This overview includes information to help you prepare for the Certified Clinical Hemodialysis Technician exam. You will find details about eligibility, the current test format, clinical and technical content, registration, fees, scoring, retakes, recertification, and study resources.
Questions
150 multiple-choice questions
Time Limit
3 hours
Passing Standard
Standard score of 95
Exam Fee
$225
What Is the CCHT Exam?
The Certified Clinical Hemodialysis Technician exam is administered by the Nephrology Nursing Certification Commission.
It is designed for dialysis patient care technicians who provide direct clinical care to patients receiving hemodialysis. The examination measures whether a candidate has the entry-level knowledge needed to deliver treatment safely while working under the supervision of qualified clinical personnel.
The exam addresses patient care before, during, and after treatment, as well as dialysis equipment, water treatment, infection prevention, safety, communication, documentation, and professional responsibilities.
Federal regulations generally require newly employed dialysis patient care technicians to obtain certification through an accepted state or national program within 18 months of being hired.
CCHT and CCHT-A
The CCHT and CCHT-A are separate credentials.
CCHT
The standard certification for trained clinical hemodialysis technicians. Candidates are not required to have five years of dialysis experience.
CCHT-A
An advanced credential for experienced dialysis technicians who meet additional certification, employment, and work-hour requirements.
CCHT Eligibility Requirements
Applicants must comply with federal and state requirements governing the work of hemodialysis patient care technicians.
Required Education and Training
- Possess a high school diploma, GED, or equivalent credential from a government-approved program
- Submit documentation verifying the diploma or GED
- Complete a clinical hemodialysis technician training program
- Complete both classroom instruction and supervised clinical experience
- Obtain the required signatures or training-completion verification
Candidates Who Are Not Yet Employed
A candidate who has not obtained a clinical hemodialysis technician position must report the number of hands-on patient-care hours completed during the training program.
The candidate must also identify the facility where the clinical training occurred. A facility administrator or manager must verify that the experience was supervised by a registered nurse.
Candidates Who Are Currently or Recently Employed
A candidate who has held a clinical hemodialysis technician position during the previous 18 months must provide the employer’s name and obtain a supervisor’s verification of employment.
NNCC recommends at least six months or 1,000 hours of clinical experience before taking the exam, but this amount of experience is not currently a mandatory eligibility requirement.
Candidates Who Have Been Out of Practice
A candidate who has been unemployed as a clinical hemodialysis technician for 18 months or longer must provide proof of current retraining and hands-on experience.
The name on the diploma or GED documentation must match the name used on the examination application. Documentation of a legal name change may be required when the names differ.
Current CCHT Exam Format
The CCHT examination contains 150 multiple-choice questions and allows three hours of testing time.
Approximately 25 of the questions are experimental or pilot questions being evaluated for possible use on future examinations. Pilot questions are not scored, but they are mixed throughout the exam and are not identified.
Question Format
Four answer choices with one best answer
Testing Method
Computer-based testing
Average Pace
Approximately 72 seconds per question
Calculator
Not needed or permitted
The examination emphasizes application of dialysis knowledge to clinical situations. Most questions require more than simple memorization.
There is no penalty for an incorrect answer. Make an educated selection for every question rather than leaving an item unanswered.
CCHT Content Areas
The examination covers four dialysis practice areas. The percentages below show the approximate emphasis of each area.
Clinical
Approximately 50% | Official range: 48%–52%
Patient preparation, vascular access, treatment initiation, patient monitoring, treatment complications, medication-related procedures, laboratory samples, emergency response, treatment termination, and post-dialysis care.
Technical
Approximately 23% | Official range: 21%–25%
Hemodialysis machines, extracorporeal circuits, dialysate, equipment checks, alarms, troubleshooting, water-treatment systems, quality-control testing, concentrate preparation, and equipment-related adverse events.
Environment
Approximately 15% | Official range: 13%–17%
Standard precautions, infection prevention, environmental cleaning, chemical safety, equipment disinfection, body mechanics, fall prevention, facility safety, emergency preparation, evacuation, and maintaining a therapeutic environment.
Role Responsibilities
Approximately 12% | Official range: 10%–14%
Privacy, confidentiality, documentation, professional boundaries, communication, patient dignity, cultural awareness, teamwork, handoff reporting, patient education, scope of practice, and the roles of dialysis care-team members.
