Nephrology Nursing Certification
MAXE • THCC
★ ★
N Certified Clinical Hemodialysis Technician
E X C E L L E N C E I N D I A LY S I S PAT I E N T C A R E
EST. 2026
CCHT Exam Guide & Practice Questions
CO M P R E H E N S I V E N E P H R O LO G Y N U R S I N G C E R T I F I C AT I O N P R E PA R AT I O N
INSTITUTION Nephrology Nursing Certification EXAM CODE CCHT – Certified Clinical Hemodialysis
Commission (NNCC) Technician
PROGRAM Hemodialysis Patient Care Technician ACADEMIC YEAR
EXAM TITLE CCHT Certification Examination TOTAL QUESTIONS 75 Questions
COURSE TITLE Hemodialysis Technology & Patient Care FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ This exam covers Clinical, Technical, Environmental, and Role Responsibilities domains.
▸ Cognitive levels tested: Recall (8–13%), Comprehension (23–28%), Application (63–67%).
▸ Correct answers and detailed rationales are provided for comprehensive review.
SECTION I — HEMODIALYSIS PRINCIPLES, PATIENT CARE & SAFETY Questions 1 – 75
1. What types of technician activities are tested in the Clinical area of the CCHT exam?
A. Infection control and safety issues in the dialysis setting.
B. Patient care before, during, and after dialysis treatment.
C. Principles of water treatment and machine-related problem actions.
D. Roles of staff members and communication skills.
CORRECT ANSWER B — Patient care before, during, and after dialysis treatment.
RATIONALE The Clinical domain focuses on direct patient care activities throughout the entire dialysis treatment cycle —
pre-treatment assessment, intradialytic monitoring, and post-treatment care. Environment covers infection
control and safety. Technical covers water treatment and machine troubleshooting. Role Responsibilities
covers professional duties and communication.
,2. What is the appeal process for denied certification?
A. Submit a verbal appeal to the charge nurse within 60 days.
B. An applicant must submit a written appeal to the President of the NNCC within 30 days.
C. Reapply for the examination immediately.
D. Contact the facility manager for reconsideration.
CORRECT ANSWER B — An applicant must submit a written appeal to the President of the NNCC within 30 days.
RATIONALE The formal appeal process requires a written appeal submitted to the President of the NNCC within 30 days of
denial. Failure to request an appeal constitutes a waiver of the right to appeal. A committee appointed by the
President meets with the applicant and makes recommendations to the NNCC. The final decision is
communicated in writing within 30 days following the NNCC meeting.
3. What is the range of questions that require Application of Knowledge in the CCHT exam?
A. 8–13%.
B. 23–28%.
C. 63–67%.
D. 45–50%.
CORRECT ANSWER C — 63–67%.
RATIONALE The CCHT exam emphasizes higher-level thinking: Application of Knowledge comprises 63–67% of questions
— these require the technician to apply principles to clinical situations. Comprehension questions make up
23–28%, requiring understanding and interpretation. Recall of Knowledge (basic facts) is only 8–13%. This
distribution reflects the exam's focus on practical clinical judgment.
4. What is anemia and what medication might be administered during dialysis for a patient with anemia?
A. A shortage of white blood cells; administered heparin.
B. A shortage of oxygen-carrying red blood cells; administered erythropoietin (Epogen).
C. Excess fluid in the blood; administered furosemide.
D. Calcium deficiency; administered calcitriol.
CORRECT ANSWER B — A shortage of oxygen-carrying red blood cells; administered erythropoietin (Epogen).
RATIONALE Anemia is a deficiency of red blood cells (RBCs), reducing the blood's oxygen-carrying capacity. In chronic
kidney disease, the kidneys produce insufficient erythropoietin — the hormone that stimulates RBC
production. Erythropoietin-stimulating agents (ESAs) like Epogen (epoetin alfa) are given during dialysis to
treat anemia. Hemoglobin is the laboratory test used to monitor anemia.
5. How can a technician differentiate between arterial and venous anastomoses in an AV graft?
A. Check the patient's blood pressure on that side.
B. Cannulate both sides of the graft and observe the color of the blood.
C. Palpate for a thrill over the entire graft.
D. Measure the diameter of the graft with calipers.
CORRECT ANSWER B — Cannulate both sides of the graft and observe the color of the blood.
