HESI RN FLUID AND ELECTROLYTE MANAGEMENT
ACCURATE COMPREHENSIVE PRACTICE EXAM
WITH ALL POSSIBLE APPROVED WELL
ELABORATED PRACTICE QUESTIONS AND 100%
CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES PLUS EXPERT ANSWER KEY (100%
CORRECT VERIFIED SOLUTIONS) 2026-2027
CURRENTLY UPDATED VERSION Q&A
GUARANTEED PASS A+ INSTANT DOWNLOAD PDF
1. A patient with heart failure receives furosemide. Which electrolyte
imbalance is most likely to develop?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: B. Hypokalemia
Rationale: Loop diuretics like furosemide increase potassium excretion
in the distal tubule, leading to hypokalemia. Monitoring serum
potassium is essential.
2. A patient present with muscle cramps, weakness, and a serum
potassium of 3.0 mEq/L. Which intravenous fluid should the nurse
,anticipate administering?
A. 0.9% sodium chloride with 40 mEq KCl
B. 5% dextrose in water
C. Lactated Ringer’s solution
D. 0.45% sodium chloride
Correct Answer: A. 0.9% sodium chloride with 40 mEq KCl
Rationale: Potassium replacement is indicated for hypokalemia (K+
<3.5). Adding KCl to normal saline is standard; dextrose solutions can
worsen hypokalemia by shifting potassium into cells.
3. Which serum sodium level indicates hypernatremia?
A. 130 mEq/L
B. 135 mEq/L
C. 145 mEq/L
D. 150 mEq/L
Correct Answer: D. 150 mEq/L
Rationale: Normal sodium is 135–145 mEq/L. Hypernatremia is
defined as sodium >145 mEq/L; 150 mEq/L is clearly elevated.
4. A patient with severe vomiting has a serum pH of 7.50 and
bicarbonate of 32 mEq/L. Which acid-base disorder is present?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: D. Metabolic alkalosis
Rationale: Vomiting causes loss of gastric acid (HCl), leading to
increased bicarbonate and elevated pH, consistent with metabolic
alkalosis.
,5. The nurse assesses a patient with hyponatremia. Which finding is
most indicative of severe hyponatremia?
A. Thirst
B. Dry mucous membranes
C. Confusion and seizures
D. Increased urine output
Correct Answer: C. Confusion and seizures
Rationale: Severe hyponatremia causes cerebral edema due to water
shift into brain cells, leading to neurologic symptoms like confusion
and seizures. Thirst and dry membranes occur with hypernatremia.
6. A patient receives 3% sodium chloride for symptomatic
hyponatremia. The nurse should monitor for which complication?
A. Hyperkalemia
B. Fluid volume overload
C. Hypocalcemia
D. Metabolic acidosis
Correct Answer: B. Fluid volume overload
Rationale: Hypertonic saline draws fluid into the vascular space,
increasing risk of heart failure and pulmonary edema. Rapid
correction can also cause central pontine myelinolysis.
7. Which laboratory value is most consistent with hypovolemic
hyponatremia?
A. Urine sodium <20 mEq/L
B. Urine sodium >40 mEq/L
C. Serum osmolality >300 mOsm/kg
, D. Hematocrit decreased
Correct Answer: A. Urine sodium <20 mEq/L
Rationale: In hypovolemic hyponatremia, the kidney conserves
sodium, so urine sodium is low (<20 mEq/L). High urine sodium
suggests renal sodium wasting.
8. A patient with diabetes insipidus has a serum sodium of 155 mEq/L.
The nurse expects the urine specific gravity to be:
A. 1.005
B. 1.010
C. 1.020
D. 1.030
Correct Answer: A. 1.005
Rationale: Diabetes insipidus causes dilute urine (specific gravity
<1.010, often 1.001–1.005) due to lack of ADH, leading to
hypernatremia from water loss.
9. The nurse is caring for a patient with hyperkalemia. Which
electrocardiogram change is most characteristic?
A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. U waves
Correct Answer: B. Peaked T waves
Rationale: Peaked T waves are an early sign of hyperkalemia. As
potassium rises, QRS widens and sine wave pattern may occur.
