PNR 202/PNR202 Exam 1 V1 | Intravenous
Therapy Q&A with Rationale | Fortis
College
1. According to most State Boards of Nursing, which of the following tasks is generally outside
the scope of practice for a Licensed Practical Nurse (LPN) regarding IV therapy?
A. Initiating the first dose of an intravenous antibiotic.
B. Administering intravenous piggyback (IVPB) medications.
C. Monitoring the flow rate of an existing peripheral IV infusion.
D. Calculating the infusion rate for a prescribed IV fluid.
Correct Answer: A
Expert Explanation: In many jurisdictions, the LPN is prohibited from administering the
very first dose of an IV medication due to the high risk of anaphylaxis. The initial
assessment of a patient’s reaction to a new medication is often reserved for the Registered
Nurse. It is crucial for LPNs to consult their specific State Practice Act to ensure compliance
with local regulations.
2. A patient is prescribed 0.45% Sodium Chloride. Into which category of intravenous
solutions does this fluid fall?
A. Isotonic
B. Hypertonic
,C. Colloid
D. Hypotonic
Correct Answer: D
Expert Explanation: 0.45% Sodium Chloride, also known as half-normal saline, is a
hypotonic solution because its osmolarity is lower than that of serum. These solutions
cause fluid to shift from the intravascular space into the intracellular and interstitial
spaces. They are commonly used to treat cellular dehydration but must be monitored
closely to prevent cellular edema.
3. The nurse notes that a patient’s IV site is cool to the touch, swollen, and the infusion has
slowed. Which complication is most likely occurring?
A. Phlebitis
B. Infiltration
C. Extravasation
D. Thrombophlebitis
Correct Answer: B
Expert Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the
surrounding subcutaneous tissue, resulting in coolness and edema at the site. This differs
from phlebitis, which typically presents with warmth and redness along the vein track. The
nurse must stop the infusion immediately and follow facility protocol for catheter removal
and site care.
, 4. Which of the following is the primary physiological mechanism by which water moves from
an area of lower solute concentration to an area of higher solute concentration?
A. Active Transport
B. Diffusion
C. Filtration
D. Osmosis
Correct Answer: D
Expert Explanation: Osmosis is the passive movement of water across a semipermeable
membrane to equalize solute concentrations on both sides. This process does not require
energy, unlike active transport which moves solutes against a concentration gradient.
Understanding osmosis is fundamental to predicting how different IV fluids will affect fluid
shifts in the body.
5. When preparing to initiate a peripheral IV, which vein is generally considered the best
choice for the initial attempt in an adult patient?
A. The cephalic vein in the forearm
B. A vein in the dominant hand
C. The antecubital fossa vein
D. A vein in the foot or ankle
Correct Answer: A
Therapy Q&A with Rationale | Fortis
College
1. According to most State Boards of Nursing, which of the following tasks is generally outside
the scope of practice for a Licensed Practical Nurse (LPN) regarding IV therapy?
A. Initiating the first dose of an intravenous antibiotic.
B. Administering intravenous piggyback (IVPB) medications.
C. Monitoring the flow rate of an existing peripheral IV infusion.
D. Calculating the infusion rate for a prescribed IV fluid.
Correct Answer: A
Expert Explanation: In many jurisdictions, the LPN is prohibited from administering the
very first dose of an IV medication due to the high risk of anaphylaxis. The initial
assessment of a patient’s reaction to a new medication is often reserved for the Registered
Nurse. It is crucial for LPNs to consult their specific State Practice Act to ensure compliance
with local regulations.
2. A patient is prescribed 0.45% Sodium Chloride. Into which category of intravenous
solutions does this fluid fall?
A. Isotonic
B. Hypertonic
,C. Colloid
D. Hypotonic
Correct Answer: D
Expert Explanation: 0.45% Sodium Chloride, also known as half-normal saline, is a
hypotonic solution because its osmolarity is lower than that of serum. These solutions
cause fluid to shift from the intravascular space into the intracellular and interstitial
spaces. They are commonly used to treat cellular dehydration but must be monitored
closely to prevent cellular edema.
3. The nurse notes that a patient’s IV site is cool to the touch, swollen, and the infusion has
slowed. Which complication is most likely occurring?
A. Phlebitis
B. Infiltration
C. Extravasation
D. Thrombophlebitis
Correct Answer: B
Expert Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the
surrounding subcutaneous tissue, resulting in coolness and edema at the site. This differs
from phlebitis, which typically presents with warmth and redness along the vein track. The
nurse must stop the infusion immediately and follow facility protocol for catheter removal
and site care.
, 4. Which of the following is the primary physiological mechanism by which water moves from
an area of lower solute concentration to an area of higher solute concentration?
A. Active Transport
B. Diffusion
C. Filtration
D. Osmosis
Correct Answer: D
Expert Explanation: Osmosis is the passive movement of water across a semipermeable
membrane to equalize solute concentrations on both sides. This process does not require
energy, unlike active transport which moves solutes against a concentration gradient.
Understanding osmosis is fundamental to predicting how different IV fluids will affect fluid
shifts in the body.
5. When preparing to initiate a peripheral IV, which vein is generally considered the best
choice for the initial attempt in an adult patient?
A. The cephalic vein in the forearm
B. A vein in the dominant hand
C. The antecubital fossa vein
D. A vein in the foot or ankle
Correct Answer: A