RATIONALE Arterial blood is bright red (oxygenated) and venous blood is darker (deoxygenated). By cannulating both
sides and observing blood color, the technician can differentiate the arterial from the venous anastomosis.
The arterial side has pulsatile, brighter blood. This is important for proper needle placement — the arterial
needle is placed closer to the arterial anastomosis.
, 6. Which practice helps build a patient's immunity to hepatitis B?
A. Frequent hand hygiene.
B. Vaccination.
C. Isolation precautions.
D. Antibiotic prophylaxis.
CORRECT ANSWER B — Vaccination.
RATIONALE Hepatitis B vaccination stimulates the immune system to produce protective antibodies against the hepatitis
B virus. Dialysis patients are at increased risk due to blood exposure during treatments. The vaccine series is a
standard preventive measure. Patients positive for HBsAg must be dialyzed in a dedicated area with separate
machines and supplies. Hand hygiene and isolation support infection control but vaccination builds active
immunity.
7. What does uremia mean?
A. Excess fluid in the bloodstream.
B. An increase of wastes in the blood.
C. An electrolyte imbalance.
D. A bacterial infection of the kidneys.
CORRECT ANSWER B — An increase of wastes in the blood.
RATIONALE Uremia (uremic syndrome) is the accumulation of nitrogenous waste products (urea, creatinine, uric acid) and
other toxins in the blood due to kidney failure. Signs include fatigue, nausea, pruritus, cognitive changes, and
pericarditis. A decrease in urine output is an indicator of possible uremia. Dialysis removes these wastes.
Uremia is the clinical syndrome of advanced renal failure.
8. Why is vitamin D therapy given to dialysis patients?
A. To treat anemia.
B. Vitamin D is needed for healthy bones.
C. To prevent infections.
D. To reduce blood pressure.
CORRECT ANSWER B — Vitamin D is needed for healthy bones.
RATIONALE Dialysis patients have impaired conversion of vitamin D to its active form (calcitriol) because the kidneys
perform the final hydroxylation step. Active vitamin D (calcitriol) controls calcium and phosphorus balance,
which is essential for bone metabolism. Without adequate vitamin D, patients develop renal
osteodystrophy/mineral bone disorder. Supplementation improves bone health and manages secondary
hyperparathyroidism.
MAXE • THCC
★ ★
N Certified Clinical Hemodialysis Technician
E X C E L L E N C E I N D I A LY S I S PAT I E N T C A R E
EST. 2026
CCHT Exam Guide & Practice Questions
CO M P R E H E N S I V E N E P H R O LO G Y N U R S I N G C E R T I F I C AT I O N P R E PA R AT I O N
INSTITUTION Nephrology Nursing Certification EXAM CODE CCHT – Certified Clinical Hemodialysis
Commission (NNCC) Technician
PROGRAM Hemodialysis Patient Care Technician ACADEMIC YEAR
EXAM TITLE CCHT Certification Examination TOTAL QUESTIONS 75 Questions
COURSE TITLE Hemodialysis Technology & Patient Care FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ This exam covers Clinical, Technical, Environmental, and Role Responsibilities domains.
▸ Cognitive levels tested: Recall (8–13%), Comprehension (23–28%), Application (63–67%).
▸ Correct answers and detailed rationales are provided for comprehensive review.
SECTION I — HEMODIALYSIS PRINCIPLES, PATIENT CARE & SAFETY Questions 1 – 75
1. What types of technician activities are tested in the Clinical area of the CCHT exam?
A. Infection control and safety issues in the dialysis setting.
B. Patient care before, during, and after dialysis treatment.
C. Principles of water treatment and machine-related problem actions.
D. Roles of staff members and communication skills.
CORRECT ANSWER B — Patient care before, during, and after dialysis treatment.
RATIONALE The Clinical domain focuses on direct patient care activities throughout the entire dialysis treatment cycle —
pre-treatment assessment, intradialytic monitoring, and post-treatment care. Environment covers infection
control and safety. Technical covers water treatment and machine troubleshooting. Role Responsibilities
covers professional duties and communication.
,2. What is the appeal process for denied certification?
A. Submit a verbal appeal to the charge nurse within 60 days.
B. An applicant must submit a written appeal to the President of the NNCC within 30 days.
C. Reapply for the examination immediately.
D. Contact the facility manager for reconsideration.
CORRECT ANSWER B — An applicant must submit a written appeal to the President of the NNCC within 30 days.
