CCHT Technical Practice Test 2026 - Questions and Answers

Last Updated on June 30, 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) At power-up, a dialysis machine self-test includes

A) culturing dialysate for bacteria

B) calibrating the blood-pressure cuff

C) verifying all alarm functions operate correctly

D) cleaning the bicarbonate jug

2 / 50

2) 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

3 / 50

3) Acceptable dialysate pH prior to patient connection is

A) 5.5 – 6.0

B) 4.0 – 5.0

C) 7.9 – 8.4

D) 6.9 – 7.6

4 / 50

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

A) 50 – 70 % of incoming feed water

B) none; RO has no reject

C) twice the permeate volume

D) 5 % of feed water

5 / 50

5) Bicarbonate concentrate mixed from powder must be discarded after

A) 24 hours

B) 96 hours

C) 72 hours

D) 48 hours

6 / 50

6) Activated carbon tanks primarily remove

A) endotoxin fragments

B) chlorine and chloramines

C) calcium and magnesium ions

D) dissolved gases

7 / 50

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

A) gray fluoride oxalate

B) red-top (no additive)

C) light-blue citrate

D) lavender EDTA

8 / 50

8) A high conductivity reading means dialysate has

A) excessive electrolyte concentration

B) high bacterial counts

C) low bicarbonate content

D) too little sodium

9 / 50

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

A) stop the blood pump and clamp the lines

B) silence all alarms

C) add 1,000 units of heparin

D) raise dialysate temperature

10 / 50

10) AAMI requires product water microbial counts to be <

A) 1000 CFU/mL

B) 100 CFU/mL

C) 500 CFU/mL

D) 50 CFU/mL

11 / 50

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

A) under 30 °C

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

C) over 0.25 EU/mL endotoxin

D) below 6.0 pH

12 / 50

12) Pyrogenic reactions are most often traced to

A) endotoxin contamination in dialysate

B) low bicarbonate baths

C) sodium imbalance in bath

D) improper blood pump occlusion

13 / 50

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

A) 15 seconds

B) 5 minutes

C) no slowdown is required

D) 1 minute

14 / 50

14) The arterial pressure monitor is located

A) between the patient access and the blood pump

B) after the air detector

C) on the venous drip chamber

D) in the dialysate effluent line

15 / 50

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

A) exactly 1 ppm chlorine

B) above 2 ppm chloramine

C) equal to feed-water hardness

D) negative or below manufacturer’s limit

16 / 50

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

A) 1.0 mg/L

B) 0.1 mg/L

C) 2.0 mg/L

D) 0.5 mg/L

17 / 50

17) The proportioning system on a dialysis machine

A) measures venous air bubbles

B) sterilizes the extracorporeal circuit

C) drives the arterial blood pump

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

18 / 50

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

A) soften incoming feed water

B) remove dissolved salts and microorganisms

C) add electrolytes for taste correction

D) raise total dissolved solids (TDS)

19 / 50

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

A) lower dialysate pH

B) soften feed water

C) increase residual chlorine

D) prevent bacterial biofilm growth

20 / 50

20) Conductivity meters indirectly measure the concentration of

A) residual chlorine in the loop

B) electrolytes and total dissolved solids in dialysate

C) hemoglobin in effluent

D) bacteria in water

21 / 50

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

A) undetectable on the test strip

B) exactly 0.5 ppm

C) 5.0 ppm

D) 2.0 ppm

22 / 50

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

A) documented on an incident report per facility policy

B) ignored if the patient is stable

C) fixed without written record

D) reported only to the manufacturer

23 / 50

23) Running an acid rinse primarily

A) calibrates conductivity probes

B) checks air-detector function

C) disinfects the bloodlines

D) removes carbonate scale and bicarbonate residue

24 / 50

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

A) 2 % from baseline

B) 50 % from baseline

C) 10 % from baseline

D) cleaning is never done; membranes are discarded

25 / 50

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

A) continue ultrafiltration by gravity

B) mix fresh bicarbonate concentrate

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

D) reset the facility’s main breaker

26 / 50

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

A) red

B) purple

C) yellow

D) green or blue (per manufacturer)

