HESI Fluid & Electrolytes Exam
Questions and Answers 2026/2027 A+
Graded 100% Verified
During an 8-hour shift a client has a 6-oz (180 mL) cup of tea and 360 mL of water; the
client vomits 100 mL, and the intravenous (IV) fluids instilled equal the urinary output.
What is this client's fluid balance at the end of this 8-hour period that the nurse must
document on the client's intake and output record?
1. 240 mL
2. 340 mL
3. 440 mL
4. 540 mL - ANS -440 mL is the correct calculation.
The client's intake was 180 mL of tea and 360 mL of water for a total fluid intake of 540
mL; the client vomited 100 mL, which when subtracted from 540 mL leaves 440 mL. The
IV fluid intake and the urinary output are equal; therefore, they do not influence the final
fluid balance. The options 240 mL, 340 mL, and 540 mL are incorrect calculations.
A nurse is caring for a client with acute kidney injury who is receiving a protein-restricted
diet. The client asks why this diet is necessary. Which information should the nurse
include in a response to the client's questions?
1. A high-protein intake ensures an adequate daily supply of amino acids to compensate
for losses.
2. Essential and nonessential amino acids are necessary in the diet to supply materials
for tissue protein synthesis.
3. This supplies only essential amino acids, reducing the amount of metabolic waste
products, thus decreasing stress on the kidneys.
4. Urea nitrogen cannot be used to synthesize amino acids in the body, so the nitrogen
for amino acid synthesis must come from the dietary protein. - ANS -This supplies only
essential amino acids, reducing the amount of metabolic waste products, thus
decreasing stress on the kidneys.
,The amount of protein permitted in the diet depends on the extent of kidney function;
excess protein causes an increase in urea concentration, excess metabolic waste, and
added stress on the kidneys, which should be prevented. Adequate calories are provided
to prevent tissue catabolism that also results in an increase in metabolic waste products.
In kidney failure the kidneys are unable to eliminate the waste products of a high-protein
diet, which is to be avoided. The body is able to synthesize the nonessential amino acids.
Urea is a waste product of protein metabolism; the body is able to synthesize the
nonessential amino acids
Which diagnostic procedure helps in the detection of uropathologic features in a client
who has a urinary pouch or ileal conduit?
1. Loopogram
2. Cystogram
3. Computed tomography urogram
4. Urethrogram - ANS -Loopogram
Loopogram helps in the detection of uropathologic features in a client who has a urinary
pouch or ileal conduit. Cystogram helps to visualize the bladder and evaluates
vesicoureteral reflux. A computed tomography (CT) urogram provides excellent
visualization of kidneys and kidney size can be evaluated. When urethral trauma is
suspected, an urethrogram is done before catheterization.
The nurse is caring for a client who returns from surgery with a catheter that is attached
to a portable wound drainage system exiting from the surgical site. Which principle
underlying the function of a portable drainage system will the nurse consider when
planning care for this client?
1. Gravity
2. Osmosis
3. Active transport
4. Negative pressure - ANS -Negative Pressure
The negative pressure of a portable wound drainage system exerts a sucking force that
pulls fluid toward the collection chamber. An indwelling urinary catheter uses the
principle of gravity to draw fluid from the bladder to the collection bag held below the
level of the bladder. Osmosis occurs when a solvent moves from a solution of lesser
concentration to one of greater solute concentration when the two solutions are
separated by a semipermeable membrane; fluid moving from the interstitial compartment
into the intracellular compartment uses osmosis. Active transport occurs when ions
move across a cell membrane against a concentration gradient with the assistance of
metabolic energy; sodium and potassium ions move into and out of cells via active
transport (sodium-potassium pump)
, The client is receiving high-flow intravenous (IV) fluid replacement therapy. Which
nursing assessment findings are consistent with fluid volume overload? Select all that
apply.
1. Pulse quality
2. Pulse pressure
3. Bounding pulse
4. Presence of dependent edema
5. Neck vein distention in the upright position - ANS -Bounding pulse, presence of
dependent edema, and neck vein distention in the upright position are all indicators of
fluid overload, which should be reported by the nurse. Pulse quality and pulse pressure
are indicators to monitor the client's response to fluid therapy.
A client drinks 7.5 oz (225 mL) of orange juice, 6 oz (180 mL) of tea, and 8 oz (240 mL) of
eggnog. How many milliliters of fluid should the nurse document that the client has
consumed? Record your answer using a whole number. ___ mL - ANS -645 mL
One ounce (oz) equals approximately 30 mL. The client drank a total of 21.5 oz; multiply
21.5 × 30, which yields 645 mL.
A nurse finds it difficult to obtain intravenous (IV) access to administer electrolytes to a
2-year-old child suffering from severe diarrhea. Which other route of administration
should the nurse try?
1. Intrathecal
2. Intrapleural
3. Intraosseous
4. Intraperitoneal - ANS -intraosseous route
The nurse should use the intraosseous route to administer electrolytes to infants and
toddlers. This route is most commonly used in infants and toddlers when an emergency
arises and IV access is impossible. This method involves the infusion of medication
directly into the bone marrow. Intrathecal administration is often associated with
long-term medication administration through surgically implanted catheters.
Chemotherapeutic agents are the most common medications administered via the
intrapleural method. Chemotherapeutic agents, insulin, and antibiotics are administered
through the intraperitoneal route.
An exploratory laparotomy is performed on a client with melena, and gastric cancer is
discovered. A partial gastrectomy is performed, and a jejunostomy tube is surgically
implanted. A nasogastric tube to suction is in place. What should the nurse expect
regarding the client's nasogastric tube drainage during the first 24 hours after surgery?
