ESTUDYR
NURS 328 – Midterm UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED SUCCESS
WITH DETAILED RATIONALES
A. Lower body surface area relative to body mass
B. B. Higher total body water and greater body surface area proportionally ✔
C. More developed renal concentrating ability
D. Lower metabolic rate
Rationale: Infants have a larger %TBW and proportionally larger surface area → greater
insensible losses and risk of imbalance.
because they:
A. Sweat more effectively
B. B. Cannot shiver effectively and have immature thermoregulation ✔
C. Have fewer brown fat stores
D. Have lower metabolic rate
Rationale: Newborns rely on brown fat and cannot shiver well; this affects fluid/electrolyte
balance and energy use.
A. ECF proportion is lower than in adults
B. ECF is primarily intracellular in infants
C. C. Infants have a relatively larger proportion of ECF, making them more vulnerable to ECF
loss ✔
D. ECF volume does not affect dehydration risk
Rationale: Infants have higher ECF fraction → ECF losses (vomiting, diarrhea) rapidly cause
hypovolemia.
A. Improved ability to concentrate urine
B. Faster elimination of drugs requiring renal clearance
C. C. Reduced glomerular filtration and concentrating ability → greater fluid loss risk ✔
D. Lower insensible water loss
Rationale: Immature GFR and tubular function limit compensation for fluid shifts.
,ESTUDYR
A. Serum electrolytes and BUN/creatinine
B. Urine specific gravity and blood gases
C. Serum osmolality and albumin
D. D. Routine EEG ✔
Rationale: EEG is neurologic, not a primary F&E assessment; others evaluate hydration and
renal function.
A. 120–125 mEq/L
B. 125–130 mEq/L
C. C. 132–141 mEq/L (infant/child) ✔
D. 145–155 mEq/L
Rationale: Typical pediatric sodium falls roughly in that range; neonates slightly wider.
A. Only hyperglycemic
B. Only hypoglycemic
C. C. Either hypo- OR hyperglycemic depending on stress response and reserves ✔
D. Unaffected by stress
Rationale: Infants have limited glycogen stores and high metabolic demands; stress can cause
variable responses.
A. Hypoglycemia
B. B. Hyperglycemia ✔
C. Both equal
D. Neither is treated urgently
Rationale: Hyperglycemia can be rapidly treated with insulin/fluids per protocol; hypoglycemia
needs immediate dextrose but the user note indicated hyperglycemia treated faster —
interpret for study context.
A. Heat stroke
B. Burns
C. C. Diarrhea (often with vomiting) ✔
D. Excessive sweating only
Rationale: Acute gastroenteritis is the leading cause of dehydration in young children.
,ESTUDYR
nance fluid requirement for a child weighing 7.4 kg is:
A. 500 mL/day
B. B. 740 mL/day (100 mL/kg for first 1–10 kg) ✔
C. 1500 mL/day
D. 200 mL/day
Rationale: Standard rule: 100 mL/kg for first 10 kg.
-hour maintenance fluid using the standard formula equals:
A. 800 mL/day
B. 1400 mL/day
C. C. 1300 mL/day (1000 mL for first 10 kg + 50 mL/kg × 6 kg) ✔
D. 2000 mL/day
Rationale: First 10 kg = 1000 mL; next 6 kg × 50 = 300 mL → 1300 mL.
ate loss of water and sodium (serum Na
normal)?
A. Hypotonic dehydration
B. Hypertonic dehydration
C. C. Isotonic (isonatremic) dehydration ✔
D. Osmotic dehydration
Rationale: Isotonic loss maintains sodium concentration but decreases volume; most common.
A. Serum Na >150 mEq/L
B. B. Serum Na <130 mEq/L; electrolyte loss exceeds water loss; risk of seizures ✔
C. Normal serum Na and no shock risk
D. No neurologic symptoms
Rationale: Low sodium causes water shift into cells → cerebral edema and seizures.
A. Isotonic
B. B. Hypertonic (hypernatremic) dehydration ✔
C. Mild hypotonic
D. Chronic isotonic
Rationale: Hypernatremia causes cellular shrinkage and high risk of neurologic injury/seizures;
correction must be slow.
A. 5 mL/kg of D5W
B. B. 20 mL/kg of isotonic crystalloid (NS or LR) ✔
, ESTUDYR
C. 50 mL/kg of half-normal saline
D. 100 mL/kg of D10W
Rationale: Rapid isotonic bolus restores intravascular volume in hypovolemic shock.
A. Severe dehydration with shock only
B. B. Mild to moderate dehydration ✔
C. Never in children under 5
D. Only for hypertonic dehydration
Rationale: ORS is first-line for mild/moderate dehydration; severe cases need IV.
A. Pedialyte or WHO ORS
B. Breastmilk for infants
C. C. High-sugar drinks like soda or apple juice ✔
D. Small frequent sips
Rationale: High-carbohydrate beverages worsen osmotic diarrhea and impede rehydration.
A. Immediate addition of potassium (K+) in the first bolus
B. B. Initial isotonic fluids without K+ until urine output is confirmed ✔
C. Only D5W for bolus therapy
D. Rapid hypotonic fluids to correct hypernatremia quickly
Rationale: Avoid K+ until renal perfusion/urine output is established; correct hypernatremia
slowly.
A. Campylobacter and Salmonella
B. E. coli O157:H7
C. C. Norovirus and Rotavirus ✔
D. Pinworms and giardia
Rationale: Norovirus and rotavirus are common viral pathogens causing vomiting/diarrhea.
A. Respiratory droplets
B. B. Fecal–oral route (contaminated food/water, person-to-person) ✔
C. Vector insects
D. Skin contact only
Rationale: Norovirus is highly contagious via fecal–oral spread.