27 / 50

27) If total chlorine exceeds limits, the technician must

A) ignore; carbon removes all chlorine

B) lower dialysate sodium

C) add more sodium hypochlorite to the feed water

D) stop treatments and place machines in bypass

28 / 50

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

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

B) administer 100 mL saline bolus

C) silence the alarm and resume treatment

D) increase dialysate flow to clear the sensor

29 / 50

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

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

B) bleach solution

C) plain tap water only

D) glucose standard

30 / 50

30) Transmembrane pressure (TMP) refers to the

A) speed of the blood pump

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

C) temperature of dialysate outflow

D) pH of bicarbonate concentrate

31 / 50

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

A) dialysate too cool

B) kink in arterial tubing

C) high conductance in bath

D) venous needle dislodgement

32 / 50

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

A) 0.5 mS/cm at 4 °C

B) 7 mS/cm at 10 °C

C) 14 mS/cm at 25 °C

D) 25 mS/cm at 60 °C

33 / 50

33) Water softeners remove

A) chlorine and chloramines via adsorption

B) bacteria via ultraviolet light

C) endotoxin via ultrafiltration

D) calcium and magnesium ions via ion exchange

34 / 50

34) Proper blood pump occlusion is verified using a

A) hardness test kit

B) pH meter

C) drip test or occlusion gauge

D) glucose test strip

35 / 50

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

A) raise dialysate temperature

B) take the machine out of service and investigate

C) add more bicarbonate powder to the mix

D) start treatment; 6.6 is acceptable

36 / 50

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

A) softener

B) carbon tank

C) multimedia filter

D) ultrafilter

37 / 50

37) A persistent high venous pressure alarm usually indicates

A) clotting in the venous line or dialyzer

B) kink in arterial line

C) machine in bypass

D) temperature out of range

38 / 50

38) 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

39 / 50

39) Pre-dialysis potassium samples are drawn from the

A) dialysate drain hose

B) arterial bloodline sampling port before the pump

C) patient’s fingerstick

D) venous drip chamber

40 / 50

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

A) dialysate temperature

B) conductivity spikes in dialysate

C) air bubbles before blood returns to the patient

D) pH changes in blood

41 / 50

41) 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

42 / 50

42) Hardness testing after softener regeneration should read

A) 10 ppm exactly

B) < 1 ppm as CaCO₃

C) 50 ppm minimum

D) > 75 ppm

43 / 50

43) Acid concentrate containers are color-coded

A) red to avoid mix-ups with bicarbonate

B) clear for visibility

C) green for environmental safety

D) blue for bacterial monitoring

44 / 50

44) A dialysate temperature alarm will place the machine into

A) sodium-profile mode

B) heat-disinfection mode

C) bleaching cycle

D) bypass and stop ultrafiltration

45 / 50

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

A) after every patient treatment

B) before each dialysis shift and every 4 hours thereafter

C) when the softener regenerates

D) once per week only

46 / 50

46) Dialysate hotter than 41 °C may cause

A) significant hypernatremia

B) metabolic alkalosis

C) hemolysis of red blood cells

D) hypoglycemia

47 / 50

47) Monthly water cultures are drawn from

A) any dialysis machine effluent line

B) the raw-water feed line

C) the RO reject drain

D) the product water port after the final ultrafilter

48 / 50

48) Independent conductivity reading must agree with the machine within

A) ± 1.0 mS/cm

B) ± 5.0 mS/cm

C) ± 0.4 mS/cm

D) ± 2.0 mS/cm

49 / 50

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

A) inspect for kinks or clots between patient and pump

B) silence the alarm if the patient feels fine

C) increase blood-flow rate

D) change dialysate conductivity setting

50 / 50

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

A) 5.0 EU/mL

B) 0.25 EU/mL

C) 10 EU/mL

D) 1.0 EU/mL

Your score is

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