CHT Hemodialysis Technologist 2 — Questions and Answers
Question 1: Which type of vascular access is considered the 'gold standard' for hemodialysis?
- Central venous catheter
- Arteriovenous graft
- Arteriovenous fistula (Correct answer)
- Subclavian catheter
Correct answer: Arteriovenous fistula
An arteriovenous (AV) fistula is the preferred access because it has lower infection rates and longer patency than grafts or catheters.
Question 2: A patient's pre-dialysis BUN is 80 mg/dL and post-dialysis BUN is 20 mg/dL. What is the URR?
- 60%
- 70%
- 75% (Correct answer)
- 80%
Correct answer: 75%
URR = (pre-BUN − post-BUN) / pre-BUN × 100 = (80 − 20) / 80 × 100 = 75%.
Question 3: When priming a dialyzer with normal saline, what is the primary purpose?
- Sterilize the dialyzer membrane
- Remove air and reprocessing chemicals from the circuit (Correct answer)
- Activate the ultrafiltration mechanism
- Test the blood pump speed
Correct answer: Remove air and reprocessing chemicals from the circuit
Priming flushes air and any residual disinfectant from the extracorporeal circuit before connecting the patient.
Question 4: Which electrolyte imbalance is MOST commonly associated with muscle cramps during hemodialysis?
- Hypernatremia
- Hyperkalemia
- Hypocalcemia (Correct answer)
- Hyperphosphatemia
Correct answer: Hypocalcemia
Hypocalcemia causes neuromuscular irritability that manifests as muscle cramps during dialysis.
Question 5: What does the term 'Kt/V' measure in hemodialysis adequacy?
- Blood flow rate relative to dialysate flow
- Urea clearance normalized to body water volume (Correct answer)
- Ultrafiltration rate per treatment hour
- Transmembrane pressure across the dialyzer
Correct answer: Urea clearance normalized to body water volume
Kt/V quantifies urea clearance (K × time) divided by the patient's urea distribution volume (V); a value ≥1.2 per treatment is the KDOQI minimum.
Question 6: A patient suddenly develops chest pain, shortness of breath, and hypotension 15 minutes into treatment. The FIRST action should be to:
- Increase blood flow rate to improve clearance
- Return blood to the patient and stop treatment (Correct answer)
- Administer IV saline bolus and continue treatment
- Decrease ultrafiltration rate only
Correct answer: Return blood to the patient and stop treatment
Suspected acute reactions require immediate termination of dialysis and return of blood to the patient to stabilize the patient.
Question 7: What is the normal range for dialysate sodium concentration used in most adult hemodialysis treatments?
- 120–130 mEq/L
- 135–145 mEq/L (Correct answer)
- 150–160 mEq/L
- 160–170 mEq/L
Correct answer: 135–145 mEq/L
Dialysate sodium is typically set between 135–145 mEq/L to match normal plasma sodium and prevent osmotic imbalances.
CHT Hemodialysis Technologist 2
Which type of vascular access is considered the 'gold standard' for hemodialysis?