200+ Free CDN Practice Questions

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Question 1

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Which of the following best describes the pathophysiology of chronic kidney disease (CKD)?

Acute reversible damage to renal tubules

Progressive and irreversible loss of nephron function over time

Sudden obstruction of the renal artery causing ischemia

Autoimmune destruction of glomerular basement membrane

to track

2026 Statistics

Key Facts: CDN Exam

150

Exam Questions

NNCC

70%

Passing Score

Scaled score 95

3 hrs

Exam Duration

NNCC

$350

Exam Fee

NNCC

52%

Hemodialysis

Largest section

3 years

Certification Validity

NNCC

The CDN exam has 150 questions in 3 hours with a passing score of 70% (scaled score 95). The four content areas are: Kidney Disease Concepts (28%), Hemodialysis (52%), Peritoneal Dialysis (16%), and Transplantation/Acute Therapies (4%). Requires RN license and 2,000+ hours nephrology experience. Certification valid for 3 years. Exam fee is $350 ($300 with ANNA membership).

Sample CDN Practice Questions

Try these sample questions to test your CDN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Which of the following best describes the pathophysiology of chronic kidney disease (CKD)?

A.Acute reversible damage to renal tubules

B.Progressive and irreversible loss of nephron function over time

C.Sudden obstruction of the renal artery causing ischemia

D.Autoimmune destruction of glomerular basement membrane

Explanation: CKD is defined as progressive and irreversible loss of nephron function over a period of months to years. The loss of nephrons is permanent and leads to declining glomerular filtration rate (GFR).

2A patient with CKD stage 4 has a GFR of 28 mL/min/1.73m². What is the most accurate description of this stage?

A.Kidney damage with normal or high GFR

B.Mild decrease in GFR

C.Moderate decrease in GFR

D.Severe decrease in GFR

Explanation: CKD Stage 4 is defined as severe decrease in GFR with a range of 15-29 mL/min/1.73m². At this stage, patients require preparation for renal replacement therapy.

3Which laboratory finding is most consistent with acute kidney injury (AKI) in the oliguric phase?

A.Serum creatinine decreasing by 0.5 mg/dL per day

B.BUN:creatinine ratio of 10:1

C.Rising serum potassium and phosphate levels

D.Dilute urine with low specific gravity

Explanation: During the oliguric phase of AKI, the kidneys cannot excrete potassium and phosphate, leading to hyperkalemia and hyperphosphatemia. BUN and creatinine rise, and urine output is low.

4Which of the following is the primary cause of anemia in patients with CKD?

A.Iron deficiency from poor dietary intake

B.Decreased erythropoietin production by the kidneys

C.Chronic blood loss through dialysis circuit

D.Vitamin B12 deficiency from restricted diet

Explanation: The primary cause of anemia in CKD is decreased erythropoietin (EPO) production by the damaged kidneys. EPO stimulates red blood cell production in the bone marrow.

5A dialysis patient presents with bone pain and fractures. Which mineral bone disorder is most likely responsible?

A.Osteoporosis from steroid use

B.Osteitis fibrosa cystica from secondary hyperparathyroidism

C.Osteomalacia from vitamin D intoxication

D.Paget disease of bone

Explanation: Renal osteodystrophy includes osteitis fibrosa cystica caused by secondary hyperparathyroidism due to phosphate retention, low calcium, and decreased vitamin D activation in CKD.

6Which medication should be held before administering intravenous contrast to a patient with CKD?

A.Erythropoietin stimulating agents

B.Metformin

C.Calcium carbonate

D.Sevelamer

Explanation: Metformin should be held before and after contrast administration due to the risk of lactic acidosis if contrast-induced nephropathy occurs.

7What is the recommended protein intake for a stable hemodialysis patient?

A.0.6 g/kg/day

B.0.8 g/kg/day

C.1.0-1.2 g/kg/day

D.2.0 g/kg/day

Explanation: Hemodialysis patients require higher protein intake (1.0-1.2 g/kg/day) to compensate for amino acid losses during dialysis and maintain nutritional status.

8Which electrolyte abnormality is most dangerous in AKI and requires immediate intervention?

