Clinical Annual Competency Exam – Fresenius
COMPLETE QUIZZES AND SOLUTIONS
2026|INSTANT DOWNLOAD PDF
1. Which vascular access site is considered the most preferred
for hemodialysis in chronic patients?
A. Temporary catheter
B. Arteriovenous (AV) fistula
C. Arteriovenous graft
D. Peripherally inserted central catheter (PICC)
Correct answer: B. Arteriovenous (AV) fistula – AV fistulas have
the lowest infection rates and longest patency, making them
the preferred choice for long-term hemodialysis.
2. What is the recommended temperature range for dialysate
during hemodialysis?
A. 35–36°C
B. 36–37°C
C. 37–38°C
D. 38–39°C
Correct answer: B. 36–37°C – Maintaining dialysate
temperature in this range prevents hypotension and patient
discomfort.
3. During hemodialysis, a patient experiences muscle cramps.
What is the priority nursing intervention?
,A. Stop dialysis immediately
B. Administer diuretics
C. Reduce ultrafiltration rate and massage affected muscles
D. Increase blood flow rate
Correct answer: C. Reduce ultrafiltration rate and massage
affected muscles – Cramps are often caused by rapid fluid
removal; slowing ultrafiltration alleviates symptoms.
4. Which of the following is the most common cause of
hypotension during hemodialysis?
A. Rapid ultrafiltration
B. Infection
C. Electrolyte imbalance
D. High dialysate temperature
Correct answer: A. Rapid ultrafiltration – Rapid removal of fluid
can lead to intravascular volume depletion, causing
hypotension.
5. A patient with an AV fistula shows redness, warmth, and
tenderness at the access site. What is the most likely cause?
A. Hematoma
B. Infection
C. Thrombosis
D. Steal syndrome
Correct answer: B. Infection – Redness, warmth, and tenderness
are classic signs of infection at a vascular access site.
,6. The recommended needle placement for AV fistula
cannulation is:
A. Antegrade only
B. Retrograde only
C. Both antegrade and retrograde (rope-ladder or buttonhole
technique)
D. Through the middle of the fistula repeatedly
Correct answer: C. Both antegrade and retrograde – Rotating
sites prevents aneurysm formation and preserves the access.
7. Which electrolyte imbalance is most dangerous during
hemodialysis?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
Correct answer: A. Hypokalemia – Low potassium can lead to
life-threatening arrhythmias during dialysis.
8. Which action is essential before connecting a patient to the
dialysis machine?
A. Check vital signs and weight
B. Administer IV antibiotics
C. Give oral fluids
, D. Flush fistula with saline only
Correct answer: A. Check vital signs and weight – Baseline
assessment is crucial to detect changes during treatment and
calculate ultrafiltration.
9. What is the first sign of air embolism during dialysis?
A. Coughing and dyspnea
B. Muscle cramps
C. Hypotension
D. Fever
Correct answer: A. Coughing and dyspnea – Air embolism
obstructs pulmonary circulation, causing respiratory distress.
10. Which of the following is a correct step in preventing
dialysis-related infections?
A. Wash hands and wear gloves
B. Reuse single-use dialyzers without disinfection
C. Avoid cleaning the station between patients
D. Skip mask use if patient is asymptomatic
Correct answer: A. Wash hands and wear gloves – Standard
infection control practices prevent transmission of pathogens.
11. What is the proper response if a patient’s blood pressure
drops significantly during dialysis?
A. Increase ultrafiltration
COMPLETE QUIZZES AND SOLUTIONS
2026|INSTANT DOWNLOAD PDF
1. Which vascular access site is considered the most preferred
for hemodialysis in chronic patients?
A. Temporary catheter
B. Arteriovenous (AV) fistula
C. Arteriovenous graft
D. Peripherally inserted central catheter (PICC)
Correct answer: B. Arteriovenous (AV) fistula – AV fistulas have
the lowest infection rates and longest patency, making them
the preferred choice for long-term hemodialysis.
2. What is the recommended temperature range for dialysate
during hemodialysis?
A. 35–36°C
B. 36–37°C
C. 37–38°C
D. 38–39°C
Correct answer: B. 36–37°C – Maintaining dialysate
temperature in this range prevents hypotension and patient
discomfort.
3. During hemodialysis, a patient experiences muscle cramps.
What is the priority nursing intervention?
,A. Stop dialysis immediately
B. Administer diuretics
C. Reduce ultrafiltration rate and massage affected muscles
D. Increase blood flow rate
Correct answer: C. Reduce ultrafiltration rate and massage
affected muscles – Cramps are often caused by rapid fluid
removal; slowing ultrafiltration alleviates symptoms.
4. Which of the following is the most common cause of
hypotension during hemodialysis?
A. Rapid ultrafiltration
B. Infection
C. Electrolyte imbalance
D. High dialysate temperature
Correct answer: A. Rapid ultrafiltration – Rapid removal of fluid
can lead to intravascular volume depletion, causing
hypotension.
5. A patient with an AV fistula shows redness, warmth, and
tenderness at the access site. What is the most likely cause?
A. Hematoma
B. Infection
C. Thrombosis
D. Steal syndrome
Correct answer: B. Infection – Redness, warmth, and tenderness
are classic signs of infection at a vascular access site.
,6. The recommended needle placement for AV fistula
cannulation is:
A. Antegrade only
B. Retrograde only
C. Both antegrade and retrograde (rope-ladder or buttonhole
technique)
D. Through the middle of the fistula repeatedly
Correct answer: C. Both antegrade and retrograde – Rotating
sites prevents aneurysm formation and preserves the access.
7. Which electrolyte imbalance is most dangerous during
hemodialysis?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
Correct answer: A. Hypokalemia – Low potassium can lead to
life-threatening arrhythmias during dialysis.
8. Which action is essential before connecting a patient to the
dialysis machine?
A. Check vital signs and weight
B. Administer IV antibiotics
C. Give oral fluids
, D. Flush fistula with saline only
Correct answer: A. Check vital signs and weight – Baseline
assessment is crucial to detect changes during treatment and
calculate ultrafiltration.
9. What is the first sign of air embolism during dialysis?
A. Coughing and dyspnea
B. Muscle cramps
C. Hypotension
D. Fever
Correct answer: A. Coughing and dyspnea – Air embolism
obstructs pulmonary circulation, causing respiratory distress.
10. Which of the following is a correct step in preventing
dialysis-related infections?
A. Wash hands and wear gloves
B. Reuse single-use dialyzers without disinfection
C. Avoid cleaning the station between patients
D. Skip mask use if patient is asymptomatic
Correct answer: A. Wash hands and wear gloves – Standard
infection control practices prevent transmission of pathogens.
11. What is the proper response if a patient’s blood pressure
drops significantly during dialysis?
A. Increase ultrafiltration
