CHT Certified Hemodialysis Technologist/Technician 3 — Questions and Answers
Question 1: The Kt/V adequacy target for thrice-weekly hemodialysis per KDOQI guidelines is at least:
- 0.9
- 1.0
- 1.2 (Correct answer)
- 1.4
Correct answer: 1.2
KDOQI guidelines recommend a minimum single-pool Kt/V of 1.2 for thrice-weekly hemodialysis treatments.
Question 2: Which action should a technician take FIRST upon discovering a patient has a clotted dialyzer mid-treatment?
- Increase heparin dose immediately
- Notify the supervising nurse or physician (Correct answer)
- Replace the dialyzer and resume treatment
- Discontinue heparin and flush with saline
Correct answer: Notify the supervising nurse or physician
Clotting mid-treatment is a clinical complication requiring immediate nurse or physician notification before any intervention.
Question 3: Hard water syndrome in dialysis is caused by:
- Excess sodium in the dialysate
- Inadequate water treatment allowing calcium and magnesium into dialysate (Correct answer)
- Low bicarbonate concentration
- Bacterial contamination of the water supply
Correct answer: Inadequate water treatment allowing calcium and magnesium into dialysate
Hard water syndrome occurs when water softening fails, allowing excess calcium and magnesium to enter dialysate and causing nausea, hypotension, and burning sensations.
Question 4: Which needle gauge is most commonly used for cannulating an arteriovenous fistula?
- 18-gauge
- 16-gauge (Correct answer)
- 14-gauge
- 20-gauge
Correct answer: 16-gauge
16-gauge needles are standard for AVF cannulation, balancing adequate blood flow rates with minimal vessel trauma.
Question 5: Reverse osmosis (RO) in water treatment works primarily by:
- Using activated carbon to adsorb chlorine
- Forcing water through a semi-permeable membrane under pressure (Correct answer)
- Exchanging sodium ions for calcium and magnesium ions
- Exposing water to ultraviolet light
Correct answer: Forcing water through a semi-permeable membrane under pressure
RO forces water under high pressure through a membrane that blocks dissolved salts, bacteria, and most contaminants.
Question 6: A patient on hemodialysis develops sudden onset chest pain and dyspnea during treatment. The technician's priority action is to:
- Slow the blood pump to 100 mL/min and continue treatment
- Stop the treatment, return blood if safe, and call for emergency help (Correct answer)
- Increase the ultrafiltration rate to remove excess fluid
- Administer supplemental oxygen and monitor vitals only
Correct answer: Stop the treatment, return blood if safe, and call for emergency help
Acute chest pain and dyspnea may indicate an air embolism, cardiac event, or hemolysis — treatment must be stopped and emergency response initiated.
Question 7: The AAMI/ISO standard for endotoxin levels in hemodialysis water is less than:
- 0.1 EU/mL
- 0.25 EU/mL (Correct answer)
- 1.0 EU/mL
- 2.0 EU/mL
Correct answer: 0.25 EU/mL
Standard hemodialysis water must contain less than 0.25 EU/mL of endotoxins per AAMI/ISO standards.
CHT Certified Hemodialysis Technologist/Technician 3
The Kt/V adequacy target for thrice-weekly hemodialysis per KDOQI guidelines is at least: