FREE CCHT Practice Test 2025 Official Study Guide [PDF]

Last Updated on June 14, 2025

FREE CCHT Practice Test 2025 Official Study Guide [PDF]. The Nephrology Nursing Certification Commission (NNCC) administers the Certified Clinical Hemodialysis Technician (CCHT) certification. The Clinical/Technical Examination Board is made up of representatives from the CCHT and CCHT-A Test Committees.

The CCHT is the nationally recognized entry-level certification for U.S. dialysis technicians. It is awarded by the Nephrology Nursing Certification Commission (NNCC). It verifies that the holder can safely perform the clinical, technical, safety, and communication tasks required in routine outpatient hemodialysis care.

Table of Contents

CCHT Practice Test 2025

Try our free CCHT Practice Tests. The official test consists of 150 questions that match the test blueprint. About 25 of the questions are new experimental or “pilot” questions that are not scored. The passing score of the test is determined by a panel of technicians who serve as subject matter experts (SMEs). A score of about 74% correct is required to pass the CCHT examination.

FREE CCHT Sample Practice Test

CCHT Sample Practice Test
Certified Clinical Hemodialysis Technician Test
Total: Questions: 40
Time Limit: N/A

1 / 50

1) Dialyzer clearance (K) increases when you

A) increase blood-flow rate (QB)

B) use smaller surface-area dialyzer

C) shorten treatment time

D) decrease dialysate flow (QD)

2 / 50

2) When speaking with a hard-of-hearing patient, the technician should

A) rely solely on written instructions

B) cover mouth with mask and speak faster

C) raise voice and speak from behind

D) face the patient, speak clearly, and use visual cues

3 / 50

3) A patient tells the technician, “I don’t understand why my fluid goal is so high today.” The FIRST step is to

A) blame yesterday’s diet choices

B) pause and clarify what part is confusing, then explain or involve the RN

C) change the UF goal immediately

D) ignore the comment; the nurse will explain

4 / 50

4) When a machine goes into bypass,

A) dialysate stops flowing through the dialyzer

B) arterial pressure rises after the dialyzer

C) heparin is not administered

D) ultrafiltration stops

5 / 50

5) The minimum recommended hand-rub time with an alcohol-based sanitizer is

A) 20 seconds

B) 10 seconds

C) 45 seconds

D) 5 seconds

6 / 50

6) At the end of a patient’s treatment, which finding should be reported to the nurse?

A) Blood pressure 122/68 mm Hg

B) A weight loss of 6.6 lb (3 kg)

C) Temperature 98 °F (36.3 °C)

D) A pulse rate of 55 beats per minute

7 / 50

7) Which lab value should be reviewed BEFORE administering erythropoiesis-stimulating agents (ESAs)?

A) Serum phosphorus

B) Serum albumin

C) Serum potassium

D) Hemoglobin/hematocrit

8 / 50

8) Suspected clotted access is confirmed when

A) swelling is present

B) a bruit is absent

C) redness is present

D) a thrill is present

9 / 50

9) A persistent low arterial-pressure alarm typically indicates

A) clot in the venous line

B) needle dislodgement or line separation before the pump

C) exhausted bicarbonate concentrate

D) dialysate temperature too high

10 / 50

10) The primary goal of QAPI in a dialysis facility is to

A) achieve better patient outcomes

B) increase fragmentation of care

C) promote hierarchical management

D) improve the ratio of staff to patients

11 / 50

11) Legally, if a treatment was performed but not charted, it was

A) only partially billable

B) insignificant

C) confidential

D) not done

12 / 50

12) When transferring a patient from wheelchair to treatment chair, proper body mechanics include

A) lifting with the back muscles

B) twisting at the waist while lifting

C) keeping feet shoulder-width apart and knees bent

D) extending arms fully for reach

13 / 50

13) A dialysis patient with diabetes should be observed for low blood sugar signs such as

A) anxiety and confusion

B) fever and chills

C) thirst and weight gain

D) low blood pressure and heart rate

14 / 50

14) A patient asks, “Why am I getting vitamin D therapy?” Which response is accurate?

