DAVITA RN FINAL EXAM 200 ACTUAL QUESTIONS AND
CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+
1. A patient's dialyzer has clotted during treatment. What is the most likely cause
of this complication?
A) Insufficient heparin dose
B) Excessive ultrafiltration
C) High blood flow rate
D) Low dialysate temperature
Answer: A
Rationale: Inadequate heparinization is the most common cause of dialyzer
clotting. When the heparin dose is insufficient, fibrin formation occurs within the
hollow fibers, leading to clot formation and loss of the dialyzer.
2. What is the primary reason for using a high-flux dialyzer?
A) To remove larger middle molecules more effectively
B) To increase ultrafiltration capacity
C) To reduce treatment time
D) To decrease heparin requirements
Answer: A
Rationale: High-flux dialyzers have larger pores that allow for better clearance of
middle-molecular-weight toxins such as beta-2-microglobulin, which is associated
with dialysis-related amyloidosis.
3. A patient's arterial pressure is reading -250 mmHg. What does this indicate?
A) Adequate blood flow
B) Access stenosis or needle against the vessel wall
C) Venous obstruction
D) Normal operating range
Answer: B
Rationale: An arterial pressure of -250 mmHg indicates excessive negative
pressure, which is often caused by access stenosis or the needle being positioned
against the vessel wall. This restricts blood flow and requires intervention.
4. What is the primary purpose of the dialysate conductivity monitor?
A) To measure electrolyte concentration in the dialysate
,B) To monitor dialysate temperature
C) To detect blood leaks
D) To measure ultrafiltration rate
Answer: A
Rationale: The conductivity monitor measures the electrolyte concentration
(primarily sodium) in the dialysate. Any deviation from the set conductivity
triggers an alarm to prevent delivery of incorrect dialysate composition.
5. A patient with a new AV fistula presents with a very weak thrill on
postoperative day 1. What is the most appropriate nursing action?
A) Document the finding and continue to monitor
B) Apply a warm compress to promote flow
C) Notify the surgeon or nephrologist immediately
D) Elevate the arm to reduce swelling
Answer: C
Rationale: A weak thrill on the first postoperative day may indicate thrombosis or
poor vessel maturation. The surgeon or nephrologist must be notified immediately
for urgent Doppler ultrasound evaluation.
6. What is the correct ratio of dialysate flow to blood flow for optimal clearance?
A) 1:1 ratio
B) 1.5:1 ratio
C) 2:1 ratio
D) 3:1 ratio
Answer: C
Rationale: A dialysate flow rate that is approximately twice the blood flow rate
(2:1 ratio) provides optimal clearance by maintaining a concentration gradient
across the dialyzer membrane throughout the treatment.
7. A patient receives dialysis with a dialysate sodium of 140 mEq/L. The patient
complains of excessive thirst after treatment. What is the likely cause?
A) Hypernatremia from high sodium dialysate
B) Dehydration from excessive ultrafiltration
C) Hyperglycemia
D) Potassium loss
Answer: A
Rationale: A high dialysate sodium concentration (140 mEq/L) can cause sodium
loading and subsequent hypernatremia, which stimulates thirst. Lowering the
dialysate sodium may help control post-dialysis thirst.
,8. Which of the following indicates proper heparinization during dialysis?
A) Venous pressure of 50 mmHg
B) Clear tubing with no visible clots
C) Blood flow rate of 400 mL/min
D) Dialysate temperature of 37°C
Answer: B
Rationale: Clear tubing with no visible clots indicates adequate anticoagulation.
Visible fibrin strands or clots in the venous chamber or tubing suggest insufficient
heparin and risk of dialyzer clotting.
9. A patient has a serum magnesium level of 1.2 mEq/L. What is the most
appropriate dietary teaching?
A) Increase intake of green leafy vegetables
B) Avoid dairy products
C) Limit fluid intake
D) Increase intake of red meat
Answer: A
Rationale: A low magnesium level (1.2 mEq/L) requires dietary intake of
magnesium-rich foods such as green leafy vegetables, nuts, and whole grains. This
should be implemented with monitoring to prevent overshoot.
