CLINICAL ANNUAL COMPETENCY FRESENIUS
CERTIFICATION EVALUATION 2026 TESTED
QUESTIONS SOLVED
◉ Treatments options - what is peritoneal dialysis . Answer: uses a
permanently placed catheter in the patients higly vascularized
peritoneal cavity. The peritoneum is the membrane surrounding the
abdominal organs. Dialysate fluid is infused into the cavity and is
allowed to dwell there for a period of time. Then the fluid is drained.
Through osmosis and diffusion, excess fluid and waste products are
removed.
◉ Treatments options - What is transplantation . Answer: surgically
implanting a working kidney from a living or cadaver donor and
involves anti- rejection medications.
◉ intracellular. Answer: inside the cells
◉ extracellular. Answer: outside the cells
◉ intravascular. Answer: inside the blood vessels
◉ interstitial. Answer: between the cells
,◉ What is homeostasis ?. Answer: the steady internal state of
equilibrium in the body. A naturally occurring constant balance
within the internal environment of the body.
- the steady state of being
- the kidneys conserve or excrete excess fluid as needed to keep the
internal environment in balance.
◉ What is diffusion ?. Answer: The scientific principle that causes
the sodium to move across the semipermeable membrane .
◉ What is a semi- permeable membrane ?. Answer: A membrane
made from protein, with small pores or holes. Only certain
molecules can fit through the pores depending on the pore size.
Molecules larger than the pore size will not pass through the semi-
permeable membrane. Red blood cells and proteins are too large to
pass through the semi-permeable membrane pores of the dialyzer.
Urea, sodium, potassium and water for example can pass through
the pores of the membranes.
◉ What factors impact the rate of diffusion ?. Answer: Concentration
gradient, temperature, molecular weight of solutes, nature of the
solution, membrane permeablilty, surface area, flow geometry
convection ( solvent drag)
,◉ At what point during the hemodialysis treatment will diffusion
cease to occur ?. Answer: Diffusion will continue throughout the
dialysis treatment until the concentration of each electrolyte found
in the patients blood is equal to the electrolyte concentration in the
dialysate.
◉ What is countercurrent flow ?. Answer: Blood and dialysate flow
in opposite directions - called countercurrent flow. Blood flows
down into the dialyzer (areterial to Venous) dialasate flows up
(venous to arterial). This opposite flow allows for better clearance
and diffusion.
◉ What happens to diffusion when dialyzer fibers clot ?. Answer:
When dialyzer fibers clot - either from inadequate heperanization or
an improperly primed dialyzer, diffusion is decreased. Clotted fibers
cause the permeability of the fiber to be reduced or eliminated
causing a decrease in treatment adequacy.
◉ What are the compartments of the dialyzer and what seperates
them ?. Answer: The dialyzer is composed of two compartments
housed inside a plastic casing. The blood compartment is seperated
from the dialysate compartment by a semi- permeable membrane.
The blood and dialysate do not mix together. There is a potting
material on both ends of the dialyzer to assure seperation of blood
and dialysate.
, ◉ What are three types of solutions ?. Answer: Hypotonic -
containing less particles
Isotonic - containing equal particles
Hypertonic - containing more particles
◉ When is it known that a patient has developed sensitivity to a
dialyzer?. Answer: Patients develop mild to severe reactions in some
cases, usually seen the first half hour of treatment. Sneezing, itching,
pain at the access site, chest pain, rashing, hives, fever
◉ How ling can a dialyzer recirculate with saline before it is
considered unsafe to use ?. Answer: 4 hours
after 2 hours recirculate
◉ What volume should be used for fresh fill/ run off ?. Answer:
Fresh fill / run off must be performed prior to the initiation of every
treatment. 50 ml of saline should be drained from the arterial line
and 250 ml should be drained from the venous line before lines are
connected to the patient.
◉ When dialyzing a patient what position should the dialyzer be in
during hemodialysis ?. Answer: place the dialyzer arterial end up
◉ What should be checked on a dialyzer before machine set up ?.
