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Quizzes > Health & Medicine

Hemodialysis Quiz for Nurses: Sharpen Your Clinical Skills

Quick, free hemodialysis practice questions. Instant results.

Editorial: Review CompletedCreated By: Montel BainesUpdated Aug 26, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper cut illustration of nurse hands connecting dialysis tubing and kidney shape on coral background

This hemodialysis quiz for nurses helps you check core skills on access care, fluid management, medications, and common complications. For more focused practice, take our critical care nursing quiz, work through perfusion nclex questions, or brush up on access and draws with a phlebotomy quiz.

The primary purpose of assessing an AV fistula for a continuous thrill is to verify which of the following?
Patency and adequate blood flow through the anastomosis
Presence of infection at the cannulation site
Adequate collateral circulation in the distal limb
Correct orientation of the arterial and venous needles
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Which of the following is the safest immediate action when the venous bloodline disconnects and a needle dislodges during dialysis?
Silence the alarm and observe for 5 minutes
Stop the blood pump and clamp the venous line, then apply direct pressure
Raise the ultrafiltration goal to maintain blood pressure
Increase the blood pump speed to flush the line
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Intradialytic hypotension occurs. The patient is symptomatic and systolic BP is 82 mmHg. What is the most appropriate first action?
Administer a 500 mL IV bolus without stopping UF
Increase dialysate temperature to 38.5 C
Stop ultrafiltration and place the patient supine with legs elevated
Give an extra dose of antihypertensive medication
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Which of the following is the best indicator that a patient is at or near their dry weight after a treatment?
Any post-dialysis weight lower than pre-dialysis weight
No edema, normal blood pressure without cramping or dizziness
A high venous pressure alarm during treatment
Presence of muscle cramps near the end of treatment
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Which dialysate bicarbonate concentration is most commonly used for adult maintenance hemodialysis unless otherwise indicated?
50-60 mEq/L
2-4 mEq/L
10-15 mEq/L
32-38 mEq/L
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Which of the following pre-dialysis medications is most likely to increase the risk of intradialytic hypotension if taken just before treatment?
Phosphate binders
Proton pump inhibitors
Erythropoiesis-stimulating agents
Short-acting antihypertensives
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For a new central venous catheter used for dialysis, the safest technique for initiating connection is which of the following?
Alcohol prep only; CHG is unnecessary for catheters
Aseptic technique with mask, sterile gloves, CHG prep, and proper cap changes
No mask needed if the nurse is asymptomatic
Clean gloves only because the site is already healed
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For a thrice-weekly in-center hemodialysis patient, what is the minimum acceptable single-pool Kt/V adequacy target per treatment per KDOQI/KDIGO guidance?
spKt/V 1.4 or higher required for all patients
spKt/V 1.2 or higher
spKt/V 1.0 or higher
spKt/V 0.9 or higher
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Which dialysate potassium prescription is most appropriate for a stable patient with a pre-dialysis serum potassium of 5.9 mEq/L and no ECG changes?
4.0 mEq/L K bath
5.0 mEq/L K bath
0.0 mEq/L K bath
2.0 mEq/L K bath
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A new AV graft cannulation should generally be delayed until which condition is met?
Adequate healing and clinical assessment of maturity by the provider
When the patient requests to use it
As soon as the swelling resolves, without further assessment
Two days after surgery regardless of physical exam
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Which intradialytic ultrafiltration rate is associated with higher risk of complications and should generally be avoided if possible?
3 mL/kg/hour
8-10 mL/kg/hour
> 13 mL/kg/hour
5 mL/kg/hour
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Which finding most likely explains a sudden high venous pressure alarm during hemodialysis?
Low dialysate conductivity
Arterial needle against the vessel wall
Air in the arterial line
Kinked venous bloodline or clotting in the venous needle
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A patient on hemodialysis has HBsAg positive status. Which infection control practice is correct?
No special precautions beyond routine hand hygiene
Dialyze in a dedicated hepatitis B isolation area with dedicated machine
Place with hepatitis C positive patients to cohort
Use standard machines but schedule as last patient of the day
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What is the appropriate response when the blood leak detector alarms and visual inspection confirms a red tinge in the dialysate effluent?
Stop dialysis and do not return the blood
Continue treatment at a lower blood flow rate
Increase dialysate flow to clear the leak
Ignore if the patient is asymptomatic
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The recommended total chlorine (free + combined) limit after the carbon tanks (post-carbon, prior to the RO) in the dialysis water system is which value or lower?
0.5 mg/L (ppm) or less
0.2 mg/L (ppm) or less only after the RO
1.0 mg/L (ppm) or less
0.1 mg/L (ppm) or less
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Which symptom cluster most strongly suggests a Type A (anaphylactoid) dialyzer reaction early in treatment?
Mild back pain after 2 hours
Chest tightness, wheeze, hypotension, flushing within minutes of start
Cramps and thirst near end of treatment
Mild pruritus the evening after dialysis
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A hemodialysis patient with suspected HIT (heparin-induced thrombocytopenia) should receive which anticoagulation strategy during dialysis pending evaluation?
Warfarin loading dose before dialysis
Standard heparin bolus and infusion
Heparin-free dialysis with saline flushes or non-heparin anticoagulant per protocol
Protamine infusion at start of treatment
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What is the most appropriate immediate action if a patient shows signs of hemolysis during dialysis (cherry-red blood, back pain, hypotension)?
Increase dialysate temperature and continue
Administer an IV fluid bolus and continue dialysis
Stop dialysis immediately and do not return the blood
Switch to a higher K bath and continue
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Which lab thresholds most commonly guide IV iron initiation in hemodialysis patients per KDIGO when the goal is to raise Hb or reduce ESA dose?
No iron if on ESA therapy
TSAT <= 10% and ferritin <= 50 ng/mL only
TSAT >= 50% and ferritin >= 800 ng/mL
TSAT <= 30% and ferritin <= 500 ng/mL
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Which of the following best describes the purpose of sodium modeling (sodium profiling) during dialysis?
To sterilize the dialyzer membrane mid-treatment
To reverse heparin anticoagulation
To mitigate intradialytic hypotension and cramps by adjusting dialysate sodium over time
To increase phosphate removal by raising dialysate sodium
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Study Outcomes

