CERTIFIED DIALYSIS NURSE TEST REVIEW LATEST 2026
TEST BANK| COMPLETE 250 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) GRADED A+ (BRAND NEW!!)
1. A patient’s prescribed dialysate flow rate is 500 mL/min. The
actual measured flow is 420 mL/min. What is the most
appropriate action?
A) Document the flow and continue treatment
B) Increase blood flow to compensate
C) Troubleshoot the dialysate delivery system
D) Notify the nephrologist after the session
Answer: C
Rationale: Dialysate flow below prescription reduces
clearance. The nurse should troubleshoot (check connectors,
1
, pump, alarms) before or immediately after starting;
continuing may lead to inadequate dialysis.
2. During priming of a dialyzer, air bubbles remain in the
header after saline flushes. What should the nurse do next?
A) Begin treatment; air will be trapped in the air detector
B) Tap the dialyzer gently and continue priming
C) Discard the dialyzer and prime a new one
D) Increase saline flow rate to 300 mL/min
Answer: B
Rationale: Tapping helps dislodge air bubbles trapped in
the fiber bundle or header. Small bubbles can cause clotting
or air emboli risk if not removed.
3. A patient on high-flux hemodialysis has a post-dialysis BUN of
18 mg/dL and pre-dialysis BUN of 70 mg/dL. Calculate the URR
(nearest whole percent).
2
, A) 65%
B) 74%
C) 79%
D) 82%
Answer: B
Rationale: URR = (pre-BUN − post-BUN) / pre-BUN × 100
= (70−18)/70 × 100 = 52/70 × 100 = 74.2%. Target
URR ≥65% for adequate dialysis.
4. Which dialysate potassium concentration is safest for a patient
with a pre-dialysis serum K+ of 6.2 mEq/L?
A) 0 mEq/L (potassium-free)
B) 1 mEq/L
C) 2 mEq/L
D) 3 mEq/L
Answer: C
3
, Rationale: A 2.0 mEq/L K+ bath is typical for
hyperkalemia. Zero K+ can cause cardiac instability and
rapid K+ drop. 3.0 mEq/L may not lower K+ enough.
5. A patient complains of chest pain and shortness of breath 30
minutes into HD. BP is 80/50 mmHg (baseline 130/80). First
action?
A) Give normal saline bolus
B) Stop ultrafiltration, check for air or blood leak
C) Decrease blood flow to 150 mL/min
D) Administer oxygen 2L NC
Answer: B
Rationale: Hypotension with chest pain may indicate air
embolism, hemolysis, or dialyzer reaction. Stop UF first, then
assess. Saline may worsen if cause is air.
4
TEST BANK| COMPLETE 250 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) GRADED A+ (BRAND NEW!!)
1. A patient’s prescribed dialysate flow rate is 500 mL/min. The
actual measured flow is 420 mL/min. What is the most
appropriate action?
A) Document the flow and continue treatment
B) Increase blood flow to compensate
C) Troubleshoot the dialysate delivery system
D) Notify the nephrologist after the session
Answer: C
Rationale: Dialysate flow below prescription reduces
clearance. The nurse should troubleshoot (check connectors,
1
, pump, alarms) before or immediately after starting;
continuing may lead to inadequate dialysis.
2. During priming of a dialyzer, air bubbles remain in the
header after saline flushes. What should the nurse do next?
A) Begin treatment; air will be trapped in the air detector
B) Tap the dialyzer gently and continue priming
C) Discard the dialyzer and prime a new one
D) Increase saline flow rate to 300 mL/min
Answer: B
Rationale: Tapping helps dislodge air bubbles trapped in
the fiber bundle or header. Small bubbles can cause clotting
or air emboli risk if not removed.
3. A patient on high-flux hemodialysis has a post-dialysis BUN of
18 mg/dL and pre-dialysis BUN of 70 mg/dL. Calculate the URR
(nearest whole percent).
2
, A) 65%
B) 74%
C) 79%
D) 82%
Answer: B
Rationale: URR = (pre-BUN − post-BUN) / pre-BUN × 100
= (70−18)/70 × 100 = 52/70 × 100 = 74.2%. Target
URR ≥65% for adequate dialysis.
4. Which dialysate potassium concentration is safest for a patient
with a pre-dialysis serum K+ of 6.2 mEq/L?
A) 0 mEq/L (potassium-free)
B) 1 mEq/L
C) 2 mEq/L
D) 3 mEq/L
Answer: C
3
, Rationale: A 2.0 mEq/L K+ bath is typical for
hyperkalemia. Zero K+ can cause cardiac instability and
rapid K+ drop. 3.0 mEq/L may not lower K+ enough.
5. A patient complains of chest pain and shortness of breath 30
minutes into HD. BP is 80/50 mmHg (baseline 130/80). First
action?
A) Give normal saline bolus
B) Stop ultrafiltration, check for air or blood leak
C) Decrease blood flow to 150 mL/min
D) Administer oxygen 2L NC
Answer: B
Rationale: Hypotension with chest pain may indicate air
embolism, hemolysis, or dialyzer reaction. Stop UF first, then
assess. Saline may worsen if cause is air.
4
