FREE CCHT Practice Test 2026 Official Study Guide [PDF]

Last Updated on October 1, 2026

FREE CCHT Practice Test 2026 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 2026

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 test’s passing score 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) 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) shift documentation responsibility away from staff

C) feel empowered by active involvement

D) display compulsive behavior to control anxiety

2 / 50

2) An AV fistula is an example of

A) a peripheral access

B) a central venous access

C) a temporary access

D) an artificial graft access

3 / 50

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

A) They often have allergies to most antibiotics

B) Their diet is usually restricted in vitamin C

C) They usually have weak immune systems

D) Their kidneys cannot filter out toxins

4 / 50

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

A) dialyzers

B) catheters

C) needles

D) bloodlines

5 / 50

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

A) confidential

B) insignificant

C) only partially billable

D) not done

6 / 50

6) 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) inform the charge nurse

C) instruct her to sit down

D) assist her to the scale

7 / 50

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

A) Carbon tank

B) Softener (ion-exchange resin)

C) Ultrafilter

D) UV light

8 / 50

8) 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

9 / 50

9) Suspected clotted access is confirmed when

A) a bruit is absent

B) swelling is present

C) a thrill is present

D) redness is present

10 / 50

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

A) low blood pressure and heart rate

B) thirst and weight gain

C) fever and chills

D) anxiety and confusion

11 / 50

11) Dialysis disequilibrium syndrome is most often caused by

A) inadequate heparinization

B) rapid removal of urea leading to cerebral edema

C) air bubbles in the venous line

D) elevated dialysate calcium

12 / 50

12) Which water-treatment part removes endotoxins?

A) Resin bed

B) Softener

C) Deionization tank

D) Ultrafilter

13 / 50

13) When a machine goes into bypass,

A) arterial pressure rises after the dialyzer

B) dialysate stops flowing through the dialyzer

C) ultrafiltration stops

D) heparin is not administered

14 / 50

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

A) 5 seconds

B) 10 seconds

C) 20 seconds

D) 45 seconds

15 / 50

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

A) resume blood flow and retest later

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

C) add normal saline to the circuit

D) adjust the dialysate conductivity setting

16 / 50

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

A) speak quickly to cover all points

B) hand out a leaflet only

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

D) rely on family to teach later

17 / 50

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

A) staffing schedule is posted

B) patient consent forms are signed

C) expiration dates and correct concentrate labels

D) dialyzer reuse station is empty

18 / 50

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

A) an increase in the serum potassium level

B) a decrease in urine output

C) an increase of wastes in the blood

D) a decrease in the number of red blood cells

19 / 50

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

A) dehydrated

B) hypotensive

C) normotensive

D) edematous

20 / 50

20) 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) rinse the carbon tanks with bleach

C) increase dialysate sodium

D) place all machines in bypass and stop treatments

21 / 50

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

22 / 50

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

A) suggest he walk only on non-dialysis days

B) explore his willingness for a physical-therapy program

C) explore changing his dialysis schedule to keep his routine

D) suggest a non-physical activity instead of walking

23 / 50

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

A) add cool water to the dialysate jugs

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

C) silence the alarm and continue treatment

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

24 / 50

24) 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

25 / 50

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

A) Calcium

B) Chloride

C) Sodium

D) Potassium

26 / 50

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

A) hands are visibly soiled

B) latex-allergic

C) ending a shift

D) they have weeping dermatitis

27 / 50

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

A) improve the ratio of staff to patients

B) achieve better patient outcomes

C) promote hierarchical management

D) increase fragmentation of care

28 / 50

28) The purpose of ultrafiltration profiling is to

A) maximize clearance

B) minimize clotting

C) minimize hypotension

D) maximize flow rate

29 / 50

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

A) residual sterilant

B) depleted salt in the brine tank

C) a clotted dialyzer

D) an exhausted concentrate supply

30 / 50

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

A) Patient arrives 10 minutes late

B) Machine alarms for standard conductivity check

C) Venous-needle dislodgement with blood loss

D) Patient refuses a snack

31 / 50

31) Dialyzer clearance (K) increases when you

A) decrease dialysate flow (QD)

B) increase blood-flow rate (QB)

C) shorten treatment time

D) use smaller surface-area dialyzer

32 / 50

32) 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

33 / 50

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

A) 400

B) 200

C) 2,000

D) 4,000

34 / 50

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

D) raise voice and speak from behind

35 / 50

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

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

B) Social worker

C) Receptionist

D) Dietitian

36 / 50

36) A high venous-pressure alarm might indicate

A) decreased blood-flow rate

B) kink in arterial blood tubing

C) separation of venous blood tubing

D) clotting of blood in the access

37 / 50

37) A persistent low arterial-pressure alarm typically indicates

A) dialysate temperature too high

B) needle dislodgement or line separation before the pump

C) exhausted bicarbonate concentrate

D) clot in the venous line

38 / 50

38) 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) A pulse rate of 55 beats per minute

D) Blood pressure 122/68 mm Hg

39 / 50

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

A) machine in dialysate bypass

B) dialysate conductivity drift

C) low dialysate temperature

D) needle displacement and possible infiltration

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

A) extending arms fully for reach

B) lifting with the back muscles

C) keeping feet shoulder-width apart and knees bent

D) twisting at the waist while lifting

42 / 50

42) When sending stat lab samples, the technician should

A) place them in an unmarked envelope

B) hand them to any visitor leaving the building

C) store at room temperature indefinitely

D) verify patient identifiers and use a biohazard transport bag

43 / 50

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

A) Vitamin D protects nervous tissue

B) Vitamin D is needed for healthy bones

C) Vitamin D stimulates production of red blood cells

D) Vitamin D prevents infection

44 / 50

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

A) carbonated water

B) ground water

C) desalinated water

D) feed water

45 / 50

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

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

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

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

46 / 50

46) 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) administer five 4-gram glucose tablets

C) stop the blood pump

D) place him in Trendelenburg position

47 / 50

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

A) Vaccination

B) Decontamination

C) Sequestration

D) Isolation

48 / 50

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

A) Serum potassium

B) Hemoglobin/hematocrit

C) Serum albumin

D) Serum phosphorus

49 / 50

49) 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) increasing the dialysate flow rate

D) decreasing the heparin dose

50 / 50

50) 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 a limb amputation

C) patient has inadequate blood vessels in the limbs

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

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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 test basic recall, 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