100+ Free BONENT CHN Practice Questions

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Question 1

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According to the KDIGO 2024 CKD classification, a patient with an estimated glomerular filtration rate (eGFR) of 22 mL/min/1.73 m^2 falls into which CKD stage?

Stage G2

Stage G3a

Stage G3b

Stage G4

to track

2026 Statistics

Key Facts: BONENT CHN Exam

150

Multiple-Choice Questions

BONENT

3 hrs

Exam Length

BONENT

70%

Passing Score

BONENT

$235-$255

Exam Fee

BONENT

2,000 hrs

Required Nephrology RN Experience

BONENT eligibility

4 years

Certification Validity

BONENT

The BONENT CHN exam is 150 multiple-choice questions over 3 hours, costs $235-$255, and requires 70% to pass. Eligibility requires an active RN license plus 12 months and 2,000 hours of nephrology nursing experience. The credential validates an RN's ability to deliver hemodialysis aligned with KDOQI/KDIGO guidelines and CMS Conditions for Coverage.

Sample BONENT CHN Practice Questions

Try these sample questions to test your BONENT CHN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the KDIGO 2024 CKD classification, a patient with an estimated glomerular filtration rate (eGFR) of 22 mL/min/1.73 m^2 falls into which CKD stage?

A.Stage G2

B.Stage G3a

C.Stage G3b

D.Stage G4

Explanation: CKD stage G4 is defined as an eGFR of 15-29 mL/min/1.73 m^2 (severely decreased GFR). Patients in stage G4 are typically referred to nephrology for transplant evaluation and dialysis access planning before stage G5 (eGFR <15) when renal replacement therapy is usually initiated.

2A predialysis CKD patient reports fatigue, pruritus, anorexia, and a metallic taste. The nurse recognizes these as classic signs of:

A.Hypocalcemia

B.Uremic syndrome

C.Iron deficiency anemia

D.Acute glomerulonephritis

Explanation: Uremic syndrome results from accumulation of nitrogenous wastes and middle molecules when GFR is severely reduced. Hallmark symptoms include fatigue, pruritus, anorexia, nausea, metallic or 'fishy' taste (uremic fetor), pericarditis, and asterixis. Persistent uremic symptoms despite optimal medical therapy are an indication to initiate dialysis.

3Which equation does the National Kidney Foundation currently recommend for estimating GFR in adults using serum creatinine?

A.Cockcroft-Gault formula

B.MDRD 4-variable equation

C.CKD-EPI 2021 creatinine equation (race-free)

D.Schwartz pediatric formula

Explanation: The CKD-EPI 2021 creatinine equation, which removed the race coefficient, is the current NKF/ASN recommended equation for estimating GFR in adults. It uses age, sex, and serum creatinine. The race-free version was endorsed in 2021 to address health-equity concerns with the prior race coefficient.

4Per KDIGO 2017 CKD-MBD guidelines, which laboratory pattern is characteristic of secondary hyperparathyroidism in advanced CKD?

A.Elevated calcium, low phosphate, low PTH

B.Low calcium, elevated phosphate, elevated PTH

C.Elevated calcium, elevated phosphate, low PTH

D.Low calcium, low phosphate, elevated PTH

Explanation: Secondary hyperparathyroidism in CKD develops as failing kidneys retain phosphate and lose the ability to convert vitamin D to its active form (calcitriol). Hyperphosphatemia, reduced calcitriol, and resulting hypocalcemia stimulate the parathyroid glands to secrete PTH. The classic pattern is therefore low calcium, elevated phosphate, and elevated PTH.

5Per KDIGO, CKD is defined as abnormalities of kidney structure or function present for at least:

A.1 month

B.3 months

C.6 months

D.12 months

Explanation: KDIGO defines CKD as abnormalities of kidney structure or function present for >3 months with implications for health. The 3-month criterion distinguishes CKD from acute kidney injury, which can resolve within days to weeks.

6A hemodialysis patient has serum phosphate 7.8 mg/dL, calcium 8.6 mg/dL, and intact PTH 950 pg/mL despite phosphate binders and active vitamin D. Which medication class most directly suppresses PTH secretion at this point?

A.Loop diuretic

B.Calcimimetic (cinacalcet or etelcalcetide)

C.Beta-blocker

D.Sevelamer carbonate

Explanation: Calcimimetics such as cinacalcet (oral) and etelcalcetide (IV, post-dialysis) sensitize the calcium-sensing receptor on parathyroid cells, lowering PTH while also tending to lower calcium and phosphate. They are first-line for severe secondary hyperparathyroidism in dialysis patients per KDIGO 2017.

7Which finding most strongly suggests that an outpatient should be started on chronic hemodialysis?

A.Stable eGFR of 28 mL/min/1.73 m^2 with no symptoms

B.Asymptomatic proteinuria of 1.5 g/day

C.Uremic pericarditis on echocardiogram

D.Microscopic hematuria

Explanation: Uremic pericarditis is an absolute indication for urgent initiation of dialysis. Other absolute indications include uremic encephalopathy, refractory hyperkalemia, severe metabolic acidosis, and volume overload unresponsive to diuretics (mnemonic: AEIOU).

8Per KDIGO 2017 CKD-MBD, which serum phosphate target is recommended for adults on maintenance dialysis?

