CRNI Pediatric Infusion Therapy Practice Test 1 — Questions and Answers
Question 1: What is the primary reason pediatric patients are at higher risk for fluid overload during infusion therapy?
- Lower body surface area
- Smaller total blood volume relative to adults (Correct answer)
- Higher metabolic rate
- Increased renal clearance
Correct answer: Smaller total blood volume relative to adults
Pediatric patients have a smaller total blood volume relative to adults, making even small volume errors potentially dangerous. A few milliliters of excess fluid can represent a significant percentage of their circulating volume, increasing the risk of fluid overload.
Question 2: When calculating maintenance IV fluid rates for a pediatric patient using the Holliday-Segar method, what is the rate for the first 10 kg of body weight?
- 50 mL/kg/day
- 100 mL/kg/day (Correct answer)
- 20 mL/kg/day
- 150 mL/kg/day
Correct answer: 100 mL/kg/day
The Holliday-Segar formula calculates 100 mL/kg/day for the first 10 kg, 50 mL/kg/day for the next 10 kg, and 20 mL/kg/day for each kg above 20 kg. This is the most widely used method for pediatric maintenance fluid calculations.
Question 3: Which vascular access device is most appropriate for short-term peripheral infusion therapy in a neonate?
- Tunneled central venous catheter
- 24-gauge peripheral IV catheter (Correct answer)
- Implanted port
- 18-gauge midline catheter
Correct answer: 24-gauge peripheral IV catheter
A 24-gauge peripheral IV catheter is the most appropriate choice for short-term peripheral infusion in neonates due to their small vessel size. Larger gauge catheters would be too large, and central devices are reserved for longer-term or specialized therapy needs.
Question 4: What is the recommended maximum volume for a single IV push medication in a neonate?
- 5 mL
- 10 mL
- 1 mL (Correct answer)
- 3 mL
Correct answer: 1 mL
In neonates, the recommended maximum volume for a single IV push medication is generally 1 mL to prevent fluid overload and minimize the risk of adverse hemodynamic effects. Larger volumes should be given as short infusions instead.
Question 5: A nurse is preparing to start an IV on a 2-year-old child. Which site is generally preferred for peripheral IV access in this age group?
- Antecubital fossa
- Dorsum of the hand (Correct answer)
- Scalp vein
- External jugular
Correct answer: Dorsum of the hand
The dorsum of the hand is generally the preferred site for peripheral IV access in toddlers because it provides good vein visibility, allows for adequate securing, and leaves the child's arms relatively free for movement. Scalp veins are typically reserved for infants under 9 months.
Question 6: Which complication is unique to neonatal umbilical vein catheter (UVC) use?
- Air embolism
- Hepatic necrosis from malposition (Correct answer)
- Phlebitis
- Catheter occlusion
Correct answer: Hepatic necrosis from malposition
Hepatic necrosis from catheter malposition is a complication unique to umbilical vein catheters. If the UVC tip is positioned in a hepatic vein rather than the inferior vena cava, hyperosmolar solutions can cause direct liver damage and necrosis.
CRNI Pediatric Infusion Therapy Practice Test 1
What is the primary reason pediatric patients are at higher risk for fluid overload during infusion therapy?