FLORIDA BOARD OF NURSING CERTIFIED
DIALYSIS NURSE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A patient receiving hemodialysis reports muscle weakness and
electrocardiography shows peaked T waves. Which electrolyte
imbalance should the dialysis nurse suspect first?
A. Hypercalcemia
B. Hypermagnesemia
C. Hyperkalemia
D. Hyponatremia
Answer: C. Hyperkalemia
Rationale: End-stage renal disease (ESRD) impairs potassium
excretion, making hyperkalemia a life-threatening complication.
Peaked T waves, muscle weakness, and dysrhythmias are classic
manifestations. Dialysis rapidly removes potassium and is often the
treatment of choice in severe cases.
2. Which laboratory value best reflects long-term adequacy of
hemodialysis treatment?
A. Serum sodium
B. Serum creatinine
C. Kt/V
D. White blood cell count
Answer: C. Kt/V
1
,Rationale: Kt/V measures dialysis adequacy by assessing urea
clearance relative to body water volume. A target Kt/V of at least 1.2
per treatment is generally recommended for adequate dialysis.
3. During hemodialysis, a patient develops hypotension, nausea, and
yawning. What is the nurse’s priority intervention?
A. Increase ultrafiltration
B. Place patient in Trendelenburg position and administer normal saline
C. Administer insulin
D. Stop blood flow immediately
Answer: B. Place patient in Trendelenburg position and administer
normal saline
Rationale: Intradialytic hypotension commonly results from excessive
fluid removal. Trendelenburg positioning and isotonic saline restore
circulating volume and improve blood pressure.
4. Which vascular access has the lowest infection rate?
A. Non-tunneled catheter
B. Tunneled central venous catheter
C. Arteriovenous graft
D. Arteriovenous fistula
Answer: D. Arteriovenous fistula
Rationale: AV fistulas have superior longevity, higher blood flow
rates, and the lowest risk of infection and thrombosis compared with
grafts and catheters.
5. The dialysis nurse palpates an AV fistula and notes absence of a
thrill. What is the priority action?
A. Continue dialysis
B. Notify the nephrologist immediately
2
,C. Apply warm compresses
D. Encourage exercise
Answer: B. Notify the nephrologist immediately
Rationale: Absence of a thrill suggests thrombosis or occlusion, which
requires urgent evaluation to preserve access function.
6. Which electrolyte is primarily responsible for secondary
hyperparathyroidism in ESRD?
A. Sodium
B. Phosphorus
C. Chloride
D. Magnesium
Answer: B. Phosphorus
Rationale: Hyperphosphatemia decreases calcium levels and
stimulates parathyroid hormone secretion, leading to renal
osteodystrophy.
7. A patient receiving erythropoiesis-stimulating agents should be
monitored closely for:
A. Hypoglycemia
B. Hypertension
C. Hypothermia
D. Bradycardia
Answer: B. Hypertension
Rationale: Erythropoietin therapy can increase blood pressure,
particularly during rapid correction of anemia.
8. Which laboratory value is most consistent with uremia?
A. BUN 90 mg/dL
B. Sodium 138 mEq/L
3
, C. Hemoglobin 15 g/dL
D. Glucose 90 mg/dL
Answer: A. BUN 90 mg/dL
Rationale: Elevated blood urea nitrogen reflects accumulation of
nitrogenous waste products associated with renal failure.
9. What is the primary purpose of heparin during hemodialysis?
A. Prevent infection
B. Reduce blood pressure
C. Prevent clotting in the extracorporeal circuit
D. Increase ultrafiltration
Answer: C. Prevent clotting in the extracorporeal circuit
Rationale: Heparin prevents coagulation within the dialysis tubing
and dialyzer.
10. Which symptom is most indicative of dialysis disequilibrium
syndrome?
A. Fever
B. Headache and confusion
C. Hypertension only
D. Jaundice
Answer: B. Headache and confusion
Rationale: Rapid removal of urea creates cerebral edema, causing
neurologic symptoms such as headache, confusion, seizures, and
coma.
