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

Pain and coldness distal to an AVF or graft suggests vascular steal syndrome where the access diverts blood from the distal limb.

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

Catheter lumens are locked with heparin or citrate solution between treatments to prevent fibrin occlusion and maintain catheter patency.

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

Persistently high venous pressures suggest stenosis or obstruction downstream from the venous needle impeding blood return to the patient.

Question 4

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

Accepted Answer

300-400 mL/min

Answer

Blood flow rates of 300-400 mL/min are recommended to achieve adequate solute clearance (Kt/V ≥1.2) in standard hemodialysis.

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

The glucose step test or urea-based recirculation measurement quantifies the percentage of dialyzed blood re-entering the arterial needle rather than returning to the patient.

Certified Hemodialysis Technologist/Technician Exam Practice Test

Certified Hemodialysis Technologist/Technician Exam Practice Test

Certified Hemodialysis Technologist/Technician Exam Vascular Access and Cannulation 3