Fresenius Clinical Annual Competency Exam = = = = =
2026/2027: Practice Questions & Verified = = = = =
Solutions =
200 Questions with Detailed Rationales |
= = = = =
=Dialysis Technician Certification Review = = = =
=
SECTION 1: HEMODIALYSIS PRINCIPLES & MACHINE
= = = = = =
OPERATION (Questions 1-40) = = =
=
Question 1: = =
What is the primary physical principle employed in hemodialysis?
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A) Osmosis =
B) Convection =
C) Diffusion =
D) Adsorption =
Answer: C) Diffusion
= = =
Rationale: Diffusion is the main physical principle used in hemodialys
= = = = = = = = =
is, where solutes move from an area of higher concentration (the bloo
= = = = = = = = = = =
,d) to an area of lower concentration (the dialysate) across a semiper
= = = = = = = = = = =
meable membrane . This process removes waste products such as ure
= = = = = = = = = =
a and creatinine while allowing essential electrolytes to be balanced
= = = = = = = = =
. =
=
Question 2: = =
What is the normal dialysate solution flow rate during conventional
= = = = = = = = = =
hemodialysis? =
A) 100-200 mL/min = =
B) 200-400 mL/min = =
C) 500-800 mL/min = =
D) >800 mL/min = =
Answer: C) 500-800 mL/min = = = =
Rationale: The standard dialysate flow rate during conventional he
= = = = = = = =
modialysis is 500- = =
800 mL/min . This flow rate helps maintain the concentration gradien
= = = = = = = = = =
t necessary for effective diffusion of waste products across the dialy
= = = = = = = = = =
zer membrane. = =
=
Question 3: =
, =
A major factor affecting ultrafiltration during hemodialysis is:
= = = = = = = =
A) Dialysate temperature = =
B) Blood flow rate = = =
C) Pressure =
D) Time =
Answer: C) Pressure = = =
Rationale: Pressure is a primary determinant of ultrafiltration. The tr
= = = = = = = = =
ansmembrane pressure (TMP) gradient drives fluid removal across t
= = = = = = = =
he dialyzer membrane . Higher TMP increases fluid removal, while lo
= = = = = = = = = =
wer TMP reduces it.
= = = =
=
Question 4: = =
Which metric is used to quantify the adequacy of a hemodialysis ses
= = = = = = = = = = =
sion normalized to patient body water volume?
= = = = = = =
A) Creatinine clearance = =
B) Pre-dialysis BUN = =
C) Kt/V =
D) Urea Reduction Ratio (URR)
= = = =
, Answer: C) Kt/V = = =
Rationale: Kt/V is the standard measure of hemodialysis adequacy,
= = = = = = = =
representing the clearance of urea (K) multiplied by treatment time (
= = = = = = = = = = =
t) divided by the patient's total body water volume (V) . A minimum s
= = = = = = = = = = = = =
pKt/V of 1.2 is recommended by KDOQI guidelines.
= = = = = = = =
=
Question 5: = =
What is the KDOQI recommended target for weekly Kt/V for hemo
= = = = = = = = = =
dialysis adequacy? = =
A) 1.0 =
B) 1.2 =
C) 1.4 =
D) 1.8 =
Answer: B) 1.2 = = =
Rationale: The KDOQI guidelines recommend a minimum singlepool
= = = = = = =
Kt/V of 1.2 for adequate hemodialysis . Values below this threshold
= = = = = = = = = = =
indicate under-
= =
dialysis, which increases patient morbidity and mortality.
= = = = = = =
Question 6: =
=
2026/2027: Practice Questions & Verified = = = = =
Solutions =
200 Questions with Detailed Rationales |
= = = = =
=Dialysis Technician Certification Review = = = =
=
SECTION 1: HEMODIALYSIS PRINCIPLES & MACHINE
= = = = = =
OPERATION (Questions 1-40) = = =
=
Question 1: = =
What is the primary physical principle employed in hemodialysis?
= = = = = = = = =
A) Osmosis =
B) Convection =
C) Diffusion =
D) Adsorption =
Answer: C) Diffusion
= = =
Rationale: Diffusion is the main physical principle used in hemodialys
= = = = = = = = =
is, where solutes move from an area of higher concentration (the bloo
= = = = = = = = = = =
,d) to an area of lower concentration (the dialysate) across a semiper
= = = = = = = = = = =
meable membrane . This process removes waste products such as ure
= = = = = = = = = =
a and creatinine while allowing essential electrolytes to be balanced
= = = = = = = = =
. =
=
Question 2: = =
What is the normal dialysate solution flow rate during conventional
= = = = = = = = = =
hemodialysis? =
A) 100-200 mL/min = =
B) 200-400 mL/min = =
C) 500-800 mL/min = =
D) >800 mL/min = =
Answer: C) 500-800 mL/min = = = =
Rationale: The standard dialysate flow rate during conventional he
= = = = = = = =
modialysis is 500- = =
800 mL/min . This flow rate helps maintain the concentration gradien
= = = = = = = = = =
t necessary for effective diffusion of waste products across the dialy
= = = = = = = = = =
zer membrane. = =
=
Question 3: =
, =
A major factor affecting ultrafiltration during hemodialysis is:
= = = = = = = =
A) Dialysate temperature = =
B) Blood flow rate = = =
C) Pressure =
D) Time =
Answer: C) Pressure = = =
Rationale: Pressure is a primary determinant of ultrafiltration. The tr
= = = = = = = = =
ansmembrane pressure (TMP) gradient drives fluid removal across t
= = = = = = = =
he dialyzer membrane . Higher TMP increases fluid removal, while lo
= = = = = = = = = =
wer TMP reduces it.
= = = =
=
Question 4: = =
Which metric is used to quantify the adequacy of a hemodialysis ses
= = = = = = = = = = =
sion normalized to patient body water volume?
= = = = = = =
A) Creatinine clearance = =
B) Pre-dialysis BUN = =
C) Kt/V =
D) Urea Reduction Ratio (URR)
= = = =
, Answer: C) Kt/V = = =
Rationale: Kt/V is the standard measure of hemodialysis adequacy,
= = = = = = = =
representing the clearance of urea (K) multiplied by treatment time (
= = = = = = = = = = =
t) divided by the patient's total body water volume (V) . A minimum s
= = = = = = = = = = = = =
pKt/V of 1.2 is recommended by KDOQI guidelines.
= = = = = = = =
=
Question 5: = =
What is the KDOQI recommended target for weekly Kt/V for hemo
= = = = = = = = = =
dialysis adequacy? = =
A) 1.0 =
B) 1.2 =
C) 1.4 =
D) 1.8 =
Answer: B) 1.2 = = =
Rationale: The KDOQI guidelines recommend a minimum singlepool
= = = = = = =
Kt/V of 1.2 for adequate hemodialysis . Values below this threshold
= = = = = = = = = = =
indicate under-
= =
dialysis, which increases patient morbidity and mortality.
= = = = = = =
Question 6: =
=
