DaVita Annual Competency Examination Dialysis
Technician & Patient Care Technician (PCT)
2025/2026
: Final Study Tips for the DaVita Annual Competency Examination
1. Water Treatment: Understand RO, carbon tanks, water softener, chlorine testing (daily),
and bacterial/endotoxin testing (monthly). Know AAMI standards (chlorine ≤0.1 mg/L,
bacteria ≤100 CFU/mL, endotoxins ≤0.5 EU/mL).
2. Vascular Access: Know the difference between AV fistula, AV graft, and CVC. Fistula is
gold standard. Thrill and bruit indicate function. Rope ladder cannulation reduces
complications.
3. Dialysis Adequacy: URR target ≥65% (spKt/V ≥1.2). Monitor monthly.
4. Lab Values: Target ranges: Hgb 10-11.5, Ca 8.5-10.2, Phos 2.5-4.5, iPTH 150-300, K⁺ 3.5-
5.0, albumin 4.0-5.0.
5. Emergency Management: Know intradialytic hypotension (Trendelenburg, stop UF,
saline bolus), air embolism (Trendelenburg, left lateral decubitus, O₂), hemolysis (stop,
do NOT return blood), and blood leak (stop, discard dialyzer).
6. Infection Control: Hand hygiene is #1. Hepatitis B patients require isolation. Use
aseptic technique for CVC.
7. Patient Education: Fluid restriction (1-2 L/day), low phosphorus diet, phosphate binders
with meals, low sodium diet, low potassium diet.
Good luck on your DaVita Annual Competency Examination
Section 1: Dialysis Fundamentals & Water Treatment
(Questions 1–40)
1. What is the primary function of the hemodialysis machine's blood pump?
A) To filter waste products from the blood
B) To move blood from the patient through the dialyzer and back to the
patient
C) To monitor blood pressure
D) To mix dialysate solution
Answer: B
,Rationale: The blood pump (typically a peristaltic roller pump) creates
positive pressure to move blood through the extracorporeal circuit from the
patient's access to the dialyzer and back to the patient. The dialyzer
performs the filtration, not the pump itself.
2. What is the normal blood flow rate range for a standard adult
hemodialysis treatment?
A) 100-200 mL/min
B) 200-400 mL/min
C) 300-500 mL/min
D) 400-600 mL/min
Answer: C
*Rationale: Typical adult blood flow rates range from 300-500 mL/min
depending on access type and patient tolerance. AV fistulas and grafts can
generally support higher flows (400-500 mL/min) while central venous
catheters typically support 300-350 mL/min.*
3. What is the primary purpose of the dialysate solution in hemodialysis?
A) To clean the blood pump
B) To remove waste products and excess fluid from the blood through
diffusion and convection
C) To add nutrients to the blood
D) To lubricate the dialysis machine
Answer: B
Rationale: Dialysate is a specially formulated solution that creates a
concentration gradient across the dialyzer membrane, allowing waste
products (urea, creatinine) to diffuse out of the blood and into the dialysate.
Excess fluid is removed via ultrafiltration.
,4. Which water treatment component is responsible for removing chlorine
and chloramines from the water supply?
A) Sediment filter
B) Carbon tanks (activated carbon filtration)
C) Reverse osmosis (RO) unit
D) Deionization (DI) tanks
Answer: B
Rationale: Activated carbon filtration removes chlorine and chloramines
through adsorption. These substances are toxic to patients and can cause
hemolysis if not removed. Carbon tanks are typically arranged in a dual-tank
series for redundancy and to ensure complete removal.
5. What is the purpose of the reverse osmosis (RO) unit in the dialysis water
treatment system?
A) To remove particulate matter
B) To remove chlorine and chloramines
C) To remove dissolved minerals, bacteria, and endotoxins from water
D) To adjust water pH
Answer: C
*Rationale: The RO unit uses a semipermeable membrane to remove 90-99%
of dissolved solids (including calcium, magnesium, sodium, sulfates),
bacteria, and endotoxins. It is the most critical component of the water
treatment system for producing high-purity water.*
6. What is the maximum allowable level of total chlorine in water used for
hemodialysis according to AAMI standards?
, A) 0.1 mg/L
B) 0.5 mg/L
C) 1.0 mg/L
D) 2.0 mg/L
Answer: A
*Rationale: AAMI standards specify that total chlorine (free and combined)
must be ≤0.1 mg/L. Chlorine and chloramines are toxic to patients and can
cause acute hemolytic anemia, methemoglobinemia, and other serious
complications.*
7. What is the maximum allowable level of endotoxins in dialysate according
to AAMI standards?
A) 0.03 EU/mL (Endotoxin Units per milliliter)
B) 0.25 EU/mL
C) 0.5 EU/mL
D) 1.0 EU/mL
Answer: C
*Rationale: AAMI RD-5:2015 specifies that dialysate must contain <0.5
EU/mL of endotoxins. Endotoxins are fragments of bacterial cell walls that
can cause pyrogenic reactions (fever, chills, hypotension) in patients.*
8. What is the purpose of the conductivity meter in the dialysis machine?
A) To measure water temperature
B) To verify that the dialysate concentrate is properly mixed (correct
electrolyte concentration)
C) To measure blood pressure
D) To monitor ultrafiltration rate
Answer: B
Technician & Patient Care Technician (PCT)
2025/2026
: Final Study Tips for the DaVita Annual Competency Examination
1. Water Treatment: Understand RO, carbon tanks, water softener, chlorine testing (daily),
and bacterial/endotoxin testing (monthly). Know AAMI standards (chlorine ≤0.1 mg/L,
bacteria ≤100 CFU/mL, endotoxins ≤0.5 EU/mL).
