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

The arteriovenous fistula (AVF) is the gold standard vascular access for hemodialysis due to its superior longevity and lower complication rates.

Question 2

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

Accepted Answer

Inserting needles at the same site and angle each treatment

Answer

The buttonhole technique involves cannulating the exact same site at the same angle each treatment, creating a fibrous tract that reduces pain and aneurysm formation.

Question 3

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

Accepted Answer

Pulsatile, hard-feeling access with high venous pressures

Answer

A pulsatile, hard-feeling access with elevated venous pressures during dialysis suggests downstream stenosis impeding blood flow.

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

Arterial needle direction (antegrade or retrograde) depends on facility protocol and individual access characteristics to optimize blood flow.

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

A continuous, soft, low-pitched bruit heard throughout the cardiac cycle indicates a well-functioning AVF with adequate blood flow.

Certified Hemodialysis Technologist/Technician Exam Practice Test

Certified Hemodialysis Technologist/Technician Exam Practice Test

Certified Hemodialysis Technologist/Technician Exam Vascular Access and Cannulation