✅ MCQs – Principles of Hemodialysis (Set 1)
1. The primary mechanism of solute removal during hemodialysis is:
A. Filtration
B. Secretion
C. Diffusion
D. Absorption
➡️ Answer: C. Diffusion
2. Which of the following substances is most efficiently removed by diffusion during dialysis?
A. Albumin
B. Sodium
C. Urea
D. Hemoglobin
➡️ Answer: C. Urea
(Small molecules like urea diffuse easily across the dialysis membrane.)
3. The movement of water across the dialysis membrane due to pressure gradient is called:
A. Convection
B. Filtration
C. Ultrafiltration
D. Osmosis
➡️ Answer: C. Ultrafiltration
4. The dialysate in hemodialysis serves the purpose of:
A. Acting as an anticoagulant
B. Removing red blood cells
C. Creating a concentration gradient for solute exchange
D. Increasing blood pressure
➡️ Answer: C. Creating a concentration gradient for solute exchange
5. In hemodialysis, convection is the process by which:
A. Solutes move with water flow
B. Large molecules bind to membranes
C. Blood clots are filtered
D. Heat is transferred to the dialysate
➡️ Answer: A. Solutes move with water flow
(Also called "solvent drag")
6. Which of the following best describes a semipermeable membrane used in dialysis?
A. Allows all particles to pass through
B. Prevents the passage of both solutes and water
C. Allows selective passage of water and small solutes
D. Is impermeable to gases only
➡️ Answer: C. Allows selective passage of water and small solutes
7. Dialysis is typically needed when GFR falls below:
A. 90 mL/min
B. 45 mL/min
C. 30 mL/min
D. 15 mL/min
➡️ Answer: D. 15 mL/min
(Usually considered the threshold for ESRD.)
8. What is the typical blood flow rate during conventional hemodialysis?
A. 30–50 mL/min
B. 100–200 mL/min
C. 300–500 mL/min
D. 600–800 mL/min
➡️ Answer: C. 300–500 mL/min
9. Dialysate typically flows in which direction relative to blood flow?
A. Parallel flow
B. Countercurrent flow
C. Crossflow
D. Static mode
➡️ Answer: B. Countercurrent flow
(Maximizes diffusion gradient efficiency.)
10. The clearance of a solute during dialysis depends on all of the following EXCEPT:
A. Membrane surface area
B. Blood flow rate
C. Dialysate flow rate
D. Patient’s blood pressure
➡️ Answer: D. Patient’s blood pressure
11. The term "Kuf" (ultrafiltration coefficient) of a dialyzer refers to:
A. The maximum blood flow rate
B. The ability of the membrane to allow protein movement
C. The amount of water removed per hour per mmHg of TMP
D. The dialysate sodium concentration
➡️ Answer: C. The amount of water removed per hour per mmHg of TMP
12. Which type of transport is primarily responsible for removal of middle molecules (e.g., β2-microglobulin)?
A. Diffusion
B. Osmosis
C. Convection
D. Active transport
➡️ Answer: C. Convection
13. What is the normal range of dialysate flow rate in standard hemodialysis?
A. 100–200 mL/min
B. 300–800 mL/min
C. 1–2 L/min
D. 500–800 mL/min
➡️ Answer: D. 500–800 mL/min
14. Transmembrane pressure (TMP) is the pressure difference between:
A. Arterial and venous blood lines
B. Dialysate and blood compartments
C. Dialysate inflow and outflow
D. Blood flow rate and dialysate rate
➡️ Answer: B. Dialysate and blood compartments
15. The ability of a dialyzer to remove urea is measured by:
A. Hematocrit
B. KT/V
C. TMP
D. Serum albumin
➡️ Answer: B. KT/V
16. The principle that governs solute movement from higher to lower concentration in hemodialysis is:
A. Ultrafiltration
B. Filtration
C. Diffusion
D. Reabsorption
➡️ Answer: C. Diffusion
17. A high-flux dialyzer differs from a low-flux dialyzer by having:
A. A thicker membrane
B. Smaller surface area
C. Greater permeability to large molecules
D. No ability to remove water
➡️ Answer: C. Greater permeability to large molecules
18. What does URR (Urea Reduction Ratio) measure?
A. Percentage of urea removed during dialysis
B. Amount of blood processed
C. Dialysate sodium concentration
D. Dialyzer protein leakage
➡️ Answer: A. Percentage of urea removed during dialysis
19. Which factor most directly affects the efficiency of solute clearance?
A. Dialysate color
B. Dialysis nurse’s experience
C. Surface area of the dialyzer membrane
D. Patient’s height
➡️ Answer: C. Surface area of the dialyzer membrane
20. What does “dry weight” refer to in dialysis patients?
A. Weight after fasting
B. Post-dialysis weight without excess fluid
C. Target body weight after meals
D. Weight of the patient including edema
➡️ Answer: B. Post-dialysis weight without excess fluid
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