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

Before acting on a significantly elevated fluid gain, the technician must confirm the measurement is accurate using a calibrated scale, then document and report it to the nurse so an appropriate ultrafiltration goal can be safely ordered.

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

Visible air or foam in the venous blood line combined with acute neurological changes and respiratory distress are classic signs of air embolism, a life-threatening emergency requiring immediate clamp of the venous line and positional management.

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

A functioning AVF produces turbulent blood flow that is felt as a thrill (vibration on palpation) and heard as a bruit (swooshing sound on auscultation). Absence of either finding suggests thrombosis or inadequate flow and must be reported before cannulation.

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

Muscle cramps accompanied by a significant blood pressure drop indicate the ultrafiltration rate is exceeding the patient's plasma refill capacity. Reducing the UF rate is the immediate first response, followed by notifying the nurse, who may also order a saline bolus.

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

A rising fever during hemodialysis may indicate bacteremia, particularly from an infected access site or catheter. The technician must notify the nurse promptly so blood cultures can be obtained and the patient evaluated for systemic infection before continuing treatment.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Patient Assessment and Monitoring 1