  1. Evaluate Hemodialysis Nursing Principles -

    Review and assess the fundamental concepts of hemodialysis nursing, including indications, contraindications, and treatment goals.

  2. Identify Dialysis Complication Signs -

    Recognize common complications such as hypotension, cramps, and infections in dialysis exam questions and determine appropriate interventions.

  3. Interpret Machine Settings and Laboratory Values -

    Analyze dialysis machine parameters and patient lab results to ensure safe and effective treatment adjustments.

  4. Apply Best Practices from the Nursing Dialysis Quiz -

    Use evidence-based protocols to optimize patient care and reinforce skills covered in the nursing dialysis quiz.

  5. Differentiate Access Type Care -

    Compare arteriovenous fistula, graft, and catheter management techniques demonstrated in the hemodialysis patient care quiz.

  6. Analyze Case-Based Scenarios for Exam Readiness -

    Work through realistic renal dialysis nursing test scenarios to sharpen critical thinking and boost confidence for exams.

Cheat Sheet

  1. Principles of Diffusion and Ultrafiltration -

    In hemodialysis nursing, review how solute clearance relies on diffusion moving solutes down a concentration gradient, while ultrafiltration removes excess fluid via transmembrane pressure (TMP). Use the formula Qf = Kf × TMP (mL/hr) and the mnemonic "Diffusion Downhill, Filter Force" to recall the two primary mechanisms. These principles frequently appear in dialysis exam questions, highlighting core hemodialysis nursing knowledge.

  2. Dialysis Access Types and Care -

    As part of hemodialysis nursing, differentiate between AV fistulas, grafts, and tunneled catheters; fistulas have the lowest infection rates but require 6 - 8 weeks to mature (NIH, 2020). Auscultate for a "bruit" and palpate for a "thrill" every shift using the rhyme "Hear the whoosh, feel the buzz" to assess patency. Follow nursing dialysis quiz scenarios for access management to practice aseptic technique and reduce infection risk.

  3. Dialysate Composition and Electrolyte Balance -

    In hemodialysis nursing, master the standard dialysate formulation: 140 mEq/L Na❺, 2 - 3 mEq/L K❺, 32 - 36 mEq/L HCO₃❻ (NKF, 2019). Adjust potassium prescriptions using the formula Kdialysate = patient Kserum - desired drop (mEq/L) while monitoring for EKG changes. Use the mnemonic "SALT - Sodium Always Levels Tension" to recall sodium's vital role in hemodialysis patient care quiz scenarios.

  4. Fluid Management & Ultrafiltration Rate (UFR) -

    Hemodialysis nursing requires precise fluid management; calculate UFR (mL/hr) = total fluid to remove (mL) ÷ dialysis time (hr), keeping UFR ≤ 13 mL/kg/hr to reduce hypotension risk (JASN, 2018). For example, removing 2 L over 4 hrs for a 70-kg patient equals 500 mL/hr (≈ 7.1 mL/kg/hr). Recall the "13 Rule" in nursing dialysis quiz practice to maintain patient hemodynamic stability.

  5. Identifying & Managing Intradialytic Complications -

    In hemodialysis nursing, be vigilant for hypotension, muscle cramps, and disequilibrium syndrome; early interventions include lowering UFR, Trendelenburg positioning, and a normal saline bolus (WashU, 2021). Apply the "STOP" acronym - Stop filtration, Trendelenburg, Oxygen, and Patient evaluation - to guide swift, effective care. Document vital signs every 15 min, mirroring scenarios from a hemodialysis patient care quiz to ensure consistent monitoring.

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