CCHT Technical Practice Test 2026 - Questions and Answers

Last Updated on May 13, 2026

The Nephrology Nursing Certification Commission (NNCC) Certified Clinical Hemodialysis Technician (CCHT) Technical Practice Test 2025 – Questions and Answers Quiz. In the actual test, this part consists of 32 to 38 multiple-choice questions, which is approximately 21–25%.

Questions in this area concern the principles of water treatment, components of the extracorporeal circuit, and actions to take when alarms sound or machine-related problems arise. The Technical area is the second-largest part of the test, accounting for 23% of the test content. Examples of the kinds of technician activities tested in the Technical area include:

1. Participating in monitoring the water treatment system.
2. Checking the conductivity and pH of the dialysate solution with an independent device.
3. Mixing concentrates from powder (bicarbonate, electrolyte solution).
4. Processing patients’ laboratory samples.
5. Identifying/reporting/documenting an adverse event, e.g., equipment set-up problems.

CCHT Technical Practice Test

Technical

1 / 50

1) After bleach disinfection, the circuit is rinsed until total chlorine is

A) undetectable on the test strip

B) 5.0 ppm

C) exactly 0.5 ppm

D) 2.0 ppm

2 / 50

2) Which component specifically removes bacterial endotoxins from product water?

A) ultrafilter

B) carbon tank

C) softener

D) multimedia filter

3 / 50

3) Any equipment-related adverse event such as a dialyzer rupture must be

A) reported only to the manufacturer

B) fixed without written record

C) documented on an incident report per facility policy

D) ignored if the patient is stable

4 / 50

4) Conductivity meters indirectly measure the concentration of

A) residual chlorine in the loop

B) bacteria in water

C) electrolytes and total dissolved solids in dialysate

D) hemoglobin in effluent

5 / 50

5) For post-dialysis BUN, the correct tube is typically

A) lavender EDTA

B) gray fluoride oxalate

C) light-blue citrate

D) red-top (no additive)

6 / 50

6) Monthly water cultures are drawn from

A) the raw-water feed line

B) the product water port after the final ultrafilter

C) any dialysis machine effluent line

D) the RO reject drain

7 / 50

7) A conductivity meter is usually calibrated with a standard solution reading about

A) 14 mS/cm at 25 °C

B) 0.5 mS/cm at 4 °C

C) 7 mS/cm at 10 °C

D) 25 mS/cm at 60 °C

8 / 50

8) Maintaining loop velocity at ≥ 3 ft / sec helps

A) increase residual chlorine

B) prevent bacterial biofilm growth

C) lower dialysate pH

D) soften feed water

9 / 50

9) The venous-line ultrasonic sensor is designed to detect

A) conductivity spikes in dialysate

B) dialysate temperature

C) air bubbles before blood returns to the patient

D) pH changes in blood

10 / 50

10) When arterial pressure alarm is high, the technician should first

A) change dialysate conductivity setting

B) inspect for kinks or clots between patient and pump

C) silence the alarm if the patient feels fine

D) increase blood-flow rate

11 / 50

11) Pyrogenic reactions are most often traced to

A) endotoxin contamination in dialysate

B) sodium imbalance in bath

C) improper blood pump occlusion

D) low bicarbonate baths

12 / 50

12) Water softeners remove

A) chlorine and chloramines via adsorption

B) endotoxin via ultrafiltration

C) bacteria via ultraviolet light

D) calcium and magnesium ions via ion exchange

13 / 50

13) Bicarbonate concentrate must be mixed with

A) RO reject water

B) AAMI-quality water only

C) municipal tap water directly

D) distilled water from a humidifier

14 / 50

14) Proper blood pump occlusion is verified using a

A) pH meter

B) hardness test kit

C) drip test or occlusion gauge

D) glucose test strip

15 / 50

15) The AAMI action level for endotoxin in product water is

A) 5.0 EU/mL

B) 1.0 EU/mL

C) 0.25 EU/mL

D) 10 EU/mL

16 / 50

16) Typical RO reject (drain) water volume equals roughly

A) twice the permeate volume

B) 50 – 70 % of incoming feed water

C) 5 % of feed water

D) none; RO has no reject

17 / 50

17) At power-up, a dialysis machine self-test includes

A) calibrating the blood-pressure cuff

B) cleaning the bicarbonate jug

C) culturing dialysate for bacteria

D) verifying all alarm functions operate correctly

18 / 50

18) Transmembrane pressure (TMP) refers to the

A) pH of bicarbonate concentrate

B) pressure difference between blood and dialysate sides of the dialyzer

C) temperature of dialysate outflow

D) speed of the blood pump

19 / 50

19) A dialysis machine goes into bypass when dialysate conductivity is

A) outside ± 0.4 mS/cm of the set point

B) over 0.25 EU/mL endotoxin

C) under 30 °C

D) below 6.0 pH

20 / 50

20) A high conductivity reading means dialysate has

A) high bacterial counts

B) low bicarbonate content

C) too little sodium

D) excessive electrolyte concentration

21 / 50

21) To verify dialysate pH, the handheld meter is calibrated with

A) bleach solution

B) two buffer solutions that bracket the expected pH (e.g., 7.0 and 10.0)

