For Nurses Outside the US

For nurses practicing in nephrology outside of the United States, NNCC offers the Certified Dialysis Nurse - International certification program. This certification is exactly the same as the typical CDN, but with requirements that have been adjusted to match the realities of nurses practicing internationally.

For Nephrology Nurses Practicing Outside the US

Nurses Outside US

For Nephrology Nurses Practicing Outside the US

Certified Dialysis Nurse (CDN) - International


  1. 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.
  2. 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).
  3. 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.
  4. The applicant must have completed fifteen (15) contact hours* of continuing education credit in nephrology nursing within two (2) years prior to submitting the exam application.

Please be aware that although programs may meet requirements set forth by other state boards of nursing, they may not meet the Nephrology Nursing Certification Commission criteria.

* Effective July 1, 2015, the continuing education contact hour requirement will increase to twenty (20) hours.

The Exam

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

Exam Sites

Deadlines and Policies

Get Ready

Intellectual Preparation

  • 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
  • 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 through certification.

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.

Practice Exam

The purpose of this test is to allow eligible candidates for the CDN examination to practice with a test similar in content and format developed using the same process as that used in the actual CDN test development. However, no questions on the CDN practice exam will be on the actual CDN exam.

The CDN practice exam contains 50 questions and has 90-minute time limit. The fee for the exam is $50. All questions should be answered; you will not be penalized for guessing. Once the CDN practice exam is completed, all questions and rationale for the correct response will be displayed for review. The actual CDN exam contains 200 questions and must be completed in four (4) hours (150 questions in three [3] hours for the CBT exam) and requires a correct response rate of between 70 and 75% to pass the exam, depending on the version of the test. Taking the CDN practice exam is not required and does not guarantee a similar result on the CDN exam.

Your credit card payment will be processed on-line and you will be granted immediate access to the CDN Practice Exam. When entering the CDN Practice Exam, the examinee will be presented with one question at a time with four responses to choose from. The examinee should select the single best response to that question and then select “NEXT” to save that answer and move to the next question, while still having the ability to come back to that question for further review.

When all questions are completed, the examinee should then choose to “END”. You will be presented with a “Test Summary” indicating which items have responses and which do not. When you are satisfied with your responses, select “Submit test”. A score will be given and each question with the selected response and rationale will be displayed. If you choose to take the exam at another time (for the same fee), the experience will vary but the questions will be the same.

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



Recertification may be done through continuing education and clinical experience or by exam.

View CDN Recertification Information


Standard Fees

Fee Name Amount
Exam Fee
One-time Retake
CBT 90-day Extension
Expedited Review
Late Fee
Incomplete Application Fee

Online Practice Exam

Fee Name Amount
Online Practice Exam

Reduced Fees for ANNA Members

Fee Name Amount
Exam Fee
One-Time Retake
Late Fee