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NR 328 Exam 2 Pediatric Nursing 2026/2027
Chamberlain Actual Questions and Verified Answers
with Detailed Rationales Grade A NCLEX Study Guide
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: A. Immature kidney functioning
Rationale: The infant's kidneys are functionally immature at birth and inefficient in
excreting waste products. Infants have a higher body surface area, higher metabolic
rate, and greater exchange of extracellular fluid, all of which increase fluid needs and
risk for imbalances.
2. What is the required number of milliliters of fluid needed per day for a 14 kg child?
A. 1200
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B. 1100
C. 1300
D. 1400
Correct Answer: A. 1200
Rationale: For the first 10 kg, a child requires 100 mL/kg/day. For each additional kg, an
extra 50 mL is needed. (10 kg × 100 mL = 1000 mL) + (4 kg × 50 mL = 200 mL) = 1200
mL/day.
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: A. Water depletion
Rationale: These clinical manifestations indicate water depletion or dehydration. Edema
and weight gain occur with water excess. Sodium or potassium excess would not cause
these symptoms.
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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
Correct Answer: A. Increased capillary permeability
Rationale: With a major burn, capillary permeability increases, allowing plasma
proteins, fluids, and electrolytes to be lost into the interstitial space, causing edema.
Vasodilation occurs, increasing hydrostatic pressure.
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: A. Shock
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Rationale: The immediate threat to life in children with thermal injuries is airway
compromise and profound shock. During the healing phase, local infection or sepsis is
the primary complication.
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: A. Infection
Rationale: During the healing phase, local infection or sepsis is the primary
complication. Respiratory problems and shock are primary during the acute stage.
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
NR 328 Exam 2 Pediatric Nursing 2026/2027
Chamberlain Actual Questions and Verified Answers
with Detailed Rationales Grade A NCLEX Study Guide
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: A. Immature kidney functioning
Rationale: The infant's kidneys are functionally immature at birth and inefficient in
excreting waste products. Infants have a higher body surface area, higher metabolic
rate, and greater exchange of extracellular fluid, all of which increase fluid needs and
risk for imbalances.
2. What is the required number of milliliters of fluid needed per day for a 14 kg child?
A. 1200
,2|Page
B. 1100
C. 1300
D. 1400
Correct Answer: A. 1200
Rationale: For the first 10 kg, a child requires 100 mL/kg/day. For each additional kg, an
extra 50 mL is needed. (10 kg × 100 mL = 1000 mL) + (4 kg × 50 mL = 200 mL) = 1200
mL/day.
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: A. Water depletion
Rationale: These clinical manifestations indicate water depletion or dehydration. Edema
and weight gain occur with water excess. Sodium or potassium excess would not cause
these symptoms.
,3|Page
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
Correct Answer: A. Increased capillary permeability
Rationale: With a major burn, capillary permeability increases, allowing plasma
proteins, fluids, and electrolytes to be lost into the interstitial space, causing edema.
Vasodilation occurs, increasing hydrostatic pressure.
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: A. Shock
, 4|Page
Rationale: The immediate threat to life in children with thermal injuries is airway
compromise and profound shock. During the healing phase, local infection or sepsis is
the primary complication.
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: A. Infection
Rationale: During the healing phase, local infection or sepsis is the primary
complication. Respiratory problems and shock are primary during the acute stage.
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
