1
DaVita RN Final Exam 2026/2027 Actual Exam |
Complete Questions & Verified Correct Answers |
Graded A+ | Pass Guaranteed - A+ Graded
Section 1: Principles of Hemodialysis
Q1: Primary Mechanism of Urea Removal
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: Urea Reduction Ratio (URR) Calculation
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: Dialysate Component for Metabolic Acidosis
,2
Which of the following dialysate components is increased to correct metabolic acidosis in
dialysis patients?
A. Sodium
B. Potassium
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: Water Quality Standards (AAMI/ISO)
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: Ultrafiltration Principle
Ultrafiltration during hemodialysis is driven by:
A. Osmotic pressure
B. Hydrostatic pressure gradient [CORRECT]
C. Electrical charge
D. Temperature difference
Correct Answer: B
Rationale: Ultrafiltration is the removal of fluid from the blood by applying a hydrostatic
pressure gradient across the dialyzer membrane. Osmotic pressure (A) affects water movement
but is not the primary driver. Electrical charge (C) and temperature (D) are not relevant.
Q6: Dialysis Adequacy (Kt/V)
,3
The Kt/V formula is used to measure:
A. Blood flow rate
B. Dialysis adequacy [CORRECT]
C. Ultrafiltration rate
D. Dialysate flow rate
Correct Answer: B
Rationale: Kt/V is a dimensionless ratio used to quantify dialysis adequacy, where K is dialyzer
clearance, t is time, and V is urea distribution volume. Options A, C, and D are operational
parameters, not adequacy measures.
Q7: Dialysate Sodium Concentration
The typical sodium concentration in dialysate is:
A. 120 mEq/L
B. 135 mEq/L
C. 140 mEq/L [CORRECT]
D. 150 mEq/L
Correct Answer: C
Rationale: Dialysate sodium is typically 135-145 mEq/L, with 140 mEq/L being standard.
Options A and B are too low. Option D is too high and could cause hypernatremia.
Q8: Convection in Hemodialysis
Convection during hemodialysis refers to:
A. Movement of solutes due to concentration gradient
B. Movement of solutes with solvent (water) due to ultrafiltration [CORRECT]
C. Movement of water due to osmotic pressure
D. Electrical repulsion of ions
Correct Answer: B
Rationale: Convection is the "solvent drag" effect where solutes are carried with water during
ultrafiltration. Option A describes diffusion. Option C describes osmosis. Option D is not a
dialysis mechanism.
Q9: Dialysate Potassium Adjustment
A patient with hyperkalemia (K+ 6.0 mEq/L) should have their dialysate potassium set to:
A. 0 mEq/L
, 4
B. 1 mEq/L
C. 2 mEq/L [CORRECT]
D. 4 mEq/L
Correct Answer: C
Rationale: For hyperkalemia, dialysate potassium is typically lowered to 1-2 mEq/L to promote
potassium removal. Option A (0 mEq/L) risks arrhythmias. Option D (4 mEq/L) is standard for
normokalemia.
Q10: Dialysate Calcium Levels
Standard dialysate calcium concentrations are:
A. 1.0 mEq/L
B. 2.5 mEq/L [CORRECT]
C. 5.0 mEq/L
D. 8.0 mEq/L
Correct Answer: B
Rationale: Dialysate calcium is typically 2.5-3.5 mEq/L. Option A is too low. Options C and D
are excessively high and could cause hypercalcemia.
Q11: Dialysis Membrane Types
High-flux dialyzers are characterized by:
A. Low permeability to small molecules
B. High permeability to both small and middle molecules [CORRECT]
C. Reuse capability only
D. Exclusive use in pediatric patients
Correct Answer: B
Rationale: High-flux membranes have larger pores, allowing clearance of middle molecules
(e.g., beta-2 microglobulin) in addition to small molecules. Option A describes low-flux. Options
C and D are incorrect.
