Certified Hemodialysis Technologist/Technician Exam Vascular Access Management

Question 1

Which type of vascular access is considered the gold standard for chronic hemodialysis?

Accepted Answer

Arteriovenous fistula (AVF)

Answer

The arteriovenous fistula is preferred because it has the lowest complication rates, longest patency, and best outcomes for long-term hemodialysis.

Question 2

What is the minimum blood flow rate that a mature arteriovenous fistula should be able to support for adequate hemodialysis?

Accepted Answer

350 mL/min

Answer

A mature AVF should sustain at least 350 mL/min blood flow to support effective hemodialysis treatment.

Question 3

Where should the arterial needle be placed in relation to the venous needle when cannulating an AV fistula?

Accepted Answer

At least 2–3 cm upstream from venous needle (toward access)

Answer

The arterial needle is placed upstream (toward the anastomosis) and at least 2–3 cm from the venous needle to minimize recirculation.

Question 4

A thrill that is weak or absent at the AV fistula site most likely indicates:

Accepted Answer

Stenosis or thrombosis of the fistula

Answer

Absence or weakening of the thrill (palpable vibration) suggests stenosis or clot formation reducing blood flow through the fistula.

Question 5

What is the primary advantage of the buttonhole (constant-site) cannulation technique?

Accepted Answer

Reduced aneurysm formation and less pain with cannulation

Answer

The buttonhole technique creates a consistent scar tunnel that reduces pain and minimizes aneurysm formation compared to rope ladder cannulation.

Certified Hemodialysis Technologist/Technician Exam Practice Test