0202 MAXE • THCC
NNCC
Commission
CCHT Certification Division
EST. 1982
EXCELLENCE IN NEPHROLOGY CARE
CCHT Dialysis Exam 2020
CO M P L E T E CO M P R E H E N S I V E R E V I E W — A L L TO P I CS W I T H CO R R E C T A N S W E R S & R AT I O N A L E S
INSTITUTION NNCC / CCHT Certification EXAM TYPE CCHT Dialysis Examination 2020
PROGRAM Hemodialysis Technician Certification ACADEMIC YEAR
EXAM TITLE CCHT Dialysis Exam 2020 — Complete TOTAL QUESTIONS Complete Study Guide
Review
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 complete CCHT 2020 review covers dialysis principles, vascular access, water treatment, complications, medications, lab
values, infection control, patient education, and documentation.
▸ Correct answers and detailed rationales appear below each question.
▸ All content is derived from CCHT Dialysis Examination core concepts.
SECTION I — DIALYSIS PRINCIPLES, ACCESS & LAB VALUES Part A
1. What factors decrease K (urea clearance)?
A. High BFR and correct pump speed
B. Incorrect pump speed and low BFR
C. Increased dialysate flow rate
D. Larger dialyzer surface area
CORRECT ANSWER B — Incorrect pump speed and low BFR.
RATIONALE Urea clearance (K) is decreased by factors that reduce blood flow through the dialyzer: low blood flow rate
and incorrect (too slow) pump speed. Higher BFR and larger dialyzer surface area increase clearance.
2. Factors that influence V (volume of water in patient's body) include:
A. Dialysate temperature only
B. Height, weight, age, amputation, sex
C. Blood flow rate and pump speed
D. Transmembrane pressure only
CORRECT ANSWER B — Height, weight, age, amputation, sex.
RATIONALE V (total body water) is calculated based on anthropometric factors: height, weight, age, sex, and presence of
amputations. V is used in Kt/V calculation to determine dialysis adequacy.
, 3. The recommended BFR for a 15G needle is:
A. 200-250 mL/min
B. 250-350 mL/min
C. 350-450 mL/min
D. >450 mL/min
CORRECT ANSWER C — 350-450 mL/min.
RATIONALE Needle gauge determines maximum BFR: 17G = 200-250, 16G = 250-350, 15G = 350-450, 14G = >450 mL/min.
Larger gauge (smaller number) allows higher flow rates.
4. The correct steps for post-BUN lab draw are:
A. Increase BFR, draw from venous line
B. Turn off UF, decrease dialysate flow to 50, wait 15 seconds, draw from arterial port
C. Continue UF, draw from arterial line
D. Turn off blood pump, draw from venous port
CORRECT ANSWER B — Turn off UF, decrease dialysate flow to 50, wait 15 seconds, draw from arterial port.
RATIONALE Proper post-BUN technique prevents recirculation and dilution: UF off, dialysate flow to 50 mL/min, wait 15
seconds for equilibration, then draw from the arterial port. Drawing from the venous line causes falsely low
BUN.
5. A false (elevated) Kt/V can result from:
A. Drawing from the arterial port after waiting 15 seconds
B. Not decreasing BFR, not waiting 15 seconds, or drawing from venous line
C. Decreasing dialysate flow rate
D. Turning off ultrafiltration
CORRECT ANSWER B — Not decreasing BFR, not waiting 15 seconds, or drawing from venous line.
RATIONALE A false high Kt/V occurs when the post-BUN sample is diluted or contaminated: BFR not decreased,
insufficient equilibration time, or drawing from the venous (return) line. A diluted sample (saline
contamination) also falsely elevates Kt/V.
6. Why are weight and BP important when monitoring AKI patients?
A. To calculate dialysis adequacy
B. To keep them "wet" so they don't dry out
C. To determine needle size
D. To select dialyzer type
CORRECT ANSWER B — To keep them "wet" so they don't dry out.
RATIONALE AKI patients may recover kidney function—aggressive fluid removal can cause hypotension and further
ischemic kidney damage. Maintaining adequate hydration preserves residual renal function and prevents
additional injury.