CCHT Certified Clinical Hemodialysis Technician

A patient arrives for dialysis with a blood pressure of 180/110 mmHg. What is the most appropriate initial action by the hemodialysis technician?

• AAdminister an antihypertensive medication as prescribed
• BContinue with patient assessment and monitor blood pressure during dialysis
• CNotify the nurse and delay dialysis until blood pressure is evaluated
• DBegin dialysis immediately to remove fluid and lower blood pressure

During dialysis, a patient complains of muscle cramping in the legs. What should the technician do first?

• ATell the patient to endure the discomfort as it is normal
• BGive the patient a saline bolus without consulting the nurse
• CCheck the ultrafiltration rate and notify the nurse
• DImmediately stop the dialysis treatment

What is the most common cause of intradialytic hypotension?

• AAir entering the venous blood line
• BA high pre-dialysis potassium level
• CA reaction to the dialyzer membrane material
• DRemoving fluid faster than plasma can refill

A patient's pre-dialysis weight is 72 kg, and their dry weight is 68 kg. How much fluid should be removed during this treatment?

• A8 liters
• B2 liters
• C4 liters
• D6 liters

During AV fistula cannulation, what shows the technician that the needle tip has entered the vessel?

• AA flashback of blood into the needle tubing
• BFirm resistance felt as the needle is advanced
• CThe skin around the site turning pale
• DA sharp pain reported by the patient

A patient on dialysis develops chest pain and shortness of breath. The technician notices the patient is pale and diaphoretic. What is the priority action?

• AStop dialysis, return blood, and call for emergency help
• BContinue dialysis and increase the ultrafiltration rate
• CGive oxygen, then finish the treatment as scheduled
• DCheck blood glucose before doing anything else

What is the recommended angle for needle insertion when cannulating an arteriovenous (AV) fistula?

• A90 degrees (perpendicular)
• B45-60 degrees
• C10-15 degrees
• D25-35 degrees

A patient's potassium level is reported as 6.8 mEq/L pre-dialysis. What does this indicate?

• ASlightly elevated potassium that can wait for routine dialysis
• BHypokalemia requiring potassium supplementation
• CNormal potassium level for dialysis patients
• DHyperkalemia requiring immediate attention

Which of the following is a contraindication for using the buttonhole cannulation technique?

• APatient with diabetes mellitus
• BPresence of aneurysm at cannulation site
• CPatient preference for sharp needles
• DPatient on anticoagulation therapy

During dialysis, the patient's venous pressure alarm sounds. The pressure reading is 250 mmHg. What is the most likely cause?

• ABlood pump speed set lower than prescribed
• BThe venous needle slipping out of the access
• CA kink in the arterial line before the pump
• DA clot or obstruction on the venous side

What is the purpose of the "dry weight" in hemodialysis?

• AThe patient's weight when they first started dialysis
• BThe average weight of the patient over the past month
• CThe estimated weight of the patient with minimal excess fluid
• DThe patient's weight measured without the dialysis machine attached

A patient on hemodialysis reports long-standing itchy skin between treatments. What is the most likely cause?

• AToo little sodium in the dialysate
• BToo much phosphorus in the blood
• CLow blood pressure during each treatment
• DA reaction to the heparin given in the circuit

What is the correct procedure when a patient experiences a blood leak from their vascular access?

• AApply a tourniquet proximal to the bleeding access site
• BApply direct pressure and notify the nurse immediately
• CRemove the needle and continue dialysis
• DElevate the arm above heart level only

Which laboratory value best indicates adequate dialysis delivery?

• AHemoglobin of 12 g/dL after treatment
• BPre-dialysis potassium of 5.5 mEq/L
• CUrea reduction ratio (URR) of 70%
• DSerum albumin of 3.0 g/dL

What is the appropriate response when a patient complains of nausea and vomiting during dialysis?

• ATell the patient it is normal and will pass
• BStop UF, check blood pressure, and tell the nurse
• CGive an antiemetic medication right away
• DRaise the dialysate sodium level on your own authority