What is the hourly fluid maintenance rate for a 13.5 kg child?
109 ml per hour.
79 ml per hour.
49 ml per hour.
200 ml per hour.
The Correct Answer is C
Choice A reason: A 109 ml/hour rate is excessive for a 13.5 kg child. Using the 4-2-1 rule (4 ml/kg/hour for the first 10 kg, 2 ml/kg/hour for the next 3.5 kg), the total is 47 ml/hour, not 109, which could cause fluid overload and cardiovascular strain.
Choice B reason: A 79 ml/hour rate overestimates maintenance fluids for a 13.5 kg child. The 4-2-1 rule yields 47 ml/hour (40 ml for 10 kg + 7 ml for 3.5 kg). Higher rates risk hypervolemia, potentially causing pulmonary edema or electrolyte imbalances in a child.
Choice C reason: For a 13.5 kg child, the 4-2-1 rule calculates maintenance fluids as 40 ml/hour (10 kg × 4 ml) + 7 ml/hour (3.5 kg × 2 ml) = 47 ml/hour, closest to 49 ml/hour. This rate maintains hydration without risking fluid overload, supporting renal and cardiovascular function.
Choice D reason: A 200 ml/hour rate is far too high for a 13.5 kg child, risking fluid overload, heart failure, or pulmonary edema. The correct maintenance rate, per the 4-2-1 rule, is approximately 47 ml/hour, making this choice dangerously excessive for pediatric fluid needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Decreasing fluid intake risks dehydration in burn patients, who lose significant fluids through damaged skin. Fluid replacement is critical to maintain blood volume, prevent hypovolemic shock, and support organ perfusion, making this recommendation dangerous and counterproductive to burn recovery.
Choice B reason: Increasing carbohydrate intake provides energy for metabolic demands in burn recovery, but it is not the primary focus. Protein is more critical for tissue repair and immune function. Carbohydrates support caloric needs but alone cannot address the extensive tissue regeneration required post-burn.
Choice C reason: A lower-calorie diet is inappropriate, as burn injuries increase metabolic rate, requiring higher calories for healing. Reduced activity does not offset the hypermetabolic state, which demands increased energy to support tissue repair, immune response, and prevention of muscle wasting.
Choice D reason: A high-protein diet is essential for burn patients, as protein supports wound healing, tissue regeneration, and immune function. Burns cause significant protein loss through exudates, and adequate protein intake prevents muscle breakdown, promotes collagen synthesis, and enhances recovery from extensive tissue damage.
Correct Answer is C
Explanation
Choice A reason: Woolen clothes can irritate eczema-prone skin, exacerbating inflammation and itching due to their rough texture. Eczema involves a defective skin barrier, and irritants like wool trigger flares, increasing discomfort and risking secondary infections from scratching, making this advice harmful.
Choice B reason: Fabric softeners contain fragrances and chemicals that can irritate eczema, worsening skin inflammation. Eczema requires hypoallergenic, fragrance-free detergents to minimize skin reactions, as the compromised skin barrier is highly sensitive to chemical irritants, leading to increased itching and flares.
Choice C reason: Topical corticosteroids reduce inflammation, redness, and itching in eczema by suppressing immune-mediated skin reactions. They restore the skin barrier, prevent flares, and reduce the risk of infection from scratching. Proper application under medical guidance is a cornerstone of eczema management in children.
Choice D reason: Bubble baths, with soaps and fragrances, strip natural oils from eczema-prone skin, worsening dryness and irritation. Daily baths should use gentle, fragrance-free cleansers to maintain skin hydration, as irritants exacerbate the defective skin barrier, leading to increased inflammation and discomfort.
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