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DaVita RN Final Exam 2026/2027 Actual Exam |
Complete Practice Questions & Verified Answers
| Pass Guaranteed - A+ Graded
Section 1: Principles of Hemodialysis (15 Questions)
Q1: The primary mechanism by which urea and other small molecules are removed during
hemodialysis is:
A. Ultrafiltration
B. Diffusion [CORRECT]
C. Osmosis
D. Convection
Correct Answer: B
Rationale: Diffusion is the movement of solutes from an area of higher concentration (blood) to
lower concentration (dialysate) across a semipermeable membrane. Ultrafiltration (A) removes
fluid by pressure gradient. Osmosis (C) is water movement across a membrane. Convection (D)
is solute removal with solvent drag during ultrafiltration.
Q2: A patient's pre-dialysis BUN is 80 mg/dL and post-dialysis BUN is 20 mg/dL. What is the
urea reduction ratio (URR)?
A. 25%
B. 50%
C. 75% [CORRECT]
D. 80%
Correct Answer: C
Rationale: URR = [(Pre BUN - Post BUN) / Pre BUN] × 100 = [(80 - 20) / 80] × 100 = (60/80) ×
100 = 75%. Adequate dialysis typically targets URR ≥65-70%.
Q3: Which of the following dialysate components is increased to correct metabolic acidosis in
dialysis patients?
A. Sodium
B. Potassium
,2
C. Bicarbonate [CORRECT]
D. Calcium
Correct Answer: C
Rationale: Bicarbonate is added to dialysate to correct metabolic acidosis by diffusing into the
blood. Sodium (A) affects osmolality. Potassium (B) is adjusted based on serum levels. Calcium
(D) affects bone metabolism and cardiac function.
Q4: The minimum acceptable standards for water quality in hemodialysis according to
AAMI/ISO include:
A. No bacterial growth allowed
B. <100 CFU/mL bacteria and <0.25 EU/mL endotoxin [CORRECT]
C. <1000 CFU/mL bacteria
D. No standards exist for water quality
Correct Answer: B
Rationale: AAMI/ISO standards require water for dialysis to have <100 CFU/mL bacteria and
<0.25 EU/mL endotoxin. Option A is unrealistic. Option C exceeds standards. Option D is
incorrect.
Q5: Which factor primarily drives ultrafiltration during hemodialysis?
A. Dialysate flow rate
B. Transmembrane pressure (TMP) [CORRECT]
C. Blood flow rate
D. Dialysate temperature
Correct Answer: B
Rationale: Ultrafiltration is driven by transmembrane pressure—the pressure gradient between
the blood compartment and dialysate compartment. Higher TMP increases fluid removal.
Q6: A patient has a pre-dialysis BUN of 90 mg/dL, post-dialysis BUN of 25 mg/dL, and the
dialysis duration was 4 hours. If the patient has a V (urea distribution volume) of 40L, which
Kt/V calculation is correct?
A. Kt/V = 1.0
B. Kt/V = 1.2 [CORRECT]
C. Kt/V = 1.4
,3
D. Kt/V = 0.8
Correct Answer: B
Rationale: Kt/V can be estimated using natural logarithm: Kt/V = -ln(post/pre) = -ln(25/90) = -
ln(0.278) = 1.28 ≈ 1.2. This meets the minimum adequacy target.
Q7: The dialysate sodium concentration is typically set at:
A. 100-110 mEq/L
B. 120-130 mEq/L
C. 135-145 mEq/L [CORRECT]
D. 150-160 mEq/L
Correct Answer: C
Rationale: Standard dialysate sodium ranges from 135-145 mEq/L, matching normal serum
sodium levels. Lower sodium may cause hypotension; higher sodium may cause thirst and fluid
retention.
Q8: Which of the following best describes the concept of "sodium modeling"?
A. Keeping dialysate sodium constant throughout treatment
B. Varying dialysate sodium concentration during treatment to improve tolerance [CORRECT]
C. Adding sodium to the dialysate only at the beginning
D. Removing all sodium from dialysate
Correct Answer: B
Rationale: Sodium modeling varies dialysate sodium (often higher at start, lower at end) to
reduce intradialytic hypotension and cramps while preventing sodium gain.
