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CCHT EXAM: ANDERSON CONTINUING EDUCATION
EXAM LATEST 2025|QS AND AS |A+ VERIFIED
What are some of the responsibilities & requirements of the medical director of a dialysis facility?
- Writing policies & procedures that show compliance with the standards of the local medical community.
- Accessing fistulas or grafts prior to the beginning of the dialysis session.
- Being physically present in the dialysis unit whenever a patient is receiving a dialysis treatment.
- Being knowledgeable of & and responsible for the integrity of the water treatment system in the facility.
- Being knowledgeable of & responsible for the integrity of the water treatment system in the facility. Prior to the beginning of the dialysis, what must the physician order include?
- Specific dialyzer
- Blood flow rate 3.Duration of dialysis
- Three units of packed red blood cells 1,2 & 3 To be eligible to sit for the Certified Clinical Hemodialysis Technician - Advanced (CCHT- A) exam, the technician must have which of the following?
- Hold another national certification such as CCHT
- Have been employed as a hemodialysis tech for 3 yrs of continuous employment 3.Have worked at least 5000 hours as a CCHT
- Have been eligible for & paid to take the exam within the past 12 months. 1 & 3 What abilities are required of a dialysis tech? 1.Some understanding of human anatomy & physiology & the pathophysiology of chronic kidney disease (CKD) 2.The knowledge to administer intravenous medication if an emergency arises 3.Full understanding of the principles of dialysis and treatment complications
- In an emergency, such as aspirin overdose, it is not necessary to have consent prior to beginning hemodialysis. 3. Two consents are needed for dialysis; one for the dialysis itself & one for access procedures or modifications. If a patient chooses to terminate dialysis, what should the renal staff do?
- Call the legal team for the hospital/clinic and speak with an attorney
- Keep the patient on the clinical unit until he or she can talk with the physician and determine if a court order is needed 3.Realize that is well within a patient's rights to choose to terminate dialysis 4.Notify the physician and verify that all members of the health care team agree with the decision 3. Realize that is well within a patient's rights to choose to terminate dialysis Who was the first person to use the term dialysis? 1.John Abel 2.Thomas Graham
3.Leonard Rowntree 4.Bernard Turner 2.Thomas Graham What was the primary anticoagulant used in the first artificial kidney? 1.Salicylic acid 2.Hirudin
- Low-molecular weight heparin 4.Warfarin 2.Hirudin Dr. William Kolff created the first dialyzer suitable for human use (rotating drum dialyzer) in 1943. What material was used to construct the hollow tubes on this device? 1.Rubber 2.Teflon 3.Cellophane 4.Glass 3.Cellophane
2.Epoetin alfa (epogen)
- Factor VIII
- Ruxolitinib
- Epoetin alfa (epogen) An electrolyte is a substance that dissolves in water to form:
- charged atoms
- solute
- ionized particles
- electrical current 3.Ionized particles What may result if a dialysate solution contains too much sodium?
- Water may shift into pt's blood cells, causing hypotension and cramping
- Fluid may leave the cells, causing blood cells to shrivel
- Pt may experience heart failure & ventricular dysrhythmias
- Pt may experience hypertension, profound thirst, and headache 2 & 4
With osmosis, water moves from areas of: 1.Lower water concentration to areas of higher water concentration
- Low concentration of solutes to areas of high concentration of solutes
- Acidity to areas of alkalinity
- Higher temps to lower temps
- Low concentration of solutes to areas of high concentration of solutes Buffers minimize pH changes when an acid or a base is added to a solution. What is the major plasma buffer in the body?
- Sodium
- Bicarbonate
- Potassium 4.Lactate 2.Bicarbonate Kidney failure causes retention of hydrogen ions. What is the result?
- Metabolic alkalosis
In the formation of urine, what action is occurring in Step 2?
- Water moves from the glomerulus into the Bowman's capsule?
- Water & other dissolved substances move from the tubules into the blood in the peritubular capillaries
- There is movement of selected substances from the blood in the peritubular capillaries back into the tubules
- There is secretion of hormones into the blood capillaries which will cause the kidneys to hold onto water
- Water & other dissolved substances move from the tubules into the blood in the peritubular capillaries The glomerular filtration rate is the amount of filtrate produced by the kidneys per minute. What is glomerular filtration dependent on?
