Certified Hemodialysis Technologist/Technician Exam Vascular Access Management 3

Question 1

A patient's AV fistula has a bruit that has changed from soft and continuous to harsh and high-pitched. This change suggests:

Accepted Answer

Development of a stenosis in the access

Answer

A change to a harsh, high-pitched bruit indicates turbulent flow through a narrowed area, suggesting stenosis requiring evaluation.

Question 2

When applying post-dialysis compression to an AV fistula site, how long should pressure typically be maintained?

Accepted Answer

5–10 minutes

Answer

Pressure should be applied for 5–10 minutes after needle removal to achieve hemostasis without occluding the fistula.

Question 3

Which AV graft material is most commonly used for hemodialysis access today?

Accepted Answer

Expanded polytetrafluoroethylene (ePTFE)

Answer

Expanded PTFE (Gore-Tex) is the most widely used synthetic graft material due to its durability and biocompatibility.

Question 4

What does 'dynamic venous pressure monitoring' during dialysis help detect?

Accepted Answer

Outflow stenosis in the venous segment of an access

Answer

Elevated dynamic venous pressures over multiple treatments indicate outflow stenosis, which can be confirmed with access flow studies or fistulogram.

Question 5

A tunneled dialysis catheter is locked with which solution between dialysis sessions to maintain patency?

Accepted Answer

Heparin or citrate locking solution

Answer

Heparin or citrate locking solutions fill the catheter lumens between sessions to prevent thrombus formation and maintain patency.

Certified Hemodialysis Technologist/Technician Exam Practice Test