Question 1

Which formula is most commonly used to calculate pediatric maintenance IV fluids?

 

A. Cockcroft–Gault equation

B. Holliday–Segar formula

C. Winter’s formula

D. Henderson–Hasselbalch equation

E. Schwartz equation

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Question 2

Using the 4‑2‑1 rule, what is the hourly maintenance fluid rate for a 10‑kg child?

 

A. 20 mL/hr

B. 30 mL/hr

C. 40 mL/hr

D. 50 mL/hr

E. 60 mL/hr

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Question 3

Using the 4‑2‑1 rule, what is the hourly maintenance fluid rate for a 15‑kg child?

 

A. 40 mL/hr

B. 45 mL/hr

C. 50 mL/hr

D. 55 mL/hr

E. 60 mL/hr

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Question 4

Using the Holliday–Segar daily method, what is the daily maintenance fluid requirement for a 12‑kg child?

 

A. 1100 mL/day

B. 1000 mL/day

C. 1200 mL/day

D. 1300 mL/day

E. 1500 mL/day

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Question 5

A 5‑year‑old child weighing 20 kg presents with isonatremic dehydration estimated at 8%.

What is the approximate total fluid deficit?

 

A. 800 mL

B. 1200 mL

C. 1600 mL

D. 2000 mL

E. 2400 mL

 

Question 6

A 5‑year‑old child (20 kg) with 8% isonatremic dehydration requires deficit correction.

If half of the deficit is replaced in the first 8 hours, how much fluid should be given during this time (not including maintenance)?

 

A. 400 mL

B. 600 mL

C. 1200 mL

D. 1000 mL

E.  800 mL 

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Question 7

A 10‑year‑old child weighing 30 kg develops severe AKI with oliguria. What is the most appropriate strategy for fluid management?

 

A. Continue full maintenance fluids

B. Increase fluids to 150% maintenance

C. Give 1 L saline bolus every 6 hours

D. Restrict fluids to urine output plus insensible losses

E. Start hypotonic fluids

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Question 8

A hospitalized child requires maintenance IV fluids. Which fluid type is generally recommended to reduce the risk of hospital‑acquired hyponatremia?

 

A. 0.2% saline

B. 0.45% saline

C. Isotonic saline with dextrose

D. Sterile water

E. 5% albumin

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Question 9

A 14‑year‑old patient with severe AKI receiving IV fluids develops weight gain and edema along with muscle cramps. What is the most appropriate next step?

 

A. Increase IV fluids

B. Continue the same rate

C. Add potassium to fluids

D.Restrict fluids

E. Start hypotonic fluids

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Question 10

A 6‑year‑old child with AKI produces 200 mL urine in 24 hours. Estimated insensible losses are 400 mL/day.

What is the appropriate maximum daily fluid intake?

 

A. 400 mL/day

B. 600 mL/day

C. 800 mL/day

D. 1000 mL/day

E. 1500 mL/day

 

 

Answer Key

Question 1: B. The Holliday–Segar formula estimates pediatric maintenance fluids based on body weight.

 

Question 2: C For the first 10 kg, maintenance fluids are calculated as 4 mL/kg/hr. 10 × 4 = 40 mL/hr.

 

Question 3: C. First 10 kg: 40 mL/hr. Next 5 kg: 2 mL/kg/hr × 5 = 10 mL/hr. Total = 50 mL/hr.

 

Question 4: A. Daily method: first 10 kg = 1000 mL, next 2 kg = 50 mL/kg × 2 = 100 mL. Total = 1100 mL/day.

 

Question 5: C. Fluid deficit = weight × % dehydration × 1000 mL/kg. 20 × 0.08 = 1.6 L = 1600 mL.

 

Question 6: E. Half of the 1600 mL deficit is replaced in the first 8 hours. 1600 ÷ 2 = 800 mL.

 

Question 7: D. In oliguric AKI, fluids are generally restricted to urine output plus insensible losses to prevent fluid overload.

 

Question 8: C. Isotonic fluids with dextrose are recommended in hospitalized children to reduce hospital‑acquired hyponatremia.

 

Question 9: D. Fluid overload with edema in AKI requires fluid restriction and reassessment of fluid balance.

 

Question 10: B. Fluid allowance in oliguria is urine output plus insensible losses: 200 + 400 = 600 mL/day.