NURSING HESI FUNDAMENTALS STUDY
GUIDE 2026 QUESTIONS WITH DETAILED
ANSWERS AND RATIONALES
⩥ The nurse reviews a client's electrolyte results and notes a potassium
level of 5.5 mEq/L. The nurse understands that a potassium value at this
level should be noted with which condition? Answer: Traumatic burn
Rationale:
A serum potassium level that exceeds 5.0 mEq/L is indicative of
hyperkalemia. Clients who experience the cellular shifting of potassium,
as in the early stages of massive cell destruction (i.e., with trauma,
burns, sepsis, or metabolic or respiratory acidosis), are at risk for
hyperkalemia. The client with Cushing's syndrome or diarrhea and the
client who has been overusing laxatives are at risk for hypokalemia.
⩥ The nurse reviews a client's electrolyte results and notes that the
potassium level is 5.4 mEq/L. Which should the nurse observe for on the
cardiac monitor as a result of this laboratory value? Answer: Narrow,
peaked T waves
Rationale:
A serum potassium level of 5.4 mEq/L is indicative of hyperkalemia.
Cardiac changes include a wide, flat P wave; a prolonged PR interval; a
widened QRS complex; and narrow, peaked T waves.
,⩥ "insensible fluid loss of approximately 800 mL daily." Which client is
at risk for this loss? Answer: Client with a fast respiratory rate
Rationale:
Sensible losses are those that the person is aware of, such as those that
occur through wound drainage, GI tract losses, and urination. Insensible
losses may occur without the person's awareness. Insensible losses occur
daily through the skin and the lungs.
⩥ The nurse is reviewing the health records of assigned clients. The
nurse should plan care knowing that which client is at the least likely
risk for the development of third-spacing? Answer: The client with
diabetes mellitus
Rationale:
Fluid that shifts into the interstitial spaces and remains there is referred
to as third-space fluid. Common sites for third-spacing include the
abdomen, pleural cavity, peritoneal cavity, and pericardial sac. Third-
space fluid is physiologically useless because it does not circulate to
provide nutrients for the cells. Risk factors include liver or kidney
disease, major trauma, burns, sepsis, wound healing, major surgery,
malignancy, malabsorption syndrome, malnutrition, alcoholism, and
older age.
, ⩥ The nurse should plan care knowing that which client is at risk for
fluid volume deficit? Answer: The client with a colostomy
rationale:
Causes of a fluid volume deficit include vomiting, diarrhea, conditions
that cause increased respirations or increased urinary output, insufficient
intravenous fluid replacement, draining fistulas, ileostomy, and
colostomy. A client with cirrhosis, HF, or decreased kidney function is at
risk for fluid volume excess.
⩥ The nurse is caring for a client who has been taking diuretics on a
long-term basis. Which finding should the nurse expect to note as a
result of this long-term use? Answer: Increased specific gravity of the
urine
⩥ The nurse reviews electrolyte values and notes a sodium level of 130
mEq/L. The nurse expects that this sodium level would be noted in a
client with which condition? Answer: The client with the syndrome of
inappropriate secretion of antidiuretic hormone (SIADH)
rationale:
Hyponatremia is a serum sodium level less than 135 mEq/L.
Hyponatremia can occur secondary to SIADH. The client with an
inadequate daily water intake, watery diarrhea, or diabetes insipidus is at
risk for hypernatremia.
GUIDE 2026 QUESTIONS WITH DETAILED
ANSWERS AND RATIONALES
⩥ The nurse reviews a client's electrolyte results and notes a potassium
level of 5.5 mEq/L. The nurse understands that a potassium value at this
level should be noted with which condition? Answer: Traumatic burn
Rationale:
A serum potassium level that exceeds 5.0 mEq/L is indicative of
hyperkalemia. Clients who experience the cellular shifting of potassium,
as in the early stages of massive cell destruction (i.e., with trauma,
burns, sepsis, or metabolic or respiratory acidosis), are at risk for
hyperkalemia. The client with Cushing's syndrome or diarrhea and the
client who has been overusing laxatives are at risk for hypokalemia.
⩥ The nurse reviews a client's electrolyte results and notes that the
potassium level is 5.4 mEq/L. Which should the nurse observe for on the
cardiac monitor as a result of this laboratory value? Answer: Narrow,
peaked T waves
Rationale:
A serum potassium level of 5.4 mEq/L is indicative of hyperkalemia.
Cardiac changes include a wide, flat P wave; a prolonged PR interval; a
widened QRS complex; and narrow, peaked T waves.
,⩥ "insensible fluid loss of approximately 800 mL daily." Which client is
at risk for this loss? Answer: Client with a fast respiratory rate
Rationale:
Sensible losses are those that the person is aware of, such as those that
occur through wound drainage, GI tract losses, and urination. Insensible
losses may occur without the person's awareness. Insensible losses occur
daily through the skin and the lungs.
⩥ The nurse is reviewing the health records of assigned clients. The
nurse should plan care knowing that which client is at the least likely
risk for the development of third-spacing? Answer: The client with
diabetes mellitus
Rationale:
Fluid that shifts into the interstitial spaces and remains there is referred
to as third-space fluid. Common sites for third-spacing include the
abdomen, pleural cavity, peritoneal cavity, and pericardial sac. Third-
space fluid is physiologically useless because it does not circulate to
provide nutrients for the cells. Risk factors include liver or kidney
disease, major trauma, burns, sepsis, wound healing, major surgery,
malignancy, malabsorption syndrome, malnutrition, alcoholism, and
older age.
, ⩥ The nurse should plan care knowing that which client is at risk for
fluid volume deficit? Answer: The client with a colostomy
rationale:
Causes of a fluid volume deficit include vomiting, diarrhea, conditions
that cause increased respirations or increased urinary output, insufficient
intravenous fluid replacement, draining fistulas, ileostomy, and
colostomy. A client with cirrhosis, HF, or decreased kidney function is at
risk for fluid volume excess.
⩥ The nurse is caring for a client who has been taking diuretics on a
long-term basis. Which finding should the nurse expect to note as a
result of this long-term use? Answer: Increased specific gravity of the
urine
⩥ The nurse reviews electrolyte values and notes a sodium level of 130
mEq/L. The nurse expects that this sodium level would be noted in a
client with which condition? Answer: The client with the syndrome of
inappropriate secretion of antidiuretic hormone (SIADH)
rationale:
Hyponatremia is a serum sodium level less than 135 mEq/L.
Hyponatremia can occur secondary to SIADH. The client with an
inadequate daily water intake, watery diarrhea, or diabetes insipidus is at
risk for hypernatremia.
