Dialysis Technologist Prometric exam questions with answers

1. Question 1Dialysis Equipment and Machine Monitoringmedium

   During treatment, the air detector alarms and the venous line clamp closes. Foam is visible in the venous drip chamber. What should the technologist do first?

   1. AOverride the alarm and continue treatment
   2. BOpen the clamp to return blood at once
   3. CKeep clamped, then find and remove the air
   4. DIncrease the blood pump speed to clear it
   Show answer and explanation▾

   Answer: C. Keep clamped, then find and remove the air

   The air detector stops the pump and clamps the venous line to prevent air embolism; staff must keep the patient clamped off, find the source and remove all air before restarting. Overriding or bypassing the detector can cause fatal air embolism.

2. Question 2Haemodialysis Principles and Adequacyhard

   A 70 kg patient arrives 3.5 kg above target weight for a 4-hour session. What ultrafiltration rate is needed, expressed per kilogram?

   1. AAbout 8.8 mL/kg/h
   2. BAbout 12.5 mL/kg/h
   3. CAbout 17.5 mL/kg/h
   4. DAbout 50 mL/kg/h
   Show answer and explanation▾

   Answer: B. About 12.5 mL/kg/h

   3,500 mL over 4 hours is 875 mL/h, and 875 / 70 = 12.5 mL/kg/h. Ultrafiltration rates above about 13 mL/kg/h are associated with intradialytic hypotension and higher mortality, so this patient is close to the limit.

3. Question 3Haemodialysis Principles and Adequacymedium

   For a patient on thrice-weekly haemodialysis, what is the minimum delivered single-pool Kt/V per session recommended by KDOQI?

   1. A0.8
   2. B1.0
   3. C1.2
   4. D2.0
   Show answer and explanation▾

   Answer: C. 1.2

   KDOQI recommends a target spKt/V of 1.4 per session with a minimum delivered dose of 1.2 for thrice-weekly haemodialysis. A value of 1.0 indicates inadequate dialysis associated with worse outcomes.

4. Question 4Infection Control and Patient Safetymedium

   A patient on haemodialysis is newly found to be HBsAg positive. How should this patient be managed in the unit?

   1. AAny station after routine cleaning
   2. BSuspend dialysis until it clears
   3. CSeparate room with a dedicated machine
   4. DShared machine with immune patients
   Show answer and explanation▾

   Answer: C. Separate room with a dedicated machine

   HBsAg-positive patients should be dialysed in a separate isolation room with dedicated machines, equipment, instruments and supplies, ideally with staff not caring for susceptible patients on the same shift. Routine cleaning alone does not prevent HBV transmission.

5. Question 5Renal Physiology and Kidney Failureeasy

   Below which eGFR is chronic kidney disease classified as stage 5 (kidney failure)?

   1. A60 mL/min/1.73 m2
   2. B30 mL/min/1.73 m2
   3. C15 mL/min/1.73 m2
   4. D45 mL/min/1.73 m2
   Show answer and explanation▾

   Answer: C. 15 mL/min/1.73 m2

   CKD stage G5 is defined as an eGFR below 15 mL/min/1.73 m2 and is the stage at which kidney replacement therapy is usually considered. An eGFR of 15-29 is stage G4.

6. Question 6Intradialytic Complications and Emergenciesmedium

   Blood in the venous line turns a dark port-wine colour and the patient complains of chest tightness. Which machine problem is most likely?

   1. ABlood pump speed set too low
   2. BDialysate that is overheated or hypotonic
   3. CExcess heparin in the circuit
   4. DDialysate flow rate set too high
   Show answer and explanation▾

   Answer: B. Dialysate that is overheated or hypotonic

   Overheated or hypotonic dialysate, kinked blood lines and chloramine exposure can cause acute haemolysis with port-wine coloured blood. The blood should not be returned, and the patient needs urgent assessment for hyperkalaemia.

7. Question 7Water Treatment and Dialysatehard

   Monthly culture of product water feeding the dialysis machines shows 70 CFU/mL. Under ISO 23500 standards, how should this be interpreted?

   1. AAcceptable and below every limit, so no action
   2. BAbove the maximum limit, so dialysis must stop now
   3. CIrrelevant, because only endotoxin is monitored
   4. DAbove the action level, so corrective action is needed
   Show answer and explanation▾

   Answer: D. Above the action level, so corrective action is needed

   ISO 23500 sets a maximum of 100 CFU/mL for dialysis water with an action level of 50 CFU/mL, at which disinfection and investigation should start. The endotoxin limits are 0.25 EU/mL maximum and 0.125 EU/mL action level and are monitored separately.

8. Question 8Water Treatment and Dialysateeasy

   Which component of the dialysis water system removes the majority of dissolved ions, bacteria and endotoxins?