Q12: Dialysis Machine Alarms
A high venous pressure alarm during dialysis may indicate:
A. Arterial needle infiltration
B. Venous needle infiltration
DaVita RN Final Exam 2026/2027 Actual Exam |
Complete Questions & Verified Correct Answers |
Graded A+ | Pass Guaranteed - A+ Graded
Section 1: Principles of Hemodialysis
Q1: Primary Mechanism of Urea Removal
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: Urea Reduction Ratio (URR) Calculation
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: Dialysate Component for Metabolic Acidosis
,2
Which of the following dialysate components is increased to correct metabolic acidosis in
dialysis patients?
A. Sodium
B. Potassium
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: Water Quality Standards (AAMI/ISO)
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: Ultrafiltration Principle
Ultrafiltration during hemodialysis is driven by:
A. Osmotic pressure
B. Hydrostatic pressure gradient [CORRECT]
C. Electrical charge
D. Temperature difference
Correct Answer: B
Rationale: Ultrafiltration is the removal of fluid from the blood by applying a hydrostatic
pressure gradient across the dialyzer membrane. Osmotic pressure (A) affects water movement
but is not the primary driver. Electrical charge (C) and temperature (D) are not relevant.
Q6: Dialysis Adequacy (Kt/V)
,3
The Kt/V formula is used to measure:
A. Blood flow rate
B. Dialysis adequacy [CORRECT]
C. Ultrafiltration rate
D. Dialysate flow rate
Correct Answer: B
Rationale: Kt/V is a dimensionless ratio used to quantify dialysis adequacy, where K is dialyzer
clearance, t is time, and V is urea distribution volume. Options A, C, and D are operational
parameters, not adequacy measures.
Q7: Dialysate Sodium Concentration
The typical sodium concentration in dialysate is:
A. 120 mEq/L
B. 135 mEq/L
C. 140 mEq/L [CORRECT]
D. 150 mEq/L
Correct Answer: C
Rationale: Dialysate sodium is typically 135-145 mEq/L, with 140 mEq/L being standard.
Options A and B are too low. Option D is too high and could cause hypernatremia.
Q8: Convection in Hemodialysis
Convection during hemodialysis refers to:
A. Movement of solutes due to concentration gradient
B. Movement of solutes with solvent (water) due to ultrafiltration [CORRECT]
C. Movement of water due to osmotic pressure
D. Electrical repulsion of ions
Correct Answer: B
Rationale: Convection is the "solvent drag" effect where solutes are carried with water during
ultrafiltration. Option A describes diffusion. Option C describes osmosis. Option D is not a
dialysis mechanism.
Q9: Dialysate Potassium Adjustment
A patient with hyperkalemia (K+ 6.0 mEq/L) should have their dialysate potassium set to:
A. 0 mEq/L
, 4
B. 1 mEq/L
C. 2 mEq/L [CORRECT]
D. 4 mEq/L
Correct Answer: C
Rationale: For hyperkalemia, dialysate potassium is typically lowered to 1-2 mEq/L to promote
potassium removal. Option A (0 mEq/L) risks arrhythmias. Option D (4 mEq/L) is standard for
normokalemia.
Q10: Dialysate Calcium Levels
Standard dialysate calcium concentrations are:
A. 1.0 mEq/L
B. 2.5 mEq/L [CORRECT]
C. 5.0 mEq/L
D. 8.0 mEq/L
Correct Answer: B
Rationale: Dialysate calcium is typically 2.5-3.5 mEq/L. Option A is too low. Options C and D
are excessively high and could cause hypercalcemia.
Q11: Dialysis Membrane Types
High-flux dialyzers are characterized by:
A. Low permeability to small molecules
B. High permeability to both small and middle molecules [CORRECT]
C. Reuse capability only
D. Exclusive use in pediatric patients
Correct Answer: B
Rationale: High-flux membranes have larger pores, allowing clearance of middle molecules
(e.g., beta-2 microglobulin) in addition to small molecules. Option A describes low-flux. Options
C and D are incorrect.
Q12: Dialysis Machine Alarms
A high venous pressure alarm during dialysis may indicate:
A. Arterial needle infiltration
B. Venous needle infiltration
