeal alarm rather than a dialysate alarm?
a. Conductivity b. Temperature c. Air detector d. pH ✔️ c. Air detector
✔️ Being knowledgeable of and responsible for the integrity of the water treatment system in the facility
Prior to beginning dialysis, what must the physician order include? ✔️ 1. Specific Dialyzer
- Blood Flow Rate
- Duration of the dialysis
To be eligible to sit for the Certified Clinical Hemodialysis Technicians - Advanced (CCHT-A) exam, the technician must have what? ✔️ 1. Hold another national certification such as CCHT (Certified Clinical Hemodialysis Technician)
- Worked at least 5000 hours as a clinical hemodialysis technician.
What abilities are required of a dialysis technician? ✔️ 1. Some understanding of human anatomy and physiology and the pathophysiology of chronic kidney disease (CKD).
- Full understanding of the principles of dialysis and treatment complications.
- Math Skills
Which of the following statements about informed consent for treatment is accurate? ✔️ Two consents are needed for dialysis: one for the dialysis itself and one for the access procedure or medications.
If a patient chooses to terminate dialysis, what should the renal staff do? ✔️ Realize that it is well within a patient's rights to choose to terminate dialysis.
Who was the first person to use the term dialysis? ✔️ Thomas Graham
What was the primary anticoagulant used in the first artificial kidney? ✔️ Hirudin
Dr. Willem J. Kolff created the first dialyzer suitable for human use (rotating drum dialyzer) in 1943. What material was used to construct the hollow tubes on the device? ✔️ Cellophane
The first arteriovenous (AV) shunt for chronic renal patients was placed: ✔️ Externally, using Teflon tubes
Which U.S. President signed the bill that allowed Medicare coverage to pay for treatment for all patients with chronic kidney disease? ✔️ Nixon
In 1989, FDA approval of this medication diminished the need for blood transfusions in chronic renal disease patients: ✔️ Epoetin alfa (Epogen)
What may result if a dialysate solution contains too much sodium? ✔️ 1. Fluid may leave cells, causing blood cells to shrivel
- The patient may experience hypertension, profound thirst, and headache
With osmosis, water moves from areas of: ✔️ Low concentration of solutes to areas of high concentration of solutes
Buffers minimize pH changes when an acid or a base is added to a solution. What is the major plasma buffer in the body? ✔️ Bicarbonate
Kidney failure causes retention of hydrogen ions. What is the result? ✔️ Metabolic acidosis
Which of these patient populations has the lowest proportion of body water? ✔️ Adult females
Blood urea levels are influenced by many factors. Decreased levels may result from: ✔️ Low dietary protein intake Overhydration
A shortage of oxygen-carrying red blood cells is called ✔️ anemia
The technician would expect a patient's anemia to be monitored by what laboratory test? ✔️ Hemoglobin
A patient's laboratory results reveal a significant drop inhemoglobin. Whichmedicationwouldthe technician expect the nurse to administer to the patient during dialysis treatments? ✔️ Erythropoietin (Epogen)
What practice helps to build a patient's immunity to hepatitis B? ✔️ Vaccination
