DaVita PCT Advanced Certification Examination: Hemodialysis
Transport Mechanisms, Ultrafiltration, Diffusion, Convection,
Osmosis, Renal Physiology, Electrolyte Regulation, Potassium
Disorders, Acid–Base Balance, Uremia Management, Chronic Kidney
Disease, Acute Kidney Injury, Fluid Overload, Hypertension, Left
Ventricular Hypertrophy, Anemia Management, Erythropoietin
Therapy, Mineral and Bone Disorder, Calcium–Phosphorus Control,
Vitamin D Metabolism, Vascular Access Safety, Catheter Infection
Prevention, Hand Hygiene, Infection Control Standards, Patient
Assessment, Blood Pressure Monitoring, Nutritional Status
Evaluation, Dialysis Complications, Quality Patient Care, Clinical
Decision-Making, and Kidney Function Preservation Exam Questions
Verified and Provided with Complete A+ Graded Answers Latest
Updated 2026
Explain the four transport mechanisms that play a role in hemodialysis
● Ultrafiltration: Fluid is pushed through a semipermeable membrane.
● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved through
diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable membrane from
the side with the higher concentration to the side with the lower concentration. This
difference in solute concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion occurs. Once the
concentration of a dissolved particle is the same on both sides of the semipermeable
membrane, diffusion stops.
,● Osmosis: Is a chemical process by which dissolved chemicals will migrate from an area of
high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved compounds
(called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions
To normalize electrolytes, remove wastes, provide fluid and nutrient balance
What is the function of the acid concentration
Provides the concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate
Buffers the acid concentrate
Signs and symptoms of hyperkalemia
> 5.5 mEq: extreme muscle weakness, abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia
,< 3.5 mEq: fatigue, muscle weakness, paralysis, respiratory failure, cardiac instability,
arrhythmias, cardiac arrest
What are the kidneys endocrine functions
Renin secretion, Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions
Provide medications
How much of normal kidney function is replaced by hemodialysis
15%
What is uremia and how does it affect the body?
Uremia is a buildup of wastes in the blood due to kidney failure and affects all body systems.
What are the most common causes of CKD in the usa?
Diabetes
Hypertension
Polycystic Kidney Disease
, Outline the treatment goals for a patient with CKD
-slowing the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD
So the nurse and PCT can inquire about possible problems during data collection and
assessment
Why is sodium balance important?
Leads to volume expansion, increased cardiac output, increased peripheral vascular
resistance, and increased blood pressure
Signs and symptoms of fluid imbalance
Edema, hypertension, shortness of breath
Systemic effects of CKD what would you advise for a patient who complains of: dry itchy skin,
peripheral neuropathy(nerve pain in extremities) and gi problems
Use hyper-fatted soaps and lotions, monitor patient for changes in motor function and inform
RN and physician of any bleeding problems/constipation/diarrhea
Transport Mechanisms, Ultrafiltration, Diffusion, Convection,
Osmosis, Renal Physiology, Electrolyte Regulation, Potassium
Disorders, Acid–Base Balance, Uremia Management, Chronic Kidney
Disease, Acute Kidney Injury, Fluid Overload, Hypertension, Left
Ventricular Hypertrophy, Anemia Management, Erythropoietin
Therapy, Mineral and Bone Disorder, Calcium–Phosphorus Control,
Vitamin D Metabolism, Vascular Access Safety, Catheter Infection
Prevention, Hand Hygiene, Infection Control Standards, Patient
Assessment, Blood Pressure Monitoring, Nutritional Status
Evaluation, Dialysis Complications, Quality Patient Care, Clinical
Decision-Making, and Kidney Function Preservation Exam Questions
Verified and Provided with Complete A+ Graded Answers Latest
Updated 2026
Explain the four transport mechanisms that play a role in hemodialysis
● Ultrafiltration: Fluid is pushed through a semipermeable membrane.
● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved through
diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable membrane from
the side with the higher concentration to the side with the lower concentration. This
difference in solute concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion occurs. Once the
concentration of a dissolved particle is the same on both sides of the semipermeable
membrane, diffusion stops.
,● Osmosis: Is a chemical process by which dissolved chemicals will migrate from an area of
high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved compounds
(called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions
To normalize electrolytes, remove wastes, provide fluid and nutrient balance
What is the function of the acid concentration
Provides the concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate
Buffers the acid concentrate
Signs and symptoms of hyperkalemia
> 5.5 mEq: extreme muscle weakness, abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia
,< 3.5 mEq: fatigue, muscle weakness, paralysis, respiratory failure, cardiac instability,
arrhythmias, cardiac arrest
What are the kidneys endocrine functions
Renin secretion, Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions
Provide medications
How much of normal kidney function is replaced by hemodialysis
15%
What is uremia and how does it affect the body?
Uremia is a buildup of wastes in the blood due to kidney failure and affects all body systems.
What are the most common causes of CKD in the usa?
Diabetes
Hypertension
Polycystic Kidney Disease
, Outline the treatment goals for a patient with CKD
-slowing the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD
So the nurse and PCT can inquire about possible problems during data collection and
assessment
Why is sodium balance important?
Leads to volume expansion, increased cardiac output, increased peripheral vascular
resistance, and increased blood pressure
Signs and symptoms of fluid imbalance
Edema, hypertension, shortness of breath
Systemic effects of CKD what would you advise for a patient who complains of: dry itchy skin,
peripheral neuropathy(nerve pain in extremities) and gi problems
Use hyper-fatted soaps and lotions, monitor patient for changes in motor function and inform
RN and physician of any bleeding problems/constipation/diarrhea
