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100+ Free CCHT-A Practice Questions

Pass your NNCC Certified Clinical Hemodialysis Technician — Advanced exam on the first try — instant access, no signup required.

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After a near-miss event in which the wrong dialysate concentrate was almost installed, the CCHT-A should:

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2026 Statistics

Key Facts: CCHT-A Exam

150

Multiple-Choice Qs

NNCC

3 hrs

Time Limit

NNCC

70/100

Passing Scaled Score

NNCC

$225

Standard Fee

NNCC 2026

$100

Promo Fee (Apr 2026+)

NNCC

5,000 hrs

Eligibility Requirement

NNCC

CCHT-A is NNCC's advanced tier above CCHT, recognizing technicians with preceptor, audit, and training responsibilities. NNCC has announced a $100 promotional fee for applications received on or after April 1, 2026.

Sample CCHT-A Practice Questions

Try these sample questions to test your CCHT-A exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During a pre-dialysis assessment, a patient's standing weight is 2.4 kg above their estimated dry weight. What is the most appropriate first action for the technician?
A.Set the ultrafiltration goal to remove the entire 2.4 kg minus the rinse-back volume and document the gain
B.Skip the treatment because excess weight gain indicates non-adherence
C.Administer a diuretic to help with fluid removal before dialysis
D.Increase the dialysate sodium to 145 mEq/L without notifying the nurse
Explanation: The interdialytic weight gain drives the ultrafiltration (UF) goal. The technician sets the prescribed UF goal accounting for saline rinse-back, intradialytic intake, and the dry weight, then verifies it with the licensed nurse before initiation. Documenting the gain is required for QIP ultrafiltration-rate tracking.
2How frequently should blood pressure and pulse be assessed and documented during a routine in-center hemodialysis treatment?
A.Only at the beginning and end of treatment
B.At least every 30 minutes during treatment, plus pre and post
C.Hourly is sufficient for stable patients
D.Only when the patient reports symptoms
Explanation: Standard practice and CMS Conditions for Coverage require that vital signs be measured pre-treatment, at least every 30 minutes during treatment, and post-treatment. More frequent monitoring is required for unstable patients or after interventions for hypotension.
3Which vascular access has the lowest risk of infection and is considered the gold standard for chronic hemodialysis?
A.Tunneled central venous catheter
B.Non-tunneled internal jugular catheter
C.Arteriovenous (AV) fistula
D.Arteriovenous (AV) graft
Explanation: An AV fistula has the lowest infection rate, longest patency, and best long-term outcomes. It is the access of choice per the National Kidney Foundation KDOQI vascular access guidelines and is a CMS ESRD QIP measure (long-term catheter rate).
4A patient becomes diaphoretic, nauseated, and reports cramping 90 minutes into treatment. Blood pressure is 82/48 mm Hg, down from a pre-dialysis reading of 138/86 mm Hg. What is the most appropriate first action?
A.Stop ultrafiltration, place the patient in Trendelenburg, and notify the nurse
B.Increase the blood pump speed to clear toxins faster
C.Discontinue treatment and remove the needles immediately
D.Give the patient oral fluids and continue treatment unchanged
Explanation: Intradialytic hypotension is treated by stopping (or reducing) ultrafiltration, lowering the head of the chair (Trendelenburg if tolerated), and notifying the nurse who may order a saline bolus. The blood pump usually continues to maintain access patency.
5Which statement best describes the rope-ladder cannulation technique for an AV fistula?
A.Two needle sites are used in rotation along the length of the fistula at every treatment
B.The same exact two sites are used every treatment to develop tunnel tracks
C.The arterial needle is placed in the venous limb to maximize flow
D.Cannulation is performed only by physicians during the first six weeks
Explanation: Rope-ladder rotation distributes needle sticks along the fistula at each session to prevent aneurysm formation and prolong access life. Buttonhole technique, by contrast, uses the exact same sites at the same angle and depth every time.
6Which assessment is most important after a hemodialysis treatment is terminated and the patient is preparing to leave the unit?
A.A standing post-dialysis weight and orthostatic blood pressure check
B.A repeat 12-lead electrocardiogram on every patient
C.A complete neurologic exam by the technician
D.An abdominal ultrasound for residual fluid
Explanation: Post-dialysis standing weight confirms the actual fluid removed, and orthostatic vital signs detect occult hypotension before the patient ambulates. Both findings are required documentation per CMS Conditions for Coverage and unit policy.
7A technician palpates an AV fistula before cannulation and feels no thrill. The bruit is also absent on auscultation. What is the most appropriate next action?
A.Cannulate carefully because the access is probably fine
B.Apply warm compresses for 10 minutes and re-attempt cannulation
C.Hold cannulation and notify the nurse immediately for evaluation
D.Insert a temporary IV in the contralateral arm to start treatment
Explanation: Loss of thrill and bruit suggests fistula thrombosis. The technician must hold cannulation, notify the nurse, and avoid attempts that could worsen the clot or extravasate. Time-critical referral for thrombectomy can salvage the access.
8Sudden onset of chest pain, dyspnea, and a feeling of impending doom in a hemodialysis patient should make the technician most suspicious of which complication?
A.Disequilibrium syndrome
B.Air embolism
C.Mild muscle cramping
D.Restless legs syndrome
Explanation: Air embolism presents with acute chest pain, dyspnea, cyanosis, and may include neurologic changes. Immediate actions are clamping the venous line, stopping the blood pump, and placing the patient in left lateral Trendelenburg while the nurse and physician are notified.
9Why is it important to ask a hemodialysis patient about recent missed treatments during the pre-dialysis assessment?
A.Missed treatments shorten the length of the next treatment automatically
B.Missed treatments increase the risk of hyperkalemia and volume overload
C.Missed treatments require the technician to administer additional medications
D.Missed treatments must be reported to the FBI under HIPAA
Explanation: Missing dialysis allows potassium, fluid, and uremic toxins to accumulate, raising the risk of cardiac arrhythmia, pulmonary edema, and hospitalization. ESRD QIP tracks all-cause hospitalization, partly driven by missed treatments.
10A patient develops severe muscle cramps during the last hour of dialysis. The technician has already stopped ultrafiltration. Which dialysate adjustment, ordered by the nurse or physician, most directly relieves cramping?
A.Decreasing dialysate calcium
B.Increasing dialysate sodium (sodium modeling) per protocol
C.Decreasing dialysate temperature below 34 degrees Celsius
D.Increasing dialysate bicarbonate above 45 mEq/L
Explanation: Sodium modeling that holds higher dialysate sodium during cramping draws fluid from the intracellular space, supports plasma refilling, and relieves cramping. Saline boluses serve a similar purpose. Adjustments require an order; technicians implement them per protocol.