Answer: the dialyzer should be checked for sterility I the dialyzer
CERTIFICATION EVALUATION 2026 TESTED
QUESTIONS SOLVED
◉ Treatments options - what is peritoneal dialysis . Answer: uses a
permanently placed catheter in the patients higly vascularized
peritoneal cavity. The peritoneum is the membrane surrounding the
abdominal organs. Dialysate fluid is infused into the cavity and is
allowed to dwell there for a period of time. Then the fluid is drained.
Through osmosis and diffusion, excess fluid and waste products are
removed.
◉ Treatments options - What is transplantation . Answer: surgically
implanting a working kidney from a living or cadaver donor and
involves anti- rejection medications.
◉ intracellular. Answer: inside the cells
◉ extracellular. Answer: outside the cells
◉ intravascular. Answer: inside the blood vessels
◉ interstitial. Answer: between the cells
,◉ What is homeostasis ?. Answer: the steady internal state of
equilibrium in the body. A naturally occurring constant balance
within the internal environment of the body.
- the steady state of being
- the kidneys conserve or excrete excess fluid as needed to keep the
internal environment in balance.
◉ What is diffusion ?. Answer: The scientific principle that causes
the sodium to move across the semipermeable membrane .
◉ What is a semi- permeable membrane ?. Answer: A membrane
made from protein, with small pores or holes. Only certain
molecules can fit through the pores depending on the pore size.
Molecules larger than the pore size will not pass through the semi-
permeable membrane. Red blood cells and proteins are too large to
pass through the semi-permeable membrane pores of the dialyzer.
Urea, sodium, potassium and water for example can pass through
the pores of the membranes.
◉ What factors impact the rate of diffusion ?. Answer: Concentration
gradient, temperature, molecular weight of solutes, nature of the
solution, membrane permeablilty, surface area, flow geometry
convection ( solvent drag)
,◉ At what point during the hemodialysis treatment will diffusion
cease to occur ?. Answer: Diffusion will continue throughout the
dialysis treatment until the concentration of each electrolyte found
in the patients blood is equal to the electrolyte concentration in the
dialysate.
◉ What is countercurrent flow ?. Answer: Blood and dialysate flow
in opposite directions - called countercurrent flow. Blood flows
down into the dialyzer (areterial to Venous) dialasate flows up
(venous to arterial). This opposite flow allows for better clearance
and diffusion.
◉ What happens to diffusion when dialyzer fibers clot ?. Answer:
When dialyzer fibers clot - either from inadequate heperanization or
an improperly primed dialyzer, diffusion is decreased. Clotted fibers
cause the permeability of the fiber to be reduced or eliminated
causing a decrease in treatment adequacy.
◉ What are the compartments of the dialyzer and what seperates
them ?. Answer: The dialyzer is composed of two compartments
housed inside a plastic casing. The blood compartment is seperated
from the dialysate compartment by a semi- permeable membrane.
The blood and dialysate do not mix together. There is a potting
material on both ends of the dialyzer to assure seperation of blood
and dialysate.
, ◉ What are three types of solutions ?. Answer: Hypotonic -
containing less particles
Isotonic - containing equal particles
Hypertonic - containing more particles
◉ When is it known that a patient has developed sensitivity to a
dialyzer?. Answer: Patients develop mild to severe reactions in some
cases, usually seen the first half hour of treatment. Sneezing, itching,
pain at the access site, chest pain, rashing, hives, fever
◉ How ling can a dialyzer recirculate with saline before it is
considered unsafe to use ?. Answer: 4 hours
after 2 hours recirculate
◉ What volume should be used for fresh fill/ run off ?. Answer:
Fresh fill / run off must be performed prior to the initiation of every
treatment. 50 ml of saline should be drained from the arterial line
and 250 ml should be drained from the venous line before lines are
connected to the patient.
◉ When dialyzing a patient what position should the dialyzer be in
during hemodialysis ?. Answer: place the dialyzer arterial end up
◉ What should be checked on a dialyzer before machine set up ?.
Answer: the dialyzer should be checked for sterility I the dialyzer
