For Nurses Outside the US

For Nephrology Nurses Practicing Outside the US

Certified Dialysis Nurse® (CDN®) - International

Three Easy Steps to Certification

  • The applicant must hold a current, full and unrestricted license as a first-level general nurse in the country in which one's general nursing education was completed.
  • The applicant must meet the eligibility criteria for licensure as a registered nurse (RN) in the United States in accordance with requirements of the Commission on Graduates of Foreign Nursing Schools (CGFNS).
  • The applicant must have completed a minimum of 2000 hours experience as a licensed nurse in nephrology nursing nursing caring for patients who require or may require dialysis, or educating/supervising staff who care for patients who require or may require dialysis within the two (2) years prior to submitting this application.
  • The applicant must have completed twenty (20) contact hours of continuing education credit in nephrology nursing within two (2) years prior to submitting the exam application.

The CDN paper-and-pencil exam consists of 200 questions and must be completed in four (4) hours. The CDN computer-based exam consists of 175 questions and must be completed in three (3) hours. A correct response rate of no less than 70% is required to pass the exam.

Download the Exam Application

Standard Fees

Fee Name Amount
Exam Fee
One-time Retake
CBT 90-day Extension
Exam Application Processing Fee (Non-refundable, included in exam fee)
Expedited Review
Late Fee
Incomplete Application Fee
Returned Check/Cancelled Payment Fee
Duplicate Wallet Card or Certificate
Certification Validation Letter (Except to State Boards of Nursing)

Reduced Fees for Partner* Members

Fee Name Amount
Exam Fee
One-Time Retake
Late Fee

*Current partner organizations include the American Nephrology Nurses Association, the American Society of Nephrology, the National Kidney Foundation, and the Nurses Organization of Veterans Affairs.

  • Download our Certification Preparation Guide.
  • Determine the content of the examination from the test blueprint.
  • Read the test specifications to determine which content areas have the most "weight," because those will have the highest number of questions.
  • Review the exam reference list to familiarize yourself with material that will be included on the test.
  • Focus on areas with which you are least familiar.
  • Take the Online Practice Exam (see info below)
  • Learning strategies:
    • attend a certification review course - check with your local chapter regarding upcoming opportunities or locations may be listed on the ANNA site.
    • systematically review a nephrology nursing reference textbook.
    • participate in a study group.
    • spend a day with a colleague working in an area you need to learn about.
  • Listen to the directions given prior to the examination and follow them exactly.
  • Caution: Test preparation websites offering alternative and/or shortcuts to test preparation should be avoided. Exam content is confidential and is not shared with any individuals involved in test preparation activities. "Tricks of testing" and "short cut methods for test preparation" are specifically avoided when creating this exam. We test candidates on content and not on their "test taking skills." If you have any questions about the best methods to prepare please call us at 888.884.6622. Our goal is that each exam candidate best use their time and money to reach the end result of demonstrating their excellence in nephrology nursing care through certification.

The purpose of the CDN Practice Test is to allow candidates for the CDN examination to practice with a test similar in content and format to the actual CDN examination. However, no questions on the CDN Practice Test will be on the actual CDN examination. Taking the CDN Practice Test is not required and does not guarantee a similar result on the CDN examination.

The fee for the test is $50. The CDN Practice Test contains 50 multiple-choice questions available in two modes: Practice Mode provides the correct answer and rationale after each question, while Test Mode holds the results until the end of the test. Both modes at the end of the test provide a Score Report which displays your score and breakdown of percentage correct in each area of the test blueprint. The actual CDN examination contains 150 questions in three [3] hours and requires a correct response rate of 73% correct to pass.

You will have access to the test for 90 days. Several scrambled versions are offered for retesting. Your credit card payment will be processed on-line and you will be granted immediate access to the CDN Practice Test.

To purchase the CDN Practice Exam, please read the Terms of Agreement and click the appropriate button below.

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Return to the CDN Practice Test

Online Practice Exam

Fee Name Amount
Online Practice Exam

Core References

  • Bodin, S.M. (Ed.) (2022). Contemporary Nephrology Nursing, 4th ed.  Pitman, NJ: ANNA.

    More Info and Purchase Here

  • Centers for Medicare and Medicaid Services (CMS). End-Stage Kidney Disease Program Interpretive Guidance Version 1.1

    View Online

  • Counts, C.S. (Ed.) (2020). Core Curriculum for Nephrology Nursing, 7th ed.  Pitman, NJ: ANNA.

    More Info and Purchase Here

  • Gomez, N. (Ed.) (2022). Nephrology Nursing Scope and Standards of Practice, 9th ed. Pitman, NJ: ANNA.

    More Info and Purchase Here

  • Kallenbach, J.Z. (2016). Review of hemodialysis for Nurses and Dialysis Personnel, 9th ed.  St. Louis, MO: Elsevier/Mosby.
  • Wilson, B.A., Shannon, M.T., & Shields, K.M. (2017). Pearson Nurse’s Drug Guide 2017. Hoboken, NJ: Pearson Education, Inc. (you may consult any similar current nurse’s drug guide)

Emotional Preparation

  • Moderate anxiety is normal and may be helpful - you may be more alert and open to learning; however too much anxiety is detrimental and will interfere with learning and test-taking.
  • Study and prepare for the examination so that you feel confident.
  • Think positively - you possess a wealth of experience and the examination will allow you to demonstrate that knowledge.
  • Use anxiety-reducing strategies:
    • relaxation response.
    • guided imagery.
    • exercise.
    • prayer.
  • Even though some test takers may finish the exam early, use as much of the allotted time as you need to think through and answer the questions.

Physical Preparation

  • Get a good night's sleep.
  • Eat before the examination - those gray cells will have glucose available when you're answering questions.
  • Gather all the materials you need to take the test the night before the exam:
    • government-issued photo ID.
    • nursing license.
    • examination permit.
    • sweater or jacket in case the room is cool.
  • Allow plenty of time to arrive early.
  • If you are distracted by other candidates during the test or leaving to use the rest room, select a seat at the front of the room where you will be less likely to notice the other candidates.

Tips on Answering Examination Questions

  • Read the questions carefully and focus on key words in the question such as "first", "most likely", "most important", "best". These words are usually printed in boldface type to attract your attention.
  • As you read the question, anticipate the correct answer.
  • Read each of the four choices carefully. Even if the first option sounds correct, read all options before choosing the answer.
  • Do not "read into" the question. Answer the question based only on the information presented, even if you think the answer is too obvious or too easy.
  • Do not be afraid to change an answer. Research has shown that more often than not, test takers change answers to the correct one.
  • Do not spend too much time on any one question. Make a note of the questions of which you are uncertain and return to them later if you have time.
  • If you are unsure about one of the content areas, you may find it helpful to complete the other areas first and leave the problem area for last.
  • "Being certified says to my patients and colleagues that I'm vested in my patients, our program and the staff that I help train and mentor. As a nurse, I'm ethically committed to keeping myself educated and informed as I provide care to renal patients."

    B. Burns, RN CDN