CHT Hemodialysis Technologist 5 — Questions and Answers
Question 1: Which of the following BEST describes the 'buttonhole' cannulation technique for AV fistulas?
- Rotating needle insertion sites with each treatment
- Using the same needle insertion site and angle every treatment to create a track (Correct answer)
- Inserting the needle at a 90-degree angle each time
- Using only blunt needles in a randomly selected site
Correct answer: Using the same needle insertion site and angle every treatment to create a track
The buttonhole technique uses the exact same puncture site and angle repeatedly, forming a fibrous tunnel that allows blunt needle insertion and reduces trauma.
Question 2: A patient's access recirculation is measured at 25%. What does this indicate?
- The access is functioning optimally with excellent blood flow
- Dialyzed blood is re-entering the arterial needle, reducing treatment efficiency (Correct answer)
- The patient has adequate urea clearance
- The venous pressure is within normal range
Correct answer: Dialyzed blood is re-entering the arterial needle, reducing treatment efficiency
High recirculation (>10–15%) means already-dialyzed blood re-enters the arterial needle, diluting the uremic blood and significantly reducing Kt/V.
Question 3: Which parameter is adjusted on the dialysis machine to control the rate of fluid removal from the patient?
- Blood flow rate (Qb)
- Dialysate flow rate (Qd)
- Ultrafiltration rate (UFR) (Correct answer)
- Dialysate conductivity
Correct answer: Ultrafiltration rate (UFR)
The ultrafiltration rate directly controls the volume of fluid removed per hour through convective transport across the dialyzer membrane.
Question 4: OSHA's Bloodborne Pathogens Standard requires that hemodialysis technicians use which type of precautions with all patients?
- Contact precautions only for HBV-positive patients
- Standard (Universal) Precautions with all patients (Correct answer)
- Airborne precautions for all dialysis patients
- Droplet precautions for all vascular access procedures
Correct answer: Standard (Universal) Precautions with all patients
Standard Precautions treat all patient blood and body fluids as potentially infectious, requiring gloves, face protection, and gowns as appropriate.
Question 5: A hemodialysis patient with a serum phosphorus of 7.2 mg/dL is MOST likely to require which intervention?
- Increased dialysate calcium to bind phosphorus
- Phosphate binder therapy and dietary phosphorus restriction (Correct answer)
- Increased dialysate bicarbonate concentration
- Reduction in dialysis treatment time
Correct answer: Phosphate binder therapy and dietary phosphorus restriction
Hyperphosphatemia in dialysis patients is managed with phosphate binders taken with meals and limiting dietary intake of phosphorus-rich foods.
Question 6: What is the MOST important reason to document the pre-treatment weight of a hemodialysis patient?
- To calculate medication doses only
- To determine the ultrafiltration goal and ensure appropriate fluid removal (Correct answer)
- To assess nutritional status for billing purposes
- To set the blood pump speed for the session
Correct answer: To determine the ultrafiltration goal and ensure appropriate fluid removal
Pre-treatment weight compared to the patient's dry weight (target weight) determines how much fluid (ultrafiltration volume) must be removed during the treatment.
Question 7: Which of the following water treatment components is responsible for removing chloramines from municipal water before it enters the reverse osmosis system?
- Sediment filter
- Activated carbon filter (Correct answer)
- Softener resin bed
- Reverse osmosis membrane
Correct answer: Activated carbon filter
Activated carbon filters adsorb chlorine and chloramines, which would otherwise destroy the reverse osmosis membrane and cause hemolysis in patients.
CHT Hemodialysis Technologist 5
Which of the following BEST describes the 'buttonhole' cannulation technique for AV fistulas?