1
HESI Pediatric Fluids &
Electrolytes Exam Bank:
Dehydration, IV Therapy &
Renal Q&A
Table of Contents
Subtopic 1: Fluid Balance Assessment and Daily Maintenance Needs in
Pediatrics.........................................................................................................2
Subtopic 2: Electrolyte Imbalances in Pediatric Patients—Recognition and
Management..................................................................................................10
Subtopic 3: Pediatric Dehydration Types—Causes, Assessment, and
Interventions..................................................................................................19
Subtopic 4: Pediatric IV Therapy—Calculation, Monitoring, and Complications
.......................................................................................................................28
Subtopic 5: Pediatric Renal Disorders and Fluid/Electrolyte Imbalance.........36
, 2
Subtopic 1: Fluid Balance Assessment and
Daily Maintenance Needs in Pediatrics
(Questions 1–20)
Question 1:
A 3-year-old child weighing 15 kg is admitted with mild dehydration. What is
the child's total daily fluid maintenance requirement?
A. 800 mL
B. 1,250 mL
C. 1,500 mL
D. 2,000 mL
Correct Answer: B. 1,250 mL
Rationale: The daily maintenance fluid calculation for pediatrics:
First 10 kg: 100 mL/kg = 1,000 mL
Next 5 kg: 50 mL/kg = 250 mL
Total = 1,250 mL/day.
Question 2:
Which clinical sign is an early indicator of dehydration in infants?
A. Sunken fontanel
B. Hypotension
C. Tachycardia
D. Oliguria
, 3
Correct Answer: C. Tachycardia
Rationale: Tachycardia is an early compensatory response to volume loss.
Hypotension and oliguria occur later.
Question 3:
A nurse assessing a toddler notes dry mucous membranes, sunken eyes, and
decreased skin turgor. Which action is a priority?
A. Obtain a urine sample
B. Administer an antipyretic
C. Begin IV rehydration
D. Monitor for seizure activity
Correct Answer: C. Begin IV rehydration
Rationale: These are signs of moderate to severe dehydration; IV fluids are
needed to restore volume quickly.
Question 4:
Which lab value most directly reflects a child’s hydration status?
A. Hemoglobin
B. Potassium
C. Serum sodium
D. Calcium
Correct Answer: C. Serum sodium
Rationale: Sodium reflects extracellular fluid balance. Hypernatremia or
hyponatremia indicates dehydration or overhydration.
, 4
Question 5:
Which finding suggests fluid overload in a pediatric patient receiving IV
fluids?
A. Weight loss
B. Periorbital edema
C. Flat neck veins
D. Bradycardia
Correct Answer: B. Periorbital edema
Rationale: Periorbital edema is an early sign of fluid overload, especially in
children.
Question 6:
What is the most accurate method to assess fluid loss in an infant?
A. Checking diaper wetness
B. Daily weight
C. Observing skin color
D. Palpating fontanel
Correct Answer: B. Daily weight
Rationale: Daily weight is the most sensitive and objective indicator of fluid
gain or loss.
Question 7:
A nurse is preparing to administer oral rehydration therapy (ORT) to a child
with mild dehydration. Which solution is appropriate?
A. Apple juice
B. Plain water
HESI Pediatric Fluids &
Electrolytes Exam Bank:
Dehydration, IV Therapy &
Renal Q&A
Table of Contents
Subtopic 1: Fluid Balance Assessment and Daily Maintenance Needs in
Pediatrics.........................................................................................................2
Subtopic 2: Electrolyte Imbalances in Pediatric Patients—Recognition and
Management..................................................................................................10
Subtopic 3: Pediatric Dehydration Types—Causes, Assessment, and
Interventions..................................................................................................19
Subtopic 4: Pediatric IV Therapy—Calculation, Monitoring, and Complications
.......................................................................................................................28
Subtopic 5: Pediatric Renal Disorders and Fluid/Electrolyte Imbalance.........36
, 2
Subtopic 1: Fluid Balance Assessment and
Daily Maintenance Needs in Pediatrics
(Questions 1–20)
Question 1:
A 3-year-old child weighing 15 kg is admitted with mild dehydration. What is
the child's total daily fluid maintenance requirement?
A. 800 mL
B. 1,250 mL
C. 1,500 mL
D. 2,000 mL
Correct Answer: B. 1,250 mL
Rationale: The daily maintenance fluid calculation for pediatrics:
First 10 kg: 100 mL/kg = 1,000 mL
Next 5 kg: 50 mL/kg = 250 mL
Total = 1,250 mL/day.
Question 2:
Which clinical sign is an early indicator of dehydration in infants?
A. Sunken fontanel
B. Hypotension
C. Tachycardia
D. Oliguria
, 3
Correct Answer: C. Tachycardia
Rationale: Tachycardia is an early compensatory response to volume loss.
Hypotension and oliguria occur later.
Question 3:
A nurse assessing a toddler notes dry mucous membranes, sunken eyes, and
decreased skin turgor. Which action is a priority?
A. Obtain a urine sample
B. Administer an antipyretic
C. Begin IV rehydration
D. Monitor for seizure activity
Correct Answer: C. Begin IV rehydration
Rationale: These are signs of moderate to severe dehydration; IV fluids are
needed to restore volume quickly.
Question 4:
Which lab value most directly reflects a child’s hydration status?
A. Hemoglobin
B. Potassium
C. Serum sodium
D. Calcium
Correct Answer: C. Serum sodium
Rationale: Sodium reflects extracellular fluid balance. Hypernatremia or
hyponatremia indicates dehydration or overhydration.
, 4
Question 5:
Which finding suggests fluid overload in a pediatric patient receiving IV
fluids?
A. Weight loss
B. Periorbital edema
C. Flat neck veins
D. Bradycardia
Correct Answer: B. Periorbital edema
Rationale: Periorbital edema is an early sign of fluid overload, especially in
children.
Question 6:
What is the most accurate method to assess fluid loss in an infant?
A. Checking diaper wetness
B. Daily weight
C. Observing skin color
D. Palpating fontanel
Correct Answer: B. Daily weight
Rationale: Daily weight is the most sensitive and objective indicator of fluid
gain or loss.
Question 7:
A nurse is preparing to administer oral rehydration therapy (ORT) to a child
with mild dehydration. Which solution is appropriate?
A. Apple juice
B. Plain water
