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

A) achieve better patient outcomes

B) improve the ratio of staff to patients

C) promote hierarchical management

D) increase fragmentation of care

2 / 50

2) When a machine goes into bypass,

A) heparin is not administered

B) arterial pressure rises after the dialyzer

C) ultrafiltration stops

D) dialysate stops flowing through the dialyzer

3 / 50

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

A) Isolation

B) Decontamination

C) Vaccination

D) Sequestration

4 / 50

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

A) dialyzer reuse station is empty

B) patient consent forms are signed

C) expiration dates and correct concentrate labels

D) staffing schedule is posted

5 / 50

5) Suspected clotted access is confirmed when

A) a thrill is present

B) redness is present

C) a bruit is absent

D) swelling is present

6 / 50

6) 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) increase dialysate flow rate

B) place him in Trendelenburg position

C) administer five 4-gram glucose tablets

D) stop the blood pump

7 / 50

7) 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) decreasing the heparin dose

C) increasing the dialysate flow rate

D) increasing the ultrafiltration rate

8 / 50

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

A) an exhausted concentrate supply

B) depleted salt in the brine tank

C) residual sterilant

D) a clotted dialyzer

9 / 50

9) Dialysis disequilibrium syndrome is most often caused by

A) air bubbles in the venous line

B) rapid removal of urea leading to cerebral edema

C) inadequate heparinization

D) elevated dialysate calcium

10 / 50

10) Dialyzer clearance (K) increases when you

A) use smaller surface-area dialyzer

B) shorten treatment time

C) decrease dialysate flow (QD)

D) increase blood-flow rate (QB)

11 / 50

11) The purpose of ultrafiltration profiling is to

A) maximize clearance

B) maximize flow rate

C) minimize clotting

D) minimize hypotension

12 / 50

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

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

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

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

13 / 50

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

A) Sodium

B) Chloride

C) Potassium

D) Calcium

14 / 50

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

A) only partially billable

B) confidential

C) not done

D) insignificant

15 / 50

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

A) low blood pressure and heart rate

B) anxiety and confusion

C) thirst and weight gain

D) fever and chills

16 / 50

16) 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) Temperature 98 °F (36.3 °C)

C) Blood pressure 122/68 mm Hg

D) A pulse rate of 55 beats per minute

17 / 50

17) Which water-treatment part removes endotoxins?

A) Softener

B) Resin bed

C) Deionization tank

D) Ultrafilter

18 / 50

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

A) lifting with the back muscles

B) keeping feet shoulder-width apart and knees bent

C) extending arms fully for reach

D) twisting at the waist while lifting

19 / 50

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

A) 75–90 degrees

B) 25–35 degrees

C) 10–15 degrees

D) 45–60 degrees

20 / 50

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

A) on a dedicated machine in an assigned area

B) after nurse vaccination

C) while wearing a mask in the main area

D) in the main area, then rinse the machine

21 / 50

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

A) catheters

B) bloodlines

C) needles

D) dialyzers

22 / 50

22) A high venous-pressure alarm might indicate

A) clotting of blood in the access

B) decreased blood-flow rate

C) kink in arterial blood tubing

D) separation of venous blood tubing

23 / 50

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

A) Serum albumin

B) Serum phosphorus

C) Serum potassium

D) Hemoglobin/hematocrit

24 / 50

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

A) explore his willingness for a physical-therapy program

B) explore changing his dialysis schedule to keep his routine

C) suggest a non-physical activity instead of walking

D) suggest he walk only on non-dialysis days

25 / 50

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

A) 10 seconds

B) 5 seconds

C) 45 seconds

D) 20 seconds

26 / 50

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

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

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

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

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

27 / 50

27) 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

28 / 50

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

A) 2,000

B) 200

C) 4,000

D) 400

29 / 50

29) 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

30 / 50

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

A) latex-allergic

B) they have weeping dermatitis

C) ending a shift

D) hands are visibly soiled

31 / 50

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

A) machine in dialysate bypass

B) dialysate conductivity drift

C) needle displacement and possible infiltration

D) low dialysate temperature

32 / 50

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

A) ground water

B) desalinated water

C) carbonated water

D) feed water

33 / 50

33) A persistent low arterial-pressure alarm typically indicates

A) dialysate temperature too high

B) clot in the venous line

C) needle dislodgement or line separation before the pump

D) exhausted bicarbonate concentrate

34 / 50

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

A) speak quickly to cover all points

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

C) hand out a leaflet only

D) rely on family to teach later

35 / 50

35) 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

36 / 50

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

A) assist her to the scale

B) administer normal saline

C) inform the charge nurse

D) instruct her to sit down

37 / 50

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

A) cover mouth with mask and speak faster

B) raise voice and speak from behind

C) rely solely on written instructions

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

38 / 50

38) When sending stat lab samples, the technician should

A) hand them to any visitor leaving the building

B) place them in an unmarked envelope

C) verify patient identifiers and use a biohazard transport bag

D) store at room temperature indefinitely

39 / 50

39) When lifting a heavy box, the technician should

A) stand with feet together

B) lift with back muscles

C) hold the box close to the body

D) bend at the waist

40 / 50

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

A) a decrease in the number of red blood cells

B) a decrease in urine output

C) an increase in the serum potassium level

D) an increase of wastes in the blood

41 / 50

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

A) patient has inadequate blood vessels in the limbs

B) patient has a limb amputation

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

D) patient’s dialysis adequacy needs to be reduced

42 / 50

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

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

B) silence the alarm and continue treatment

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

D) add cool water to the dialysate jugs

43 / 50

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

A) increase dialysate sodium

B) rinse the carbon tanks with bleach

C) place all machines in bypass and stop treatments

D) reset the RO pump speed

44 / 50

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

A) feel empowered by active involvement

B) keep journals in case legal action is required

C) display compulsive behavior to control anxiety

D) shift documentation responsibility away from staff

45 / 50

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

A) Softener (ion-exchange resin)

B) Carbon tank

C) UV light

D) Ultrafilter

46 / 50

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

A) Machine alarms for standard conductivity check

B) Patient refuses a snack

C) Venous-needle dislodgement with blood loss

D) Patient arrives 10 minutes late

47 / 50

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

A) Vitamin D prevents infection

B) Vitamin D protects nervous tissue

C) Vitamin D stimulates production of red blood cells

D) Vitamin D is needed for healthy bones

48 / 50

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

A) Receptionist

B) Social worker

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

D) Dietitian

49 / 50

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

A) They usually have weak immune systems

B) They often have allergies to most antibiotics

C) Their kidneys cannot filter out toxins

D) Their diet is usually restricted in vitamin C

50 / 50

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

A) edematous

B) hypotensive

C) dehydrated

D) normotensive

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