Paediatric drug doses, fluids and procedures

10 AIIMS NORCET (Nursing Officer) practice questions on Paediatric drug doses, fluids and procedures, part of Paediatric Nursing. The first 10 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
In a child with pneumonia, WHO guidance is to start oxygen when the pulse oximeter reading at sea level falls below:
1. A95%
2. B90%
3. C85%
4. D94%
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Answer: B · 90%
WHO advises oxygen for children with SpO2 below 90% at sea level, or with danger signs such as central cyanosis or inability to drink. Oxygen is given by nasal prongs or catheter and stopped when SpO2 stays at 90% or more in room air. Pulse oximetry is checked at least daily, and more often when the child is unstable. Oxygen is a drug and needs a prescribed flow rate.
- A: 95% is within the normal range and does not need oxygen.
- C: Waiting until 85% leaves the child hypoxic for too long.
- D: 94% is a common target in other settings, not the WHO starting threshold for children.
Question 2 · Easy
Young's rule calculates a child's dose from the adult dose and the child's:
1. AWeight in pounds
2. BBody surface area
3. CAge in years
4. DWeight in kilograms
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Answer: C · Age in years
Young's rule is child dose = age in years / (age + 12) x adult dose. It is used for children of about 1-12 years. Clark's rule instead uses weight in pounds divided by 150. In practice most paediatric drugs are now prescribed by mg/kg or by body surface area, which are more accurate.
- A: Weight in pounds is used in Clark's rule.
- B: Body surface area is used in the BSA formula.
- D: Weight in kilograms is used in mg/kg dosing.
Question 3 · Medium
A child weighs 18 kg. By the Holliday-Segar method, the daily maintenance fluid is:
1. A900 mL
2. B1400 mL
3. C1160 mL
4. D1800 mL
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Answer: B · 1400 mL
The first 10 kg need 10 x 100 = 1000 mL. The next 8 kg need 8 x 50 = 400 mL. The total is 1400 mL per day, or about 58 mL/h. Using 100 mL/kg for the whole weight is a common error that overloads the child.
- A: 900 mL uses 50 mL/kg for the whole weight.
- C: 1160 mL uses 20 mL/kg for the second 10 kg.
- D: 1800 mL uses 100 mL/kg for all 18 kg.
Question 4 · Easy
By the Holliday-Segar method, the daily maintenance fluid for each kilogram of the first 10 kg of body weight is:
1. A20 mL
2. B150 mL
3. C50 mL
4. D100 mL
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Answer: D · 100 mL
The Holliday-Segar method gives 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 kilogram above 20 kg. The hourly version is the 4-2-1 rule. These volumes match average daily water losses from metabolism. Extra fluid is added for deficits and ongoing losses.
- A: 20 mL/kg applies to each kilogram above 20 kg.
- B: 150 mL/kg is a neonatal feeding volume, not the Holliday-Segar figure.
- C: 50 mL/kg applies to the second 10 kg.
Question 5 · Hard
A 25 kg child needs maintenance IV fluid. By the 4-2-1 rule, the hourly rate is:
1. A100 mL/h
2. B45 mL/h
3. C73 mL/h
4. D65 mL/h
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Answer: D · 65 mL/h
The 4-2-1 rule gives 4 mL/kg/h for the first 10 kg (40 mL), 2 mL/kg/h for the next 10 kg (20 mL) and 1 mL/kg/h for each kilogram above 20 (5 mL). The total is 40 + 20 + 5 = 65 mL/h. This matches the daily Holliday-Segar volume of 1600 mL divided by 24. The rate is reduced in conditions such as raised ICP or SIADH.
- A: 100 mL/h uses 4 mL/kg/h for the whole 25 kg.
- B: 45 mL/h leaves out the 2 mL/kg/h for the second 10 kg.
- C: 73 mL/h uses 50 mL/kg/day, not 20, for the weight above 20 kg.
Question 6 · Medium
Using a paediatric microdrip set (60 drops/mL), an infusion ordered at 40 mL/h should run at:
1. A40 drops per minute
2. B10 drops per minute
3. C13 drops per minute
4. D160 drops per minute
Answer and explanation in LearnFree account
Question 7 · Easy
A mummy restraint is most suitable for:
1. AHolding a toddler in a chair during feeds
2. BPreventing a child from climbing out of a cot
3. CScalp vein cannulation in a young infant
4. DKeeping a child's hands off a cleft lip repair
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Question 8 · Hard
A 12 kg child is prescribed paracetamol 15 mg/kg per dose. The syrup contains 120 mg in 5 mL. How much syrup should the nurse give?
1. A15 mL
2. B7.5 mL
3. C1.5 mL
4. D3.75 mL
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Question 9 · Medium
A measured-volume chamber (burette) is placed in a child's IV set mainly to:
1. AWarm the fluid before it reaches the vein
2. BAllow two fluids to run at the same time
3. CFilter air bubbles out of the infusion line
4. DLimit how much fluid can run in by accident
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Question 10 · Medium
The adult dose of a drug is 500 mg. A child's body surface area is 0.8 m². Using the BSA formula, the child's dose is about:
1. A231 mg
2. B625 mg
3. C289 mg
4. D400 mg
Answer and explanation in LearnFree account

Paediatric drug doses, fluids and procedures

In a child with pneumonia, WHO guidance is to start oxygen when the pulse oximeter reading at sea level falls below:

Young's rule calculates a child's dose from the adult dose and the child's:

A child weighs 18 kg. By the Holliday-Segar method, the daily maintenance fluid is:

By the Holliday-Segar method, the daily maintenance fluid for each kilogram of the first 10 kg of body weight is:

A 25 kg child needs maintenance IV fluid. By the 4-2-1 rule, the hourly rate is:

Using a paediatric microdrip set (60 drops/mL), an infusion ordered at 40 mL/h should run at:

A mummy restraint is most suitable for:

A 12 kg child is prescribed paracetamol 15 mg/kg per dose. The syrup contains 120 mg in 5 mL. How much syrup should the nurse give?

A measured-volume chamber (burette) is placed in a child's IV set mainly to:

The adult dose of a drug is 500 mg. A child's body surface area is 0.8 m². Using the BSA formula, the child's dose is about: