LPN Module 9 Exam: IV Therapy & Advanced Skills (2026 Update)
1. Which assessment finding is most characteristic of IV infiltration?
A. Coolness and swelling at the site
B. Redness and warmth at the site
C. Purulent drainage from the catheter hub
D. A palpable cord-like vein
Answer: A
Rationale: Infiltration occurs when non-vesicant fluid leaks into the subcutaneous tissue,
causing localized edema and a cool temperature due to the infusion fluid being cooler than
body temperature.
2. The nurse is preparing to administer a unit of packed red blood cells. Which IV
solution is the only one compatible with blood products?
A. 0.45% Sodium Chloride
B. Lactated Ringer’s
C. 5% Dextrose in Water
D. 0.9% Sodium Chloride
Answer: D
Rationale: Normal Saline (0.9% NaCl) is the only solution used with blood products; other
solutions like Dextrose cause hemolysis of red blood cells.
,3. A patient reports sudden chills, low back pain, and itching 10 minutes after a
blood transfusion begins. What is the priority nursing action?
A. Slow the infusion rate
B. Notify the healthcare provider
C. Stop the transfusion immediately
D. Administer diphenhydramine
Answer: C
Rationale: Low back pain and chills indicate a possible hemolytic reaction. The priority is
to stop the transfusion to prevent further exposure to the antigen.
4. When assessing an IV site, the nurse notes a red streak following the vein and
the area is warm to the touch. This likely indicates:
A. Infiltration
B. Extravasation
C. Phlebitis
D. Circulatory overload
Answer: C
Rationale: Phlebitis is the inflammation of the vein, characterized by redness, warmth, and
a visible red streak along the vein path.
5. A client is receiving a hypertonic IV solution. The nurse should monitor closely
for which complication?
A. Fluid volume deficit
B. Cellular swelling
C. Hypotension
D. Fluid volume overload
Answer: D
Rationale: Hypertonic solutions pull fluid from the intracellular space into the vascular
space, increasing the risk of circulatory fluid volume overload.
, 6. What is the standard time frame for a nurse to stay with a patient after
starting a blood transfusion?
A. 5 minutes
B. 30 minutes
C. 15 minutes
D. 60 minutes
Answer: C
Rationale: Most severe transfusion reactions occur within the first 15 minutes or first 50
mL of the infusion.
7. Which gauge needle is typically preferred for the administration of blood
products in an adult to prevent hemolysis?
A. 18-gauge
B. 24-gauge
C. 22-gauge
D. 27-gauge
Answer: A
Rationale: A larger bore needle (18-20 gauge) is preferred for blood products to allow the
cells to pass through without being damaged (hemolysis).
8. The nurse notes that the IV pump is alarming ‘occlusion.’ What should the
nurse check first?
A. The patient’s blood pressure
B. The IV site for redness
C. The tubing for kinks or clamps
D. The expiration date of the bag
Answer: C
Rationale: Occlusion alarms are most commonly caused by mechanical issues like kinked
tubing or a closed roller clamp.
1. Which assessment finding is most characteristic of IV infiltration?
A. Coolness and swelling at the site
B. Redness and warmth at the site
C. Purulent drainage from the catheter hub
D. A palpable cord-like vein
Answer: A
Rationale: Infiltration occurs when non-vesicant fluid leaks into the subcutaneous tissue,
causing localized edema and a cool temperature due to the infusion fluid being cooler than
body temperature.
2. The nurse is preparing to administer a unit of packed red blood cells. Which IV
solution is the only one compatible with blood products?
A. 0.45% Sodium Chloride
B. Lactated Ringer’s
C. 5% Dextrose in Water
D. 0.9% Sodium Chloride
Answer: D
Rationale: Normal Saline (0.9% NaCl) is the only solution used with blood products; other
solutions like Dextrose cause hemolysis of red blood cells.
,3. A patient reports sudden chills, low back pain, and itching 10 minutes after a
blood transfusion begins. What is the priority nursing action?
A. Slow the infusion rate
B. Notify the healthcare provider
C. Stop the transfusion immediately
D. Administer diphenhydramine
Answer: C
Rationale: Low back pain and chills indicate a possible hemolytic reaction. The priority is
to stop the transfusion to prevent further exposure to the antigen.
4. When assessing an IV site, the nurse notes a red streak following the vein and
the area is warm to the touch. This likely indicates:
A. Infiltration
B. Extravasation
C. Phlebitis
D. Circulatory overload
Answer: C
Rationale: Phlebitis is the inflammation of the vein, characterized by redness, warmth, and
a visible red streak along the vein path.
5. A client is receiving a hypertonic IV solution. The nurse should monitor closely
for which complication?
A. Fluid volume deficit
B. Cellular swelling
C. Hypotension
D. Fluid volume overload
Answer: D
Rationale: Hypertonic solutions pull fluid from the intracellular space into the vascular
space, increasing the risk of circulatory fluid volume overload.
, 6. What is the standard time frame for a nurse to stay with a patient after
starting a blood transfusion?
A. 5 minutes
B. 30 minutes
C. 15 minutes
D. 60 minutes
Answer: C
Rationale: Most severe transfusion reactions occur within the first 15 minutes or first 50
mL of the infusion.
7. Which gauge needle is typically preferred for the administration of blood
products in an adult to prevent hemolysis?
A. 18-gauge
B. 24-gauge
C. 22-gauge
D. 27-gauge
Answer: A
Rationale: A larger bore needle (18-20 gauge) is preferred for blood products to allow the
cells to pass through without being damaged (hemolysis).
8. The nurse notes that the IV pump is alarming ‘occlusion.’ What should the
nurse check first?
A. The patient’s blood pressure
B. The IV site for redness
C. The tubing for kinks or clamps
D. The expiration date of the bag
Answer: C
Rationale: Occlusion alarms are most commonly caused by mechanical issues like kinked
tubing or a closed roller clamp.