Clinical Care Topics
Clinical care is the largest portion of the examination. Candidates should understand the complete hemodialysis treatment process.
Before Treatment
- Patient identification
- Pre-dialysis weight
- Vital signs
- Access assessment
- Recent symptoms and events
During Treatment
- Patient monitoring
- Machine monitoring
- Fluid removal
- Access observation
- Recognizing complications
After Treatment
- Treatment termination
- Access-site care
- Post-dialysis weight
- Post-treatment vital signs
- Documentation and reporting
Common Complications to Review
- Hypotension and orthostatic hypotension
- Muscle cramps
- Nausea and vomiting
- Chest pain
- Hypoglycemia
- Blood loss and exsanguination risk
- Air embolism
- Hemolysis
- Disequilibrium syndrome
- Access infection, stenosis, infiltration, or clotting
- Changes in mental status
- Falls and other emergency events
Vascular Access
Candidates should understand the purpose, assessment, cannulation, monitoring, and post-treatment care of the major hemodialysis access types.
Arteriovenous Fistula
Surgically joins an artery and a vein. Review bruit, thrill, maturation, cannulation, stenosis, infiltration, clotting, and bleeding.
Arteriovenous Graft
Uses synthetic material to connect an artery and vein. Review access assessment, cannulation, infection, stenosis, and clotting.
Central Venous Catheter
Provides immediate vascular access but carries an increased infection risk. Review aseptic care, connection, disconnection, and reporting requirements.
A missing bruit or thrill, uncontrolled bleeding, suspected infection, or other sign of access failure must be recognized and reported promptly according to facility policy and the technician’s scope of practice.
Dialysis Equipment and Water Treatment
Technical questions cover the dialysis machine, extracorporeal circuit, dialysate, water-treatment system, equipment testing, and responses to alarms.
Technical Topics to Review
- Principles of diffusion, osmosis, and ultrafiltration
- Dialyzer structure and function
- Bloodlines and the extracorporeal circuit
- Blood-pump and pressure-monitoring systems
- Air-detector and venous-line safety systems
- Conductivity, pH, and temperature
- Bypass conditions
- Arterial, venous, transmembrane-pressure, and air alarms
- Concentrate mixing and labeling
- Water softeners, carbon tanks, reverse osmosis, and ultrafilters
- Chlorine and chloramine testing
- Corrective action when equipment or water-quality problems occur
Responding to an Alarm
Candidates should understand that an alarm should not simply be silenced or overridden. The technician must protect the patient, identify the cause, follow facility procedures, correct only issues within the technician’s authorized role, and report the event when required.
Infection Prevention and Safety
Environment questions focus on maintaining a safe dialysis setting for patients and staff.
Infection Prevention
- Hand hygiene
- Standard precautions
- Personal protective equipment
- Clean and contaminated areas
- Hepatitis B precautions
Cleaning and Disinfection
- Machine surfaces
- Treatment chairs
- Shared equipment
- Chemical use
- Safe waste disposal
Facility Safety
- Fall prevention
- Safe transfers
- Body mechanics
- Emergency exits
- Fire and disaster response
Professional Responsibilities
The CCHT exam also measures whether candidates understand the limits and responsibilities of the technician’s role.
- Protect patient privacy and confidentiality
- Maintain patient dignity
- Maintain appropriate professional boundaries
- Document observations and completed activities accurately
- Report changes in patient status to the appropriate team member
- Provide a complete handoff before leaving for a break or shift change
- Communicate respectfully with patients, families, and staff
- Reinforce education from the established patient teaching plan
- Recognize when a question or task must be referred to a nurse or another qualified professional
- Work within the technician’s authorized scope of practice
Registration, Fees, and Testing Locations
Candidates must submit a complete CCHT examination application with the required documentation, signatures, and payment.
Application Process
- Review the current CCHT eligibility and application instructions.
- Complete all sections of the examination application.
- Obtain the required educator, manager, or supervisor signatures.
- Attach a copy of the qualifying diploma or GED documentation.
- Include legal name-change documentation when necessary.
- Submit the $225 examination fee.
- Wait for application review and the examination permit.
