CRNI CRNI Pediatric Infusion Therapy Practice Test 4 — Questions and Answers
Question 1: A 4-year-old weighing 16 kg requires maintenance IV fluids. Using the Holliday-Segar method, what is the correct hourly fluid rate?
- 48 mL/hr
- 52 mL/hr (Correct answer)
- 40 mL/hr
- 60 mL/hr
Correct answer: 52 mL/hr
Holliday-Segar: 100 mL/kg for first 10 kg (1000 mL) + 50 mL/kg for next 10 kg (300 mL) = 1300 mL/24 hr ≈ 52 mL/hr for a 16 kg child.
Question 2: When selecting a peripheral IV catheter for a neonate, which gauge is most appropriate to minimize vascular trauma?
- 18 gauge
- 20 gauge
- 24 gauge (Correct answer)
- 22 gauge
Correct answer: 24 gauge
A 24-gauge catheter is preferred for neonates because their small, fragile vessels require the smallest gauge that still allows adequate flow.
Question 3: A child receiving a vesicant chemotherapy infusion via a peripheral IV reports burning at the site. The nurse notes swelling and pallor. What is the priority intervention?
- Slow the infusion rate and reassess in 15 minutes
- Stop the infusion immediately and aspirate residual drug (Correct answer)
- Apply a warm compress and elevate the extremity
- Flush the line with normal saline to dilute the drug
Correct answer: Stop the infusion immediately and aspirate residual drug
Vesicant extravasation requires immediate infusion cessation and aspiration of residual drug before initiating site-specific antidote protocols.
Question 4: Which blood product requires a leukocyte-reduction filter when transfused to a pediatric patient who has had prior febrile non-hemolytic transfusion reactions?
- Fresh frozen plasma
- Cryoprecipitate
- Packed red blood cells (Correct answer)
- Albumin
Correct answer: Packed red blood cells
Leukoreduced packed red blood cells are indicated for patients with prior febrile non-hemolytic reactions, as white blood cells are the primary cause of these reactions.
Question 5: A 7-year-old with cystic fibrosis is prescribed tobramycin. Which parameter is most critical to monitor during IV aminoglycoside therapy in pediatric patients?
- Liver function tests
- Serum creatinine and drug trough levels (Correct answer)
- Complete blood count
- Serum glucose
Correct answer: Serum creatinine and drug trough levels
Aminoglycosides are nephrotoxic and ototoxic; monitoring serum creatinine and trough levels ensures therapeutic dosing while preventing accumulation-related toxicity.
Question 6: In a pediatric patient with a PICC line, which finding is the earliest indicator of a catheter-associated bloodstream infection (CLABSI)?
- Purulent drainage at the insertion site
- Unexplained fever or temperature instability (Correct answer)
- Positive blood culture from a peripheral site only
- Redness and warmth along the catheter tract
Correct answer: Unexplained fever or temperature instability
Unexplained fever or temperature instability is often the earliest systemic sign of CLABSI, especially in neonates and infants who may not show localized signs.
Question 7: A nurse is preparing to administer a 10 mL/kg normal saline bolus to a 5 kg infant in compensated shock. What volume should be infused?
- 25 mL
- 100 mL
- 50 mL (Correct answer)
- 75 mL
Correct answer: 50 mL
10 mL/kg × 5 kg = 50 mL; this standard resuscitation bolus is given over 5–20 minutes and reassessed for hemodynamic response.
CRNI CRNI Pediatric Infusion Therapy Practice Test 4
A 4-year-old weighing 16 kg requires maintenance IV fluids.
Using the Holliday-Segar method, what is the correct hourly fluid rate?