- Sufficient blood circulation to the glomerulus
- Proper reabsorption of ions & molecules
- Adequate glucose to supply energy for renal functions
- Maintenance of normal filtration pressures 1 & 4
Blood urea levels are influenced by many factors. Decreased levels may result from: 1.Gastrointestinal tract bleeding
- Low dietary protein intake 3.Overhydration 4.Steroid use 2 & 3 At the conference for Kidney Disease: Improving Global Outcomes (KDIGO) on Chronic Kidney Disease it was recommended that stage 3 be subdivided into 3a and 3b. What is the recommended glomerular filtration rate for 3b?
- 60-88 mL/min/1.73 m
- 30-44 mL/min/ 1.73 m
- 45-59 mL/min/1.73 m
- 15-29 mL/min/1.73 m 30-44 mL/min/1.73 m The National Kidney Foundation (NKF) recommends that all individuals be assessed for increased risk for developing chronic kidney disease
- Uncontrolled hypertension
- Foamy urine 1,2, & 3 What is a common clinical manifestation of renal cell carcinoma? 1.Excess ankle swelling 2.Blood in urine 3.Periorbital edema
- Weight gain Blood in urine Which of the following maybe a cause of postrenal acute renal failure?
- Severe dehydration
- Obstruction in the ureter or urethera
- Heart failure
- Toxicity related to antibiotic administration Obstruction in the ureter or urethera
What is the target blood pressure in patients with CKD recommended by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP?
- less than 130/
- less than 150/
- less than 140/
- less than 125/ Less than 130/ A patient presents to the nephrologist office complaining of chest pain, fever, and chills. The healthcare provider hears a pericardial friction rub during auscultation of heart and lung sounds. Echocardiogram confirms a pericardial tamponade. The renal staff should prepare the patient for which of these procedures?
- A pericardiocentesis where a needle is inserted into the pericardial space to remove fluid
- Immediate dialysis utilizing ultrafiltration to remove excess fluid
- Type & cross match for at least 2 units of packed red blood cells
- Insertion of an IV catheter and stat dose of Lasix, a diuretic A pericardiocentesis where a needle is inserted into the pericardial space to remove fluid
2.Proper use of isolation for all HIV positive dialysis patients 3.Catether dressing change technique 4.Vascular access technique 1,3, & 4 What are some of the causes of anemia in CKD patients?
- Decreased production of erythropoietin 2.Impaired intake of iron from foods 3.Loss of blood through the gastrointestinal tract 4.Extended life span of red blood cells 1,2 & 3 What are some of the signs/symptoms of anemia in CKD patients? 1.Bruising & edema 2.Confusion & insomnia 3.Dyspnea & fatigue
- Pallor & prolonged capillary refill 1, 2, & 3
What is the recommended treatment for osteodystrophy in CKD patients? 1.Increasing intake of aluminum 2.A diet high in protein 3.Administration of phosphate-binding agents 4.Encouraging use of joint splints Administration of phosphate-binding agents Most patients who have been on dialysis for more than _____ have dialysis amyloidosis (DA)
- 2 yrs 2.6 months
- 10 years
- 3 years 10 years CKD patients are at risk for developing peripheral neuropathy, which may manifest as?
- An intolerance to touch 2.Increased deep tendon reflexes
What are some negative aspects of synthetic membranes? 1.They are expensive 2.They require automated ultrafiltration control 3.They can absorb proteins on the membrane surface 4.Patients have a higher degree of bio-incompatibility than with other types of membranes 1,2, & 3 Long-term exposure to bioincompatible membranes used during dialysis has been associated with: 1.Red blood cell destruction 2.Increased incidence of infection & malignancy 3.Impaired nutritional status 4.Human immunodeficiency virus 2 & 3 Which of the following statements about bicarbonate dialysate is accurate?
1.The bicarbonate concentrate is very susceptible to bacterial contamination 2.Calcium & magnesium are very stable in solution with bicarbonate
- The 'A' (acidified) concentrate is made up primarily of potassium
- The 'B' (bicarbonate) concentrate is very stable & has a long shelf life The bicarbonate concentrate is very susceptible to bacterial contamination Which laboratory test is used to detect & quantify bacterial endotoxins? 1.Limulus amebocyte lysate (LAL)
- Culture and sensitivity (C & S)
- Colony-forming units (CFU)
- Enzyme-linked immunosorbent assay (ELISA) Limulus amebocyte lysate (LAL) What may occur if the bicarbonate concentrate is overmixed? 1.A decrease in serum calcium levels 2.An increase in sodium levels 3.A drop in phosphate levels
