DAVITA RN 2026 FINAL EXAM | COMPLETE EXAM QUESTIONS
WITH VERIFIED CORRECT ANSWERS AND DETAILED
EXPLANATION – LATEST UPDATE
1. A patient receiving hemodialysis suddenly reports dizziness and
nausea, and the blood pressure falls from 138/78 mmHg to 88/52
mmHg. What should the RN do first?
A. Increase the ultrafiltration rate
B. Assess the patient and intervene for suspected intradialytic hypotension
C. Encourage the patient to ambulate
D. Continue treatment without intervention
Correct Answer: B. Assess the patient and intervene for suspected
intradialytic hypotension
Explanation: A sudden blood-pressure decrease accompanied by symptoms
is concerning for intradialytic hypotension. The RN should immediately assess
the patient, stop or reduce fluid removal as clinically appropriate, position the
patient safely, and follow the dialysis center's emergency protocol. The cause
should then be investigated.
2. Which assessment finding is most important when evaluating an
arteriovenous fistula before initiating dialysis?
A. Presence of a palpable thrill and audible bruit
B. Presence of peripheral edema
C. Patient's respiratory rate only
D. Temperature of the opposite extremity
Correct Answer: A. Presence of a palpable thrill and audible bruit
Explanation: A functioning AV fistula should generally have a palpable thrill
and an audible bruit. Absence or a significant change in these findings can
indicate impaired blood flow or thrombosis and requires prompt evaluation
before cannulation.
pg. 1
,3. Which action should the RN avoid when caring for a patient's AV
fistula arm?
A. Assessing the access
B. Checking for a thrill
C. Measuring blood pressure on the access arm
D. Inspecting the skin
Correct Answer: C. Measuring blood pressure on the access arm
Explanation: Blood-pressure measurements and unnecessary compression of
an AV access can compromise blood flow. The access arm should be protected
from avoidable pressure, trauma, and venipuncture according to facility
policy.
4. A patient develops muscle cramps during dialysis. Which factor is
commonly associated with this complication?
A. Excessive or rapid fluid removal
B. Excessive oxygen administration
C. Increased hemoglobin
D. Increased dialysate temperature only
Correct Answer: A. Excessive or rapid fluid removal
Explanation: Muscle cramps can occur during dialysis when fluid is removed
faster than the patient's vascular compartment can adequately refill. The RN
should assess blood pressure, fluid-removal goals, symptoms, and the overall
clinical situation before intervening according to protocol.
5. Which electrolyte abnormality is particularly dangerous because it
can cause life-threatening cardiac dysrhythmias in a patient with kidney
failure?
A. Hyperkalemia
B. Hypernatremia
pg. 2
,C. Mild hypocalcemia
D. Mild hypermagnesemia
Correct Answer: A. Hyperkalemia
Explanation: The kidneys normally excrete potassium. Kidney failure can
therefore result in potassium accumulation. Significant hyperkalemia can alter
cardiac conduction and produce dangerous dysrhythmias or cardiac arrest,
making prompt assessment and treatment essential.
6. Which medication class is commonly used to help manage anemia
associated with chronic kidney disease?
A. Erythropoiesis-stimulating agents
B. Antacids
C. Antihistamines
D. Antitussives
Correct Answer: A. Erythropoiesis-stimulating agents
Explanation: Diseased kidneys produce inadequate erythropoietin,
contributing to anemia. Erythropoiesis-stimulating agents can promote red
blood cell production when clinically indicated. Iron status is also commonly
evaluated because adequate iron is necessary for erythropoiesis.
7. A dialysis patient has a temperature of 38.8°C (101.8°F) and reports
chills during treatment. What should the RN consider first?
A. Possible infection or other acute complication
B. Normal response to dialysis
C. Expected effect of ultrafiltration
D. Evidence that dialysis is complete
Correct Answer: A. Possible infection or other acute complication
Explanation: Fever and chills during dialysis are abnormal findings that
require prompt assessment. The RN should evaluate the patient, inspect the
pg. 3
, vascular access, assess for other infection signs, obtain cultures or other tests
when ordered, and follow the facility's infection and emergency procedures.
8. Which finding at a central venous dialysis catheter exit site requires
prompt attention?
A. Clean, dry dressing
B. Intact skin without drainage
C. Redness with purulent drainage
D. Secure catheter connections
Correct Answer: C. Redness with purulent drainage
Explanation: Redness, warmth, swelling, tenderness, or purulent drainage
can indicate an infection. Because catheter-related bloodstream infections can
become serious quickly, the RN should assess the patient and follow the
facility's catheter infection protocol.
9. What is the primary purpose of ultrafiltration during hemodialysis?
A. Remove excess fluid from the blood
B. Increase red blood cell production
C. Increase serum potassium
D. Replace all plasma proteins
Correct Answer: A. Remove excess fluid from the blood
Explanation: Ultrafiltration removes excess water from the patient's blood
during dialysis. The amount prescribed depends on the patient's fluid status
and treatment goals. Excessive fluid removal can contribute to hypotension,
cramping, and other complications.
