DaVita RN Final Exam 2026/2027: Complete
Questions with Verified Correct Answers –
Comprehensive Review for Dialysis Nurses –
Graded A+
SECTION 1: RENAL PHYSIOLOGY AND PATHOPHYSIOLOGY (Questions 1-15)
Q1: The kidneys perform multiple critical functions. Which of the following is an
ENDOCRINE function of the kidney?
A. Ultrafiltration of plasma to form urine
B. Activation of vitamin D to calcitriol
C. Excretion of urea and creatinine
D. Regulation of sodium and water balance
Correct Answer: B
Rationale: The kidneys have three endocrine functions: (1) production of renin
(regulates blood pressure via RAAS), (2) production of erythropoietin (stimulates RBC
production in bone marrow), and (3) activation of vitamin D (converts 25-hydroxyvitamin
D to active calcitriol for calcium absorption and bone health). Ultrafiltration (A),
excretion of wastes (C), and electrolyte/fluid balance (D) are excretory functions, not
,endocrine. Understanding kidney functions helps nurses anticipate complications when
these functions fail in ESRD.
(Topic: Kidney Functions | Difficulty: Easy | DaVita Protocol: Core Curriculum)
Q2: A patient has a GFR of 25 mL/min/1.73m². According to CKD staging, this patient
has:
A. Stage 2 CKD
B. Stage 3 CKD
C. Stage 4 CKD
D. Stage 5 CKD
Correct Answer: C
Rationale: CKD staging by GFR: Stage 1 (≥90 with kidney damage), Stage 2 (60-89),
Stage 3 (30-59), Stage 4 (15-29), Stage 5 (<15 or dialysis). GFR 25 falls in Stage 4
(severe decrease in GFR). These patients need preparation for renal replacement
therapy (education, access planning). Stage 5 (D) requires dialysis or transplantation.
Accurate staging guides treatment decisions, medication dosing, and patient education
intensity.
(Topic: CKD Staging | Difficulty: Easy | DaVita Protocol: Clinical Practice Guidelines)
Q3: Which of the following is the most common cause of chronic kidney disease in the
United States?
A. Hypertension
,B. Diabetes mellitus
C. Glomerulonephritis
D. Polycystic kidney disease
Correct Answer: B
Rationale: Diabetes mellitus is the leading cause of CKD and ESRD in the US, accounting
for approximately 44% of new dialysis patients. Hypertension (A) is second (about 28%).
Glomerulonephritis (C) and polycystic kidney disease (D) are less common causes.
Diabetic nephropathy develops over 10-20 years with persistent hyperglycemia causing
glomerular basement membrane thickening and mesangial expansion. DaVita nurses
must understand this epidemiology to anticipate patient populations and provide
diabetes-focused education.
(Topic: CKD Etiology | Difficulty: Easy | DaVita Protocol: Population Health)
Q4: Approximately what percentage of kidney function must be lost before dialysis
initiation is typically required?
A. 50%
B. 65%
C. 75%
D. 90%
Correct Answer: C
Rationale: Patients typically initiate dialysis when GFR falls to 10-15 mL/min,
representing approximately 75-90% loss of kidney function (using 100% as normal GFR
, ~125 mL/min). However, the specific threshold is 75% loss of function (remaining 25%
or less). At this point, uremic symptoms (nausea, anorexia, pruritus, fluid overload,
acidosis, hyperkalemia) become unmanageable with conservative therapy. Early referral
to nephrology (GFR <30) allows for optimal preparation.
(Topic: CKD Progression | Difficulty: Medium | DaVita Protocol: CKD Education)
Q5: Hemodialysis replaces approximately what percentage of normal kidney function?
A. 5%
B. 15%
C. 50%
D. 85%
Correct Answer: B
Rationale: Despite being a life-sustaining therapy, hemodialysis replaces only about 15%
of normal kidney function. This explains why patients still experience limitations, dietary
restrictions, and complications despite regular treatments. Normal kidneys function
24/7; hemodialysis provides intermittent clearance (typically 3 treatments/week × 4
hours). This limited replacement underscores the importance of residual renal function
preservation and why nocturnal/home dialysis (more frequent treatments) may provide
better outcomes.
