Nephrology Nursing Certification
MAXE • THCC
NNCC
Commission
CCHT Examination Division
EST. 1982
EXCELLENCE IN NEPHROLOGY CARE
CCHT EXAM
CO M P R E H E N S I V E R E V I E W — L A B VA LU E S , D I A LYS I S P R I N C I P L E S & C L I N I C A L PA R A M E T E R S
INSTITUTION NNCC / CCHT Certification EXAM TYPE CCHT Examination Review
PROGRAM Hemodialysis Technician Certification ACADEMIC YEAR
EXAM TITLE CCHT EXAM — Lab Values & Principles TOTAL QUESTIONS Complete Study Guide
COURSE TITLE Certified Clinical Hemodialysis Technician FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ This comprehensive CCHT review covers dialysis adequacy measures, lab values (hemoglobin, calcium, phosphorus, PTH,
sodium, potassium, BUN, creatinine), CKD staging, dialysis principles (diffusion, osmosis, ultrafiltration), fluid dynamics, and
clinical complications.
▸ Correct answers and detailed rationales appear below each question.
▸ All content is derived from CCHT Examination core concepts.
SECTION I — DIALYSIS ADEQUACY & CKD STAGING Part A
1. The monthly adequacy of dialysis target is:
A. 90% or greater
B. 96% or greater
C. 85% or greater
D. 80% or greater
CORRECT ANSWER B — 96% or greater.
RATIONALE Adequacy of dialysis is measured monthly with a target of 96% or greater, reflecting optimal solute clearance
and fluid removal to maintain patient health.
2. The monthly Kt/V target is:
A. Greater than or equal to 1.0
B. Greater than or equal to 1.2
C. Greater than or equal to 1.5
D. Greater than or equal to 2.0
CORRECT ANSWER B — Greater than or equal to 1.2.
RATIONALE Kt/V is the gold standard for measuring dialysis adequacy. KDOQI guidelines recommend Kt/V ≥1.2. K
represents urea clearance, t is time, and V is the patient's total body water volume.
, 3. The monthly URR (Urea Reduction Ratio) target is:
A. Greater than or equal to 55%
B. Greater than or equal to 65%
C. Greater than or equal to 75%
D. Greater than or equal to 85%
CORRECT ANSWER B — Greater than or equal to 65%.
RATIONALE URR measures the percentage of urea removed during a dialysis treatment. KDOQI guidelines recommend
URR ≥65%. URR = (pre-BUN - post-BUN) ÷ pre-BUN × 100.
4. The GFR for Stage 5 CKD (when dialysis begins) is:
A. >90%
B. 60-89%
C. 30-59%
D. <15%
CORRECT ANSWER D — <15%.
RATIONALE CKD staging: Stage 1 >90% (diet change), Stage 2 60-89% (no EPO production), Stage 3 30-59% (vascular
access planning), Stage 4 15-29% (symptomatic), Stage 5 <15% (dialysis initiated).
5. The target hemoglobin range for dialysis patients is:
A. 8-10 g/dL
B. 10-12 g/dL
C. 12-14 g/dL
D. 14-16 g/dL
CORRECT ANSWER B — 10-12 g/dL.
RATIONALE The target hemoglobin for dialysis patients is 10-12 g/dL. Values below this indicate anemia requiring EPO
and iron management. Hematocrit target is 30-36%. Values <6 g/dL may require blood transfusion.
6. The normal serum sodium (Na+) range is:
A. 125-130 mEq/L
B. 135-143 mEq/L
C. 145-155 mEq/L
D. 120-130 mEq/L
CORRECT ANSWER B — 135-143 mEq/L.
RATIONALE Normal serum sodium is 135-143 mEq/L. High sodium causes excessive thirst and fluid weight gain. Sodium
modeling (lowering sodium at the end of treatment) helps prevent hypotension. To remove more water, add
more salt to the dialysate.
MAXE • THCC
NNCC
Commission
CCHT Examination Division
EST. 1982
EXCELLENCE IN NEPHROLOGY CARE
CCHT EXAM
CO M P R E H E N S I V E R E V I E W — L A B VA LU E S , D I A LYS I S P R I N C I P L E S & C L I N I C A L PA R A M E T E R S
INSTITUTION NNCC / CCHT Certification EXAM TYPE CCHT Examination Review
PROGRAM Hemodialysis Technician Certification ACADEMIC YEAR
EXAM TITLE CCHT EXAM — Lab Values & Principles TOTAL QUESTIONS Complete Study Guide
COURSE TITLE Certified Clinical Hemodialysis Technician FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ This comprehensive CCHT review covers dialysis adequacy measures, lab values (hemoglobin, calcium, phosphorus, PTH,
sodium, potassium, BUN, creatinine), CKD staging, dialysis principles (diffusion, osmosis, ultrafiltration), fluid dynamics, and
clinical complications.
▸ Correct answers and detailed rationales appear below each question.
▸ All content is derived from CCHT Examination core concepts.
SECTION I — DIALYSIS ADEQUACY & CKD STAGING Part A
1. The monthly adequacy of dialysis target is:
A. 90% or greater
B. 96% or greater
C. 85% or greater
D. 80% or greater
CORRECT ANSWER B — 96% or greater.
RATIONALE Adequacy of dialysis is measured monthly with a target of 96% or greater, reflecting optimal solute clearance
and fluid removal to maintain patient health.
2. The monthly Kt/V target is:
A. Greater than or equal to 1.0
B. Greater than or equal to 1.2
C. Greater than or equal to 1.5
D. Greater than or equal to 2.0
CORRECT ANSWER B — Greater than or equal to 1.2.
RATIONALE Kt/V is the gold standard for measuring dialysis adequacy. KDOQI guidelines recommend Kt/V ≥1.2. K
represents urea clearance, t is time, and V is the patient's total body water volume.
, 3. The monthly URR (Urea Reduction Ratio) target is:
A. Greater than or equal to 55%
B. Greater than or equal to 65%
C. Greater than or equal to 75%
D. Greater than or equal to 85%
CORRECT ANSWER B — Greater than or equal to 65%.
RATIONALE URR measures the percentage of urea removed during a dialysis treatment. KDOQI guidelines recommend
URR ≥65%. URR = (pre-BUN - post-BUN) ÷ pre-BUN × 100.
4. The GFR for Stage 5 CKD (when dialysis begins) is:
A. >90%
B. 60-89%
C. 30-59%
D. <15%
CORRECT ANSWER D — <15%.
RATIONALE CKD staging: Stage 1 >90% (diet change), Stage 2 60-89% (no EPO production), Stage 3 30-59% (vascular
access planning), Stage 4 15-29% (symptomatic), Stage 5 <15% (dialysis initiated).
5. The target hemoglobin range for dialysis patients is:
A. 8-10 g/dL
B. 10-12 g/dL
C. 12-14 g/dL
D. 14-16 g/dL
CORRECT ANSWER B — 10-12 g/dL.
RATIONALE The target hemoglobin for dialysis patients is 10-12 g/dL. Values below this indicate anemia requiring EPO
and iron management. Hematocrit target is 30-36%. Values <6 g/dL may require blood transfusion.
6. The normal serum sodium (Na+) range is:
A. 125-130 mEq/L
B. 135-143 mEq/L
C. 145-155 mEq/L
D. 120-130 mEq/L
CORRECT ANSWER B — 135-143 mEq/L.
RATIONALE Normal serum sodium is 135-143 mEq/L. High sodium causes excessive thirst and fluid weight gain. Sodium
modeling (lowering sodium at the end of treatment) helps prevent hypotension. To remove more water, add
more salt to the dialysate.
