NR328 EXAM 2 WITH ACCURATE ANSWERS AND RATIONALES
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
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.
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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
Answer: A
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.
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
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.
, 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
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.
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5.What is the most immediate threat to life in children with
thermal injuries?
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
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.
,-
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
Answer: A
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.
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
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.
, 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
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.
-
5.What is the most immediate threat to life in children with
thermal injuries?