A.Lower elevated phosphate toward the normal range

B.Maintain phosphate strictly at 2.0-3.0 mg/dL

C.Maintain phosphate at 6.0-7.5 mg/dL

D.Avoid measuring phosphate routinely

Explanation: KDIGO 2017 recommends lowering elevated serum phosphate toward the normal range in dialysis patients, rather than aiming for a fixed numeric target. Severe hyperphosphatemia is associated with vascular calcification and cardiovascular mortality. Phosphate is monitored at least monthly in HD patients.

9In hemodialysis, the movement of solute across the semipermeable membrane down a concentration gradient is termed:

A.Ultrafiltration

B.Convection

C.Diffusion

D.Osmosis

Explanation: Diffusion is the passive movement of solutes across a semipermeable membrane from an area of higher concentration to lower concentration, driven by a concentration gradient. It is the principal mechanism for removing small solutes such as urea and creatinine in hemodialysis.

10Ultrafiltration during hemodialysis is achieved primarily by:

A.A hydrostatic pressure gradient across the dialyzer membrane

B.A glucose concentration gradient in the dialysate

C.A diffusion gradient between blood and dialysate

D.A pH gradient between blood and dialysate

Explanation: Ultrafiltration in hemodialysis is created by a transmembrane pressure (TMP) gradient — a positive pressure on the blood side and/or negative pressure on the dialysate side. The volume of plasma water removed is calculated as TMP multiplied by the dialyzer's ultrafiltration coefficient (KUf).

About the BONENT CHN Exam

The BONENT CHN credential certifies RNs who deliver and monitor hemodialysis treatments. The exam covers renal pathophysiology, dialysis principles, vascular access, prescription and adequacy, complications, pharmacology, patient education, and professional practice.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

70%

Exam Fee

$235-$255 (BONENT (Board of Nephrology Examiners Nursing and Technology))

BONENT CHN Exam Content Outline

15%

Renal Pathophysiology and CKD

CKD stages, GFR estimation, uremia, CKD-MBD

15%

Hemodialysis Principles

Diffusion, convection, ultrafiltration, Kt/V, URR, dialyzer reuse

15%

Vascular Access

AVF, AVG, catheters, cannulation techniques, KDOQI surveillance

15%

HD Prescription and Adequacy

Dry weight, UFR, dialysate composition, blood/dialysate flow, anticoagulation

15%

Complications

Hypotension, cramps, disequilibrium, first-use reactions, hemolysis, air embolism, electrolytes

10%

Pharmacology

Phosphate binders, ESAs, HIF-PHIs, IV iron, vitamin D analogs, calcimimetics, heparin

Patient Education and Self-Management

Fluid restriction, dietary K/Phos/Na, interdialytic weight gain

10%

Professional Practice and Ethics

KDOQI, ESRD QIP, CMS CfC, HIPAA, advance directives, palliative care

How to Pass the BONENT CHN Exam

What You Need to Know

Passing score: 70%
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $235-$255

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

BONENT CHN Study Tips from Top Performers

1Memorize KDOQI/KDIGO target numbers: spKt/V at least 1.2, URR at least 65%, UFR less than 13 mL/kg/hr, dialysate Na 135-145, K 2-3, Ca 2.5-3.5, HCO3 35-40, Hgb 10-11.5

2Master vascular access: fistula-first per KDOQI, rope-ladder vs buttonhole, the 'rule of 6s' for fistula maturity, and CDC catheter-care bundle

3Drill complications: intradialytic hypotension protocol, DDS at initiation, Type A vs Type B first-use, hemolysis vs air embolism management

4Know CKD-MBD pharmacology cold: phosphate binders (Ca-based vs sevelamer/lanthanum/ferric citrate), vitamin D analogs, calcimimetics (cinacalcet/etelcalcetide)

5Distinguish RN vs technician scope under CMS Conditions for Coverage and your state nurse practice act

Frequently Asked Questions

What is the BONENT CHN exam?

The BONENT Certified Hemodialysis Nurse (CHN) exam is a 150-question, 3-hour multiple-choice test for registered nurses delivering hemodialysis. It is administered by BONENT (Board of Nephrology Examiners Nursing and Technology) and requires an active RN license plus 12 months and 2,000 hours of qualifying nephrology nursing experience.

How much does the BONENT CHN exam cost?

The BONENT CHN exam fee is approximately $235-$255 depending on member status. Confirm the current fee on the BONENT website before applying. The credential is valid for 4 years and requires recertification by continuing education or re-examination.

What is the passing score for the CHN exam?

BONENT CHN candidates must score at least 70% to pass. Score reports are typically provided immediately after the test ends, and detailed performance feedback by content area is shared with applicants who do not pass.

How is the CHN different from the CHT or CCHT?

The CHN is for registered nurses delivering and supervising hemodialysis. The CHT (BONENT) and CCHT (NNCC) are technician-level credentials for hemodialysis technicians. CHN questions emphasize RN-scope responsibilities such as patient assessment, plan-of-care management, IV medication administration, and supervision of unlicensed personnel.

How should I study for the CHN exam?

Plan 60-100 hours over 6-12 weeks. Focus on KDOQI vascular access guidelines, KDIGO CKD-MBD and anemia targets, dialysate composition (Na 135-145, K 2-3, Ca 2.5-3.5, HCO3 35-40), Kt/V and URR adequacy targets, and CMS Conditions for Coverage. Use the BONENT candidate handbook for the official content outline and practice with question banks.

Are practice questions enough to pass the CHN?

Practice questions help reinforce concepts but should be combined with reviewing KDOQI/KDIGO guidelines, the BONENT candidate handbook, and a nephrology nursing textbook (e.g., the ANNA Core Curriculum). Pair this free 100-question bank with our AI tutor to drill weak areas.