CCHT PRACTICE EXAM DAVITA EXAM QUESTIONS ACCURATE AND VERIFIED ACTUAL EXAM QUESTIONS WITH DETAILED ANSWERS FOR GUARANTEED PASS | ALREADY GRADED A

Which of the following monitoring activities should be performed before each patient shift or at least every four hours? A. Endotoxin assay B. Total chlorine level testing C. Bacterial culture sampling D. Aluminum concentration testing Correct Answer: B. Total chlorine level testing Rationale: Total chlorine (including chloramines) must be tested before each shift or every four hours to prevent hemolysis and other complications in hemodialysis patients. Which of the following substances are removed by the water softener? A. Chlorine and chloramines B. Bacteria and endotoxins C. Calcium and magnesium D. Sodium and potassium Correct Answer: C. Calcium and magnesium Rationale: A water softener removes hardness minerals such as calcium and magnesium through ion exchange, preventing scaling of the reverse osmosis membrane. According to AAMI standards, the total microbial count of dialysate shall not exceed: A. 50 CFU/mL B. 100 CFU/mL C. 200 CFU/mL D. 500 CFU/mL Correct Answer: C. 200 CFU/mL Rationale: The Association for the Advancement of Medical Instrumentation (AAMI) sets the maximum allowable microbial count for dialysate at 200 CFU/mL to ensure patient safety. The water softener operates on which principle? A. Filtration B. Reverse osmosis C. Distillation D. Ion exchange Correct Answer: D. Ion exchange Rationale: Water softeners function by ion exchange, replacing calcium and magnesium ions with sodium ions. Which of the following best describes dialysis-quality water? A. Untreated municipal tap water B. Bottled spring water C. Water treated to meet AAMI standards D. Distilled water only Correct Answer: C. Water treated to meet AAMI standards Rationale: Dialysis-quality water must meet AAMI standards for chemical and microbial contaminants to be safe for patient use. Exposure to chloramines during hemodialysis may cause: A. Hypertension B. Hemolysis C. Hyperkalemia D. Clotting Correct Answer: B. Hemolysis Rationale: Chloramine contamination can destroy red blood cells, leading to hemolysis, a lifethreatening complication. According to AAMI standards, endotoxin levels in dialysate must be less than: A. 0.25 EU/mL B. 1.0 EU/mL C. 2.0 EU/mL D. 5.0 EU/mL Correct Answer: C. 2.0 EU/mL Rationale: AAMI specifies that endotoxin levels must not exceed 2.0 EU/mL to reduce pyrogenic reactions. Percent rejection in reverse osmosis is calculated using which formula? A. Product conductivity ÷ feed conductivity × 100 B. Feed conductivity – product conductivity ÷ feed conductivity × 100 C. Feed pressure × product pressure D. Product flow ÷ feed flow Correct Answer: B. Feed conductivity – product conductivity ÷ feed conductivity × 100 Rationale: Percent rejection measures membrane efficiency by comparing feed and product conductivity. A mixed-bed deionization (DI) tank contains: A. Sodium and chloride B. Carbon and sand C. Cations and anions D. Chlorine and fluoride Correct Answer: C. Cations and anions Rationale: Mixed-bed DI tanks contain both cation and anion exchange resins to remove dissolved ions from water. Which substance may be added to municipal drinking water to make it clearer? A. Fluoride B. Chlorine C. Aluminum D. Potassium Correct Answer: C. Aluminum Rationale: Aluminum salts are used as flocculants in water treatment to clarify water by causing particles to clump together. AAMI chemical analysis of water used for hemodialysis should be performed: A. Monthly B. Quarterly C. Semiannually D. Annually Correct Answer: D. Annually Rationale: Comprehensive chemical analysis of dialysis water is performed annually to ensure compliance with safety standards. The part of the bacterial cell wall that can cause fever in hemodialysis patients when released is: A. Cytoplasm B. Capsule C. Endotoxin D. Flagella Correct Answer: C. Endotoxin Rationale: Endotoxins are components of gram-negative bacterial cell walls that can trigger fever and inflammatory reactions. During hemodialysis, a low venous pressure alarm is most likely caused by: A. Clotted dialyzer B. High blood flow rate C. Disconnection of the blood line D. Kinked arterial line Correct Answer: C. Disconnection of the blood line Rationale: A drop in