PNR 202/PNR202 Final Exam V2 | Intravenous
Therapy Q&A with Rationale | Fortis College
1. A nurse is preparing to administer a transfusion of packed red blood cells (PRBCs). Which of
the following solutions is the only one compatible with blood products?
A. Lactated Ringer’s
B. 5% Dextrose in Water (D5W)
C. 0.9% Sodium Chloride
D. 0.45% Sodium Chloride
Correct Answer: C
Explanation: 0.9% Sodium Chloride (Normal Saline) is the only fluid compatible with
blood products because it prevents hemolysis of the red blood cells. Solutions containing
dextrose can cause clumping, while Lactated Ringer’s contains calcium which may cause
clotting in the tubing. The nurse must always verify compatibility to ensure patient safety
during the transfusion process.
2. When assessing a patient’s peripheral IV site, the nurse notes coolness of the skin, edema,
and a significant decrease in the flow rate. What is the most likely complication?
A. Phlebitis
B. Infiltration
C. Extravasation
,D. Thrombosis
Correct Answer: B
Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the surrounding
subcutaneous tissue, characterized by coolness, swelling, and blanched skin. In contrast,
phlebitis usually presents with warmth and redness along the vein track. Prompt
identification and discontinuation of the IV are required to prevent further tissue damage.
3. Which electrolyte should never be administered as a direct IV bolus (IV push)?
A. Sodium Chloride
B. Magnesium Sulfate
C. Calcium Gluconate
D. Potassium Chloride
Correct Answer: D
Explanation: Potassium Chloride must always be diluted and administered via an infusion
pump to avoid cardiac arrest. Giving potassium as an IV push delivers a lethal dose to the
heart muscle instantly. The nurse must carefully monitor the infusion rate and assess the
site for irritation as potassium is highly caustic to veins.
4. A nurse is caring for a patient receiving continuous IV fluids. The patient begins to manifest
respiratory distress, crackles upon auscultation, and neck vein distention. Which action
should the nurse take first?
A. Increase the IV rate to flush the system
, B. Slow the IV infusion to a keep-vein-open (KVO) rate
C. Place the patient in a prone position
D. Administer a bolus of Normal Saline
Correct Answer: B
Explanation: Respiratory distress and crackles are hallmark signs of circulatory overload,
indicating the heart cannot handle the fluid volume. The nurse should immediately slow
the infusion and elevate the head of the bed to facilitate breathing. Notifying the provider is
the next critical step to obtain orders for diuretics or oxygen therapy.
5. Which type of solution causes water to shift from the intracellular space to the
extracellular space, potentially causing cell shrinkage?
A. Hypertonic
B. Hypotonic
C. Isotonic
D. Crystalloid
Correct Answer: A
Explanation: Hypertonic solutions have a higher osmolality than the blood, creating an
osmotic pull that draws water out of the cells. This is often used to treat cerebral edema or
severe hyponatremia. The nurse must monitor these patients closely for signs of fluid
volume excess in the vascular space.
Therapy Q&A with Rationale | Fortis College
1. A nurse is preparing to administer a transfusion of packed red blood cells (PRBCs). Which of
the following solutions is the only one compatible with blood products?
A. Lactated Ringer’s
B. 5% Dextrose in Water (D5W)
C. 0.9% Sodium Chloride
D. 0.45% Sodium Chloride
Correct Answer: C
Explanation: 0.9% Sodium Chloride (Normal Saline) is the only fluid compatible with
blood products because it prevents hemolysis of the red blood cells. Solutions containing
dextrose can cause clumping, while Lactated Ringer’s contains calcium which may cause
clotting in the tubing. The nurse must always verify compatibility to ensure patient safety
during the transfusion process.
2. When assessing a patient’s peripheral IV site, the nurse notes coolness of the skin, edema,
and a significant decrease in the flow rate. What is the most likely complication?
A. Phlebitis
B. Infiltration
C. Extravasation
,D. Thrombosis
Correct Answer: B
Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the surrounding
subcutaneous tissue, characterized by coolness, swelling, and blanched skin. In contrast,
phlebitis usually presents with warmth and redness along the vein track. Prompt
identification and discontinuation of the IV are required to prevent further tissue damage.
3. Which electrolyte should never be administered as a direct IV bolus (IV push)?
A. Sodium Chloride
B. Magnesium Sulfate
C. Calcium Gluconate
D. Potassium Chloride
Correct Answer: D
Explanation: Potassium Chloride must always be diluted and administered via an infusion
pump to avoid cardiac arrest. Giving potassium as an IV push delivers a lethal dose to the
heart muscle instantly. The nurse must carefully monitor the infusion rate and assess the
site for irritation as potassium is highly caustic to veins.
4. A nurse is caring for a patient receiving continuous IV fluids. The patient begins to manifest
respiratory distress, crackles upon auscultation, and neck vein distention. Which action
should the nurse take first?
A. Increase the IV rate to flush the system
, B. Slow the IV infusion to a keep-vein-open (KVO) rate
C. Place the patient in a prone position
D. Administer a bolus of Normal Saline
Correct Answer: B
Explanation: Respiratory distress and crackles are hallmark signs of circulatory overload,
indicating the heart cannot handle the fluid volume. The nurse should immediately slow
the infusion and elevate the head of the bed to facilitate breathing. Notifying the provider is
the next critical step to obtain orders for diuretics or oxygen therapy.
5. Which type of solution causes water to shift from the intracellular space to the
extracellular space, potentially causing cell shrinkage?
A. Hypertonic
B. Hypotonic
C. Isotonic
D. Crystalloid
Correct Answer: A
Explanation: Hypertonic solutions have a higher osmolality than the blood, creating an
osmotic pull that draws water out of the cells. This is often used to treat cerebral edema or
severe hyponatremia. The nurse must monitor these patients closely for signs of fluid
volume excess in the vascular space.
