NR 439 evidence based practice EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS LATEST UPDATE!!!!

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NR 328 Exam #2 2026 A+ GRADE ASSURED COMPLETE
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SOLUTIONS AND VERIFIED ANSWERS (866C9) zm zm zm zm




QUESTION 1 zm




What factor predisposes an infant to fluid imbalances?
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a. Immature kidney functioning
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b. Decreased surface area
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c. Lower metabolic rate
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d. Decreased daily exchange of extracellular fluid
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ANSWER

Answer: A Rationale: The infant's kidneys are functionally immature at birth and are inefficient in e
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xcreting waste products of metabolism. Infants have a relatively high body surface area (BSA) comp
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ared with adults. This allows a higher loss of fluid to the environment. A higher metabolic rate is pr
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esent as a result of the higher BSA in relation to active metabolic tissue. The higher metabolic rate i
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ncreases heat production, which results in greater insensible water loss. Infants have a greater exch
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ange of extracellular fluid, leaving them with a reduced fluid reserve in conditions of dehydration.
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QUESTION 2 zm




What is the required number of milliliters of fluid needed per day for a 14 kg child?
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a. 1200
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b. 1100
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c. 1300
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d. 1400
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ANSWER

Answer: A Rationale: For the first 10 kg of body weight, a child requires 100 mL/kg. For each addit
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ional kilogram of body weight, an extra 50 mL is needed. 10 kg ´ 100 mL/kg/day = 1000 mL 4 kg ´
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m50 mL/kg/day = 200 mL 1000 mL + 200 mL = 1200 ml/day 800 to 1000 mL is too little; 1400 mL
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is too much.
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QUESTION 3 zm

,An infant is brought to the emergency department with the following clinical manifest
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ations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is sug
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gestive of which situation?
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a. Water depletion
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b. Water excess
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c. Potassium excess
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d. Sodium depletion
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ANSWER

Answer: A Rationale: These clinical manifestations indicate water depletion or dehydration. Edema a
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nd weight gain occur with water excess or over-
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hydration. Sodium or potassium excess would not cause these symptoms.
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QUESTION 4 zm




What explains physiologically the edema formation that occurs with burns?
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a. Increased capillary permeability
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b. Decreased capillary permeability
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c. Vasoconstriction
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d. Diminished hydrostatic pressure within capillaries
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ANSWER

Answer: A Rationale: With a major burn, capillary permeability increases, allowing plasma proteins, f
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luids, and electrolytes to be lost into the interstitial space, causing edema. Maximum edema in a sm
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all wound occurs about 8 to 12 hr after injury. In larger injuries, the maximum edema may not occ
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ur until 18 to 24 hr later. Vasodilation occurs, causing an increase in hydrostatic pressure.
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QUESTION 5 zm




What is the most immediate threat to life in children with thermal injuries?
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a. Shock
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b. Anemia
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c. Local infection
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d. Systemic sepsis
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ANSWER

Answer: A Rationale: The immediate threat to life in children with thermal injuries is airway compr
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omise and profound shock. Anemia is not of immediate concern. During the healing phase, local infe
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ction or sepsis is the primary complication.
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QUESTION 6 zm




After the acute stage and during the healing process, what is the primary complicatio
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n from burn injury?
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a. Infection
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, b. Shock zm



c. Renal shutdown
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d. Asphyxia
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ANSWER

Answer: A Rationale: During the healing phase, local infection or sepsis is the primary complication.
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Respiratory problems, primarily airway compromise, and shock are the primary complications durin
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g the acute stage of burn injury. Renal shutdown is not a complication of the burn injury but may b
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e a result of the profound shock.
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QUESTION 7 zm




What finding is the most reliable guide to the adequacy of fluid replacement for a sm
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all child with burns?
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a. Urinary output of 1 to 2 mL/kg of body weight/hr
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b. Increased seepage from burn wound
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c. Falling hematocrit
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d. Absence of thirst
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ANSWER

Answer: A Rationale: Replacement fluid therapy is delivered to provide a urinary output of 30 mL/h
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r in older children or 1 to 2 mL/kg of body weight/hr for children weighing less than 30 kg (66 po
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unds). Thirst is the result of a complex set of interactions and is not a reliable indicator of hydratio
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n. Thirst occurs late in dehydration. A falling hematocrit would be indicative of hemodilution. This
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may reflect fluid shifts and may not accurately represent fluid replacement therapy. Increased seepa
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ge from a burn wound would be indicative of increased output, not adequate hydration.
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QUESTION 8 zm




What intervention is contraindicated in a suspected case of appendicitis?
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a. Enemas zm



b. Palpating the abdomen
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c. Administration of antibiotics
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d. Administration of antipyretics for fever
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ANSWER

Answer: A Rationale: In any instance in which severe abdominal pain is observed and appendicitis is
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suspected, the nurse must be aware of the danger of administering laxatives or enemas. Such meas
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ures stimulate bowel motility and increase the risk of perforation. The abdomen is palpated after ot
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her assessments are made. Antibiotics should be administered, and antipyretics are not contraindicat
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ed.



QUESTION 9 zm