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DAVITA RN
FINAL EXAM STUDY GUIDE
2026/2027 EDITION
━━━━━━━━━━━━━━━━
200 Questions with Verified Answers & Rationales | Graded A+
· · · · · · ·
◆ ◇ ◆ ◇ ◆
Renal physiology • hemodialysis • peritoneal dialysis • patient safety
DaVita RN Final Exam Study Guide | 1
,DaVita RN Final Exam Study Guide | 2
,Section 1: Brief Introduction
This 200-question RN final-exam study guide reviews renal physiology, CKD and ESRD,
hemodialysis, vascular access, peritoneal dialysis, complications, fluid and electrolyte
management, anemia, renal bone disease, infection prevention, emergency response, patient
education, medication safety, adequacy, and documentation. Each item presents a dialysis-
nursing scenario followed by the correct answer and rationale.
Section 2: The Complete Exam
1. A patient asks what the nephron does.
A. connect glomerular filtration, tubular handling, endocrine function, acid-base balance,
electrolyte regulation, and blood-pressure control
B. assume kidneys only produce urine
C. attribute all renal effects to filtration alone
D. ignore endocrine and acid-base functions
Answer: A. connect glomerular filtration, tubular handling, endocrine function, acid-base
balance, electrolyte regulation, and blood-pressure control Rationale: The kidneys regulate
filtration, reabsorption, secretion, concentration, acid-base balance, electrolytes, erythropoiesis, vitamin
D activation, and blood pressure. Renal disease therefore produces multisystem effects beyond urine
formation.
2. A patient has progressive albuminuria and declining eGFR.
A. use one creatinine value to stage every patient
B. monitor kidney function, albuminuria, complications, cardiovascular risk, and readiness for
renal replacement using trends and individualized care
C. wait for symptoms before monitoring progression
D. treat ESRD as a purely urinary condition
Answer: B. monitor kidney function, albuminuria, complications, cardiovascular risk, and
readiness for renal replacement using trends and individualized care Rationale: CKD is defined
and staged by kidney function and markers of kidney damage over time. Complications include anemia,
mineral-bone disorder, acidosis, electrolyte problems, hypertension, cardiovascular disease, and uremic
symptoms; trends guide planning.
3. A patient has a newly created AV fistula.
A. use the access arm for routine blood pressure
B. cannulate without assessing the site
C. assess patency and infection, protect the access from pressure or trauma, use aseptic
technique, and escalate abnormal findings promptly
D. ignore absent thrill if the patient feels well
Answer: C. assess patency and infection, protect the access from pressure or trauma, use
aseptic technique, and escalate abnormal findings promptly Rationale: Vascular access is the
DaVita RN Final Exam Study Guide | 3
, patient’s lifeline. Nurses assess bruit, thrill, appearance, function, bleeding, pain, and infection; protect
the arm from compression and unnecessary venipuncture, and report changes promptly.
4. A hemodialysis prescription specifies blood-flow rate.
A. change prescription settings without authorization
B. skip weight and identity checks
C. silence alarms without identifying the cause
D. verify the prescription, patient identity, access, parameters, safety checks, and treatment
response before and during dialysis
Answer: D. verify the prescription, patient identity, access, parameters, safety checks, and
treatment response before and during dialysis Rationale: Safe hemodialysis requires accurate
prescription verification, machine and water-safety checks, correct patient and access identification,
monitoring of blood pressure and symptoms, and documentation of delivered treatment.
5. A patient develops hypotension during ultrafiltration.
A. stop and assess the patient and treatment, place the patient safely, follow the dialysis
protocol, and notify the responsible clinician for persistent or severe findings
B. continue ultrafiltration to reach the target regardless of symptoms
C. treat symptoms without reassessing blood pressure
D. assume every headache is disequilibrium
Answer: A. stop and assess the patient and treatment, place the patient safely, follow the
dialysis protocol, and notify the responsible clinician for persistent or severe findings
Rationale: Dialysis complications require immediate patient assessment, vital signs, review of
ultrafiltration and machine data, and protocol-based intervention. Persistent hypotension, chest pain,
dyspnea, neurologic change, fever, or severe symptoms require escalation.
6. A patient has a new AV fistula.
A. apply tight clothing over the access
B. teach access protection, daily assessment, bleeding control, infection signs, and prompt
reporting of changes
C. ignore loss of thrill until the next session
D. use unapproved creams or instruments on the site
Answer: B. teach access protection, daily assessment, bleeding control, infection signs, and
prompt reporting of changes Rationale: Access education includes checking for thrill or bruit as
instructed, protecting the limb from pressure and trauma, recognizing bleeding, infection, ischemia,
infiltration, and dysfunction, and contacting the dialysis team promptly.