- Schedule the examination at an approved testing site.
Current Fees
Examination
$225
Expedited Review
$75
90-Day Extension
$125
The examination permit is valid for 90 days. Candidates must test within the dates printed on the permit.
One additional 90-day testing window may be requested before the original permit expires. The extension fee applies.
Computer-based examinations are offered year-round by appointment at approved testing sites. NNCC does not currently offer the CCHT exam as an at-home or internet-proctored examination.
What Should I Expect on Test Day?
Test-Day Checklist
- Confirm the date, time, and testing-center location.
- Arrive approximately 30 minutes before the appointment.
- Bring the examination permit.
- Bring current, permanent, government-issued photo identification containing a signature.
- Make sure the name on the identification matches the examination permit.
- Do not bring notes, reference books, study materials, or a calculator.
- Store phones, watches, bags, and other personal belongings as directed.
- Complete the computer tutorial before beginning the examination.
- Answer every question before the three-hour testing period ends.
How Is the CCHT Exam Scored?
The exam uses a reported standard score. Candidates must earn a standard score of at least 95.
NNCC states that this passing standard is achieved by answering 74% of the examination questions correctly.
The score report is available at the end of the examination.
Passing Result
The report provides the candidate’s score and information about certification processing and directory listing.
Unsuccessful Result
The report includes performance information for the four dialysis practice areas to help identify subjects needing additional review.
Retaking the CCHT Exam
NNCC does not currently impose a lifetime limit on the number of CCHT examination attempts.
- Submit another examination application after an unsuccessful attempt.
- Pay the current examination fee again.
- Obtain a new examination permit.
- Schedule another appointment at an approved testing site.
- Use the score-report breakdown to focus preparation on weaker practice areas.
Maintaining the CCHT Credential
Initial CCHT certification is valid for three years from the final day of the month in which the candidate passed the exam.
Certification must be renewed every three years. Certificants may generally renew through continuing education and clinical experience or by taking the certification examination again.
Continuing Education and Experience
- Complete 30 approved contact hours during the three-year certification period.
- Include at least 10 nephrology-specific contact hours.
- Complete at least 3,000 hours of dialysis technician work during the certification period.
- Retain certificates and supporting documents in case the application is audited.
- Submit the application and current recertification fee before the credential expires.
Recertification by Education
$100
Recertification by Exam
$225
How Can I Prepare?
Begin with a diagnostic practice test and organize missed questions according to the four official practice areas.
Clinical content accounts for approximately half of the examination. However, technical, environmental, and professional-responsibility questions together account for the other half and should not be neglected.
CCHT Study Checklist
- Review kidney function and the basic principles of hemodialysis.
- Study patient identification, weights, vital signs, and fluid-status assessment.
- Review fistulas, grafts, catheters, cannulation, and access complications.
- Study treatment initiation, patient monitoring, and treatment termination.
- Review hypotension, cramping, bleeding, air embolism, hemolysis, and other complications.
- Study dialysis machines, dialyzers, bloodlines, dialysate, alarms, and bypass.
- Review water-treatment components and required monitoring procedures.
- Study hand hygiene, standard precautions, hepatitis B isolation, and environmental disinfection.
- Review emergency preparation, evacuation, fall prevention, and safe patient transfers.
- Study privacy, confidentiality, documentation, professional boundaries, and communication.
- Complete full-length practice within three hours.
- Review the explanation for every missed answer and every correct answer obtained through guessing.
Question Strategy
- Read for words such as first, best, most important, and most likely.
- Identify whether the question involves patient care, equipment, safety, or professional responsibility.
- Prioritize patient safety and immediate reporting of serious changes.
- Do not select actions outside the technician’s authorized role.
- Read all four answer choices before selecting a response.
- Do not add facts that are not included in the question.
- Make an educated choice when uncertain because guessing is not penalized.
CCHT Study Resources
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CCHT®, Certified Clinical Hemodialysis Technician®, CCHT-A®, NNCC®, and Nephrology Nursing Certification Commission® are marks associated with their respective owners. NNCC, C-NET, and PSI are not involved with or affiliated with Mometrix Media LLC or StudyGuideZone.com, nor do they endorse or sponsor products or services offered by Mometrix Media LLC or StudyGuideZone.com.