RATIONALE The formal appeal process requires a written appeal submitted to the President of the NNCC within 30 days of
denial. Failure to request an appeal constitutes a waiver of the right to appeal. A committee appointed by the
President meets with the applicant and makes recommendations to the NNCC. The final decision is
communicated in writing within 30 days following the NNCC meeting.
3. What is the range of questions that require Application of Knowledge in the CCHT exam?
A. 8–13%.
B. 23–28%.
C. 63–67%.
D. 45–50%.
CORRECT ANSWER C — 63–67%.
RATIONALE The CCHT exam emphasizes higher-level thinking: Application of Knowledge comprises 63–67% of questions
— these require the technician to apply principles to clinical situations. Comprehension questions make up
23–28%, requiring understanding and interpretation. Recall of Knowledge (basic facts) is only 8–13%. This
distribution reflects the exam's focus on practical clinical judgment.
4. What is anemia and what medication might be administered during dialysis for a patient with anemia?
A. A shortage of white blood cells; administered heparin.
B. A shortage of oxygen-carrying red blood cells; administered erythropoietin (Epogen).
C. Excess fluid in the blood; administered furosemide.
D. Calcium deficiency; administered calcitriol.
CORRECT ANSWER B — A shortage of oxygen-carrying red blood cells; administered erythropoietin (Epogen).
RATIONALE Anemia is a deficiency of red blood cells (RBCs), reducing the blood's oxygen-carrying capacity. In chronic
kidney disease, the kidneys produce insufficient erythropoietin — the hormone that stimulates RBC
production. Erythropoietin-stimulating agents (ESAs) like Epogen (epoetin alfa) are given during dialysis to
treat anemia. Hemoglobin is the laboratory test used to monitor anemia.
5. How can a technician differentiate between arterial and venous anastomoses in an AV graft?
A. Check the patient's blood pressure on that side.
B. Cannulate both sides of the graft and observe the color of the blood.
C. Palpate for a thrill over the entire graft.
D. Measure the diameter of the graft with calipers.
CORRECT ANSWER B — Cannulate both sides of the graft and observe the color of the blood.
RATIONALE Arterial blood is bright red (oxygenated) and venous blood is darker (deoxygenated). By cannulating both
sides and observing blood color, the technician can differentiate the arterial from the venous anastomosis.
The arterial side has pulsatile, brighter blood. This is important for proper needle placement — the arterial
needle is placed closer to the arterial anastomosis.
, 6. Which practice helps build a patient's immunity to hepatitis B?
A. Frequent hand hygiene.
B. Vaccination.
C. Isolation precautions.
D. Antibiotic prophylaxis.
CORRECT ANSWER B — Vaccination.
RATIONALE Hepatitis B vaccination stimulates the immune system to produce protective antibodies against the hepatitis
B virus. Dialysis patients are at increased risk due to blood exposure during treatments. The vaccine series is a
standard preventive measure. Patients positive for HBsAg must be dialyzed in a dedicated area with separate
machines and supplies. Hand hygiene and isolation support infection control but vaccination builds active
immunity.
7. What does uremia mean?
A. Excess fluid in the bloodstream.
B. An increase of wastes in the blood.
C. An electrolyte imbalance.
D. A bacterial infection of the kidneys.
CORRECT ANSWER B — An increase of wastes in the blood.
RATIONALE Uremia (uremic syndrome) is the accumulation of nitrogenous waste products (urea, creatinine, uric acid) and
other toxins in the blood due to kidney failure. Signs include fatigue, nausea, pruritus, cognitive changes, and
pericarditis. A decrease in urine output is an indicator of possible uremia. Dialysis removes these wastes.
Uremia is the clinical syndrome of advanced renal failure.
8. Why is vitamin D therapy given to dialysis patients?
A. To treat anemia.
B. Vitamin D is needed for healthy bones.
C. To prevent infections.
D. To reduce blood pressure.
CORRECT ANSWER B — Vitamin D is needed for healthy bones.
RATIONALE Dialysis patients have impaired conversion of vitamin D to its active form (calcitriol) because the kidneys
perform the final hydroxylation step. Active vitamin D (calcitriol) controls calcium and phosphorus balance,
which is essential for bone metabolism. Without adequate vitamin D, patients develop renal
osteodystrophy/mineral bone disorder. Supplementation improves bone health and manages secondary
hyperparathyroidism.