10. A patient's pre-dialysis weight is 78.4 kg and prescribed post-dialysis
target weight is 75.9 kg. Ignoring other factors, approximately how much
fluid corresponds to the weight difference?
pg. 4
WITH VERIFIED CORRECT ANSWERS AND DETAILED
EXPLANATION – LATEST UPDATE
1. A patient receiving hemodialysis suddenly reports dizziness and
nausea, and the blood pressure falls from 138/78 mmHg to 88/52
mmHg. What should the RN do first?
A. Increase the ultrafiltration rate
B. Assess the patient and intervene for suspected intradialytic hypotension
C. Encourage the patient to ambulate
D. Continue treatment without intervention
Correct Answer: B. Assess the patient and intervene for suspected
intradialytic hypotension
Explanation: A sudden blood-pressure decrease accompanied by symptoms
is concerning for intradialytic hypotension. The RN should immediately assess
the patient, stop or reduce fluid removal as clinically appropriate, position the
patient safely, and follow the dialysis center's emergency protocol. The cause
should then be investigated.
2. Which assessment finding is most important when evaluating an
arteriovenous fistula before initiating dialysis?
A. Presence of a palpable thrill and audible bruit
B. Presence of peripheral edema
C. Patient's respiratory rate only
D. Temperature of the opposite extremity
Correct Answer: A. Presence of a palpable thrill and audible bruit
Explanation: A functioning AV fistula should generally have a palpable thrill
and an audible bruit. Absence or a significant change in these findings can
indicate impaired blood flow or thrombosis and requires prompt evaluation
before cannulation.
pg. 1
,3. Which action should the RN avoid when caring for a patient's AV
fistula arm?
A. Assessing the access
B. Checking for a thrill
C. Measuring blood pressure on the access arm
D. Inspecting the skin
Correct Answer: C. Measuring blood pressure on the access arm
Explanation: Blood-pressure measurements and unnecessary compression of
an AV access can compromise blood flow. The access arm should be protected
from avoidable pressure, trauma, and venipuncture according to facility
policy.
4. A patient develops muscle cramps during dialysis. Which factor is
commonly associated with this complication?
A. Excessive or rapid fluid removal
B. Excessive oxygen administration
C. Increased hemoglobin
D. Increased dialysate temperature only
Correct Answer: A. Excessive or rapid fluid removal
Explanation: Muscle cramps can occur during dialysis when fluid is removed
faster than the patient's vascular compartment can adequately refill. The RN
should assess blood pressure, fluid-removal goals, symptoms, and the overall
clinical situation before intervening according to protocol.
5. Which electrolyte abnormality is particularly dangerous because it
can cause life-threatening cardiac dysrhythmias in a patient with kidney
failure?
A. Hyperkalemia
B. Hypernatremia
pg. 2
,C. Mild hypocalcemia
D. Mild hypermagnesemia
Correct Answer: A. Hyperkalemia
Explanation: The kidneys normally excrete potassium. Kidney failure can
therefore result in potassium accumulation. Significant hyperkalemia can alter
cardiac conduction and produce dangerous dysrhythmias or cardiac arrest,
making prompt assessment and treatment essential.
6. Which medication class is commonly used to help manage anemia
associated with chronic kidney disease?
A. Erythropoiesis-stimulating agents
B. Antacids
C. Antihistamines
D. Antitussives
Correct Answer: A. Erythropoiesis-stimulating agents
Explanation: Diseased kidneys produce inadequate erythropoietin,
contributing to anemia. Erythropoiesis-stimulating agents can promote red
blood cell production when clinically indicated. Iron status is also commonly
evaluated because adequate iron is necessary for erythropoiesis.
7. A dialysis patient has a temperature of 38.8°C (101.8°F) and reports
chills during treatment. What should the RN consider first?
A. Possible infection or other acute complication
B. Normal response to dialysis
C. Expected effect of ultrafiltration
D. Evidence that dialysis is complete
Correct Answer: A. Possible infection or other acute complication
Explanation: Fever and chills during dialysis are abnormal findings that
require prompt assessment. The RN should evaluate the patient, inspect the
pg. 3
, vascular access, assess for other infection signs, obtain cultures or other tests
when ordered, and follow the facility's infection and emergency procedures.
8. Which finding at a central venous dialysis catheter exit site requires
prompt attention?
A. Clean, dry dressing
B. Intact skin without drainage
C. Redness with purulent drainage
D. Secure catheter connections
Correct Answer: C. Redness with purulent drainage
Explanation: Redness, warmth, swelling, tenderness, or purulent drainage
can indicate an infection. Because catheter-related bloodstream infections can
become serious quickly, the RN should assess the patient and follow the
facility's catheter infection protocol.
9. What is the primary purpose of ultrafiltration during hemodialysis?
A. Remove excess fluid from the blood
B. Increase red blood cell production
C. Increase serum potassium
D. Replace all plasma proteins
Correct Answer: A. Remove excess fluid from the blood
Explanation: Ultrafiltration removes excess water from the patient's blood
during dialysis. The amount prescribed depends on the patient's fluid status
and treatment goals. Excessive fluid removal can contribute to hypotension,
cramping, and other complications.
10. A patient's pre-dialysis weight is 78.4 kg and prescribed post-dialysis
target weight is 75.9 kg. Ignoring other factors, approximately how much
fluid corresponds to the weight difference?
pg. 4
