PNR 202/PNR202 Final Exam V3 | Intravenous
Therapy Q&A with Rationale | Fortis College
1. Which of the following is considered an isotonic solution commonly used for volume
expansion?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. 0.9% Sodium Chloride
D. 0.33% Sodium Chloride
Correct Answer: C
Explanation: 0.9% Sodium Chloride, also known as normal saline, is an isotonic solution
because its osmolarity matches that of human blood. It is used to increase extracellular
fluid volume without causing a shift in water between the cells and the plasma. This
solution is frequently ordered for fluid resuscitation and blood transfusions.
2. A patient complains of pain at the IV site, and the nurse notes redness and a palpable cord
along the vein. Which complication is most likely?
A. Infiltration
B. Extravasation
C. Air Embolism
D. Phlebitis
,Correct Answer: D
Explanation: Phlebitis is the inflammation of the vein and is characterized by pain,
warmth, redness, and sometimes a palpable venous cord. It is often graded on a scale of 0
to 4 based on the severity of the symptoms. Immediate intervention includes stopping the
infusion and removing the catheter.
3. When selecting a site for a new peripheral IV, which principle should the nurse follow?
A. Start at the most proximal site available.
B. Start at the most distal site and move proximally.
C. Select the dominant hand for patient comfort.
D. Always use the antecubital fossa first.
Correct Answer: B
Explanation: Selecting the most distal site first allows for subsequent attempts higher up
the arm if the initial site fails. Starting proximally would render the distal portion of the
vein unusable for future cannulation due to potential leakage. This approach preserves the
integrity of the vascular system for long-term therapy.
4. Which gauge size is most appropriate for a patient who requires a rapid blood transfusion?
A. 24-gauge
B. 22-gauge
C. 18-gauge
, D. 27-gauge
Correct Answer: C
Explanation: An 18-gauge catheter is large enough to allow the rapid flow of viscous blood
products without damaging the red blood cells. Using a smaller gauge like a 22 or 24 may
slow the transfusion and increase the risk of hemolysis. In emergency situations, even a 14
or 16-gauge might be preferred for massive resuscitation.
5. The nurse suspects an air embolism in a patient with a central venous line. What is the
immediate priority action?
A. Instruct the patient to perform a Valsalva maneuver.
B. Elevate the head of the bed to 45 degrees.
C. Administer a bolus of 500 mL Normal Saline.
D. Place the patient in Trendelenburg position on their left side.
Correct Answer: D
Explanation: Placing the patient on their left side in the Trendelenburg position helps trap
the air bubble in the apex of the right ventricle. This prevents the air from entering the
pulmonary artery and obstructing blood flow to the lungs. The nurse must then notify the
provider immediately and administer oxygen as ordered.
6. A patient is receiving 5% Dextrose in Water (D5W). Which statement regarding this fluid is
true?
A. It remains isotonic in the body indefinitely.
Therapy Q&A with Rationale | Fortis College
1. Which of the following is considered an isotonic solution commonly used for volume
expansion?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. 0.9% Sodium Chloride
D. 0.33% Sodium Chloride
Correct Answer: C
Explanation: 0.9% Sodium Chloride, also known as normal saline, is an isotonic solution
because its osmolarity matches that of human blood. It is used to increase extracellular
fluid volume without causing a shift in water between the cells and the plasma. This
solution is frequently ordered for fluid resuscitation and blood transfusions.
2. A patient complains of pain at the IV site, and the nurse notes redness and a palpable cord
along the vein. Which complication is most likely?
A. Infiltration
B. Extravasation
C. Air Embolism
D. Phlebitis
,Correct Answer: D
Explanation: Phlebitis is the inflammation of the vein and is characterized by pain,
warmth, redness, and sometimes a palpable venous cord. It is often graded on a scale of 0
to 4 based on the severity of the symptoms. Immediate intervention includes stopping the
infusion and removing the catheter.
3. When selecting a site for a new peripheral IV, which principle should the nurse follow?
A. Start at the most proximal site available.
B. Start at the most distal site and move proximally.
C. Select the dominant hand for patient comfort.
D. Always use the antecubital fossa first.
Correct Answer: B
Explanation: Selecting the most distal site first allows for subsequent attempts higher up
the arm if the initial site fails. Starting proximally would render the distal portion of the
vein unusable for future cannulation due to potential leakage. This approach preserves the
integrity of the vascular system for long-term therapy.
4. Which gauge size is most appropriate for a patient who requires a rapid blood transfusion?
A. 24-gauge
B. 22-gauge
C. 18-gauge
, D. 27-gauge
Correct Answer: C
Explanation: An 18-gauge catheter is large enough to allow the rapid flow of viscous blood
products without damaging the red blood cells. Using a smaller gauge like a 22 or 24 may
slow the transfusion and increase the risk of hemolysis. In emergency situations, even a 14
or 16-gauge might be preferred for massive resuscitation.
5. The nurse suspects an air embolism in a patient with a central venous line. What is the
immediate priority action?
A. Instruct the patient to perform a Valsalva maneuver.
B. Elevate the head of the bed to 45 degrees.
C. Administer a bolus of 500 mL Normal Saline.
D. Place the patient in Trendelenburg position on their left side.
Correct Answer: D
Explanation: Placing the patient on their left side in the Trendelenburg position helps trap
the air bubble in the apex of the right ventricle. This prevents the air from entering the
pulmonary artery and obstructing blood flow to the lungs. The nurse must then notify the
provider immediately and administer oxygen as ordered.
6. A patient is receiving 5% Dextrose in Water (D5W). Which statement regarding this fluid is
true?
A. It remains isotonic in the body indefinitely.