Q9: The primary purpose of the reverse osmosis (RO) system in water treatment is to:
A. Add minerals to water
B. Remove bacteria only
C. Remove dissolved inorganic ions and contaminants [CORRECT]
D. Heat the water
Correct Answer: C
Rationale: Reverse osmosis removes dissolved inorganic ions, bacteria, endotoxins, and other
contaminants by forcing water through a semipermeable membrane.
, 4
Q10: Which of the following is a characteristic of high-flux dialyzers compared to low-flux
dialyzers?
A. Lower ultrafiltration coefficients
B. Smaller pore size
C. Better removal of middle molecules (β2-microglobulin) [CORRECT]
D. Lower clearance of small solutes
Correct Answer: C
Rationale: High-flux dialyzers have larger pore sizes and higher ultrafiltration coefficients,
allowing better removal of middle molecules like β2-microglobulin while maintaining small
solute clearance.
Q11: During dialysis, a patient develops severe itching and chest tightness immediately after
initiation. This is most suggestive of:
A. Hemolysis
B. Type A dialyzer reaction (anaphylactic) [CORRECT]
C. Air embolism
D. Disequilibrium syndrome
Correct Answer: B
Rationale: Type A dialyzer reactions occur within minutes of dialysis start, causing anaphylaxis-
like symptoms (itching, chest tightness, dyspnea, hypotension) due to ethylene oxide or
membrane reactions.
Q12: Which of the following is the primary determinant of dialysis adequacy?
A. Blood flow rate alone
B. Dialysate flow rate alone
C. The combination of treatment time and clearance (Kt/V) [CORRECT]
D. Patient's age
Correct Answer: C
Rationale: Dialysis adequacy depends on the clearance of urea (K), treatment time (t), and
volume of distribution (V), expressed as Kt/V. All factors must be optimized.
Q13: A patient with a large surface area dialyzer and high blood flow rate still has inadequate
Kt/V. Which factor should be assessed?
DaVita RN Final Exam 2026/2027 Actual Exam |
Complete Practice Questions & Verified Answers
| Pass Guaranteed - A+ Graded
Section 1: Principles of Hemodialysis (15 Questions)
Q1: The primary mechanism by which urea and other small molecules are removed during
hemodialysis is:
A. Ultrafiltration
B. Diffusion [CORRECT]
C. Osmosis
D. Convection
Correct Answer: B
Rationale: Diffusion is the movement of solutes from an area of higher concentration (blood) to
lower concentration (dialysate) across a semipermeable membrane. Ultrafiltration (A) removes
fluid by pressure gradient. Osmosis (C) is water movement across a membrane. Convection (D)
is solute removal with solvent drag during ultrafiltration.
Q2: A patient's pre-dialysis BUN is 80 mg/dL and post-dialysis BUN is 20 mg/dL. What is the
urea reduction ratio (URR)?
A. 25%
B. 50%
C. 75% [CORRECT]
D. 80%
Correct Answer: C
Rationale: URR = [(Pre BUN - Post BUN) / Pre BUN] × 100 = [(80 - 20) / 80] × 100 = (60/80) ×
100 = 75%. Adequate dialysis typically targets URR ≥65-70%.
Q3: Which of the following dialysate components is increased to correct metabolic acidosis in
dialysis patients?
A. Sodium
B. Potassium
,2
C. Bicarbonate [CORRECT]
D. Calcium
Correct Answer: C
Rationale: Bicarbonate is added to dialysate to correct metabolic acidosis by diffusing into the
blood. Sodium (A) affects osmolality. Potassium (B) is adjusted based on serum levels. Calcium
(D) affects bone metabolism and cardiac function.
Q4: The minimum acceptable standards for water quality in hemodialysis according to
AAMI/ISO include:
A. No bacterial growth allowed
B. <100 CFU/mL bacteria and <0.25 EU/mL endotoxin [CORRECT]
C. <1000 CFU/mL bacteria
D. No standards exist for water quality
Correct Answer: B
Rationale: AAMI/ISO standards require water for dialysis to have <100 CFU/mL bacteria and
<0.25 EU/mL endotoxin. Option A is unrealistic. Option C exceeds standards. Option D is
incorrect.
