Certified Hemodialysis Technologist/Technician Exam Vascular Access and Cannulation

Question 1

What is the preferred vascular access type for chronic hemodialysis patients?

Accepted Answer

Arteriovenous fistula

Answer

Tunneled central venous catheter

Answer

Non-tunneled catheter

Answer

Arteriovenous graft

Question 2

The 'buttonhole' or constant-site cannulation technique involves:

Accepted Answer

Inserting needles at the same site and angle each treatment

Answer

Using a new site every treatment

Answer

Only using the arterial needle

Answer

Rotating between three sites

Question 3

Which sign during fistula assessment indicates possible stenosis or outflow obstruction?

Accepted Answer

Pulsatile, hard-feeling access with high venous pressures

Answer

Soft, easily compressible thrill

Answer

Bruit heard at anastomosis only

Answer

Low arterial pressures during dialysis

Question 4

When cannulating an AVF, the arterial needle should be inserted pointing in which direction relative to blood flow?

Accepted Answer

Retrograde or antegrade depending on facility protocol and access characteristics

Answer

Always antegrade (toward the heart)

Answer

Always retrograde (away from the heart)

Answer

Perpendicular to the vessel

Question 5

A patient's fistula has a bruit that is continuous and high-pitched throughout systole and diastole. This is:

Accepted Answer

Normal — indicates good blood flow through the access

Answer

Abnormal — indicates steal syndrome

Answer

Abnormal — indicates thrombosis

Answer

Normal only if present at the anastomosis

Question 6

Which complication of AVF cannulation is characterized by blood tracking into surrounding tissue during needle insertion?

Accepted Answer

Infiltration/hematoma

Answer

Thrombosis

Answer

Stenosis

Answer

Aneurysm