10. What is the purpose of the venous bubble trap or chamber?
A) To trap air bubbles in the venous line
B) To measure venous pressure
C) To administer medications
D) All of the above
Answer: D
Rationale: The venous bubble trap serves multiple functions: it traps air bubbles
that could cause embolism, provides a site for venous pressure monitoring, and
allows for medication or fluid administration.
11. A patient complains of severe itching all over their body. What is this symptom
most likely related to?
A) Hyperkalemia
B) Hyperphosphatemia with secondary hyperparathyroidism
C) Hyponatremia
D) Hypocalcemia
Answer: B
, Rationale: Uremic pruritus (itching) is strongly associated with hyperphosphatemia
and secondary hyperparathyroidism. Elevated phosphorus and PTH levels lead to
calcium-phosphate deposition in the skin, causing intense itching.
12. What is the normal range for serum bicarbonate in a dialysis patient after
treatment?
A) 15-18 mEq/L
B) 18-22 mEq/L
C) 22-26 mEq/L
D) 26-30 mEq/L
Answer: C
Rationale: The normal serum bicarbonate range is 22-26 mEq/L. In dialysis
patients, the goal is to achieve this range post-treatment to correct metabolic
acidosis.
13. Which of the following vascular access types has the lowest infection rate?
A) Central venous catheter
B) Arteriovenous graft
C) Arteriovenous fistula
D) Peritoneal dialysis catheter
Answer: C
Rationale: Arteriovenous fistulas have the lowest infection rate among vascular
accesses because they are created entirely from the patient's own tissue and are
located in the subcutaneous layer, making them less prone to contamination.
14. A patient is receiving hemodialysis and develops a runny nose, sneezing, and
watery eyes. What should the nurse suspect?
A) Allergic reaction to the dialyzer
B) Hypersensitivity to heparin
C) Flu-like illness
D) Pyrogenic reaction
Answer: A
Rationale: Symptoms of runny nose, sneezing, and watery eyes during dialysis
suggest a Type I hypersensitivity reaction to the dialyzer membrane or ethylene
oxide used in sterilization. This requires switching to a different dialyzer type.
15. What is the recommended blood flow rate for a patient with a newly cannulated
AV fistula?
A) 150-200 mL/min
B) 250-300 mL/min
CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+
1. A patient's dialyzer has clotted during treatment. What is the most likely cause
of this complication?
A) Insufficient heparin dose
B) Excessive ultrafiltration
C) High blood flow rate
D) Low dialysate temperature
Answer: A
Rationale: Inadequate heparinization is the most common cause of dialyzer
clotting. When the heparin dose is insufficient, fibrin formation occurs within the
hollow fibers, leading to clot formation and loss of the dialyzer.
2. What is the primary reason for using a high-flux dialyzer?
A) To remove larger middle molecules more effectively
B) To increase ultrafiltration capacity
C) To reduce treatment time
D) To decrease heparin requirements
Answer: A
Rationale: High-flux dialyzers have larger pores that allow for better clearance of
middle-molecular-weight toxins such as beta-2-microglobulin, which is associated
with dialysis-related amyloidosis.
3. A patient's arterial pressure is reading -250 mmHg. What does this indicate?
A) Adequate blood flow
B) Access stenosis or needle against the vessel wall
C) Venous obstruction
D) Normal operating range
Answer: B
Rationale: An arterial pressure of -250 mmHg indicates excessive negative
pressure, which is often caused by access stenosis or the needle being positioned
against the vessel wall. This restricts blood flow and requires intervention.
4. What is the primary purpose of the dialysate conductivity monitor?
A) To measure electrolyte concentration in the dialysate
,B) To monitor dialysate temperature
C) To detect blood leaks
D) To measure ultrafiltration rate
Answer: A
Rationale: The conductivity monitor measures the electrolyte concentration
(primarily sodium) in the dialysate. Any deviation from the set conductivity
triggers an alarm to prevent delivery of incorrect dialysate composition.
5. A patient with a new AV fistula presents with a very weak thrill on
postoperative day 1. What is the most appropriate nursing action?
A) Document the finding and continue to monitor
B) Apply a warm compress to promote flow
C) Notify the surgeon or nephrologist immediately
D) Elevate the arm to reduce swelling
Answer: C
Rationale: A weak thrill on the first postoperative day may indicate thrombosis or
poor vessel maturation. The surgeon or nephrologist must be notified immediately
for urgent Doppler ultrasound evaluation.
