NR 326 Pediatric Dosage Calculation
Exam 2026/2027 ACTUAL EXAM TEST
BANK 250 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION
QUESTION
A nurse is caring for a school-age child who weighs 35 kg. What is the child's daily maintenance
fluid requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 1,800 mL/day
EXPERT RATIONALE
Daily maintenance fluid requirements in pediatric patients are calculated using the Holliday-
Segar method, which is based on body weight and reflects metabolic water needs.
For a 35 kg child, the calculation is divided into weight tiers:
• The first 10 kg require 100 mL/kg/day (10 × 100 = 1,000 mL)
• The second 10 kg require 50 mL/kg/day (10 × 50 = 500 mL)
• The remaining 15 kg require 20 mL/kg/day (15 × 20 = 300 mL)
Total maintenance fluid requirement is therefore 1,000 + 500 + 300 = 1,800 mL/day.
This stepwise reduction reflects decreasing metabolic demand per kilogram as body mass
increases. School-age children generally have lower fluid needs per kilogram compared to
younger children due to reduced metabolic rate and lower body surface area-to-weight ratio.
Accurate calculation is essential in clinical practice to maintain fluid homeostasis and prevent
complications such as dehydration or fluid overload, particularly in pediatric patients whose
fluid balance is more easily disrupted.
,DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
OBJ: Calculate maintenance fluid requirements in children
TOP: Fluid and Electrolyte Balance / Nursing Process Step: Planning
QUESTION
A nurse is caring for a preschool-age child who weighs 18 kg. What is the child's daily
maintenance fluid requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 1,400 mL/day
EXPERT RATIONALE
Maintenance fluid requirements in children are calculated using the Holliday-Segar method,
which estimates daily fluid needs based on weight and metabolic requirements.
For an 18 kg child:
• The first 10 kg require 100 mL/kg/day (10 × 100 = 1,000 mL)
• The remaining 8 kg require 50 mL/kg/day (8 × 50 = 400 mL)
Total daily maintenance fluid requirement is 1,000 + 400 = 1,400 mL/day.
Preschool-age children have relatively high fluid requirements per kilogram due to increased
metabolic activity and a higher surface area-to-body mass ratio compared with older children.
Precise fluid calculation is essential in pediatric nursing to ensure adequate hydration, maintain
renal perfusion, and prevent complications such as dehydration or fluid overload, particularly
during illness or reduced oral intake.
DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
OBJ: Calculate maintenance fluid requirements in children
TOP: Fluid and Electrolyte Balance / Nursing Process Step: Planning
QUESTION
,A nurse is caring for a toddler who weighs 13.5 kg. What is the toddler's daily maintenance fluid
requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 1,175 mL/day
EXPERT RATIONALE
Daily maintenance fluid requirements are calculated using the Holliday-Segar method, which
estimates fluid needs based on metabolic requirements by weight. For children, the formula is
100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each additional
kilogram.
For a 13.5 kg toddler:
• First 10 kg: 10 × 100 = 1,000 mL
• Remaining 3.5 kg: 3.5 × 50 = 175 mL
Total: 1,000 + 175 = 1,175 mL/day
Toddlers have relatively high fluid requirements due to increased metabolic rate and higher
body surface area relative to weight. Accurate fluid calculation is essential to prevent
dehydration, especially because toddlers are more susceptible to rapid fluid shifts due to illness,
limited intake, or fever.
DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
OBJ: Calculate maintenance fluid requirements in children
TOP: Fluid and Electrolyte Balance / Nursing Process Step: Planning
QUESTION
A nurse is preparing to administer clindamycin 10 mg/kg PO divided in equal doses every 8 hr to
a toddler who weighs 30 lb. Available is clindamycin oral suspension 75 mg/5 mL. How many mL
should the nurse administer per dose? (Round the answer to the nearest whole number. Use a
leading zero if it applies. Do not use a trailing zero.)
CORRECT ANSWER: 3 mL per dose
EXPERT RATIONALE
First, convert weight from pounds to kilograms: 30 lb ÷ 2.2 = 13.6 kg (approx).
, Total daily dose:
10 mg/kg × 13.6 kg = 136 mg/day
The medication is divided every 8 hours (3 doses/day):
136 ÷ 3 = 45.3 mg per dose
Convert concentration:
75 mg / 5 mL = 15 mg/mL
Volume per dose:
45.3 ÷ 15 = 3.0 mL ≈ 3 mL
Accurate weight conversion and dose division are essential in pediatric pharmacology to avoid
underdosing or toxicity. Pediatric dosing is strictly weight-based due to differences in drug
metabolism and clearance compared with adults.
DIF: Application
REF: Pediatric Medication Dosage Calculation
OBJ: Calculate safe pediatric medication dosages
TOP: Pharmacological and Parenteral Therapies / Medication Administration
QUESTION
A nurse is caring for an infant who weighs 6 kg. What is the infant's daily maintenance fluid
requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 600 mL/day
EXPERT RATIONALE
Using the Holliday-Segar method, infants require 100 mL/kg/day for the first 10 kg of body
weight.
For a 6 kg infant:
6 × 100 = 600 mL/day
Infants have the highest fluid requirements per kilogram due to high metabolic rate, rapid
growth, and immature renal concentrating ability. Even small fluid losses can significantly affect
hydration status, making precise fluid management critical in this population.
DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
Exam 2026/2027 ACTUAL EXAM TEST
BANK 250 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION
QUESTION
A nurse is caring for a school-age child who weighs 35 kg. What is the child's daily maintenance
fluid requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 1,800 mL/day
EXPERT RATIONALE
Daily maintenance fluid requirements in pediatric patients are calculated using the Holliday-
Segar method, which is based on body weight and reflects metabolic water needs.
For a 35 kg child, the calculation is divided into weight tiers:
• The first 10 kg require 100 mL/kg/day (10 × 100 = 1,000 mL)
• The second 10 kg require 50 mL/kg/day (10 × 50 = 500 mL)
• The remaining 15 kg require 20 mL/kg/day (15 × 20 = 300 mL)
Total maintenance fluid requirement is therefore 1,000 + 500 + 300 = 1,800 mL/day.
This stepwise reduction reflects decreasing metabolic demand per kilogram as body mass
increases. School-age children generally have lower fluid needs per kilogram compared to
younger children due to reduced metabolic rate and lower body surface area-to-weight ratio.
Accurate calculation is essential in clinical practice to maintain fluid homeostasis and prevent
complications such as dehydration or fluid overload, particularly in pediatric patients whose
fluid balance is more easily disrupted.
,DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
OBJ: Calculate maintenance fluid requirements in children
TOP: Fluid and Electrolyte Balance / Nursing Process Step: Planning
QUESTION
A nurse is caring for a preschool-age child who weighs 18 kg. What is the child's daily
maintenance fluid requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 1,400 mL/day
EXPERT RATIONALE
Maintenance fluid requirements in children are calculated using the Holliday-Segar method,
which estimates daily fluid needs based on weight and metabolic requirements.
For an 18 kg child:
• The first 10 kg require 100 mL/kg/day (10 × 100 = 1,000 mL)
• The remaining 8 kg require 50 mL/kg/day (8 × 50 = 400 mL)
Total daily maintenance fluid requirement is 1,000 + 400 = 1,400 mL/day.
Preschool-age children have relatively high fluid requirements per kilogram due to increased
metabolic activity and a higher surface area-to-body mass ratio compared with older children.
Precise fluid calculation is essential in pediatric nursing to ensure adequate hydration, maintain
renal perfusion, and prevent complications such as dehydration or fluid overload, particularly
during illness or reduced oral intake.
DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
OBJ: Calculate maintenance fluid requirements in children
TOP: Fluid and Electrolyte Balance / Nursing Process Step: Planning
QUESTION
,A nurse is caring for a toddler who weighs 13.5 kg. What is the toddler's daily maintenance fluid
requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 1,175 mL/day
EXPERT RATIONALE
Daily maintenance fluid requirements are calculated using the Holliday-Segar method, which
estimates fluid needs based on metabolic requirements by weight. For children, the formula is
100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each additional
kilogram.
For a 13.5 kg toddler:
• First 10 kg: 10 × 100 = 1,000 mL
• Remaining 3.5 kg: 3.5 × 50 = 175 mL
Total: 1,000 + 175 = 1,175 mL/day
Toddlers have relatively high fluid requirements due to increased metabolic rate and higher
body surface area relative to weight. Accurate fluid calculation is essential to prevent
dehydration, especially because toddlers are more susceptible to rapid fluid shifts due to illness,
limited intake, or fever.
DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
OBJ: Calculate maintenance fluid requirements in children
TOP: Fluid and Electrolyte Balance / Nursing Process Step: Planning
QUESTION
A nurse is preparing to administer clindamycin 10 mg/kg PO divided in equal doses every 8 hr to
a toddler who weighs 30 lb. Available is clindamycin oral suspension 75 mg/5 mL. How many mL
should the nurse administer per dose? (Round the answer to the nearest whole number. Use a
leading zero if it applies. Do not use a trailing zero.)
CORRECT ANSWER: 3 mL per dose
EXPERT RATIONALE
First, convert weight from pounds to kilograms: 30 lb ÷ 2.2 = 13.6 kg (approx).
, Total daily dose:
10 mg/kg × 13.6 kg = 136 mg/day
The medication is divided every 8 hours (3 doses/day):
136 ÷ 3 = 45.3 mg per dose
Convert concentration:
75 mg / 5 mL = 15 mg/mL
Volume per dose:
45.3 ÷ 15 = 3.0 mL ≈ 3 mL
Accurate weight conversion and dose division are essential in pediatric pharmacology to avoid
underdosing or toxicity. Pediatric dosing is strictly weight-based due to differences in drug
metabolism and clearance compared with adults.
DIF: Application
REF: Pediatric Medication Dosage Calculation
OBJ: Calculate safe pediatric medication dosages
TOP: Pharmacological and Parenteral Therapies / Medication Administration
QUESTION
A nurse is caring for an infant who weighs 6 kg. What is the infant's daily maintenance fluid
requirement? (Round the answer to the nearest whole number.)
CORRECT ANSWER: 600 mL/day
EXPERT RATIONALE
Using the Holliday-Segar method, infants require 100 mL/kg/day for the first 10 kg of body
weight.
For a 6 kg infant:
6 × 100 = 600 mL/day
Infants have the highest fluid requirements per kilogram due to high metabolic rate, rapid
growth, and immature renal concentrating ability. Even small fluid losses can significantly affect
hydration status, making precise fluid management critical in this population.
DIF: Application
REF: Pediatric Fluid & Electrolyte Balance / Maintenance Fluids
