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1. A nurse is preparing to initiate an intravenous (IV) infusion. Which action should the
nurse perform first?
A. Select the appropriate IV tubing
B. Verify the provider's prescription
C. Prime the IV tubing
D. Assess the client's pain level
Answer: B. Verify the provider's prescription
Rationale: The nurse must first verify the healthcare provider's prescription to ensure the correct
solution, rate, and route are ordered before gathering equipment or initiating therapy. This
promotes patient safety and prevents medication or fluid errors.
2. Which vein is commonly preferred for initiating a peripheral IV in an adult client?
A. Jugular vein
B. Basilic vein of the upper arm
C. Dorsal metacarpal veins of the hand
D. Femoral vein
Answer: C. Dorsal metacarpal veins of the hand
Rationale: The dorsal metacarpal veins are easily accessible and commonly used for peripheral
IV insertion. Distal veins should generally be selected first to preserve more proximal sites for
future use.
3. A nurse notices swelling, coolness, and pallor at the IV insertion site. Which
complication is most likely occurring?
A. Phlebitis
B. Infiltration
,C. Infection
D. Air embolism
Answer: B. Infiltration
Rationale: Infiltration occurs when non-vesicant IV fluid leaks into surrounding tissue. Classic
signs include swelling, coolness, pallor, discomfort, and slowed infusion. The infusion should be
stopped immediately.
4. Which assessment finding is most consistent with phlebitis?
A. Cool, pale skin around the catheter
B. Redness, warmth, tenderness, and a palpable cord
C. Severe chest pain and dyspnea
D. Sudden fever and hypotension
Answer: B. Redness, warmth, tenderness, and a palpable cord
Rationale: Phlebitis is inflammation of the vein caused by mechanical irritation, chemical
irritation, or infection. Symptoms include redness, warmth, tenderness, swelling, and sometimes
a palpable venous cord.
5. Which action helps reduce the risk of catheter-associated bloodstream infections?
A. Reusing clean gloves between patients
B. Maintaining strict aseptic technique during insertion
C. Changing dressings only when visibly soiled
D. Flushing with tap water
Answer: B. Maintaining strict aseptic technique during insertion
Rationale: Proper hand hygiene and aseptic technique during insertion and maintenance
significantly reduce catheter-related infections. Sterile procedures are essential for central lines
and clean technique for peripheral maintenance.
6. Which IV solution is classified as isotonic?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
, C. 0.9% Sodium Chloride
D. D5W after metabolism
Answer: C. 0.9% Sodium Chloride
Rationale: Normal saline (0.9% sodium chloride) is isotonic and remains primarily within the
intravascular space, making it useful for fluid replacement and resuscitation.
7. Which IV solution is considered hypertonic?
A. 0.45% Sodium Chloride
B. Lactated Ringer's
C. 3% Sodium Chloride
D. Sterile water
Answer: C. 3% Sodium Chloride
Rationale: Hypertonic saline has a higher osmolarity than plasma and pulls water into the
vascular space. It is used cautiously because it can rapidly shift fluids and increase the risk of
fluid overload.
8. Which solution is hypotonic?
A. 5% Albumin
B. 0.45% Sodium Chloride
C. 0.9% Sodium Chloride
D. Lactated Ringer's
Answer: B. 0.45% Sodium Chloride
Rationale: Half-normal saline is hypotonic and moves water into cells. It is used to treat
intracellular dehydration but should be used cautiously in clients at risk for increased
intracranial pressure.
9. The nurse is administering potassium chloride intravenously. Which action is correct?
A. Administer by IV push
B. Dilute and administer using an infusion pump
C. Mix with blood products
D. Infuse rapidly over 15 minutes