6. What is the correct ratio of dialysate flow to blood flow for optimal clearance?
A) 1:1 ratio
B) 1.5:1 ratio
C) 2:1 ratio
D) 3:1 ratio
Answer: C
Rationale: A dialysate flow rate that is approximately twice the blood flow rate
(2:1 ratio) provides optimal clearance by maintaining a concentration gradient
across the dialyzer membrane throughout the treatment.
7. A patient receives dialysis with a dialysate sodium of 140 mEq/L. The patient
complains of excessive thirst after treatment. What is the likely cause?
A) Hypernatremia from high sodium dialysate
B) Dehydration from excessive ultrafiltration
C) Hyperglycemia
D) Potassium loss
Answer: A
Rationale: A high dialysate sodium concentration (140 mEq/L) can cause sodium
loading and subsequent hypernatremia, which stimulates thirst. Lowering the
dialysate sodium may help control post-dialysis thirst.
,8. Which of the following indicates proper heparinization during dialysis?
A) Venous pressure of 50 mmHg
B) Clear tubing with no visible clots
C) Blood flow rate of 400 mL/min
D) Dialysate temperature of 37°C
Answer: B
Rationale: Clear tubing with no visible clots indicates adequate anticoagulation.
Visible fibrin strands or clots in the venous chamber or tubing suggest insufficient
heparin and risk of dialyzer clotting.
9. A patient has a serum magnesium level of 1.2 mEq/L. What is the most
appropriate dietary teaching?
A) Increase intake of green leafy vegetables
B) Avoid dairy products
C) Limit fluid intake
D) Increase intake of red meat
Answer: A
Rationale: A low magnesium level (1.2 mEq/L) requires dietary intake of
magnesium-rich foods such as green leafy vegetables, nuts, and whole grains. This
should be implemented with monitoring to prevent overshoot.
10. What is the purpose of the venous bubble trap or chamber?
A) To trap air bubbles in the venous line
B) To measure venous pressure
C) To administer medications
D) All of the above
Answer: D
Rationale: The venous bubble trap serves multiple functions: it traps air bubbles
that could cause embolism, provides a site for venous pressure monitoring, and
allows for medication or fluid administration.
11. A patient complains of severe itching all over their body. What is this symptom
most likely related to?
A) Hyperkalemia
B) Hyperphosphatemia with secondary hyperparathyroidism
C) Hyponatremia
D) Hypocalcemia
Answer: B
, Rationale: Uremic pruritus (itching) is strongly associated with hyperphosphatemia
and secondary hyperparathyroidism. Elevated phosphorus and PTH levels lead to
calcium-phosphate deposition in the skin, causing intense itching.
12. What is the normal range for serum bicarbonate in a dialysis patient after
treatment?
A) 15-18 mEq/L
B) 18-22 mEq/L
C) 22-26 mEq/L
D) 26-30 mEq/L
Answer: C
Rationale: The normal serum bicarbonate range is 22-26 mEq/L. In dialysis
patients, the goal is to achieve this range post-treatment to correct metabolic
acidosis.
13. Which of the following vascular access types has the lowest infection rate?
A) Central venous catheter
B) Arteriovenous graft
C) Arteriovenous fistula
D) Peritoneal dialysis catheter
Answer: C
Rationale: Arteriovenous fistulas have the lowest infection rate among vascular
accesses because they are created entirely from the patient's own tissue and are
located in the subcutaneous layer, making them less prone to contamination.
14. A patient is receiving hemodialysis and develops a runny nose, sneezing, and
watery eyes. What should the nurse suspect?
A) Allergic reaction to the dialyzer
B) Hypersensitivity to heparin
C) Flu-like illness
D) Pyrogenic reaction
Answer: A
Rationale: Symptoms of runny nose, sneezing, and watery eyes during dialysis
suggest a Type I hypersensitivity reaction to the dialyzer membrane or ethylene
oxide used in sterilization. This requires switching to a different dialyzer type.
15. What is the recommended blood flow rate for a patient with a newly cannulated
AV fistula?
A) 150-200 mL/min
B) 250-300 mL/min
