To design a solution that meets the replication requirement for Veeam University Hospital, you need to consider some of the mitigating techniques that might be required for the virtual machines that have several separate large VMDKs with a high change rate per virtual machine on the same datastore. This will help you to overcome some of the challenges and limitations that may affect the replication performance and efficiency, as well as the recovery point objective (RPO) of the organization.
According to the Veeam Backup & Replication Best Practice Guide, some of the mitigating techniques that might be required are:
•Implement WAN accelerator. This technique can help you to reduce the amount of data that needs to be transferred and processed between the source and target sites, by using caching, deduplication, compression, and encryption. You need to deploy a pair of WAN accelerators, one at the source site and one at the target site, and configure them in the replication job settings. This technique can improve the replication speed and efficiency, as well as save network bandwidth and storage space.
•Recommend migrating some of the VMDKs to alternative datastores. This technique can help you to avoid performance degradation and resource contention on the source datastore, by distributing the load and I/O across multiple datastores. You need to use VMware tools or commands, such as Storage vMotion or svmotion, to migrate some of the VMDKs to other datastores that have enough capacity and performance. This technique can improve the replication stability and reliability, as well as reduce the impact on the production environment.
Therefore, based on these techniques, the answer that describes which mitigating techniques might be required is A and C.