7. A patient is prescribed peritoneal dialysis.
A. reinfuse cloudy effluent without reporting
B. reuse contaminated supplies
C. use meticulous connection technique, inspect effluent, monitor drainage and symptoms, and
report possible peritonitis or catheter dysfunction immediately
D. ignore abdominal pain if the exit site looks normal
DaVita RN Final Exam Study Guide | 4
▲ ╱╲ ╱╲ ╱╲
· · · · · · ·
━━━━━━━━━━━━━━━━
DAVITA RN
FINAL EXAM STUDY GUIDE
2026/2027 EDITION
━━━━━━━━━━━━━━━━
200 Questions with Verified Answers & Rationales | Graded A+
· · · · · · ·
◆ ◇ ◆ ◇ ◆
Renal physiology • hemodialysis • peritoneal dialysis • patient safety
DaVita RN Final Exam Study Guide | 1
,DaVita RN Final Exam Study Guide | 2
,Section 1: Brief Introduction
This 200-question RN final-exam study guide reviews renal physiology, CKD and ESRD,
hemodialysis, vascular access, peritoneal dialysis, complications, fluid and electrolyte
management, anemia, renal bone disease, infection prevention, emergency response, patient
education, medication safety, adequacy, and documentation. Each item presents a dialysis-
nursing scenario followed by the correct answer and rationale.
Section 2: The Complete Exam
1. A patient asks what the nephron does.
A. connect glomerular filtration, tubular handling, endocrine function, acid-base balance,
electrolyte regulation, and blood-pressure control
B. assume kidneys only produce urine
C. attribute all renal effects to filtration alone
D. ignore endocrine and acid-base functions
Answer: A. connect glomerular filtration, tubular handling, endocrine function, acid-base
balance, electrolyte regulation, and blood-pressure control Rationale: The kidneys regulate
filtration, reabsorption, secretion, concentration, acid-base balance, electrolytes, erythropoiesis, vitamin
D activation, and blood pressure. Renal disease therefore produces multisystem effects beyond urine
formation.
2. A patient has progressive albuminuria and declining eGFR.
A. use one creatinine value to stage every patient
B. monitor kidney function, albuminuria, complications, cardiovascular risk, and readiness for
renal replacement using trends and individualized care
C. wait for symptoms before monitoring progression
D. treat ESRD as a purely urinary condition
Answer: B. monitor kidney function, albuminuria, complications, cardiovascular risk, and
readiness for renal replacement using trends and individualized care Rationale: CKD is defined
and staged by kidney function and markers of kidney damage over time. Complications include anemia,
mineral-bone disorder, acidosis, electrolyte problems, hypertension, cardiovascular disease, and uremic
symptoms; trends guide planning.
3. A patient has a newly created AV fistula.
A. use the access arm for routine blood pressure
B. cannulate without assessing the site
C. assess patency and infection, protect the access from pressure or trauma, use aseptic
technique, and escalate abnormal findings promptly
D. ignore absent thrill if the patient feels well
Answer: C. assess patency and infection, protect the access from pressure or trauma, use
aseptic technique, and escalate abnormal findings promptly Rationale: Vascular access is the
DaVita RN Final Exam Study Guide | 3
, patient’s lifeline. Nurses assess bruit, thrill, appearance, function, bleeding, pain, and infection; protect
the arm from compression and unnecessary venipuncture, and report changes promptly.
4. A hemodialysis prescription specifies blood-flow rate.
A. change prescription settings without authorization
B. skip weight and identity checks
C. silence alarms without identifying the cause
D. verify the prescription, patient identity, access, parameters, safety checks, and treatment
response before and during dialysis
Answer: D. verify the prescription, patient identity, access, parameters, safety checks, and
treatment response before and during dialysis Rationale: Safe hemodialysis requires accurate
prescription verification, machine and water-safety checks, correct patient and access identification,
monitoring of blood pressure and symptoms, and documentation of delivered treatment.
5. A patient develops hypotension during ultrafiltration.
A. stop and assess the patient and treatment, place the patient safely, follow the dialysis
protocol, and notify the responsible clinician for persistent or severe findings
B. continue ultrafiltration to reach the target regardless of symptoms
C. treat symptoms without reassessing blood pressure
D. assume every headache is disequilibrium
Answer: A. stop and assess the patient and treatment, place the patient safely, follow the
dialysis protocol, and notify the responsible clinician for persistent or severe findings
Rationale: Dialysis complications require immediate patient assessment, vital signs, review of
ultrafiltration and machine data, and protocol-based intervention. Persistent hypotension, chest pain,
dyspnea, neurologic change, fever, or severe symptoms require escalation.
6. A patient has a new AV fistula.
A. apply tight clothing over the access
B. teach access protection, daily assessment, bleeding control, infection signs, and prompt
reporting of changes
C. ignore loss of thrill until the next session
D. use unapproved creams or instruments on the site
Answer: B. teach access protection, daily assessment, bleeding control, infection signs, and
prompt reporting of changes Rationale: Access education includes checking for thrill or bruit as
instructed, protecting the limb from pressure and trauma, recognizing bleeding, infection, ischemia,
infiltration, and dysfunction, and contacting the dialysis team promptly.
7. A patient is prescribed peritoneal dialysis.
A. reinfuse cloudy effluent without reporting
B. reuse contaminated supplies
C. use meticulous connection technique, inspect effluent, monitor drainage and symptoms, and
report possible peritonitis or catheter dysfunction immediately
D. ignore abdominal pain if the exit site looks normal
DaVita RN Final Exam Study Guide | 4
