Certification Practice Exam Questions

Certified Nephrology Nurse (CNN) Certification Practice Exam Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

(All nephrology nursing domains included: Clinical Practice, Hemodialysis,

Peritoneal Dialysis, Transplantation, and Professional Practice)

• The kidneys are primarily responsible for regulating which of the

following?

• Heart rate
• Fluid and electrolyte balance
• Lung expansion
• Muscle contraction

Rationale: The kidneys maintain homeostasis by regulating fluid volume,

electrolytes, and acid-base balance. 1 / 4

2. The normal glomerular filtration rate (GFR) in adults is approximately:

• 50 mL/min/1.73m²
• 125 mL/min/1.73m²
• 200 mL/min/1.73m²
• 90 mL/min/1.73m²

Rationale: A normal GFR of 125 mL/min/1.73m² indicates healthy kidney

function.

• Which laboratory value is most specific for evaluating kidney function?

A. AST

• Serum creatinine
• Hemoglobin
• Albumin

Rationale: Serum creatinine directly reflects kidney filtration efficiency and

is used to calculate GFR.

4. A major complication of peritoneal dialysis is:

• Hypertension
• Peritonitis
• Hyperkalemia
• Metabolic alkalosis 2 / 4

Rationale: Peritonitis is a common and serious infection in peritoneal

dialysis due to contamination during exchanges.

5. In hemodialysis, the principle of solute removal by diffusion depends on:

• Blood flow rate only
• Concentration gradient across the membrane
• Ultrafiltration pressure
• Dialysate temperature

Rationale: Diffusion occurs as solutes move from an area of higher

concentration (blood) to lower concentration (dialysate).

• Which electrolyte imbalance is commonly seen in chronic kidney disease

(CKD)?

• Hypokalemia
• Hyperphosphatemia
• Hypocalcemia
• Hyponatremia

Rationale: Impaired phosphate excretion leads to hyperphosphatemia in

CKD.

• The main cause of anemia in patients with end-stage renal disease (ESRD)

is: 3 / 4

• Blood loss
• Decreased erythropoietin production
• Vitamin B12 deficiency
• Hemolysis

Rationale: Diseased kidneys fail to produce erythropoietin, reducing red

blood cell production.

• Which of the following medications is a phosphate binder?
• Epoetin alfa
• Sevelamer
• Furosemide
• Spironolactone

Rationale: Sevelamer binds dietary phosphate in the gut, reducing

absorption and serum phosphate levels.

9. During hemodialysis, hypotension can occur primarily because of:

• Sodium retention
• Rapid fluid removal
• Hypothermia
• Metabolic acidosis

Rationale: Excessive ultrafiltration reduces intravascular volume, leading

to hypotension.

• / 4