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The CCHT-A exam has 150 questions and runs 3 hours.
These 10 free CCHT-A questions are organized by exam domain, so you can see how each part of the Certified Clinical Hemodialysis Technician - Advanced blueprint is tested. Reveal the answer and explanation under each question.
Over three consecutive treatments, a patient's fistula needle sites have taken progressively longer to stop bleeding. The access arm is now swollen, and the previously low-pitched, continuous bruit has become high-pitched and predominantly systolic. The heparin prescription is unchanged, and there is no bleeding elsewhere. Taken together, these changes most strongly suggest:
Correct answer: B - Fistula venous outflow stenosis
During hemodialysis, a patient develops abrupt back pain, chest tightness, and shortness of breath. Blood in the extracorporeal tubing appears unusually translucent and cherry-red. The technician has stopped the blood pump, clamped the lines, and summoned the emergency team. How should the blood remaining in the circuit be managed?
Correct answer: A - Do not return it because red-cell destruction may have released potassium.
The nurse has approved a four-hour treatment to take a stable patient from 73.6 kg to a target weight of 70.4 kg. The plan includes 200 mL of oral fluid and a total of 400 mL of saline entering the patient, including rinseback. Another 400 mL of priming saline was discarded before connection. No other intake or output is expected. Select the machine ultrafiltration goal and average hourly rate that account for the fluids the patient will actually receive.
Correct answer: B - 3,800 mL at 950 mL/hour
An experienced technician is preparing a mature fistula buttonhole with no signs of infection. The access skin has been cleansed, antiseptic applied, and the site allowed to dry. The technician then completely removes the scab with a sterile single-use device. The planned blunt needle is ready. The next step before entering the tract is to:
Correct answer: D - Apply antiseptic again and allow it to dry before cannulation.
A patient receiving maintenance hemodialysis arrives 4.5 kg above target weight with ankle edema. Two hours into treatment, cramps and a blood pressure of 84/50 mmHg develop soon after the ultrafiltration rate is increased. The patient is still substantially above target and remains alert, without rash or wheezing. The nurse pauses ultrafiltration and gives a prescribed small saline bolus; symptoms promptly improve. Which mechanism best explains this episode?
Correct answer: C - Ultrafiltration has outpaced plasma refilling from the tissues.
At an unchanged blood-pump setting of 350 mL/min, the pre-pump arterial pressure changes from -165 to -285 mmHg. Venous pressure remains near 150 mmHg. The patient is comfortable, and neither needle site is swollen. Before manipulating a needle, the technician traces the tubing for an external obstruction. Where would a kink best explain this pressure pattern?
Correct answer: D - Between the withdrawal needle and the blood pump
A two-tank carbon system produces confirmed total-chlorine results of 0.18 mg/L after the first tank and 0.04 mg/L after the second tank. The facility's action threshold is 0.10 mg/L. The responsible nurse and water-system specialist have been notified. What do these measurements establish?
Correct answer: A - The first bed has breakthrough; final water remains below the action threshold.
A patient has left each of the last three treatments 30 minutes early. In a private conversation, the patient explains, 'The van leaves at 2:00. I want to finish dialysis, but I cannot afford another ride.' The patient asks whether running the blood pump faster would make up the missed time. Which response addresses the reason treatments are being shortened?
Correct answer: C - Coordinate with the nurse and social worker to resolve the transportation conflict.
A preceptor interrupts a catheter-connection procedure when a trainee touches a disinfected hub with a contaminated glove. The hub is re-prepared before connection. Later, the trainee accurately explains the procedure and passes the written infection-control assessment. What additional evidence is most important before the preceptor validates this procedural competency?
Correct answer: B - Observed aseptic catheter connection without prompting or correction
An outpatient dialysis patient has chronic hepatitis C with detectable HCV RNA. Testing shows no current hepatitis B infection and no immunity to hepatitis B. There is no other indication for transmission-based precautions. A staff member proposes moving the patient into the hepatitis B isolation room because 'both infections are bloodborne.' Which assignment follows CDC recommendations for this infection status?
Correct answer: C - A routine station with dialysis-specific infection-control precautions
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