A.Hyponatremia with sodium of 128 mEq/L

B.Hyperkalemia with potassium of 6.8 mEq/L

C.Hypocalcemia with calcium of 8.0 mg/dL

D.Hyperphosphatemia with phosphate of 5.5 mg/dL

Explanation: Severe hyperkalemia (K+ >6.5 mEq/L) can cause life-threatening cardiac arrhythmias and requires immediate treatment with calcium, insulin/glucose, and dialysis.

9A patient with diabetic nephropathy asks about the earliest sign of kidney damage. What should the nurse explain?

A.Elevated serum creatinine

B.Decreased urine output

C.Microalbuminuria

D.High blood pressure

Explanation: Microalbuminuria (30-300 mg/day) is the earliest marker of diabetic nephropathy and indicates increased permeability of the glomerular basement membrane.

10Which of the following is a modifiable risk factor for progression of CKD?

A.Age over 65 years

B.Family history of polycystic kidney disease

C.Uncontrolled hypertension

D.Male gender

Explanation: Uncontrolled hypertension is a major modifiable risk factor for CKD progression. Maintaining BP <130/80 mmHg can slow progression of kidney disease.

About the CDN Exam

The CDN (Certified Dialysis Nurse) exam validates expertise in dialysis nursing care. It covers kidney disease concepts, hemodialysis, peritoneal dialysis, and transplantation/acute therapies. The exam tests knowledge of acute and chronic kidney disease, dialysis principles and procedures, vascular access management, complications, patient education, and professional nursing practice in dialysis settings.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

70% (Scaled score 95)

Exam Fee

$350 ($300 with ANNA membership) (NNCC (Nephrology Nursing Certification Commission))

CDN Exam Content Outline

52%

Hemodialysis

Dialysis principles, vascular access, machine operation, treatment delivery, complications management, patient assessment, water treatment, and safety protocols

28%

Kidney Disease Concepts

Acute kidney injury, chronic kidney disease, end-stage renal disease, electrolyte imbalances, acid-base disorders, anemia management, bone disease, and nutrition

16%

Peritoneal Dialysis

PD modalities, catheter care, infection control, complications, and patient education

Transplantation and Acute Therapies

Transplant basics, immunosuppression, CRRT, and acute dialysis therapies

How to Pass the CDN Exam

What You Need to Know

Passing score: 70% (Scaled score 95)
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $350 ($300 with ANNA membership)

Keys to Passing

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

CDN Study Tips from Top Performers

1Master hemodialysis (52%) — dialysis principles, vascular access types, and complications management

2Study renal pathophysiology — AKI, CKD stages, ESRD progression, and disease processes

3Know electrolyte imbalances — hyperkalemia, hyperphosphatemia, and management strategies

4Understand vascular access — AV fistula (preferred), AV graft, central venous catheters

5Review peritoneal dialysis — CAPD vs APD, catheter care, peritonitis prevention and treatment

6Learn transplant basics — immunosuppressants (tacrolimus, mycophenolate), rejection types, CRRT indications

Frequently Asked Questions

What is the CDN certification?

CDN (Certified Dialysis Nurse) is a certification from the NNCC for registered nurses specializing in dialysis nursing. It validates expertise in kidney disease management, hemodialysis, peritoneal dialysis, and transplantation/acute therapies in dialysis settings.

How many questions are on the CDN exam?

The CDN exam has 150 multiple-choice questions with a 3-hour time limit. The passing score is 70% (scaled score of 95). Hemodialysis is the largest content area at 52% of the exam.

What are the prerequisites for the CDN exam?

You need an active RN license, at least 2,000 hours of nephrology nursing experience, and 20 contact hours of continuing education in nephrology within the last 3 years. Experience must be within the last 2 years.

What is the most heavily tested topic on the CDN exam?

Hemodialysis accounts for 52% of the exam — more than half of all questions. Focus on dialysis principles, vascular access (AVF, AVG, catheters), machine operation, complications (hypotension, cramping, air embolism), and water treatment.

How should I prepare for the CDN exam?

Plan for 150-200 hours of study. Master hemodialysis principles (52% of exam). Study renal pathophysiology, electrolyte management, and acid-base disorders. Know peritoneal dialysis modalities and complications. Understand transplant basics and CRRT. Complete 200+ practice questions with detailed explanations.