CCHT Hemodialysis and Renal Care Examination: Water Treatment, Dialysate
Safety, Chlorine and Chloramine Removal, Hardness Testing, Reverse Osmosis,
Ultrafilters, Aluminum Toxicity, Electrolyte Imbalances, Hyperkalemia,
Hypokalemia, Hypernatremia, Hyponatremia, Hypercalcemia, Hypocalcemia,
Metabolic Acidosis, Metabolic Alkalosis, Uremia, Acute Kidney Injury, Chronic
Kidney Disease, Glomerular Filtration, Nephron Function, Endocrine Renal
Function, Erythropoietin, Calcitriol, Renin-Angiotensin System, Patient
Monitoring, Conductivity, Dialysate pH, Dialysate Temperature, Microbial
Contaminants, Inorganic Chemical Contaminants, and Emergency Response
Protocols Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026
Aluminum in water used for dialysis causes:
Anemia, bone disease, nausea & vomiting
Chlorine in water used for hemodialysis causes:
Anemia, hemolysis
Excess calcium and sodium in water used for dialysis causes:
Hypertension, muscle weakness
Excess calcium and magnesium in water used for dialysis causes:
,Muscle weakness
What is the acceptable level, action level, and unacceptable level of water/dialysate culture
results?
Acceptable level: below 50 cfu/ml
Action level: 50 - 199 cfu/ml
Unacceptable level: 200 cfu/ml or greater
What is the acceptable level, action level, and unacceptable level for water/dialysate endotoxin
testing results?
Acceptable level: below 1 EU/ml
Action level: 1 EU/ml or greater but less than 2 EU/ml
Unacceptable level: 2 EU/ml or greater
What removes chlorine/chloramines?
Carbon tanks/filters
When and where do you test for chlorine/chloramines?
When: before first tx and every 4 hrs
Where: after primary tank
, What is the acceptable result and the action if results are too high post primary tank when
testing for chlorine/chloramines?
Acceptable result: 0.1 mg/L or less
Action: repeat, check after 2nd tank
What is the F/U if secondary test results are within limits when testing for
chloramines/chlorines?
If w/in 0.1 mg/L or less, check every 30 mins
What is the F/U if the secondary test results are too high when testing for
chlorine/chloramines?
Stop dialysis/put machines into bypass
In regards to hardness testing, what is removed?
"hardness" ions
Calcium and magnesium
Why is hardness testing important and when do we test?
It's important for RO protection and is checked daily (at the end of the day)
What does the RO remove?
Organic and inorganic contaminants
Safety, Chlorine and Chloramine Removal, Hardness Testing, Reverse Osmosis,
Ultrafilters, Aluminum Toxicity, Electrolyte Imbalances, Hyperkalemia,
Hypokalemia, Hypernatremia, Hyponatremia, Hypercalcemia, Hypocalcemia,
Metabolic Acidosis, Metabolic Alkalosis, Uremia, Acute Kidney Injury, Chronic
Kidney Disease, Glomerular Filtration, Nephron Function, Endocrine Renal
Function, Erythropoietin, Calcitriol, Renin-Angiotensin System, Patient
Monitoring, Conductivity, Dialysate pH, Dialysate Temperature, Microbial
Contaminants, Inorganic Chemical Contaminants, and Emergency Response
Protocols Exam Questions Verified and Provided with Complete A+ Graded
Rationales Latest Updated 2026
Aluminum in water used for dialysis causes:
Anemia, bone disease, nausea & vomiting
Chlorine in water used for hemodialysis causes:
Anemia, hemolysis
Excess calcium and sodium in water used for dialysis causes:
Hypertension, muscle weakness
Excess calcium and magnesium in water used for dialysis causes:
,Muscle weakness
What is the acceptable level, action level, and unacceptable level of water/dialysate culture
results?
Acceptable level: below 50 cfu/ml
Action level: 50 - 199 cfu/ml
Unacceptable level: 200 cfu/ml or greater
What is the acceptable level, action level, and unacceptable level for water/dialysate endotoxin
testing results?
Acceptable level: below 1 EU/ml
Action level: 1 EU/ml or greater but less than 2 EU/ml
Unacceptable level: 2 EU/ml or greater
What removes chlorine/chloramines?
Carbon tanks/filters
When and where do you test for chlorine/chloramines?
When: before first tx and every 4 hrs
Where: after primary tank
, What is the acceptable result and the action if results are too high post primary tank when
testing for chlorine/chloramines?
Acceptable result: 0.1 mg/L or less
Action: repeat, check after 2nd tank
What is the F/U if secondary test results are within limits when testing for
chloramines/chlorines?
If w/in 0.1 mg/L or less, check every 30 mins
What is the F/U if the secondary test results are too high when testing for
chlorine/chloramines?
Stop dialysis/put machines into bypass
In regards to hardness testing, what is removed?
"hardness" ions
Calcium and magnesium
Why is hardness testing important and when do we test?
It's important for RO protection and is checked daily (at the end of the day)
What does the RO remove?
Organic and inorganic contaminants