2. Vascular Access: Know the difference between AV fistula, AV graft, and CVC. Fistula is
gold standard. Thrill and bruit indicate function. Rope ladder cannulation reduces
complications.
3. Dialysis Adequacy: URR target ≥65% (spKt/V ≥1.2). Monitor monthly.
4. Lab Values: Target ranges: Hgb 10-11.5, Ca 8.5-10.2, Phos 2.5-4.5, iPTH 150-300, K⁺ 3.5-
5.0, albumin 4.0-5.0.
5. Emergency Management: Know intradialytic hypotension (Trendelenburg, stop UF,
saline bolus), air embolism (Trendelenburg, left lateral decubitus, O₂), hemolysis (stop,
do NOT return blood), and blood leak (stop, discard dialyzer).
6. Infection Control: Hand hygiene is #1. Hepatitis B patients require isolation. Use
aseptic technique for CVC.
7. Patient Education: Fluid restriction (1-2 L/day), low phosphorus diet, phosphate binders
with meals, low sodium diet, low potassium diet.
Good luck on your DaVita Annual Competency Examination
Section 1: Dialysis Fundamentals & Water Treatment
(Questions 1–40)
1. What is the primary function of the hemodialysis machine's blood pump?
A) To filter waste products from the blood
B) To move blood from the patient through the dialyzer and back to the
patient
C) To monitor blood pressure
D) To mix dialysate solution
Answer: B
,Rationale: The blood pump (typically a peristaltic roller pump) creates
positive pressure to move blood through the extracorporeal circuit from the
patient's access to the dialyzer and back to the patient. The dialyzer
performs the filtration, not the pump itself.
2. What is the normal blood flow rate range for a standard adult
hemodialysis treatment?
A) 100-200 mL/min
B) 200-400 mL/min
C) 300-500 mL/min
D) 400-600 mL/min
Answer: C
*Rationale: Typical adult blood flow rates range from 300-500 mL/min
depending on access type and patient tolerance. AV fistulas and grafts can
generally support higher flows (400-500 mL/min) while central venous
catheters typically support 300-350 mL/min.*
3. What is the primary purpose of the dialysate solution in hemodialysis?
A) To clean the blood pump
B) To remove waste products and excess fluid from the blood through
diffusion and convection
C) To add nutrients to the blood
D) To lubricate the dialysis machine
Answer: B
Rationale: Dialysate is a specially formulated solution that creates a
concentration gradient across the dialyzer membrane, allowing waste
products (urea, creatinine) to diffuse out of the blood and into the dialysate.
Excess fluid is removed via ultrafiltration.
,4. Which water treatment component is responsible for removing chlorine
and chloramines from the water supply?
A) Sediment filter
B) Carbon tanks (activated carbon filtration)
C) Reverse osmosis (RO) unit
D) Deionization (DI) tanks
Answer: B
Rationale: Activated carbon filtration removes chlorine and chloramines
through adsorption. These substances are toxic to patients and can cause
hemolysis if not removed. Carbon tanks are typically arranged in a dual-tank
series for redundancy and to ensure complete removal.
5. What is the purpose of the reverse osmosis (RO) unit in the dialysis water
treatment system?
A) To remove particulate matter
B) To remove chlorine and chloramines
C) To remove dissolved minerals, bacteria, and endotoxins from water
D) To adjust water pH
Answer: C
*Rationale: The RO unit uses a semipermeable membrane to remove 90-99%
of dissolved solids (including calcium, magnesium, sodium, sulfates),
bacteria, and endotoxins. It is the most critical component of the water
treatment system for producing high-purity water.*
6. What is the maximum allowable level of total chlorine in water used for
hemodialysis according to AAMI standards?
, A) 0.1 mg/L
B) 0.5 mg/L
C) 1.0 mg/L
D) 2.0 mg/L
Answer: A
*Rationale: AAMI standards specify that total chlorine (free and combined)
must be ≤0.1 mg/L. Chlorine and chloramines are toxic to patients and can
cause acute hemolytic anemia, methemoglobinemia, and other serious
complications.*
7. What is the maximum allowable level of endotoxins in dialysate according
to AAMI standards?
A) 0.03 EU/mL (Endotoxin Units per milliliter)
B) 0.25 EU/mL
C) 0.5 EU/mL
D) 1.0 EU/mL
Answer: C
*Rationale: AAMI RD-5:2015 specifies that dialysate must contain <0.5
EU/mL of endotoxins. Endotoxins are fragments of bacterial cell walls that
can cause pyrogenic reactions (fever, chills, hypotension) in patients.*
8. What is the purpose of the conductivity meter in the dialysis machine?
A) To measure water temperature
B) To verify that the dialysate concentrate is properly mixed (correct
electrolyte concentration)
C) To measure blood pressure
D) To monitor ultrafiltration rate
Answer: B
