Certified Hemodialysis Technologist/Technician Exam Vascular Access and Cannulation 3

Question 1

A patient reports arm pain distal to the fistula during and after dialysis, with cold fingers. This is most consistent with:

Accepted Answer

Access-related ischemic mononeuropathy (steal syndrome)

Answer

Normal post-dialysis fatigue

Answer

Carpal tunnel syndrome unrelated to access

Answer

High blood flow through the access being beneficial

Question 2

When using a tunneled hemodialysis catheter, the recommended locking solution placed in the catheter lumens between treatments is:

Accepted Answer

Heparin (1000-5000 units/mL) or citrate locking solution

Answer

Normal saline only

Answer

Antibiotic-only solution

Answer

Sterile water

Question 3

Elevated venous pressure during hemodialysis (above 250 mmHg at a 400 mL/min flow rate) most likely indicates:

Accepted Answer

Venous stenosis or outflow obstruction

Answer

Arterial needle malposition

Answer

Elevated blood pressure

Answer

Normal finding in all patients

Question 4

The minimum recommended blood flow rate for adequate hemodialysis in most adult patients is:

Accepted Answer

300-400 mL/min

Answer

100-150 mL/min

Answer

200-250 mL/min

Answer

500-600 mL/min

Question 5

When recirculation in a dialysis access is suspected, which test can confirm it?

Accepted Answer

Glucose step test or urea-based recirculation test

Answer

Blood pressure measurement

Answer

Checking venous pressure only

Answer

Observing needle site appearance

Question 6

An AV fistula thrill that is absent on palpation and a bruit that is absent on auscultation most likely indicates:

Accepted Answer

Access thrombosis

Answer

Normal fistula maturation

Answer

High cardiac output state

Answer

Excellent access function