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Exam Code: CHT
Exam Name: BONENT Certified Hemodialysis Technologist - Technician (CHT)
Format: 150 multiple-choice questions.
Time Limit: 3 hours.
Delivery Methods:
Paper and Pencil exam (PPE): Offered at specific locations and dates (check the PPE schedule on the BONENT website).
Computer-Based Testing (CBT): Available at approved testing centers, with scheduling flexibility after application approval.
Scoring: Uses a scaled scoring system (1–100). A minimum scaled score of 70 is required to pass. Results are provided immediately for CBT; PPE results may take longer.

DOMAIN I: Patient Care (45%)
- Evaluate Patient Pre and Post Treatment
- Evaluate fluid management
- Replacement therapy
- Sequential ultrafiltration
- Ultrafiltration concepts
- Collect and evaluate patient data
- Vital signs
- Weight evaluation
- Access patency
- Edema
- Signs and symptoms of infection
- Hemostasis
- Orthostasis
- Need for supplemental oxygen
- Document exam
- Report complaints or observations to nurse
- Document observations in medical record
- Discuss ultrafiltration plan with nurse
- Evaluate, Intervene and Manage Treatment
- Pre treatment
- Set treatment parameters per physician order (e.g., bath, blood flow rate, dialysate flow rate)
- Check reuse dialyzer label
- Inspect dialyzer
- Evaluate access (e.g., patency, infection, appearance)
- Prepare vascular access for cannulation
- Prepare CVC and change dressing
- Gain access
- Collect laboratory samples (e.g., cultures, blood, urine)
- Administer heparin for initiation of treatment
- Verify patient identification at initiation of dialysis
- treatment (e.g., set parameters, blood flow rate, dialysate flow)
- Document observations and patient data
- During treatment
- Collect laboratory samples (e.g., cultures, blood, urine)
- Monitor and record treatment data
- Identify and respond to complications
- Notify nurse of any changes in patient condition
- Administer oxygen to patient by cannula or mask
- Respond to dialysis machine alarms
- Document observations and patient data
- Post treatment
- Collect laboratory samples (e.g., cultures, blood, urine)
- Perform procedures to terminate dialysis treatment
- Needle site care per protocol (e.g., removal, pressure, dressing)
- Catheter care per protocol
- Document observations and patient data
- Check dialyzer efficiency (e.g., clots, fibers, leaks)

DOMAIN II: Machine Technology (12%)
- Maintain Dialysis Machine
- Clean and disinfect dialysis equipment
- Record all machine disinfection
- Check readiness of emergency equipment
- Verify the calibration of ancillary medical equipment
- Recognize errors in blood and dialysate flow rates
- Set-up Machine
- Prepare dialysis equipment for treatment (e.g., prime, rinse, fluid delivery system)
- Prepare auxiliary equipment (e.g., oxygen therapy, glucometer, conductivity meter)
- Rotate dialysis equipment in dialysis unit
- Perform residual chemical checks
- Perform required safety checks on dialysis equipment (e.g., conductivity, pH, temperature)
- Test alarms (e.g., air detector, venous/arterial pressure, blood leak detector)
- Prepare and verify bicarbonate and acid solutions
- Document daily equipment logs
- Evaluate Machine Operation
- Understand quality control of dialysis equipment per Association for the Advancement of Medical
- Perform rinse procedures for dialysis delivery systems
- Perform disinfect procedures for dialysis delivery systems
- Understand equipment maintenance records for compliances with regulatory and standard setting
- Adhere to equipment maintenance procedures and schedules

DOMAIN III: Water Treatment (15%)
- Understand Components/Design of Systems
- Recognize actions
- Recognize the process of ultraviolet light exposure
- Maintain Systems
- Understand the process of disinfecting water treatment system
- Understand the maintenance of all treatment components
- Perform water treatment system checks
- Monitor and Evaluate Systems
- Understand quality control of reprocessing equipment per AAMI standards
- Monitor total chlorine or chloramines
- Maintain water treatment systems records for compliance with regulatory and standard setting

DOMAIN IV: Infection Control (18%)
- Maintain a Clean and Safe Patient Environment
- Follow all clean/dirty procedures in order to eliminate cross-contamination
- Recognize complications in dialysis treatments regarding infectious diseases (e.g., AIDS, TB, influenza)
- Ancillary equipment and supplies
- Demonstrate understanding and perform cannulation using aseptic technique for needle insertion and all
- Glove changing
- Wash machines, station area, and chairs after each patient run
- Hand washing
- Use Dialysis Precautions
- Personal protective equipment (PPE) (e.g., gown, gloves, mask)
- Disinfecting dialysis station
- Disposal of biohazard waste and SHARPS
- Implement Isolation Procedures
- Designated equipment
- Understand CMS requirements for designated staff
- Understand status of patients hepatitis survey
- Disinfection

DOMAIN V: Education and Professional Development (10%)
- Educate Patient
- Advise patient of discharge instructions (e.g., diet, fluid intake, medication regiment)
- Advise patient and family members based on physicians orders (e.g., personal hygiene, self- care, treatment modalities)
- Explain dialysis concepts to patients
- Review and reinforce dialysis prescription
- Describe basic features of end stage renal disease (ESRD)
- Complications
- Hemodialysis treatment
- Psychosocial implications
- Dietary restrictions
- Treatment modality
- Describe treatment of acute renal failure
- Engage in Professional Development
- Continuing education of dialysis (e.g., attend meetings, workshops, conferences)
- Multidisciplinary care plans
- Medications in the dialysis clinic (e.g., anticoagulants, antihypertensives, erythropoietic stimulating agents (ESA))
- Proper body mechanics for patient and self
- Professional ethics and boundaries
- Dialysis unit safety procedures (e.g., fire drills, disaster drill, bomb threat)
- Professional literature
- Role of the preceptor
- Government regulations
- Treatment modalities (e.g., peritoneal, transplant, home hemodialysis)
- Understand Quality-Related Issues
- Document incidents (e.g., emergency-related, equipment/devices, patient care)
- Maintain documentation/data
- Process improvement
- Treatment
- Maintain storage of medications (e.g., heparin, normal saline, Xylocaine)
- Maintain storage of equipment and supplies
- Participate in quality assurance process improvement (QAPI) activities
- Participate in the development of dialysis unit objectives
- Demonstrate Communication Skills with Staff Members
- Promote a teamwork approach by offering information, advice, and assistance
- Contribute to constructive working relationships
- Participate in self and/or peer evaluations as directed
- Ensure the confidentiality of patient and employee information
- Assist in orientation of new staff members