BSN 445 Week 10 Sherpath 2026/2027 – 60+ Questions & Answers | AKI, Fluid & Electrolytes, Hemodialysis, CRRT & Renal Care

This BSN 445 Week 10 Sherpath 2026/2027 exam resource contains 60+ questions with correct answers across 26 pages, providing comprehensive preparation on renal assessment, fluid-volume disorders, electrolyte imbalances, acute kidney injury (AKI), rhabdomyolysis, contrast-associated kidney injury, renal pharmacology, hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT). The opening section emphasizes kidney-focused health-history collection and physical assessment, including medication and contrast exposure, hypertension, urinary retention and frequency, nephrotic syndrome history, orthopnea, skin turgor, jugular and peripheral venous distention, pitting edema, costovertebral tenderness, central venous pressure, and clinical manifestations of calcium imbalance. A major section concentrates on acute kidney injury assessment and classification. Students review abrupt changes in urine output, blood pressure and serum creatinine, along with the RIFLE and Acute Kidney Injury Network (AKIN) classification systems. The questions differentiate prerenal, intrarenal, and postrenal causes through clinical examples such as cardiogenic shock, rhabdomyolysis, and prostate cancer. Nursing priorities include hourly urine-output monitoring, checking urinary-catheter patency when output suddenly falls, and recognizing laboratory patterns associated with impaired renal perfusion. The document provides substantial practice in renal laboratory interpretation and urinalysis. Students analyze BUN, serum creatinine, creatinine clearance, albumin, urine specific gravity, osmolality, protein-to-creatinine ratios, ketones, leukocyte esterase, urinary bacteria, white blood cells, casts, and epithelial cells. Urinalysis findings are linked with conditions such as diabetic ketoacidosis, urinary tract infection, pyelonephritis, and intrarenal AKI. The material also reviews fluid shifts associated with hepatic failure and laboratory manifestations of significant renal dysfunction. Another key section examines AKI prevention, rhabdomyolysis, and contrast-associated kidney injury. Sepsis is connected with altered vascular permeability and interstitial fluid shifts, while rhabdomyolysis questions address crystalloid resuscitation, creatine kinase, renal injury, electrolyte disturbances, sodium bicarbonate, and mannitol. Contrast-related material discusses high-risk patients, hydration with normal saline, minimizing nephrotoxic exposure, use of low-osmolar contrast agents, and medication considerations surrounding contrast procedures. Students also review intravenous pyelography and diagnostic approaches for renal disease. The fluid, electrolyte, and renal pharmacology content covers hypocalcemia, hypokalemia, hyperphosphatemia, volume depletion and overload, albumin replacement, diuretics, analgesics, and nephrotoxic medication considerations. Questions address acetaminophen use in patients with kidney disease, 5% albumin for protein and volume replacement, spironolactone-associated hyperkalemia and ECG changes, safe administration of mannitol, and intravenous furosemide precautions. The resource also links severe fluid overload with pulmonary crackles and potential need for renal replacement therapy. A substantial portion is devoted to hemodialysis and vascular-access nursing care. Students review indications such as metabolic acidosis and clinically significant fluid overload, ultrafiltration for fluid removal, heparin-associated bleeding and protamine sulfate, temporary vascular access for emergent renal replacement therapy, and care of an arteriovenous fistula. The questions emphasize protecting dialysis access, managing bleeding after treatment, reducing discomfort associated with fistula cannulation, and recognizing when renal replacement therapy may be required. The final section provides focused preparation on continuous renal replacement therapy (CRRT) and peritoneal dialysis. Students differentiate continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), continuous venovenous hemodiafiltration (CVVHDF), and slow continuous ultrafiltration (SCUF). The material reviews diffusion, convection, adsorption, fluid and toxin removal, anticoagulation monitoring, access-site bleeding, circuit-pressure alarms, and assessment of renal recovery. Peritoneal dialysis questions address vital-sign monitoring during fill, dwell and drain phases, prevention of air entering the tubing, shoulder discomfort, and recognition of potential treatment complications. For evidence-based academic reinforcement, these topics correspond broadly with standard references such as AACN Essentials of Critical Care Nursing and Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems. AKI definitions and staging should also be compared with current Kidney Disease: Improving Global Outcomes (KDIGO) guidance, while dialysis and renal replacement therapy concepts can be reinforced through contemporary nephrology literature and current institutional protocols. Some classifications and clinical recommendations in educational question banks may differ from current practice; therefore, contemporary KDIGO criteria and current evidence-based policies should take precedence for clinical decision-making. Relevant Students: This document is particularly relevant for BSN 445 students, Sherpath nursing students, BSN and RN students, critical-care and ICU nursing students, adult health and medical-surgical nursing students, nephrology nursing learners, and students preparing for examinations involving renal dysfunction. It can also support HESI, ATI Adult Medical-Surgical, NCLEX-RN, and critical-care review involving AKI, fluid and electrolyte disorders, renal assessment, urinalysis, rhabdomyolysis, dialysis, CRRT, renal medications, and kidney-related nursing interventions. 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