1. Minimal to no drainage
Questions and Answers 2026/2027 A+
Graded 100% Verified
During an 8-hour shift a client has a 6-oz (180 mL) cup of tea and 360 mL of water; the
client vomits 100 mL, and the intravenous (IV) fluids instilled equal the urinary output.
What is this client's fluid balance at the end of this 8-hour period that the nurse must
document on the client's intake and output record?
1. 240 mL
2. 340 mL
3. 440 mL
4. 540 mL - ANS -440 mL is the correct calculation.
The client's intake was 180 mL of tea and 360 mL of water for a total fluid intake of 540
mL; the client vomited 100 mL, which when subtracted from 540 mL leaves 440 mL. The
IV fluid intake and the urinary output are equal; therefore, they do not influence the final
fluid balance. The options 240 mL, 340 mL, and 540 mL are incorrect calculations.
A nurse is caring for a client with acute kidney injury who is receiving a protein-restricted
diet. The client asks why this diet is necessary. Which information should the nurse
include in a response to the client's questions?
1. A high-protein intake ensures an adequate daily supply of amino acids to compensate
for losses.
2. Essential and nonessential amino acids are necessary in the diet to supply materials
for tissue protein synthesis.
3. This supplies only essential amino acids, reducing the amount of metabolic waste
products, thus decreasing stress on the kidneys.
4. Urea nitrogen cannot be used to synthesize amino acids in the body, so the nitrogen
for amino acid synthesis must come from the dietary protein. - ANS -This supplies only
essential amino acids, reducing the amount of metabolic waste products, thus
decreasing stress on the kidneys.
,The amount of protein permitted in the diet depends on the extent of kidney function;
excess protein causes an increase in urea concentration, excess metabolic waste, and
added stress on the kidneys, which should be prevented. Adequate calories are provided
to prevent tissue catabolism that also results in an increase in metabolic waste products.
In kidney failure the kidneys are unable to eliminate the waste products of a high-protein
diet, which is to be avoided. The body is able to synthesize the nonessential amino acids.
Urea is a waste product of protein metabolism; the body is able to synthesize the
nonessential amino acids
Which diagnostic procedure helps in the detection of uropathologic features in a client
who has a urinary pouch or ileal conduit?
1. Loopogram
2. Cystogram
3. Computed tomography urogram
4. Urethrogram - ANS -Loopogram
Loopogram helps in the detection of uropathologic features in a client who has a urinary
pouch or ileal conduit. Cystogram helps to visualize the bladder and evaluates
vesicoureteral reflux. A computed tomography (CT) urogram provides excellent
visualization of kidneys and kidney size can be evaluated. When urethral trauma is
suspected, an urethrogram is done before catheterization.
The nurse is caring for a client who returns from surgery with a catheter that is attached
to a portable wound drainage system exiting from the surgical site. Which principle
underlying the function of a portable drainage system will the nurse consider when
planning care for this client?
1. Gravity
2. Osmosis
3. Active transport
4. Negative pressure - ANS -Negative Pressure
The negative pressure of a portable wound drainage system exerts a sucking force that
pulls fluid toward the collection chamber. An indwelling urinary catheter uses the
principle of gravity to draw fluid from the bladder to the collection bag held below the
level of the bladder. Osmosis occurs when a solvent moves from a solution of lesser
concentration to one of greater solute concentration when the two solutions are
separated by a semipermeable membrane; fluid moving from the interstitial compartment
into the intracellular compartment uses osmosis. Active transport occurs when ions
move across a cell membrane against a concentration gradient with the assistance of
metabolic energy; sodium and potassium ions move into and out of cells via active
transport (sodium-potassium pump)
, The client is receiving high-flow intravenous (IV) fluid replacement therapy. Which
nursing assessment findings are consistent with fluid volume overload? Select all that
apply.
1. Pulse quality
2. Pulse pressure
3. Bounding pulse
4. Presence of dependent edema
5. Neck vein distention in the upright position - ANS -Bounding pulse, presence of
dependent edema, and neck vein distention in the upright position are all indicators of
fluid overload, which should be reported by the nurse. Pulse quality and pulse pressure
are indicators to monitor the client's response to fluid therapy.
A client drinks 7.5 oz (225 mL) of orange juice, 6 oz (180 mL) of tea, and 8 oz (240 mL) of
eggnog. How many milliliters of fluid should the nurse document that the client has
consumed? Record your answer using a whole number. ___ mL - ANS -645 mL
One ounce (oz) equals approximately 30 mL. The client drank a total of 21.5 oz; multiply
21.5 × 30, which yields 645 mL.
A nurse finds it difficult to obtain intravenous (IV) access to administer electrolytes to a
2-year-old child suffering from severe diarrhea. Which other route of administration
should the nurse try?
1. Intrathecal
2. Intrapleural
3. Intraosseous
4. Intraperitoneal - ANS -intraosseous route
The nurse should use the intraosseous route to administer electrolytes to infants and
toddlers. This route is most commonly used in infants and toddlers when an emergency
arises and IV access is impossible. This method involves the infusion of medication
directly into the bone marrow. Intrathecal administration is often associated with
long-term medication administration through surgically implanted catheters.
Chemotherapeutic agents are the most common medications administered via the
intrapleural method. Chemotherapeutic agents, insulin, and antibiotics are administered
through the intraperitoneal route.
An exploratory laparotomy is performed on a client with melena, and gastric cancer is
discovered. A partial gastrectomy is performed, and a jejunostomy tube is surgically
implanted. A nasogastric tube to suction is in place. What should the nurse expect
regarding the client's nasogastric tube drainage during the first 24 hours after surgery?
1. Minimal to no drainage
