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NR 328 Exam #2 Pediatric Nursing Exam Review | NCLEX Cardiology: Congenital Heart Disease, Heart Failure, Digoxin, CHF, PDA, VSD, ASD, Coarctation, TET Spells, Hypoxemia, Cyanosis, Pulmonary Hypertension | Burns, Fluid & Electrolytes, Dehydration, Shock,

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NR 328 Exam #2 Pediatric Nursing Exam Review | NCLEX Cardiology: Congenital Heart Disease, Heart Failure, Digoxin, CHF, PDA, VSD, ASD, Coarctation, TET Spells, Hypoxemia, Cyanosis, Pulmonary Hypertension | Burns, Fluid & Electrolytes, Dehydration, Shock, IV Therapy, Pain Management | GERD, Hirschsprung, Nephrotic Syndrome, Glomerulonephritis, UTI, Hypertension | Kawasaki Disease, Appendicitis, Pyloric Stenosis, Gastrostomy Tube, Nutrition, Safety, Assessment, Vital Signs, Growth & Development, Medications, Parent Education Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 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. 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. 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.

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NR 328 Exam #2 Pediatric Nursing Exam Review | NCLEX Cardiology:
Congenital Heart Disease, Heart Failure, Digoxin, CHF, PDA, VSD, ASD,
Coarctation, TET Spells, Hypoxemia, Cyanosis, Pulmonary
Hypertension | Burns, Fluid & Electrolytes, Dehydration, Shock, IV
Therapy, Pain Management | GERD, Hirschsprung, Nephrotic
Syndrome, Glomerulonephritis, UTI, Hypertension | Kawasaki Disease,
Appendicitis, Pyloric Stenosis, Gastrostomy Tube, Nutrition, Safety,
Assessment, Vital Signs, Growth & Development, Medications, Parent
Education Exam Questions Verified and Provided with Complete A+
Graded Rationales Latest Updated 2026




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.




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.




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.

, 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.




What is the most immediate threat to life in children with thermal injuries?



a. Shock



b. Anemia



c. Local infection

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