NURS 328 – Midterm UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED SUCCESS
WITH DETAILED RATIONALES
A. Lower body surface area relative to body mass
B. B. Higher total body water and greater body surface area proportionally ✔
C. More developed renal concentrating ability
D. Lower metabolic rate
Rationale: Infants have a larger %TBW and proportionally larger surface area → greater
insensible losses and risk of imbalance.
because they:
A. Sweat more effectively
B. B. Cannot shiver effectively and have immature thermoregulation ✔
C. Have fewer brown fat stores
D. Have lower metabolic rate
Rationale: Newborns rely on brown fat and cannot shiver well; this affects fluid/electrolyte
balance and energy use.
A. ECF proportion is lower than in adults
B. ECF is primarily intracellular in infants
C. C. Infants have a relatively larger proportion of ECF, making them more vulnerable to ECF
loss ✔
D. ECF volume does not affect dehydration risk
Rationale: Infants have higher ECF fraction → ECF losses (vomiting, diarrhea) rapidly cause
hypovolemia.
A. Improved ability to concentrate urine
B. Faster elimination of drugs requiring renal clearance
C. C. Reduced glomerular filtration and concentrating ability → greater fluid loss risk ✔
D. Lower insensible water loss
Rationale: Immature GFR and tubular function limit compensation for fluid shifts.
,ESTUDYR
A. Serum electrolytes and BUN/creatinine
B. Urine specific gravity and blood gases
C. Serum osmolality and albumin
D. D. Routine EEG ✔
Rationale: EEG is neurologic, not a primary F&E assessment; others evaluate hydration and
renal function.
A. 120–125 mEq/L
B. 125–130 mEq/L
C. C. 132–141 mEq/L (infant/child) ✔
D. 145–155 mEq/L
Rationale: Typical pediatric sodium falls roughly in that range; neonates slightly wider.
A. Only hyperglycemic
B. Only hypoglycemic
C. C. Either hypo- OR hyperglycemic depending on stress response and reserves ✔
D. Unaffected by stress
Rationale: Infants have limited glycogen stores and high metabolic demands; stress can cause
variable responses.
A. Hypoglycemia
B. B. Hyperglycemia ✔
C. Both equal
D. Neither is treated urgently
Rationale: Hyperglycemia can be rapidly treated with insulin/fluids per protocol; hypoglycemia
needs immediate dextrose but the user note indicated hyperglycemia treated faster —
interpret for study context.
A. Heat stroke
B. Burns
C. C. Diarrhea (often with vomiting) ✔
D. Excessive sweating only
Rationale: Acute gastroenteritis is the leading cause of dehydration in young children.
,ESTUDYR
nance fluid requirement for a child weighing 7.4 kg is:
A. 500 mL/day
B. B. 740 mL/day (100 mL/kg for first 1–10 kg) ✔
C. 1500 mL/day
D. 200 mL/day
Rationale: Standard rule: 100 mL/kg for first 10 kg.
-hour maintenance fluid using the standard formula equals:
A. 800 mL/day
B. 1400 mL/day
C. C. 1300 mL/day (1000 mL for first 10 kg + 50 mL/kg × 6 kg) ✔
D. 2000 mL/day
Rationale: First 10 kg = 1000 mL; next 6 kg × 50 = 300 mL → 1300 mL.
ate loss of water and sodium (serum Na
normal)?
A. Hypotonic dehydration
B. Hypertonic dehydration
C. C. Isotonic (isonatremic) dehydration ✔
D. Osmotic dehydration
Rationale: Isotonic loss maintains sodium concentration but decreases volume; most common.
A. Serum Na >150 mEq/L
B. B. Serum Na <130 mEq/L; electrolyte loss exceeds water loss; risk of seizures ✔
C. Normal serum Na and no shock risk
D. No neurologic symptoms
Rationale: Low sodium causes water shift into cells → cerebral edema and seizures.
A. Isotonic
B. B. Hypertonic (hypernatremic) dehydration ✔
C. Mild hypotonic
D. Chronic isotonic
Rationale: Hypernatremia causes cellular shrinkage and high risk of neurologic injury/seizures;
correction must be slow.
A. 5 mL/kg of D5W
B. B. 20 mL/kg of isotonic crystalloid (NS or LR) ✔
, ESTUDYR
C. 50 mL/kg of half-normal saline
D. 100 mL/kg of D10W
Rationale: Rapid isotonic bolus restores intravascular volume in hypovolemic shock.
A. Severe dehydration with shock only
B. B. Mild to moderate dehydration ✔
C. Never in children under 5
D. Only for hypertonic dehydration
Rationale: ORS is first-line for mild/moderate dehydration; severe cases need IV.
A. Pedialyte or WHO ORS
B. Breastmilk for infants
C. C. High-sugar drinks like soda or apple juice ✔
D. Small frequent sips
Rationale: High-carbohydrate beverages worsen osmotic diarrhea and impede rehydration.
A. Immediate addition of potassium (K+) in the first bolus
B. B. Initial isotonic fluids without K+ until urine output is confirmed ✔
C. Only D5W for bolus therapy
D. Rapid hypotonic fluids to correct hypernatremia quickly
Rationale: Avoid K+ until renal perfusion/urine output is established; correct hypernatremia
slowly.
A. Campylobacter and Salmonella
B. E. coli O157:H7
C. C. Norovirus and Rotavirus ✔
D. Pinworms and giardia
Rationale: Norovirus and rotavirus are common viral pathogens causing vomiting/diarrhea.
A. Respiratory droplets
B. B. Fecal–oral route (contaminated food/water, person-to-person) ✔
C. Vector insects
D. Skin contact only
Rationale: Norovirus is highly contagious via fecal–oral spread.
