NURS 101L | IV Therapy Basics & Fluid Administration (2026 Update)
WCU
1. A nurse is preparing to administer a hypertonic solution to a patient with
severe hyponatremia. Which solution should the nurse anticipate using?
A. 3% Sodium Chloride
B. Lactated Ringer’s
C. 0.45% Sodium Chloride
D. 0.9% Sodium Chloride
Answer: A
Rationale: 3% Sodium Chloride is a hypertonic solution used to increase serum sodium
levels by pulling water out of the cells into the vascular space. 0.45% is hypotonic, while
0.9% and LR are isotonic.
2. When initiating an IV on an elderly patient with fragile skin, which technique
is most appropriate to prevent hematoma formation?
A. Apply the tourniquet tightly for at least 2 minutes.
B. Avoid using a tourniquet or use a blood pressure cuff inflated to just below diastolic pressure.
C. Vigorously rub the site with alcohol before insertion.
D. Use the smallest possible gauge and a minimal angle of insertion.
Answer: B
Rationale: Elderly patients have fragile veins and skin. Using a blood pressure cuff or no
tourniquet reduces the risk of vein rupture and hematoma. Tightly applied tourniquets can
cause vessel damage.
,3. A patient receiving IV therapy reports sudden shortness of breath and chest
pain. The nurse notes tachycardia and a cough. Which complication should be
suspected first?
A. Speed shock
B. Air embolism
C. Catheter embolism
D. Fluid volume overload
Answer: B
Rationale: The sudden onset of respiratory distress, chest pain, and tachycardia in a
patient with an IV line is classic for an air embolism. Fluid overload usually presents with
crackles and peripheral edema.
4. What is the most critical action for the nurse to take immediately after an
accidental needle stick injury during IV insertion?
A. Wash the area with soap and water.
B. Squeeze the wound to encourage bleeding.
C. Report to the charge nurse immediately.
D. Complete an incident report within 24 hours.
Answer: A
Rationale: Immediate first aid for a needle stick is to wash the area thoroughly with soap
and water to reduce the risk of pathogen transmission. Reporting and documentation
follow this step.
, 5. The nurse is assessing an IV site and finds it cool to the touch, swollen, and
the infusion has slowed. Which nursing intervention is the priority?
A. Apply a warm compress to the site.
B. Flush the line with 10 mL of normal saline.
C. Stop the infusion and remove the catheter.
D. Lower the IV bag below the level of the heart to check for blood return.
Answer: C
Rationale: Coolness and swelling indicate infiltration. The priority is to stop the infusion
and remove the catheter to prevent further tissue damage.
6. Which IV gauge is most appropriate for a patient scheduled for an emergency
blood transfusion in the operating room?
A. 24-gauge
B. 18-gauge
C. 22-gauge
D. 20-gauge
Answer: B
Rationale: An 18-gauge needle is preferred for rapid fluid resuscitation and blood
transfusions to prevent hemolysis and allow high flow rates.
7. A nurse observes a red, warm streak traveling up the arm from a patient’s IV
site. How should the nurse document this finding?
A. Infiltration
B. Extravasation
C. Phlebitis
D. Venous spasm
Answer: C
Rationale: Phlebitis is inflammation of the vein characterized by redness, warmth, and a
palpable cord or streak. Infiltration involves coolness and swelling.
WCU
1. A nurse is preparing to administer a hypertonic solution to a patient with
severe hyponatremia. Which solution should the nurse anticipate using?
A. 3% Sodium Chloride
B. Lactated Ringer’s
C. 0.45% Sodium Chloride
D. 0.9% Sodium Chloride
Answer: A
Rationale: 3% Sodium Chloride is a hypertonic solution used to increase serum sodium
levels by pulling water out of the cells into the vascular space. 0.45% is hypotonic, while
0.9% and LR are isotonic.
2. When initiating an IV on an elderly patient with fragile skin, which technique
is most appropriate to prevent hematoma formation?
A. Apply the tourniquet tightly for at least 2 minutes.
B. Avoid using a tourniquet or use a blood pressure cuff inflated to just below diastolic pressure.
C. Vigorously rub the site with alcohol before insertion.
D. Use the smallest possible gauge and a minimal angle of insertion.
Answer: B
Rationale: Elderly patients have fragile veins and skin. Using a blood pressure cuff or no
tourniquet reduces the risk of vein rupture and hematoma. Tightly applied tourniquets can
cause vessel damage.
,3. A patient receiving IV therapy reports sudden shortness of breath and chest
pain. The nurse notes tachycardia and a cough. Which complication should be
suspected first?
A. Speed shock
B. Air embolism
C. Catheter embolism
D. Fluid volume overload
Answer: B
Rationale: The sudden onset of respiratory distress, chest pain, and tachycardia in a
patient with an IV line is classic for an air embolism. Fluid overload usually presents with
crackles and peripheral edema.
4. What is the most critical action for the nurse to take immediately after an
accidental needle stick injury during IV insertion?
A. Wash the area with soap and water.
B. Squeeze the wound to encourage bleeding.
C. Report to the charge nurse immediately.
D. Complete an incident report within 24 hours.
Answer: A
Rationale: Immediate first aid for a needle stick is to wash the area thoroughly with soap
and water to reduce the risk of pathogen transmission. Reporting and documentation
follow this step.
, 5. The nurse is assessing an IV site and finds it cool to the touch, swollen, and
the infusion has slowed. Which nursing intervention is the priority?
A. Apply a warm compress to the site.
B. Flush the line with 10 mL of normal saline.
C. Stop the infusion and remove the catheter.
D. Lower the IV bag below the level of the heart to check for blood return.
Answer: C
Rationale: Coolness and swelling indicate infiltration. The priority is to stop the infusion
and remove the catheter to prevent further tissue damage.
6. Which IV gauge is most appropriate for a patient scheduled for an emergency
blood transfusion in the operating room?
A. 24-gauge
B. 18-gauge
C. 22-gauge
D. 20-gauge
Answer: B
Rationale: An 18-gauge needle is preferred for rapid fluid resuscitation and blood
transfusions to prevent hemolysis and allow high flow rates.
7. A nurse observes a red, warm streak traveling up the arm from a patient’s IV
site. How should the nurse document this finding?
A. Infiltration
B. Extravasation
C. Phlebitis
D. Venous spasm
Answer: C
Rationale: Phlebitis is inflammation of the vein characterized by redness, warmth, and a
palpable cord or streak. Infiltration involves coolness and swelling.
