PNR 202/PNR202 Exam 2 V3 | Intravenous
Therapy Q&A with Rationale | Fortis College
1. A nurse is preparing to administer a 0.45% Sodium Chloride solution. Which type of
intravenous solution is this classified as?
A. Isotonic
B. Hypertonic
C. Colloid
D. Hypotonic
Correct Answer: D
Rationale: 0.45% Sodium Chloride is a hypotonic solution because its osmolarity is lower
than that of plasma. This causes fluid to move from the intravascular space into the
intracellular space to rehydrate cells. Nurses must monitor for signs of cellular swelling
and decreased blood pressure when administering this fluid.
2. Which assessment finding at an IV site is most indicative of infiltration?
A. Redness and warmth along the vein
B. Coolness to the touch and edema
C. Purulent drainage from the insertion site
D. A palpable cord-like vein
Correct Answer: B
,Rationale: Infiltration occurs when non-vesicant IV fluid leaks into the surrounding tissue,
causing the site to become cool, pale, and swollen. This differs from phlebitis, which
presents with warmth and redness. The nurse should immediately stop the infusion and
remove the catheter if these signs are noted.
3. A patient receiving IV therapy reports sudden shortness of breath, cough, and the nurse
notes crackles in the lungs. What is the priority nursing action?
A. Slow the IV rate to keep vein open (KVO) and notify the provider
B. Increase the IV rate to improve circulation
C. Apply a warm compress to the IV site
D. Place the patient in a Trendelenburg position
Correct Answer: A
Rationale: These symptoms indicate fluid volume overload, a common complication of
rapid IV administration. The nurse must immediately slow the infusion to a minimum rate
and elevate the head of the bed to facilitate breathing. Notifying the healthcare provider is
essential for further orders, such as diuretics.
4. When selecting a site for a new peripheral IV in an adult, which principle should the nurse
follow?
A. Always choose the most proximal site first
B. Select the dominant hand for patient comfort
C. Choose the most distal site on the non-dominant arm
, D. Use the antecubital fossa as the primary choice
Correct Answer: C
Rationale: Selecting a distal site preserves the proximal portions of the vein for future
access if the initial site fails. Using the non-dominant arm promotes patient independence
and reduces the risk of dislodgement. The antecubital fossa should be avoided if possible as
it limits joint mobility.
5. A nurse is preparing to hang a bag of Total Parenteral Nutrition (TPN). Which route is
required for this administration?
A. Peripheral IV in the hand
B. Central venous access device
C. Large-bore needle in the antecubital space
D. Midline catheter
Correct Answer: B
Rationale: TPN is a highly concentrated hypertonic solution containing high levels of
glucose and amino acids. It must be administered through a central line to ensure rapid
dilution in a large, high-flow vein. Administering TPN through a peripheral vein can cause
severe irritation and chemical phlebitis.
6. Which gauge size is most appropriate for a patient who requires a rapid blood transfusion
in an emergency?
A. 24-gauge
Therapy Q&A with Rationale | Fortis College
1. A nurse is preparing to administer a 0.45% Sodium Chloride solution. Which type of
intravenous solution is this classified as?
A. Isotonic
B. Hypertonic
C. Colloid
D. Hypotonic
Correct Answer: D
Rationale: 0.45% Sodium Chloride is a hypotonic solution because its osmolarity is lower
than that of plasma. This causes fluid to move from the intravascular space into the
intracellular space to rehydrate cells. Nurses must monitor for signs of cellular swelling
and decreased blood pressure when administering this fluid.
2. Which assessment finding at an IV site is most indicative of infiltration?
A. Redness and warmth along the vein
B. Coolness to the touch and edema
C. Purulent drainage from the insertion site
D. A palpable cord-like vein
Correct Answer: B
,Rationale: Infiltration occurs when non-vesicant IV fluid leaks into the surrounding tissue,
causing the site to become cool, pale, and swollen. This differs from phlebitis, which
presents with warmth and redness. The nurse should immediately stop the infusion and
remove the catheter if these signs are noted.
3. A patient receiving IV therapy reports sudden shortness of breath, cough, and the nurse
notes crackles in the lungs. What is the priority nursing action?
A. Slow the IV rate to keep vein open (KVO) and notify the provider
B. Increase the IV rate to improve circulation
C. Apply a warm compress to the IV site
D. Place the patient in a Trendelenburg position
Correct Answer: A
Rationale: These symptoms indicate fluid volume overload, a common complication of
rapid IV administration. The nurse must immediately slow the infusion to a minimum rate
and elevate the head of the bed to facilitate breathing. Notifying the healthcare provider is
essential for further orders, such as diuretics.
4. When selecting a site for a new peripheral IV in an adult, which principle should the nurse
follow?
A. Always choose the most proximal site first
B. Select the dominant hand for patient comfort
C. Choose the most distal site on the non-dominant arm
, D. Use the antecubital fossa as the primary choice
Correct Answer: C
Rationale: Selecting a distal site preserves the proximal portions of the vein for future
access if the initial site fails. Using the non-dominant arm promotes patient independence
and reduces the risk of dislodgement. The antecubital fossa should be avoided if possible as
it limits joint mobility.
5. A nurse is preparing to hang a bag of Total Parenteral Nutrition (TPN). Which route is
required for this administration?
A. Peripheral IV in the hand
B. Central venous access device
C. Large-bore needle in the antecubital space
D. Midline catheter
Correct Answer: B
Rationale: TPN is a highly concentrated hypertonic solution containing high levels of
glucose and amino acids. It must be administered through a central line to ensure rapid
dilution in a large, high-flow vein. Administering TPN through a peripheral vein can cause
severe irritation and chemical phlebitis.
6. Which gauge size is most appropriate for a patient who requires a rapid blood transfusion
in an emergency?
A. 24-gauge
