Davita RISE PCT Study Guide questions and answers
2026\2027 A+ Grade
List the four transport mechanisms that play a role in hemodialysis
- correct answer Ultrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis
- correct answer Fluid is pushed through the semipermeable membrane (SPM). Think: wringing out a
wet rag.
Explain convection in hemodialysis
- correct answer Solutes DRAG across the semipermeable membrane with fluid
Explain diffusion in hemodialysis
- correct answer PARTICLES move from HIGH concentration to LOW concentration
Explain osmosis in hemodialysis
- correct answer FLUID moves LOW concentration to HIGH concentration
What are the kidneys' excretory functions?
- correct answer To normalize electrolytes, remove wastes, provide fluid and nutrient balance
How do we replace normal excretory kidney functions?
- correct answer By using acid concentrate to help normalize electrolytes and ultrafiltration to provide
fluid balance
,What is the function of acid concentrate
- correct answer Provides the concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate in the dialysate solution?
- correct answer It buffers the acid concentrate
What is the function of bicarbonate when it diffuses into the patient's blood?
- correct answer It normalizes body pH
What are some S/Sx of hyperkalemia?
- correct answer K+ > 6.5 mEq
extreme muscle weakness, dysrhythmias, and possible cardiac arrest
What are some S/Sx of hypokalemia?
- correct answer K+ < 3.5 mEq
fatigue, muscle weakness, paralysis, resp. failure, cardiac instability, arrhythmias, cardiac arrest
What is the normal blood pH range?
- correct answer 7.35 - 7.45
What are the kidneys' endocrine functions?
- correct answer Renin secretion
Erythropoietin secretion
Vitamin d activation
How do we replace normal endocrine kidney functions?
- correct answer By providing medications
How much of normal kidney function is replaced by HD?
- correct answer 15%
,What is uremia?
- correct answer Uremia is a buildup of wastes in the blood due to kidney failure
What does uremia affect?
- correct answer Uremia affects all body systems
What are the most common causes of CKD in the US?
- correct answer diabetes, HTN and polycystic kidney disease
List the treatment goals for a pt. w/ CKD
- correct answer -slowing the progression of CKD
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects if CKD on pt. lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it so important to know what caused your pt.'s CKD?
- correct answer So the RN and PCT can ask about possible problems during data collection and
assessment
List some S/Sx of fluid imbalance
- correct answer HTN, edema, and SOB
Why is sodium balance important?
- correct answer Leads to volume expansion,
increased cardiac output,
increased peripheral vascular resistance
and increased BP
List some systemic effects of CKD
- correct answer -Dry, itchy skin
, -Peripheral neuropathy in the extremities
-GI problems (N/V)
-Psychological problems (anxiety, depression)
What would you advise for a pt. with dry, itchy skin?
- correct answer -use hyper-fatted soaps and lotions
-assess for safety at home
-provide emotional support
-control diabetes and phosphorus
What would you advise for a pt. with peripheral neuropathy?
- correct answer -Monitor pt. for changes in motor function, decreased strength in legs, C/O restless
legs, and burning feet.
-Advise not to walk barefoot
-Practice good foot care
What would you advise for a pt. with GI problems?
- correct answer -inform RN and MD of any bleeding problems, constipation, diarrhea
- inform RN and MD of ER visits
-Take meds as ordered (stool softeners, immodium, etc.)
What would you advise for a pt. with psychological problems?
- correct answer Verbalize struggles to IDT (core team), especially the social worker
A common cause of HTN in dialysis patients is:
- correct answer Fluid overload
What does HTN lead to?
- correct answer Left ventricular hypertrophy
Left ventricular hypertrophy leads to:
- correct answer Ischemic heart disease, arrhythmia, myocardial infarction, and sudden death.
2026\2027 A+ Grade
List the four transport mechanisms that play a role in hemodialysis
- correct answer Ultrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis
- correct answer Fluid is pushed through the semipermeable membrane (SPM). Think: wringing out a
wet rag.
Explain convection in hemodialysis
- correct answer Solutes DRAG across the semipermeable membrane with fluid
Explain diffusion in hemodialysis
- correct answer PARTICLES move from HIGH concentration to LOW concentration
Explain osmosis in hemodialysis
- correct answer FLUID moves LOW concentration to HIGH concentration
What are the kidneys' excretory functions?
- correct answer To normalize electrolytes, remove wastes, provide fluid and nutrient balance
How do we replace normal excretory kidney functions?
- correct answer By using acid concentrate to help normalize electrolytes and ultrafiltration to provide
fluid balance
,What is the function of acid concentrate
- correct answer Provides the concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate in the dialysate solution?
- correct answer It buffers the acid concentrate
What is the function of bicarbonate when it diffuses into the patient's blood?
- correct answer It normalizes body pH
What are some S/Sx of hyperkalemia?
- correct answer K+ > 6.5 mEq
extreme muscle weakness, dysrhythmias, and possible cardiac arrest
What are some S/Sx of hypokalemia?
- correct answer K+ < 3.5 mEq
fatigue, muscle weakness, paralysis, resp. failure, cardiac instability, arrhythmias, cardiac arrest
What is the normal blood pH range?
- correct answer 7.35 - 7.45
What are the kidneys' endocrine functions?
- correct answer Renin secretion
Erythropoietin secretion
Vitamin d activation
How do we replace normal endocrine kidney functions?
- correct answer By providing medications
How much of normal kidney function is replaced by HD?
- correct answer 15%
,What is uremia?
- correct answer Uremia is a buildup of wastes in the blood due to kidney failure
What does uremia affect?
- correct answer Uremia affects all body systems
What are the most common causes of CKD in the US?
- correct answer diabetes, HTN and polycystic kidney disease
List the treatment goals for a pt. w/ CKD
- correct answer -slowing the progression of CKD
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects if CKD on pt. lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it so important to know what caused your pt.'s CKD?
- correct answer So the RN and PCT can ask about possible problems during data collection and
assessment
List some S/Sx of fluid imbalance
- correct answer HTN, edema, and SOB
Why is sodium balance important?
- correct answer Leads to volume expansion,
increased cardiac output,
increased peripheral vascular resistance
and increased BP
List some systemic effects of CKD
- correct answer -Dry, itchy skin
, -Peripheral neuropathy in the extremities
-GI problems (N/V)
-Psychological problems (anxiety, depression)
What would you advise for a pt. with dry, itchy skin?
- correct answer -use hyper-fatted soaps and lotions
-assess for safety at home
-provide emotional support
-control diabetes and phosphorus
What would you advise for a pt. with peripheral neuropathy?
- correct answer -Monitor pt. for changes in motor function, decreased strength in legs, C/O restless
legs, and burning feet.
-Advise not to walk barefoot
-Practice good foot care
What would you advise for a pt. with GI problems?
- correct answer -inform RN and MD of any bleeding problems, constipation, diarrhea
- inform RN and MD of ER visits
-Take meds as ordered (stool softeners, immodium, etc.)
What would you advise for a pt. with psychological problems?
- correct answer Verbalize struggles to IDT (core team), especially the social worker
A common cause of HTN in dialysis patients is:
- correct answer Fluid overload
What does HTN lead to?
- correct answer Left ventricular hypertrophy
Left ventricular hypertrophy leads to:
- correct answer Ischemic heart disease, arrhythmia, myocardial infarction, and sudden death.