ACCURATE COMPREHENSIVE PRACTICE EXAM
WITH ALL POSSIBLE APPROVED WELL
ELABORATED PRACTICE QUESTIONS AND 100%
CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES PLUS EXPERT ANSWER KEY (100%
CORRECT VERIFIED SOLUTIONS) 2026-2027
CURRENTLY UPDATED VERSION Q&A
GUARANTEED PASS A+ INSTANT DOWNLOAD PDF
1. A patient with heart failure receives furosemide. Which electrolyte
imbalance is most likely to develop?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: B. Hypokalemia
Rationale: Loop diuretics like furosemide increase potassium excretion
in the distal tubule, leading to hypokalemia. Monitoring serum
potassium is essential.
2. A patient present with muscle cramps, weakness, and a serum
potassium of 3.0 mEq/L. Which intravenous fluid should the nurse
,anticipate administering?
A. 0.9% sodium chloride with 40 mEq KCl
B. 5% dextrose in water
C. Lactated Ringer’s solution
D. 0.45% sodium chloride
Correct Answer: A. 0.9% sodium chloride with 40 mEq KCl
Rationale: Potassium replacement is indicated for hypokalemia (K+
<3.5). Adding KCl to normal saline is standard; dextrose solutions can
worsen hypokalemia by shifting potassium into cells.
3. Which serum sodium level indicates hypernatremia?
A. 130 mEq/L
B. 135 mEq/L
C. 145 mEq/L
D. 150 mEq/L
Correct Answer: D. 150 mEq/L
Rationale: Normal sodium is 135–145 mEq/L. Hypernatremia is
defined as sodium >145 mEq/L; 150 mEq/L is clearly elevated.
4. A patient with severe vomiting has a serum pH of 7.50 and
bicarbonate of 32 mEq/L. Which acid-base disorder is present?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: D. Metabolic alkalosis
Rationale: Vomiting causes loss of gastric acid (HCl), leading to
increased bicarbonate and elevated pH, consistent with metabolic
alkalosis.
,5. The nurse assesses a patient with hyponatremia. Which finding is
most indicative of severe hyponatremia?
A. Thirst
B. Dry mucous membranes
C. Confusion and seizures
D. Increased urine output
Correct Answer: C. Confusion and seizures
Rationale: Severe hyponatremia causes cerebral edema due to water
shift into brain cells, leading to neurologic symptoms like confusion
and seizures. Thirst and dry membranes occur with hypernatremia.
6. A patient receives 3% sodium chloride for symptomatic
hyponatremia. The nurse should monitor for which complication?
A. Hyperkalemia
B. Fluid volume overload
C. Hypocalcemia
D. Metabolic acidosis
Correct Answer: B. Fluid volume overload
Rationale: Hypertonic saline draws fluid into the vascular space,
increasing risk of heart failure and pulmonary edema. Rapid
correction can also cause central pontine myelinolysis.
7. Which laboratory value is most consistent with hypovolemic
hyponatremia?
A. Urine sodium <20 mEq/L
B. Urine sodium >40 mEq/L
C. Serum osmolality >300 mOsm/kg
, D. Hematocrit decreased
Correct Answer: A. Urine sodium <20 mEq/L
Rationale: In hypovolemic hyponatremia, the kidney conserves
sodium, so urine sodium is low (<20 mEq/L). High urine sodium
suggests renal sodium wasting.
8. A patient with diabetes insipidus has a serum sodium of 155 mEq/L.
The nurse expects the urine specific gravity to be:
A. 1.005
B. 1.010
C. 1.020
D. 1.030
Correct Answer: A. 1.005
Rationale: Diabetes insipidus causes dilute urine (specific gravity
<1.010, often 1.001–1.005) due to lack of ADH, leading to
hypernatremia from water loss.
9. The nurse is caring for a patient with hyperkalemia. Which
electrocardiogram change is most characteristic?
A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. U waves
Correct Answer: B. Peaked T waves
Rationale: Peaked T waves are an early sign of hyperkalemia. As
potassium rises, QRS widens and sine wave pattern may occur.
