CCHT - Certified Clinical Hemodialysis Technician Patient Assessment and Monitoring 1

Question 1

A patient arrives for hemodialysis and their pre-treatment weight is 4.2 kg above their established dry weight. What should the technician do FIRST?

Accepted Answer

Verify the weight on a calibrated scale and document the finding before notifying the nurse

Answer

Begin treatment immediately at the maximum ultrafiltration rate

Answer

Independently lower the patient's recorded dry weight in the system

Answer

Shorten the treatment session to limit total fluid removal

Question 2

During hemodialysis, a patient suddenly becomes confused and short of breath, and the technician observes foam or bubbles in the venous blood line. Which complication should be suspected?

Accepted Answer

Air embolism

Answer

Hypertensive urgency

Answer

Hemolysis

Answer

Hypoglycemia

Question 3

Before cannulating a patient's arteriovenous fistula (AVF), which assessment finding confirms the access is patent and ready for use?

Accepted Answer

Presence of bruit on auscultation and thrill on palpation

Answer

Absence of bruit on auscultation and absence of thrill on palpation

Answer

A firm, non-compressible vessel wall with no pulsation

Answer

Skin discoloration and warmth directly over the fistula site

Question 4

Three hours into a hemodialysis session, a patient develops painful bilateral leg cramps. Their blood pressure has decreased from 138/82 mmHg at treatment start to 108/66 mmHg. What should the technician do first?

Accepted Answer

Decrease the ultrafiltration rate and notify the nurse

Answer

Administer IV calcium gluconate per standing order

Answer

Increase the blood flow rate to speed treatment completion

Answer

Terminate the treatment and transfer the patient to the emergency department

Question 5

Midway through a patient's dialysis session, the technician notes that the patient's temperature has risen from 36.7°C (98.1°F) at baseline to 38.1°C (100.6°F). What is the most appropriate next action?

Accepted Answer

Notify the nurse immediately and assess the access site and catheter for signs of infection

Answer

Continue treatment and recheck temperature in 30 minutes without intervention

Answer

Increase the dialysate temperature to match the patient's current body temperature

Answer

Administer acetaminophen and document without escalating to nursing staff

Question 6

While preparing a patient with a tunneled hemodialysis catheter for treatment, the technician observes redness, swelling, and purulent drainage at the catheter exit site. Which additional finding is most critical to report to the nurse immediately?

Accepted Answer

Patient's oral temperature of 38.4°C (101.2°F)

Answer

Catheter blood flow rate reading below 350 mL/min

Answer

Patient reports not eating breakfast before the session

Answer

The catheter dressing was last changed four days ago