(Topic: Dialysis Limitations | Difficulty: Easy | DaVita Protocol: Treatment Modalities)
Q6: Left ventricular hypertrophy (LVH) in dialysis patients is primarily a direct result of:
A. Chronic anemia requiring blood transfusions
Questions with Verified Correct Answers –
Comprehensive Review for Dialysis Nurses –
Graded A+
SECTION 1: RENAL PHYSIOLOGY AND PATHOPHYSIOLOGY (Questions 1-15)
Q1: The kidneys perform multiple critical functions. Which of the following is an
ENDOCRINE function of the kidney?
A. Ultrafiltration of plasma to form urine
B. Activation of vitamin D to calcitriol
C. Excretion of urea and creatinine
D. Regulation of sodium and water balance
Correct Answer: B
Rationale: The kidneys have three endocrine functions: (1) production of renin
(regulates blood pressure via RAAS), (2) production of erythropoietin (stimulates RBC
production in bone marrow), and (3) activation of vitamin D (converts 25-hydroxyvitamin
D to active calcitriol for calcium absorption and bone health). Ultrafiltration (A),
excretion of wastes (C), and electrolyte/fluid balance (D) are excretory functions, not
,endocrine. Understanding kidney functions helps nurses anticipate complications when
these functions fail in ESRD.
(Topic: Kidney Functions | Difficulty: Easy | DaVita Protocol: Core Curriculum)
Q2: A patient has a GFR of 25 mL/min/1.73m². According to CKD staging, this patient
has:
A. Stage 2 CKD
B. Stage 3 CKD
C. Stage 4 CKD
D. Stage 5 CKD
Correct Answer: C
Rationale: CKD staging by GFR: Stage 1 (≥90 with kidney damage), Stage 2 (60-89),
Stage 3 (30-59), Stage 4 (15-29), Stage 5 (<15 or dialysis). GFR 25 falls in Stage 4
(severe decrease in GFR). These patients need preparation for renal replacement
therapy (education, access planning). Stage 5 (D) requires dialysis or transplantation.
Accurate staging guides treatment decisions, medication dosing, and patient education
intensity.
(Topic: CKD Staging | Difficulty: Easy | DaVita Protocol: Clinical Practice Guidelines)
Q3: Which of the following is the most common cause of chronic kidney disease in the
United States?
A. Hypertension
,B. Diabetes mellitus
C. Glomerulonephritis
D. Polycystic kidney disease
Correct Answer: B
Rationale: Diabetes mellitus is the leading cause of CKD and ESRD in the US, accounting
for approximately 44% of new dialysis patients. Hypertension (A) is second (about 28%).
Glomerulonephritis (C) and polycystic kidney disease (D) are less common causes.
Diabetic nephropathy develops over 10-20 years with persistent hyperglycemia causing
glomerular basement membrane thickening and mesangial expansion. DaVita nurses
must understand this epidemiology to anticipate patient populations and provide
diabetes-focused education.
(Topic: CKD Etiology | Difficulty: Easy | DaVita Protocol: Population Health)
Q4: Approximately what percentage of kidney function must be lost before dialysis
initiation is typically required?
A. 50%
B. 65%
C. 75%
D. 90%
Correct Answer: C
Rationale: Patients typically initiate dialysis when GFR falls to 10-15 mL/min,
representing approximately 75-90% loss of kidney function (using 100% as normal GFR
, ~125 mL/min). However, the specific threshold is 75% loss of function (remaining 25%
or less). At this point, uremic symptoms (nausea, anorexia, pruritus, fluid overload,
acidosis, hyperkalemia) become unmanageable with conservative therapy. Early referral
to nephrology (GFR <30) allows for optimal preparation.
(Topic: CKD Progression | Difficulty: Medium | DaVita Protocol: CKD Education)
Q5: Hemodialysis replaces approximately what percentage of normal kidney function?
A. 5%
B. 15%
C. 50%
D. 85%
Correct Answer: B
Rationale: Despite being a life-sustaining therapy, hemodialysis replaces only about 15%
of normal kidney function. This explains why patients still experience limitations, dietary
restrictions, and complications despite regular treatments. Normal kidneys function
24/7; hemodialysis provides intermittent clearance (typically 3 treatments/week × 4
hours). This limited replacement underscores the importance of residual renal function
preservation and why nocturnal/home dialysis (more frequent treatments) may provide
better outcomes.
(Topic: Dialysis Limitations | Difficulty: Easy | DaVita Protocol: Treatment Modalities)
Q6: Left ventricular hypertrophy (LVH) in dialysis patients is primarily a direct result of:
A. Chronic anemia requiring blood transfusions