C) glucose standard

D) plain tap water only

22 / 50

22) Running an acid rinse primarily

A) removes carbonate scale and bicarbonate residue

B) calibrates conductivity probes

C) disinfects the bloodlines

D) checks air-detector function

23 / 50

23) The proportioning system on a dialysis machine

A) sterilizes the extracorporeal circuit

B) measures venous air bubbles

C) drives the arterial blood pump

D) mixes acid, bicarbonate, and water in fixed ratios

24 / 50

24) Dialysate hotter than 41 °C may cause

A) hemolysis of red blood cells

B) hypoglycemia

C) metabolic alkalosis

D) significant hypernatremia

25 / 50

25) Pre-dialysis potassium samples are drawn from the

A) dialysate drain hose

B) venous drip chamber

C) arterial bloodline sampling port before the pump

D) patient’s fingerstick

26 / 50

26) Residual chlorine/chloramine checks must be performed at minimum

A) when the softener regenerates

B) once per week only

C) before each dialysis shift and every 4 hours thereafter

D) after every patient treatment

27 / 50

27) First action when a blood-leak alarm sounds is to

A) increase dialysate flow to clear the sensor

B) administer 100 mL saline bolus

C) stop the blood pump and verify with a test strip

D) silence the alarm and resume treatment

28 / 50

28) The usual order of water-treatment components is

A) softener → multimedia filter → RO → carbon

B) multimedia filter → softener → carbon → particulate filter → RO → UV → ultrafilter

C) UV → ultrafilter → multimedia → RO

D) RO → carbon → softener → ultrafilter

29 / 50

29) Dialysate pH of 6.6 measured with pH paper means the technician should

A) raise dialysate temperature

B) add more bicarbonate powder to the mix

C) start treatment; 6.6 is acceptable

D) take the machine out of service and investigate

30 / 50

30) AAMI requires product water microbial counts to be <

A) 100 CFU/mL

B) 50 CFU/mL

C) 500 CFU/mL

D) 1000 CFU/mL

31 / 50

31) Acceptable dialysate pH prior to patient connection is

A) 6.9 – 7.6

B) 4.0 – 5.0

C) 7.9 – 8.4

D) 5.5 – 6.0

32 / 50

32) During a total power failure, the technician should first

A) manually return the patient’s blood with a hand crank or air-return

B) reset the facility’s main breaker

C) continue ultrafiltration by gravity

D) mix fresh bicarbonate concentrate

33 / 50

33) After chemical disinfection, dialysis machines cannot be used until residual disinfectant tests

A) exactly 1 ppm chlorine

B) equal to feed-water hardness

C) above 2 ppm chloramine

D) negative or below manufacturer’s limit

34 / 50

34) Heat disinfection of dialysis machines is commonly performed

A) at the end of each workday

B) only if bicarbonate is reused

C) once every 30 days

D) only after a positive water culture

35 / 50

35) Activated carbon tanks primarily remove

A) chlorine and chloramines

B) endotoxin fragments

C) calcium and magnesium ions

D) dissolved gases

36 / 50

36) A persistent high venous pressure alarm usually indicates

A) kink in arterial line

B) clotting in the venous line or dialyzer

C) machine in bypass

D) temperature out of range

37 / 50

37) Before opening the circuit to draw a sample, you must

A) add 1,000 units of heparin

B) raise dialysate temperature

C) silence all alarms

D) stop the blood pump and clamp the lines

38 / 50

38) A simultaneous low venous pressure alarm and bleeding at the needle site most likely indicate

A) high conductance in bath

B) venous needle dislodgement

C) dialysate too cool

D) kink in arterial tubing

39 / 50

39) Bicarbonate concentrate mixed from powder must be discarded after

A) 96 hours

B) 24 hours

C) 72 hours

D) 48 hours

40 / 50

40) A post-dialysis BUN specimen is drawn after reducing blood flow to 100 mL/min for

A) 15 seconds

B) no slowdown is required

C) 5 minutes

D) 1 minute

41 / 50

41) A positive blood-leak strip changes color from white to

A) yellow

B) purple

C) green or blue (per manufacturer)

D) red

42 / 50

42) Hardness testing after softener regeneration should read

A) < 1 ppm as CaCO₃

B) > 75 ppm

C) 50 ppm minimum

D) 10 ppm exactly

43 / 50

43) The primary purpose of a reverse osmosis (RO) unit in the dialysis water-treatment system is to

A) soften incoming feed water

B) raise total dissolved solids (TDS)

C) add electrolytes for taste correction

D) remove dissolved salts and microorganisms

44 / 50

44) Acid concentrate containers are color-coded

A) blue for bacterial monitoring

B) green for environmental safety

C) clear for visibility

D) red to avoid mix-ups with bicarbonate

45 / 50

45) According to AAMI standards, the action level for total chlorine (free + combined) post-carbon tank is

A) 2.0 mg/L

B) 0.1 mg/L

C) 1.0 mg/L

D) 0.5 mg/L

46 / 50

46) The arterial pressure monitor is located

A) in the dialysate effluent line

B) after the air detector

C) between the patient access and the blood pump

D) on the venous drip chamber

47 / 50

47) A dialysate temperature alarm will place the machine into

A) heat-disinfection mode

B) bleaching cycle

C) bypass and stop ultrafiltration

D) sodium-profile mode

48 / 50

48) Independent conductivity reading must agree with the machine within

A) ± 5.0 mS/cm

B) ± 2.0 mS/cm

C) ± 0.4 mS/cm

D) ± 1.0 mS/cm

49 / 50

49) If total chlorine exceeds limits, the technician must

A) add more sodium hypochlorite to the feed water

B) lower dialysate sodium

C) ignore; carbon removes all chlorine

D) stop treatments and place machines in bypass

50 / 50

50) RO membranes are chemically cleaned when product-water flow drops by about

A) 50 % from baseline

B) 2 % from baseline

C) cleaning is never done; membranes are discarded

D) 10 % from baseline

Your score is

See also: