,DaVita Competency Exam | Comprehensive Study Guide | Questions and
Answers + Expert Rationales | 2026/27 Updated | 100% Pass Guarantee
1. Attempting to remove a large amount of fluid weight gain from the patient:
A. Is safe as long as the patient is monitored
B. Results in better blood pressure control
C. Can lead to hypovolemia during the treatment which is associated with an
increased mortality rate (✔ Correct Answer)
D. Is recommended for all patients
Expert Rationale: Aggressive ultrafiltration to remove large fluid gains increases the
risk of intradialytic hypotension and hypovolemia. These episodes are independently
associated with higher mortality rates due to cardiac stunning, ischemia, and end-
organ damage. Fluid removal should be gradual and within the patient's
hemodynamic tolerance.
2. When sodium loading occurs during the dialysis treatment:
A. It has no effect on the patient
B. It causes hypokalemia
C. It leads to an increase in thirst and larger fluid weight gains with
hypertension between treatments and can contribute to headaches after the
treatment (✔ Correct Answer)
D. It improves blood pressure control
Expert Rationale: High sodium dialysate causes a positive sodium balance (sodium
loading). This increases serum osmolality, stimulating thirst and leading to increased
interdialytic fluid intake. The result is larger weight gains, hypertension, and post-
dialysis headaches due to osmotic shifts. Proper dialysate sodium prescription is
critical.
3. How long before initiating the hemodialysis treatment should the initial
loading dose of heparin be administered through the venous needle or venous
, port of the central venous catheter (CVC) to anticoagulate the patient?
A. Immediately before starting the pump
B. 1-2 minutes prior
C. A minimum of 3-5 minutes prior to treatment initiation (✔ Correct Answer)
D. 10-15 minutes prior
Expert Rationale: Heparin requires 3-5 minutes to distribute and bind to
antithrombin III to achieve systemic anticoagulation. Administering the bolus
through the venous port and waiting this interval ensures adequate anticoagulation
before blood is pumped through the extracorporeal circuit, preventing clotting.
4. Over-the-counter medications:
A. Require a physician order at all times
B. Are always safe for dialysis patients
C. Do not require a physician order but should be approved by the
nephrologist (✔ Correct Answer)
D. Should never be taken by dialysis patients
Expert Rationale: Over-the-counter (OTC) medications do not legally require a
prescription, but they can have significant effects in dialysis patients (e.g., NSAIDs
causing renal injury, magnesium-containing antacids causing hypermagnesemia). The
nephrologist should approve all OTC medications to ensure safety.
5. Per DaVita policy, prior to each medication preparation, the medication
preparation surface area:
A. Should be wiped with a dry cloth
B. Is to be disinfected with a 1:100 bleach solution or approved disinfectant (✔
Correct Answer)
C. Only needs to be cleaned weekly
D. Does not require disinfection
Expert Rationale: Medication preparation areas must be disinfected before each use
to prevent contamination. DaVita policy specifies a 1:100 bleach solution or an EPA-
approved hospital-grade disinfectant to eliminate pathogens that could compromise
sterility and patient safety.
Answers + Expert Rationales | 2026/27 Updated | 100% Pass Guarantee
1. Attempting to remove a large amount of fluid weight gain from the patient:
A. Is safe as long as the patient is monitored
B. Results in better blood pressure control
C. Can lead to hypovolemia during the treatment which is associated with an
increased mortality rate (✔ Correct Answer)
D. Is recommended for all patients
Expert Rationale: Aggressive ultrafiltration to remove large fluid gains increases the
risk of intradialytic hypotension and hypovolemia. These episodes are independently
associated with higher mortality rates due to cardiac stunning, ischemia, and end-
organ damage. Fluid removal should be gradual and within the patient's
hemodynamic tolerance.
2. When sodium loading occurs during the dialysis treatment:
A. It has no effect on the patient
B. It causes hypokalemia
C. It leads to an increase in thirst and larger fluid weight gains with
hypertension between treatments and can contribute to headaches after the
treatment (✔ Correct Answer)
D. It improves blood pressure control
Expert Rationale: High sodium dialysate causes a positive sodium balance (sodium
loading). This increases serum osmolality, stimulating thirst and leading to increased
interdialytic fluid intake. The result is larger weight gains, hypertension, and post-
dialysis headaches due to osmotic shifts. Proper dialysate sodium prescription is
critical.
3. How long before initiating the hemodialysis treatment should the initial
loading dose of heparin be administered through the venous needle or venous
, port of the central venous catheter (CVC) to anticoagulate the patient?
A. Immediately before starting the pump
B. 1-2 minutes prior
C. A minimum of 3-5 minutes prior to treatment initiation (✔ Correct Answer)
D. 10-15 minutes prior
Expert Rationale: Heparin requires 3-5 minutes to distribute and bind to
antithrombin III to achieve systemic anticoagulation. Administering the bolus
through the venous port and waiting this interval ensures adequate anticoagulation
before blood is pumped through the extracorporeal circuit, preventing clotting.
4. Over-the-counter medications:
A. Require a physician order at all times
B. Are always safe for dialysis patients
C. Do not require a physician order but should be approved by the
nephrologist (✔ Correct Answer)
D. Should never be taken by dialysis patients
Expert Rationale: Over-the-counter (OTC) medications do not legally require a
prescription, but they can have significant effects in dialysis patients (e.g., NSAIDs
causing renal injury, magnesium-containing antacids causing hypermagnesemia). The
nephrologist should approve all OTC medications to ensure safety.
5. Per DaVita policy, prior to each medication preparation, the medication
preparation surface area:
A. Should be wiped with a dry cloth
B. Is to be disinfected with a 1:100 bleach solution or approved disinfectant (✔
Correct Answer)
C. Only needs to be cleaned weekly
D. Does not require disinfection
Expert Rationale: Medication preparation areas must be disinfected before each use
to prevent contamination. DaVita policy specifies a 1:100 bleach solution or an EPA-
approved hospital-grade disinfectant to eliminate pathogens that could compromise
sterility and patient safety.
