NR 328 EXAM 2 -PEDIATRIC NURSING |ACTUAL
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
What factor predisposes an infant to fluid imbalances?
a. Immature kidney functioning
b. Decreased surface area
c. Lower metabolic rate
d. Decreased daily exchange of extracellular fluid
CORRECT ANSWER
Answer: A
Rationale: The infant's kidneys are functionally immature at birth and are inefficient in
excreting waste products of metabolism. Infants have a relatively high body surface area
(BSA) compared with adults. This allows a higher loss of fluid to the environment. A
higher metabolic rate is present as a result of the higher BSA in relation to active
metabolic tissue. The higher metabolic rate increases heat production, which results in
greater insensible water loss. Infants have a greater exchange of extracellular fluid,
leaving them with a reduced fluid reserve in conditions of dehydration.
Question 2
What is the required number of milliliters of fluid needed per day for a 14 kg child?
a. 1200
b. 1100
c. 1300
d. 1400
CORRECT ANSWER
Answer: A
1
@THE STUDY VAULT
, Rationale: For the first 10 kg of body weight, a child requires 100 mL/kg. For each
additional kilogram of body weight, an extra 50 mL is needed.
10 kg ´ 100 mL/kg/day = 1000 mL
4 kg ´ 50 mL/kg/day = 200 mL
1000 mL + 200 mL = 1200 ml/day
800 to 1000 mL is too little; 1400 mL is too much.
Question 3
An infant is brought to the emergency department with the following clinical
manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is
suggestive of which situation?
a. Water depletion
b. Water excess
c. Potassium excess
d. Sodium depletion
CORRECT ANSWER
Answer: A
Rationale: These clinical manifestations indicate water depletion or dehydration. Edema
and weight gain occur with water excess or over-hydration. Sodium or potassium excess
would not cause these symptoms.
Question 4
What explains physiologically the edema formation that occurs with burns?
a. Increased capillary permeability
b. Decreased capillary permeability
c. Vasoconstriction
d. Diminished hydrostatic pressure within capillaries
2
@THE STUDY VAULT
,CORRECT ANSWER
Answer: A
Rationale: With a major burn, capillary permeability increases, allowing plasma proteins,
fluids, and electrolytes to be lost into the interstitial space, causing edema. Maximum
edema in a small wound occurs about 8 to 12 hr after injury. In larger injuries, the
maximum edema may not occur until 18 to 24 hr later. Vasodilation occurs, causing an
increase in hydrostatic pressure.
Question 5
What is the most immediate threat to life in children with thermal injuries?
a. Shock
b. Anemia
c. Local infection
d. Systemic sepsis
CORRECT ANSWER
Answer: A
Rationale: The immediate threat to life in children with thermal injuries is airway
compromise and profound shock. Anemia is not of immediate concern. During the
healing phase, local infection or sepsis is the primary complication.
Question 6
After the acute stage and during the healing process, what is the primary complication
from burn injury?
a. Infection
b. Shock
c. Renal shutdown
d. Asphyxia
CORRECT ANSWER
3
@THE STUDY VAULT
, Answer: A
Rationale: During the healing phase, local infection or sepsis is the primary complication.
Respiratory problems, primarily airway compromise, and shock are the primary
complications during the acute stage of burn injury. Renal shutdown is not a
complication of the burn injury but may be a result of the profound shock.
Question 7
What finding is the most reliable guide to the adequacy of fluid replacement for a small
child with burns?
a. Urinary output of 1 to 2 mL/kg of body weight/hr
b. Increased seepage from burn wound
c. Falling hematocrit
d. Absence of thirst
CORRECT ANSWER
Answer: A
Rationale: Replacement fluid therapy is delivered to provide a urinary output of 30
mL/hr in older children or 1 to 2 mL/kg of body weight/hr for children weighing less than
30 kg (66 pounds). Thirst is the result of a complex set of interactions and is not a reliable
indicator of hydration. Thirst occurs late in dehydration. A falling hematocrit would be
indicative of hemodilution. This may reflect fluid shifts and may not accurately represent
fluid replacement therapy. Increased seepage from a burn wound would be indicative of
increased output, not adequate hydration.