11. The normal serum potassium level is:
A. 1.5–2.5 mEq/L
B. 2.5–3.5 mEq/L
4
DIALYSIS NURSE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A patient receiving hemodialysis reports muscle weakness and
electrocardiography shows peaked T waves. Which electrolyte
imbalance should the dialysis nurse suspect first?
A. Hypercalcemia
B. Hypermagnesemia
C. Hyperkalemia
D. Hyponatremia
Answer: C. Hyperkalemia
Rationale: End-stage renal disease (ESRD) impairs potassium
excretion, making hyperkalemia a life-threatening complication.
Peaked T waves, muscle weakness, and dysrhythmias are classic
manifestations. Dialysis rapidly removes potassium and is often the
treatment of choice in severe cases.
2. Which laboratory value best reflects long-term adequacy of
hemodialysis treatment?
A. Serum sodium
B. Serum creatinine
C. Kt/V
D. White blood cell count
Answer: C. Kt/V
1
,Rationale: Kt/V measures dialysis adequacy by assessing urea
clearance relative to body water volume. A target Kt/V of at least 1.2
per treatment is generally recommended for adequate dialysis.
3. During hemodialysis, a patient develops hypotension, nausea, and
yawning. What is the nurse’s priority intervention?
A. Increase ultrafiltration
B. Place patient in Trendelenburg position and administer normal saline
C. Administer insulin
D. Stop blood flow immediately
Answer: B. Place patient in Trendelenburg position and administer
normal saline
Rationale: Intradialytic hypotension commonly results from excessive
fluid removal. Trendelenburg positioning and isotonic saline restore
circulating volume and improve blood pressure.
4. Which vascular access has the lowest infection rate?
A. Non-tunneled catheter
B. Tunneled central venous catheter
C. Arteriovenous graft
D. Arteriovenous fistula
Answer: D. Arteriovenous fistula
Rationale: AV fistulas have superior longevity, higher blood flow
rates, and the lowest risk of infection and thrombosis compared with
grafts and catheters.
5. The dialysis nurse palpates an AV fistula and notes absence of a
thrill. What is the priority action?
A. Continue dialysis
B. Notify the nephrologist immediately
2
,C. Apply warm compresses
D. Encourage exercise
Answer: B. Notify the nephrologist immediately
Rationale: Absence of a thrill suggests thrombosis or occlusion, which
requires urgent evaluation to preserve access function.
6. Which electrolyte is primarily responsible for secondary
hyperparathyroidism in ESRD?
A. Sodium
B. Phosphorus
C. Chloride
D. Magnesium
Answer: B. Phosphorus
Rationale: Hyperphosphatemia decreases calcium levels and
stimulates parathyroid hormone secretion, leading to renal
osteodystrophy.
7. A patient receiving erythropoiesis-stimulating agents should be
monitored closely for:
A. Hypoglycemia
B. Hypertension
C. Hypothermia
D. Bradycardia
Answer: B. Hypertension
Rationale: Erythropoietin therapy can increase blood pressure,
particularly during rapid correction of anemia.
8. Which laboratory value is most consistent with uremia?
A. BUN 90 mg/dL
B. Sodium 138 mEq/L
3
, C. Hemoglobin 15 g/dL
D. Glucose 90 mg/dL
Answer: A. BUN 90 mg/dL
Rationale: Elevated blood urea nitrogen reflects accumulation of
nitrogenous waste products associated with renal failure.
9. What is the primary purpose of heparin during hemodialysis?
A. Prevent infection
B. Reduce blood pressure
C. Prevent clotting in the extracorporeal circuit
D. Increase ultrafiltration
Answer: C. Prevent clotting in the extracorporeal circuit
Rationale: Heparin prevents coagulation within the dialysis tubing
and dialyzer.
10. Which symptom is most indicative of dialysis disequilibrium
syndrome?
A. Fever
B. Headache and confusion
C. Hypertension only
D. Jaundice
Answer: B. Headache and confusion
Rationale: Rapid removal of urea creates cerebral edema, causing
neurologic symptoms such as headache, confusion, seizures, and
coma.
11. The normal serum potassium level is:
A. 1.5–2.5 mEq/L
B. 2.5–3.5 mEq/L
4