   1. AWater softener
   2. BSediment filter
   3. CReverse osmosis unit
   4. DCarbon tank
   Show answer and explanation▾

   Answer: C. Reverse osmosis unit

   Reverse osmosis is the core purification step and rejects most dissolved salts, bacteria and endotoxins. The softener only exchanges calcium and magnesium for sodium, and carbon removes chlorine and chloramine.

9. Question 9Peritoneal Dialysis and Continuous Therapiesmedium

   A CAPD patient has cloudy effluent and abdominal pain. Which effluent finding after a dwell of at least 2 hours supports peritonitis?

   1. AClear effluent with no cells
   2. BWhite cell count above 100/microlitre with over 50% neutrophils
   3. CRed cells only
   4. DWhite cell count of 10/microlitre with lymphocytes
   Show answer and explanation▾

   Answer: B. White cell count above 100/microlitre with over 50% neutrophils

   Peritonitis is supported by an effluent white cell count above 100/microlitre with more than 50% neutrophils after a dwell of at least 2 hours, together with abdominal pain or cloudy effluent. Cloudy effluent requires prompt sampling and empirical antibiotics.

10. Question 10Renal Physiology and Kidney Failuremedium

    Why do most patients with advanced CKD develop anaemia?

    1. AExcess red cell destruction by the spleen
    2. BReduced erythropoietin production by the kidneys
    3. CLoss of red cells through the dialyser membrane
    4. DExcessive iron absorption from the gut
    Show answer and explanation▾

    Answer: B. Reduced erythropoietin production by the kidneys

    The failing kidney produces insufficient erythropoietin, which is the main cause of anaemia in CKD, treated with erythropoiesis-stimulating agents and iron. Blood losses with dialysis and iron deficiency contribute but are not the main mechanism.

11. Question 11Vascular Accessmedium

    According to the rule of 6s, which finding suggests that a new fistula is mature for cannulation at 6 weeks?

    1. AFlow above 600 mL/min, diameter above 6 mm, depth under 6 mm
    2. BFlow above 60 mL/min, diameter above 6 mm, depth over 6 mm
    3. CFlow above 600 mL/min, diameter under 6 mm, depth over 6 mm
    4. DFlow above 6,000 mL/min, any diameter, any depth
    Show answer and explanation▾

    Answer: A. Flow above 600 mL/min, diameter above 6 mm, depth under 6 mm

    The rule of 6s describes a mature fistula as having blood flow above 600 mL/min, diameter at least 6 mm and depth no more than 6 mm below the skin at about 6 weeks. Deep or narrow veins are difficult to cannulate.

12. Question 12Vascular Accessmedium

    Compared with rope-ladder cannulation, what is the main disadvantage of the buttonhole technique?

    1. AMore frequent aneurysm formation
    2. BNeed for larger-gauge needles
    3. CHigher risk of access infection
    4. DNot usable for self-cannulation
    Show answer and explanation▾

    Answer: C. Higher risk of access infection

    The buttonhole technique uses the same tract each time with blunt needles and is associated with a higher rate of local and bloodstream infections, so scab removal and skin disinfection must be meticulous. Rope-ladder cannulation has fewer infections, and aneurysm formation is mainly linked to repeated area puncture.

13. Question 13Water Treatment and Dialysatemedium

    Before the first patient shift, the technologist tests water after the carbon tanks. What is the maximum allowable total chlorine level?

    1. A0.1 mg/L
    2. B0.5 mg/L
    3. C1.0 mg/L
    4. D4.0 mg/L
    Show answer and explanation▾

    Answer: A. 0.1 mg/L

    Total chlorine (free chlorine plus chloramine) in dialysis water must not exceed 0.1 mg/L, and testing is done before each shift. Levels acceptable for drinking water are far too high for dialysis, where patients are exposed to over 100 litres per session.

14. Question 14Water Treatment and Dialysatemedium

    What does a water softener in a dialysis pre-treatment system remove, and how is it regenerated?

    1. AChloramine; regenerated with dilute acid
    2. BBacteria; regenerated with hot water
    3. CCalcium and magnesium; regenerated with brine
    4. DAluminium; regenerated with bicarbonate
    Show answer and explanation▾

    Answer: C. Calcium and magnesium; regenerated with brine

    The softener's resin exchanges calcium and magnesium for sodium to protect the RO membrane from scaling, and it is regenerated with sodium chloride brine. Chloramine is removed by carbon, not by the softener.

15. Question 15Water Treatment and Dialysatemedium

    Several patients on the same shift develop falling haemoglobin with haemolysis, and the water treatment log shows a missed total chlorine test. What contaminant is most likely responsible?

    1. AChloramine
    2. BFluoride
    3. CCopper
    4. DNitrate
    Show answer and explanation▾

    Answer: A. Chloramine

    Chloramine breakthrough from exhausted or undersized carbon causes oxidant haemolysis and methaemoglobinaemia in dialysis patients. Fluoride, copper and nitrate toxicity have occurred but are not linked to a missed chlorine test.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.