About the CCHT-A Exam

The Certified Clinical Hemodialysis Technician — Advanced (CCHT-A) is the advanced credential awarded by the Nephrology Nursing Certification Commission (NNCC) to experienced patient care technicians. The exam contains 150 multiple-choice questions delivered through C-NET in a single 3-hour session. Eligibility requires existing CCHT certification, 5,000+ documented patient-care hours, and 5+ years of dialysis experience.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Scaled 70/100

Exam Fee

$225 (NNCC (delivered by C-NET))

CCHT-A Exam Content Outline

30%

Patient Care and Clinical Practice

Advanced cannulation, intradialytic complications, vascular access surveillance, fluid management, and patient education at preceptor level.

25%

Machine Technology and Water Treatment

AAMI water quality, RO and DI systems, dialysate composition, machine alarms, and equipment troubleshooting beyond entry level.

15%

Infection Control and Safety

Bloodborne pathogen exposure, hepatitis precautions, CDC dialysis guidelines, environmental safety, and outbreak prevention.

15%

Dialysis Principles

Diffusion, ultrafiltration, osmosis, anticoagulation, KT/V and URR adequacy targets, and renal pathophysiology.

10%

Documentation, Regulations, and Professional Role

ESRD QIP measures, CMS conditions for coverage, charting standards, preceptor and audit responsibilities, and ethical practice.

5%

Renal Failure and Treatment Options

AKI vs CKD progression, modalities (HD, PD, transplant, conservative care), and patient counseling on options.

How to Pass the CCHT-A Exam

What You Need to Know

  • Passing score: Scaled 70/100
  • Exam length: 150 questions
  • Time limit: 3 hours
  • Exam fee: $225

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CCHT-A Study Tips from Top Performers

1Master ESRD QIP measures and CMS Conditions for Coverage — heavily tested at advanced level
2Drill advanced cannulation: rope-ladder, buttonhole technique, and complication management
3Memorize AAMI water quality limits and corrective action thresholds
4Practice preceptor-style scenarios — many questions test judgment, not recall
5Review KT/V and URR calculations plus interpretation of inadequate dialysis

Frequently Asked Questions

What is the NNCC CCHT-A exam?

The CCHT-A is the advanced tier of NNCC's Certified Clinical Hemodialysis Technician credential. It is for experienced patient care technicians who already hold CCHT and have at least 5,000 patient-care hours plus 5+ years of dialysis experience.

How is CCHT-A different from BONENT's CHT?

CCHT-A is issued by NNCC and is an advanced credential with preceptor and audit scope, requiring CCHT prerequisite. BONENT's CHT is a separate certification from a different vendor with its own eligibility, blueprint, and scope of practice.

How many questions are on the CCHT-A exam?

The NNCC CCHT-A exam contains 150 multiple-choice questions delivered through C-NET in a 3-hour session.

What is the passing score?

Candidates must achieve a scaled score of 70 (out of 100) to pass. The cut score is set through criterion-referenced equating each cycle.

How much does the CCHT-A cost?

The standard NNCC CCHT-A application fee is $225. NNCC has announced a $100 promotional fee for applications received on or after April 1, 2026 (limited time). A $50 Fast Track processing fee is optional.