Question 8
What intervention is contraindicated in a suspected case of appendicitis?
a. Enemas
b. Palpating the abdomen
c. Administration of antibiotics
4
@THE STUDY VAULT
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
What factor predisposes an infant to fluid imbalances?
a. Immature kidney functioning
b. Decreased surface area
c. Lower metabolic rate
d. Decreased daily exchange of extracellular fluid
CORRECT ANSWER
Answer: A
Rationale: The infant's kidneys are functionally immature at birth and are inefficient in
excreting waste products of metabolism. Infants have a relatively high body surface area
(BSA) compared with adults. This allows a higher loss of fluid to the environment. A
higher metabolic rate is present as a result of the higher BSA in relation to active
metabolic tissue. The higher metabolic rate increases heat production, which results in
greater insensible water loss. Infants have a greater exchange of extracellular fluid,
leaving them with a reduced fluid reserve in conditions of dehydration.
Question 2
What is the required number of milliliters of fluid needed per day for a 14 kg child?
a. 1200
b. 1100
c. 1300
d. 1400
CORRECT ANSWER
Answer: A
1
@THE STUDY VAULT
, Rationale: For the first 10 kg of body weight, a child requires 100 mL/kg. For each
additional kilogram of body weight, an extra 50 mL is needed.
10 kg ´ 100 mL/kg/day = 1000 mL
4 kg ´ 50 mL/kg/day = 200 mL
1000 mL + 200 mL = 1200 ml/day
800 to 1000 mL is too little; 1400 mL is too much.
Question 3
An infant is brought to the emergency department with the following clinical
manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is
suggestive of which situation?
a. Water depletion
b. Water excess
c. Potassium excess
d. Sodium depletion
CORRECT ANSWER
Answer: A
Rationale: These clinical manifestations indicate water depletion or dehydration. Edema
and weight gain occur with water excess or over-hydration. Sodium or potassium excess
would not cause these symptoms.
Question 4
What explains physiologically the edema formation that occurs with burns?
a. Increased capillary permeability
b. Decreased capillary permeability
c. Vasoconstriction
d. Diminished hydrostatic pressure within capillaries
2
@THE STUDY VAULT
,CORRECT ANSWER
Answer: A
Rationale: With a major burn, capillary permeability increases, allowing plasma proteins,
fluids, and electrolytes to be lost into the interstitial space, causing edema. Maximum
edema in a small wound occurs about 8 to 12 hr after injury. In larger injuries, the
maximum edema may not occur until 18 to 24 hr later. Vasodilation occurs, causing an
increase in hydrostatic pressure.
Question 5
What is the most immediate threat to life in children with thermal injuries?
a. Shock
b. Anemia
c. Local infection
d. Systemic sepsis
CORRECT ANSWER
Answer: A
Rationale: The immediate threat to life in children with thermal injuries is airway
compromise and profound shock. Anemia is not of immediate concern. During the
healing phase, local infection or sepsis is the primary complication.
Question 6
After the acute stage and during the healing process, what is the primary complication
from burn injury?
a. Infection
b. Shock
c. Renal shutdown
d. Asphyxia
CORRECT ANSWER
3
@THE STUDY VAULT
, Answer: A
Rationale: During the healing phase, local infection or sepsis is the primary complication.
Respiratory problems, primarily airway compromise, and shock are the primary
complications during the acute stage of burn injury. Renal shutdown is not a
complication of the burn injury but may be a result of the profound shock.
Question 7
What finding is the most reliable guide to the adequacy of fluid replacement for a small
child with burns?
a. Urinary output of 1 to 2 mL/kg of body weight/hr
b. Increased seepage from burn wound
c. Falling hematocrit
d. Absence of thirst
CORRECT ANSWER
Answer: A
Rationale: Replacement fluid therapy is delivered to provide a urinary output of 30
mL/hr in older children or 1 to 2 mL/kg of body weight/hr for children weighing less than
30 kg (66 pounds). Thirst is the result of a complex set of interactions and is not a reliable
indicator of hydration. Thirst occurs late in dehydration. A falling hematocrit would be
indicative of hemodilution. This may reflect fluid shifts and may not accurately represent
fluid replacement therapy. Increased seepage from a burn wound would be indicative of
increased output, not adequate hydration.
Question 8
What intervention is contraindicated in a suspected case of appendicitis?
a. Enemas
b. Palpating the abdomen
c. Administration of antibiotics
4
@THE STUDY VAULT
