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) When a machine goes into bypass,

A) dialysate stops flowing through the dialyzer

B) arterial pressure rises after the dialyzer

C) ultrafiltration stops

D) heparin is not administered

2 / 50

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

A) instruct her to sit down

B) assist her to the scale

C) administer normal saline

D) inform the charge nurse

3 / 50

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

A) patient consent forms are signed

B) expiration dates and correct concentrate labels

C) dialyzer reuse station is empty

D) staffing schedule is posted

4 / 50

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

A) fever and chills

B) thirst and weight gain

C) low blood pressure and heart rate

D) anxiety and confusion

5 / 50

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

A) ignore the comment; the nurse will explain

B) change the UF goal immediately

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

D) blame yesterday’s diet choices

6 / 50

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

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

B) add cool water to the dialysate jugs

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

D) silence the alarm and continue treatment

7 / 50

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

A) ground water

B) feed water

C) desalinated water

D) carbonated water

8 / 50

8) A persistent low arterial-pressure alarm typically indicates

A) clot in the venous line

B) exhausted bicarbonate concentrate

C) needle dislodgement or line separation before the pump

D) dialysate temperature too high

9 / 50

9) Dialyzer clearance (K) increases when you

A) decrease dialysate flow (QD)

B) use smaller surface-area dialyzer

C) shorten treatment time

D) increase blood-flow rate (QB)

10 / 50

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

A) ending a shift

B) latex-allergic

C) hands are visibly soiled

D) they have weeping dermatitis

11 / 50

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

A) Isolation

B) Vaccination

C) Decontamination

D) Sequestration

12 / 50

12) Suspected clotted access is confirmed when

A) a bruit is absent

B) redness is present

C) a thrill is present

D) swelling is present

13 / 50

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

A) display compulsive behavior to control anxiety

B) keep journals in case legal action is required

C) feel empowered by active involvement

D) shift documentation responsibility away from staff

14 / 50

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

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

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

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

15 / 50

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

A) add normal saline to the circuit

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

C) adjust the dialysate conductivity setting

D) resume blood flow and retest later

16 / 50

16) The purpose of ultrafiltration profiling is to

A) maximize flow rate

B) maximize clearance

C) minimize clotting

D) minimize hypotension

17 / 50

17) When sending stat lab samples, the technician should

A) verify patient identifiers and use a biohazard transport bag

B) place them in an unmarked envelope

C) store at room temperature indefinitely

D) hand them to any visitor leaving the building

18 / 50

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

A) depleted salt in the brine tank

B) residual sterilant

C) an exhausted concentrate supply

D) a clotted dialyzer

19 / 50

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

A) Their diet is usually restricted in vitamin C

B) Their kidneys cannot filter out toxins

C) They often have allergies to most antibiotics

D) They usually have weak immune systems

20 / 50

20) Which water-treatment part removes endotoxins?

A) Resin bed

B) Softener

C) Ultrafilter

D) Deionization tank

21 / 50

21) An AV fistula is an example of

A) a peripheral access

B) a central venous access

C) an artificial graft access

D) a temporary access

22 / 50

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

A) place all machines in bypass and stop treatments

B) increase dialysate sodium

C) rinse the carbon tanks with bleach

D) reset the RO pump speed

23 / 50

23) 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) suggest he walk only on non-dialysis days

C) suggest a non-physical activity instead of walking

D) explore his willingness for a physical-therapy program

24 / 50

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

A) Carbon tank

B) Ultrafilter

C) UV light

D) Softener (ion-exchange resin)

25 / 50

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

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

B) Dietitian

C) Receptionist

D) Social worker

26 / 50

26) 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

27 / 50

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

A) patient’s dialysis adequacy needs to be reduced

B) patient has inadequate blood vessels in the limbs

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

D) patient has a limb amputation

28 / 50

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

A) dialysate conductivity drift

B) machine in dialysate bypass

C) needle displacement and possible infiltration

D) low dialysate temperature

29 / 50

29) 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) stop the blood pump

B) administer five 4-gram glucose tablets

C) place him in Trendelenburg position

D) increase dialysate flow rate

30 / 50

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

A) 10–15 degrees

B) 25–35 degrees

C) 75–90 degrees

D) 45–60 degrees

31 / 50

31) When lifting a heavy box, the technician should

A) stand with feet together

B) lift with back muscles

C) bend at the waist

D) hold the box close to the body

32 / 50

32) 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) increasing the ultrafiltration rate

B) decreasing the erythropoietin (EPO) dose

C) decreasing the heparin dose

D) increasing the dialysate flow rate

33 / 50

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

A) 400

B) 4,000

C) 2,000

D) 200

34 / 50

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

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

B) Blood pressure 122/68 mm Hg

C) Temperature 98 °F (36.3 °C)

D) A pulse rate of 55 beats per minute

35 / 50

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

A) extending arms fully for reach

B) keeping feet shoulder-width apart and knees bent

C) twisting at the waist while lifting

D) lifting with the back muscles

36 / 50

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

A) needles

B) catheters

C) dialyzers

D) bloodlines

37 / 50

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

A) cover mouth with mask and speak faster

B) rely solely on written instructions

C) raise voice and speak from behind

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

38 / 50

38) Dialysis disequilibrium syndrome is most often caused by

A) elevated dialysate calcium

B) inadequate heparinization

C) rapid removal of urea leading to cerebral edema

D) air bubbles in the venous line

39 / 50

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

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

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

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

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

40 / 50

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

A) after nurse vaccination

B) while wearing a mask in the main area

C) on a dedicated machine in an assigned area

D) in the main area, then rinse the machine

41 / 50

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

A) increase fragmentation of care

B) improve the ratio of staff to patients

C) promote hierarchical management

D) achieve better patient outcomes

42 / 50

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

A) Chloride

B) Calcium

C) Potassium

D) Sodium

43 / 50

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

A) Venous-needle dislodgement with blood loss

B) Patient refuses a snack

C) Patient arrives 10 minutes late

D) Machine alarms for standard conductivity check

44 / 50

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

A) an increase of wastes in the blood

B) a decrease in urine output

C) a decrease in the number of red blood cells

D) an increase in the serum potassium level

45 / 50

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

A) 45 seconds

B) 10 seconds

C) 5 seconds

D) 20 seconds

46 / 50

46) 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 protects nervous tissue

D) Vitamin D stimulates production of red blood cells

47 / 50

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

A) hand out a leaflet only

B) speak quickly to cover all points

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

D) rely on family to teach later

48 / 50

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

A) not done

B) confidential

C) insignificant

D) only partially billable

49 / 50

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

A) Hemoglobin/hematocrit

B) Serum albumin

C) Serum phosphorus

D) Serum potassium

50 / 50

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

A) dehydrated

B) normotensive

C) hypotensive

D) edematous

Your score is

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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