Q5: Which factor primarily drives ultrafiltration during hemodialysis?
A. Dialysate flow rate
B. Transmembrane pressure (TMP) [CORRECT]
C. Blood flow rate
D. Dialysate temperature
Correct Answer: B
Rationale: Ultrafiltration is driven by transmembrane pressure—the pressure gradient between
the blood compartment and dialysate compartment. Higher TMP increases fluid removal.
Q6: A patient has a pre-dialysis BUN of 90 mg/dL, post-dialysis BUN of 25 mg/dL, and the
dialysis duration was 4 hours. If the patient has a V (urea distribution volume) of 40L, which
Kt/V calculation is correct?
A. Kt/V = 1.0
B. Kt/V = 1.2 [CORRECT]
C. Kt/V = 1.4
,3
D. Kt/V = 0.8
Correct Answer: B
Rationale: Kt/V can be estimated using natural logarithm: Kt/V = -ln(post/pre) = -ln(25/90) = -
ln(0.278) = 1.28 ≈ 1.2. This meets the minimum adequacy target.
Q7: The dialysate sodium concentration is typically set at:
A. 100-110 mEq/L
B. 120-130 mEq/L
C. 135-145 mEq/L [CORRECT]
D. 150-160 mEq/L
Correct Answer: C
Rationale: Standard dialysate sodium ranges from 135-145 mEq/L, matching normal serum
sodium levels. Lower sodium may cause hypotension; higher sodium may cause thirst and fluid
retention.
Q8: Which of the following best describes the concept of "sodium modeling"?
A. Keeping dialysate sodium constant throughout treatment
B. Varying dialysate sodium concentration during treatment to improve tolerance [CORRECT]
C. Adding sodium to the dialysate only at the beginning
D. Removing all sodium from dialysate
Correct Answer: B
Rationale: Sodium modeling varies dialysate sodium (often higher at start, lower at end) to
reduce intradialytic hypotension and cramps while preventing sodium gain.
Q9: The primary purpose of the reverse osmosis (RO) system in water treatment is to:
A. Add minerals to water
B. Remove bacteria only
C. Remove dissolved inorganic ions and contaminants [CORRECT]
D. Heat the water
Correct Answer: C
Rationale: Reverse osmosis removes dissolved inorganic ions, bacteria, endotoxins, and other
contaminants by forcing water through a semipermeable membrane.
, 4
Q10: Which of the following is a characteristic of high-flux dialyzers compared to low-flux
dialyzers?
A. Lower ultrafiltration coefficients
B. Smaller pore size
C. Better removal of middle molecules (β2-microglobulin) [CORRECT]
D. Lower clearance of small solutes
Correct Answer: C
Rationale: High-flux dialyzers have larger pore sizes and higher ultrafiltration coefficients,
allowing better removal of middle molecules like β2-microglobulin while maintaining small
solute clearance.
Q11: During dialysis, a patient develops severe itching and chest tightness immediately after
initiation. This is most suggestive of:
A. Hemolysis
B. Type A dialyzer reaction (anaphylactic) [CORRECT]
C. Air embolism
D. Disequilibrium syndrome
Correct Answer: B
Rationale: Type A dialyzer reactions occur within minutes of dialysis start, causing anaphylaxis-
like symptoms (itching, chest tightness, dyspnea, hypotension) due to ethylene oxide or
membrane reactions.
Q12: Which of the following is the primary determinant of dialysis adequacy?
A. Blood flow rate alone
B. Dialysate flow rate alone
C. The combination of treatment time and clearance (Kt/V) [CORRECT]
D. Patient's age
Correct Answer: C
Rationale: Dialysis adequacy depends on the clearance of urea (K), treatment time (t), and
volume of distribution (V), expressed as Kt/V. All factors must be optimized.
Q13: A patient with a large surface area dialyzer and high blood flow rate still has inadequate
Kt/V. Which factor should be assessed?
