PNR 202/PNR202 Exam 3 V3 | Intravenous
Therapy Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer a medication via an IV piggyback. Which action should
the nurse take to ensure the secondary medication infuses first?
A. Place the secondary bag lower than the primary bag.
B. Clamp the primary tubing completely during the infusion.
C. Hang the secondary bag higher than the primary bag.
D. Adjust the primary flow rate to match the secondary rate.
Correct Answer: C
Expert Explanation: Gravity-fed secondary infusions require the secondary container to
be higher than the primary container. This pressure differential allows the secondary fluid
to flow while the primary fluid remains stationary. Once the secondary bag is empty, the
primary infusion will automatically resume based on the height of the primary bag.
2. A patient’s IV site is cool to the touch, swollen, and the infusion has slowed down. What
complication does the nurse suspect?
A. Phlebitis
B. Extravasation
C. Infiltration
,D. Septicemia
Correct Answer: C
Expert Explanation: Infiltration is the leakage of a non-vesicant solution into the
subcutaneous tissue. The cool temperature and edema are classic signs of fluid escaping
the vascular space. The nurse must stop the infusion immediately and remove the catheter
to prevent further tissue damage.
3. Which IV solution is considered isotonic and is commonly used for fluid resuscitation in
trauma patients?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. Lactated Ringer’s
D. 10% Dextrose in Water
Correct Answer: C
Expert Explanation: Lactated Ringer’s (LR) is an isotonic solution that closely mimics the
electrolyte composition of plasma. It is preferred for rapid fluid replacement in surgical and
trauma patients. LR also contains lactate, which is metabolized into bicarbonate to help
correct metabolic acidosis.
4. A nurse is monitoring a patient receiving Total Parenteral Nutrition (TPN). Which clinical
finding requires immediate intervention?
A. A temperature of 101.2°F (38.4°C)
, B. A blood glucose level of 120 mg/dL
C. Weight gain of 1 pound in three days
D. Urine output of 50 mL per hour
Correct Answer: A
Expert Explanation: TPN has a high glucose concentration, which significantly increases
the risk for bacterial growth and catheter-related bloodstream infections. A fever is a
hallmark sign of systemic infection and must be reported immediately. The nurse should
also check for redness or drainage at the insertion site.
5. While assessing a central venous catheter (CVC), the nurse suspects an air embolism. In
what position should the nurse place the patient?
A. High-Fowler’s position
B. Left side-lying Trendelenburg
C. Supine with legs elevated
D. Prone position
Correct Answer: B
Expert Explanation: The left side-lying Trendelenburg position (Durant’s maneuver)
helps trap air in the right atrium. This prevents the air bubble from entering the pulmonary
artery and causing a blockage. The nurse should also administer 100% oxygen and notify
the rapid response team.
Therapy Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer a medication via an IV piggyback. Which action should
the nurse take to ensure the secondary medication infuses first?
A. Place the secondary bag lower than the primary bag.
B. Clamp the primary tubing completely during the infusion.
C. Hang the secondary bag higher than the primary bag.
D. Adjust the primary flow rate to match the secondary rate.
Correct Answer: C
Expert Explanation: Gravity-fed secondary infusions require the secondary container to
be higher than the primary container. This pressure differential allows the secondary fluid
to flow while the primary fluid remains stationary. Once the secondary bag is empty, the
primary infusion will automatically resume based on the height of the primary bag.
2. A patient’s IV site is cool to the touch, swollen, and the infusion has slowed down. What
complication does the nurse suspect?
A. Phlebitis
B. Extravasation
C. Infiltration
,D. Septicemia
Correct Answer: C
Expert Explanation: Infiltration is the leakage of a non-vesicant solution into the
subcutaneous tissue. The cool temperature and edema are classic signs of fluid escaping
the vascular space. The nurse must stop the infusion immediately and remove the catheter
to prevent further tissue damage.
3. Which IV solution is considered isotonic and is commonly used for fluid resuscitation in
trauma patients?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. Lactated Ringer’s
D. 10% Dextrose in Water
Correct Answer: C
Expert Explanation: Lactated Ringer’s (LR) is an isotonic solution that closely mimics the
electrolyte composition of plasma. It is preferred for rapid fluid replacement in surgical and
trauma patients. LR also contains lactate, which is metabolized into bicarbonate to help
correct metabolic acidosis.
4. A nurse is monitoring a patient receiving Total Parenteral Nutrition (TPN). Which clinical
finding requires immediate intervention?
A. A temperature of 101.2°F (38.4°C)
, B. A blood glucose level of 120 mg/dL
C. Weight gain of 1 pound in three days
D. Urine output of 50 mL per hour
Correct Answer: A
Expert Explanation: TPN has a high glucose concentration, which significantly increases
the risk for bacterial growth and catheter-related bloodstream infections. A fever is a
hallmark sign of systemic infection and must be reported immediately. The nurse should
also check for redness or drainage at the insertion site.
5. While assessing a central venous catheter (CVC), the nurse suspects an air embolism. In
what position should the nurse place the patient?
A. High-Fowler’s position
B. Left side-lying Trendelenburg
C. Supine with legs elevated
D. Prone position
Correct Answer: B
Expert Explanation: The left side-lying Trendelenburg position (Durant’s maneuver)
helps trap air in the right atrium. This prevents the air bubble from entering the pulmonary
artery and causing a blockage. The nurse should also administer 100% oxygen and notify
the rapid response team.