venous pressure commonly indicates a blood leak or disconnection in the venous line. Which parameters monitored by the hemodialysis machine must also be verified externally? A. Temperature and blood flow B. pH and conductivity C. Ultrafiltration rate and pressure D. Air detector and alarms Correct Answer: B. pH and conductivity Rationale: pH and conductivity must be independently verified to ensure dialysate safety and proper electrolyte balance. A high venous pressure alarm is most likely caused by: A. Arterial needle dislodgement B. Kinking of the venous blood line C. Blood leak detector failure D. Low dialysate flow Correct Answer: B. Kinking of the venous blood line Rationale: Obstruction in the venous return path increases venous pressure. If the conductivity alarm test fails during setup, the technician should: A. Continue treatment B. Reset the machine C. Notify the equipment technician D. Bypass the alarm Correct Answer: C. Notify the equipment technician Rationale: A failed alarm test indicates a potential safety issue requiring maintenance before use. An increase in transmembrane pressure in a low-flux dialyzer indicates: A. Air in lines B. Clotting of the extracorporeal circuit C. Low blood flow D. Hypotension Correct Answer: B. Clotting of the extracorporeal circuit Rationale: Rising transmembrane pressure often indicates clot formation restricting flow. One reason normal saline is used to prime the extracorporeal circuit is to remove: A. Bacteria B. Electrolytes C. Air D. Toxins Correct Answer: C. Air Rationale: Priming removes air from the system to prevent air embolism. The extracorporeal circuit consists of the: A. Dialysate lines only B. Blood pump only C. Blood lines and the dialyzer D. Water treatment system Correct Answer: C. Blood lines and the dialyzer Rationale: The extracorporeal circuit includes all components outside the body through which blood circulates. If a fistula needle becomes contaminated before treatment, the technician should: A. Wipe it with alcohol B. Rinse with saline C. Discard the needle D. Use it carefully Correct Answer: C. Discard the needle Rationale: A contaminated needle must be discarded to prevent infection. To initially assess AV access patency, the technician should feel for: A. A pulse B. A bruit C. A thrill D. Swelling Correct Answer: C. A thrill Rationale: A palpable vibration (thrill) indicates blood flow through the access. A patient with swelling and rising venous pressure at the needle site likely has: A. Infection B. Infiltration C. Clotting disorder D. Hemolysis Correct Answer: B. Infiltration Rationale: Swelling and increased pressure suggest the needle has infiltrated surrounding tissue. Which of the following is NOT a sign of access infection? A. Redness B. Warmth C. Drainage D. Numbness and tingling Correct Answer: D. Numbness and tingling Rationale: Numbness and tingling are not typical signs of infection; redness, warmth, and drainage are. If a venous needle infiltrates during treatment, the technician should first: A. Notify the nurse B. Apply ice C. Stop the blood pump D. Remove both needles Correct Answer: C. Stop the blood pump Rationale: Stopping the blood pump prevents further blood loss and tissue damage. Which vascular access type has the fewest complications? A. AV graft B. Central venous catheter C. AV fistula D. PICC line Correct Answer: C. AV fistula Rationale: AV fistulas have lower infection and thrombosis rates compared to other access types. The desired outcome of fistula exercises is: A. Reduced pain B. Enlargement of the vein C. Lower blood pressure D. Faster clotting Correct Answer: B. Enlargement of the vein Rationale: Exercises promote vein maturation by increasing size and strength. The bruit in an AV fistula is detected by: A. Palpation B. Observation C. Listening with a stethoscope D. Ultrasound only Correct Answer: C. Listening with a stethoscope Rationale: A bruit is an audible sound of blood flow heard with a stethoscope. Dry weight is defined as the: A. Admission weight B. Target weight after dialysis C. Weight at which the patient has no excess fluid and normal BP D. Highest safe weight Correct Answer: C. Weight at which the patient has no excess fluid and normal BP Rationale: Dry weight represents the patient’s ideal weight without fluid overload.