A) Vitamin D is needed for healthy bones

B) Vitamin D prevents infection

C) Vitamin D stimulates production of red blood cells

D) Vitamin D protects nervous tissue

15 / 50

15) The technician is unsure which one of a patient’s AV graft anastomoses is arterial and which is venous. To differentiate, the technician should

A) apply a tourniquet to the arm and feel for venous resistance

B) compress the graft in the middle and palpate each side

C) cannulate both sides of the graft and observe blood color

D) determine the anatomy of the area and palpate the radial pulse

16 / 50

16) The incoming supply to the water-treatment system is called

A) ground water

B) carbonated water

C) desalinated water

D) feed water

17 / 50

17) The purpose of ultrafiltration profiling is to

A) maximize flow rate

B) minimize clotting

C) minimize hypotension

D) maximize clearance

18 / 50

18) Which of the following practices helps to build a patient’s immunity to hepatitis B?

A) Isolation

B) Sequestration

C) Decontamination

D) Vaccination

19 / 50

19) Which water-treatment part removes endotoxins?

A) Ultrafilter

B) Deionization tank

C) Resin bed

D) Softener

20 / 50

20) Which staff member is primarily responsible for documenting daily water-treatment readings?

A) Dietitian

B) Social worker

C) Receptionist

D) Biomedical technician (or designated water-system operator)

21 / 50

21) If a technician is unsure how to explain “mineral bone disorder,” the appropriate response is

A) “It’s not a problem that will affect your quality of life.”

B) “It’s nothing to worry about; I think it involves your thyroid gland.”

C) “It’s pretty complicated—I’ll ask the nurse to explain it to you.”

D) “Right now it’s more important to focus on your fluid retention.”

22 / 50

22) A patient asks the technician, “What does uremia mean?” Uremia is

A) an increase in the serum potassium level

B) a decrease in the number of red blood cells

C) a decrease in urine output

D) an increase of wastes in the blood

23 / 50

23) Dialysis disequilibrium syndrome is most often caused by

A) inadequate heparinization

B) rapid removal of urea leading to cerebral edema

C) elevated dialysate calcium

D) air bubbles in the venous line

24 / 50

24) If total chlorine is detected above 0.1 mg/L after the secondary carbon tank, the technician should first

A) reset the RO pump speed

B) place all machines in bypass and stop treatments

C) increase dialysate sodium

D) rinse the carbon tanks with bleach

25 / 50

25) Which of the following situations requires completion of an incident report?

A) Patient refuses a snack

B) Patient arrives 10 minutes late

C) Venous-needle dislodgement with blood loss

D) Machine alarms for standard conductivity check

26 / 50

26) After treatment Mrs. Chase’s standing BP is 90/58 mm Hg and she feels dizzy. The technician should first

A) administer normal saline

B) instruct her to sit down

C) assist her to the scale

D) inform the charge nurse

27 / 50

27) Before a dialysis treatment, a patient says, “Yesterday I felt terrible and vomited up some blood. I feel much better today.” The technician can expect the treatment will be modified by

A) decreasing the erythropoietin (EPO) dose

B) increasing the ultrafiltration rate

C) decreasing the heparin dose

D) increasing the dialysate flow rate

28 / 50

28) Why are dialysis patients more likely to become infected with germs like MRSA?

A) Their diet is usually restricted in vitamin C

B) They usually have weak immune systems

C) They often have allergies to most antibiotics

D) Their kidneys cannot filter out toxins

29 / 50

29) What is the usual insertion angle for needle cannulation of a mature AV fistula?

