PNR 202/PNR202 Exam 2 V2 | Intravenous
Therapy Q&A with Rationale | Fortis
College
1. A nurse assesses an IV site and finds it cool to the touch, swollen, and the patient reports
pain. What is the most likely complication?
A. Phlebitis
B. Thrombosis
C. Extravasation
D. Infiltration
Correct Answer: D
Expert Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the
surrounding tissue, causing coolness and edema. The nurse should immediately stop the
infusion and remove the catheter. Elevating the extremity is recommended to reduce
swelling and improve patient comfort.
2. Which of the following IV fluids is considered hypotonic?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. Lactated Ringer’s
D. 5% Dextrose in 0.9% NS
,Correct Answer: B
Expert Explanation: Hypotonic solutions have a lower osmolarity than plasma, causing
fluid to shift from the intravascular space into the cells. This can lead to cellular swelling
and is often used for cellular dehydration. Monitoring for signs of fluid volume deficit in the
vascular space is a priority when administering these fluids.
3. A patient receiving IV therapy begins to experience tachycardia, dyspnea, and crackles on
lung auscultation. What is the nurse’s priority action?
A. Increase the IV rate to improve cardiac output
B. Slow the infusion and notify the provider
C. Administer a bolus of Normal Saline
D. Place the patient in a supine position
Correct Answer: B
Expert Explanation: Tachycardia, dyspnea, and crackles are hallmark signs of circulatory
overload or fluid volume excess. The nurse should immediately slow the infusion rate to a
keep-vein-open status and notify the healthcare provider. Elevating the head of the bed will
also help the patient breathe more easily while waiting for further orders.
4. What is the primary reason for using a filter when administering Total Parenteral Nutrition
(TPN)?
A. To prevent air from entering the patient’s vein
B. To catch any particulates or precipitates
, C. To regulate the flow rate of the infusion
D. To prevent the infusion from running dry
Correct Answer: B
Expert Explanation: TPN contains high concentrations of glucose, amino acids, and
sometimes lipids, which increases the risk of precipitate formation. In-line filters are
required to catch these particulates before they reach the patient’s bloodstream. This
safety measure helps prevent complications such as pulmonary emboli or systemic
infection.
5. When preparing to administer blood, which IV fluid is the only one compatible with blood
products?
A. Lactated Ringer’s
B. 0.9% Normal Saline
C. 5% Dextrose in Water
D. 0.45% Normal Saline
Correct Answer: B
Expert Explanation: 0.9% Normal Saline is the only isotonic solution used for priming
blood tubing and flushing before and after blood administration. Other solutions like D5W
can cause hemolysis or clumping of red blood cells. Using the correct solution ensures the
integrity of the blood products and patient safety.
Therapy Q&A with Rationale | Fortis
College
1. A nurse assesses an IV site and finds it cool to the touch, swollen, and the patient reports
pain. What is the most likely complication?
A. Phlebitis
B. Thrombosis
C. Extravasation
D. Infiltration
Correct Answer: D
Expert Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the
surrounding tissue, causing coolness and edema. The nurse should immediately stop the
infusion and remove the catheter. Elevating the extremity is recommended to reduce
swelling and improve patient comfort.
2. Which of the following IV fluids is considered hypotonic?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. Lactated Ringer’s
D. 5% Dextrose in 0.9% NS
,Correct Answer: B
Expert Explanation: Hypotonic solutions have a lower osmolarity than plasma, causing
fluid to shift from the intravascular space into the cells. This can lead to cellular swelling
and is often used for cellular dehydration. Monitoring for signs of fluid volume deficit in the
vascular space is a priority when administering these fluids.
3. A patient receiving IV therapy begins to experience tachycardia, dyspnea, and crackles on
lung auscultation. What is the nurse’s priority action?
A. Increase the IV rate to improve cardiac output
B. Slow the infusion and notify the provider
C. Administer a bolus of Normal Saline
D. Place the patient in a supine position
Correct Answer: B
Expert Explanation: Tachycardia, dyspnea, and crackles are hallmark signs of circulatory
overload or fluid volume excess. The nurse should immediately slow the infusion rate to a
keep-vein-open status and notify the healthcare provider. Elevating the head of the bed will
also help the patient breathe more easily while waiting for further orders.
4. What is the primary reason for using a filter when administering Total Parenteral Nutrition
(TPN)?
A. To prevent air from entering the patient’s vein
B. To catch any particulates or precipitates
, C. To regulate the flow rate of the infusion
D. To prevent the infusion from running dry
Correct Answer: B
Expert Explanation: TPN contains high concentrations of glucose, amino acids, and
sometimes lipids, which increases the risk of precipitate formation. In-line filters are
required to catch these particulates before they reach the patient’s bloodstream. This
safety measure helps prevent complications such as pulmonary emboli or systemic
infection.
5. When preparing to administer blood, which IV fluid is the only one compatible with blood
products?
A. Lactated Ringer’s
B. 0.9% Normal Saline
C. 5% Dextrose in Water
D. 0.45% Normal Saline
Correct Answer: B
Expert Explanation: 0.9% Normal Saline is the only isotonic solution used for priming
blood tubing and flushing before and after blood administration. Other solutions like D5W
can cause hemolysis or clumping of red blood cells. Using the correct solution ensures the
integrity of the blood products and patient safety.