A) 10–15 degrees

B) 45–60 degrees

C) 25–35 degrees

D) 75–90 degrees

30 / 50

30) Before mixing acid and bicarbonate concentrates, the technician must verify

A) staffing schedule is posted

B) expiration dates and correct concentrate labels

C) dialyzer reuse station is empty

D) patient consent forms are signed

31 / 50

31) An AV fistula is an example of

A) a central venous access

B) an artificial graft access

C) a peripheral access

D) a temporary access

32 / 50

32) After a blood-leak test strip turns positive, the FIRST action is to

A) stop the blood pump and return the blood to the patient

B) resume blood flow and retest later

C) add normal saline to the circuit

D) adjust the dialysate conductivity setting

33 / 50

33) Mr. Jackson keeps a notebook of labs, weights, and medications. This behavior shows that patients who self-manage their care

A) keep journals in case legal action is required

B) feel empowered by active involvement

C) shift documentation responsibility away from staff

D) display compulsive behavior to control anxiety

34 / 50

34) When lifting a heavy box, the technician should

A) lift with back muscles

B) stand with feet together

C) hold the box close to the body

D) bend at the waist

35 / 50

35) Which component of the RO system should be monitored for removal of calcium and magnesium?

A) Carbon tank

B) Ultrafilter

C) Softener (ion-exchange resin)

D) UV light

36 / 50

36) Mrs. Chase weighs 158.4 lb before treatment; target is 154 lb. The fluid to remove is (mL)

A) 4,000

B) 400

C) 2,000

D) 200

37 / 50

37) In hemodialysis, “reuse” refers to cleaning and disinfecting

A) needles

B) dialyzers

C) catheters

D) bloodlines

38 / 50

38) During the last hour of dialysis, Mr. Jackson’s blood pressure drops to 82/40 mm Hg. After changing the fluid-removal rate, the technician should

A) administer five 4-gram glucose tablets

B) stop the blood pump

C) place him in Trendelenburg position

D) increase dialysate flow rate

39 / 50

39) The best response to a patient who fears losing his morning walk due to 6 AM treatments is to

A) explore changing his dialysis schedule to keep his routine

B) explore his willingness for a physical-therapy program

C) suggest a non-physical activity instead of walking

D) suggest he walk only on non-dialysis days

40 / 50

40) A hemodialysis machine alarm sounds for high dialysate temperature. The appropriate response is to

A) place the machine in bypass and verify the temperature probe

B) reduce blood-flow rate to 50 mL/min

C) add cool water to the dialysate jugs

D) silence the alarm and continue treatment

41 / 50

41) A high venous-pressure alarm might indicate

A) separation of venous blood tubing

B) kink in arterial blood tubing

C) clotting of blood in the access

D) decreased blood-flow rate

42 / 50

42) Staff must wash with soap and water rather than alcohol rub when

A) latex-allergic

B) hands are visibly soiled

C) they have weeping dermatitis

D) ending a shift

43 / 50

43) A central venous catheter may be used as a vascular access when a

A) patient has inadequate blood vessels in the limbs

B) patient’s dialysis adequacy needs to be reduced

C) patient has a limb amputation

D) patient has an allergy to expanded polytetrafluoroethylene (Gore-Tex)

44 / 50

44) When sending stat lab samples, the technician should

A) place them in an unmarked envelope

B) store at room temperature indefinitely

C) verify patient identifiers and use a biohazard transport bag

D) hand them to any visitor leaving the building

45 / 50

45) At her target post-dialysis weight of 154 lb, Mrs. Chase is likely to be

A) hypotensive

B) normotensive

C) dehydrated

D) edematous

46 / 50

46) The BEST method to ensure effective patient teaching is to

A) hand out a leaflet only

B) speak quickly to cover all points

C) rely on family to teach later

D) ask the patient to repeat the information in their own words

47 / 50

47) Which electrolyte is removed most rapidly during conventional hemodialysis?

A) Calcium

B) Sodium

C) Chloride

D) Potassium

48 / 50

48) A patient positive for hepatitis B surface antigen should be dialyzed

A) after nurse vaccination

B) on a dedicated machine in an assigned area

C) while wearing a mask in the main area

D) in the main area, then rinse the machine

49 / 50

49) A sudden rise in venous pressure accompanied by swelling at the access site suggests

A) needle displacement and possible infiltration

B) low dialysate temperature

C) dialysate conductivity drift

D) machine in dialysate bypass

50 / 50

50) The most common cause of a low-conductivity alarm is

A) an exhausted concentrate supply

B) residual sterilant

C) a clotted dialyzer

D) depleted salt in the brine tank

Your score is

Try more tests

Eligibility

To be eligible to sit for the CCHT Exam, you must:

Requirement	Typical expectation
Education	High school diploma or GED
Training/Experience	Completion of an approved hemodialysis technician course or roughly 6 months of clinical dialysis employment (suggested minimum 1,000 hours)
Regulatory compliance	Meet your state’s hemodialysis-technician training mandate and have an unencumbered status (no disqualifying disciplinary actions)
Fees (2025)	Application + exam: about USD 225 (paid to NNCC/PSI)

Exam Format

The CCHT examination is designed to assess the knowledge required to provide safe care to patients undergoing hemodialysis treatments. There are also three Cognitive Levels: Knowledge, Comprehension, and Application.

There is no limit to the number of times you can take the exam. If you are unsuccessful on the exam, you may reapply by submitting a new application by mail.

Feature	Detail
Format	Computer-based, 150 scored multiple-choice items + 15–20 unscored pilot items
Time	3 hours
Blueprint distribution	Clinical: 48–52 % (≈ 71–78 Qs) Technical: 21–25 % (≈ 32–38 Qs) Environment: 13–17 % (≈ 19–25 Qs) Role Responsibilities: 10–14 % (≈ 15–20 Qs)
Cognitive levels	Knowledge, Comprehension, Application (about two-thirds of the test is application-level)
Passing Score	Determined by a scaled score (typically ~70%)
Passing standard	Criterion-referenced cut score set by psychometric panel; pass/fail shown immediately at the test center.

CCHT Exam Content Areas

Several different types of questions appear on the CCHT examination. Some questions require a basic recall of knowledge, while others test the technician’s ability to comprehend a concept. Most of the questions ask the technician to apply knowledge in a clinical situation.

Section	% of Exam	Description
1. Clinical	48–52%	Covers pre-, during, and post-dialysis care (e.g., patient assessment, cannulation, vital signs, response to complications)
2. Technical	21–25%	Covers water treatment systems, machine alarms, extracorporeal circuit, dialyzer setup, and technical troubleshooting
3. Environment	13–17%	Infection control, body mechanics, chemical spills, PPE use, and environmental safety
4. Role Responsibilities	10–14%	Communication, professional boundaries, confidentiality, teamwork, documentation, and patient advocacy

Distribution of 150 Question in the CCHT Exam — (Accepted April 2018, Effective 2019)

How does it differ from other U.S. dialysis tech credentials

Below is a quick-reference guide to how the NNCC Certified Clinical Hemodialysis Technician (CCHT) compares to other nationally recognized certifications in the U.S. credentials a dialysis technician might hold.

Feature	CCHT (NNCC)	CHT (BONENT)	CCNT / CBNT (NNCO)
Focus	Direct patient care	Patient care (broader test)	Clinical or biomedical track
Experience to sit	Course or ~6 mo	≥12 mo	≥12 mo
Renewal	3 yrs / 45 CE	4 yrs / 40 CE	4 yrs / 40 CE

Official Study Guide [PDF]

The Online Practice Test (found on www.nncc-exam.org) has 50 multiple-choice questions available in two modes:

 Practice Mode: provides the correct answer and rationale after each question
 Test Mode: holds the results until the end of the test

cchtPrepGuide.pdf