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NCLEX RN Exam Bank: Safe IV Therapy, Calcium,
Potassium, and Fluid Infusion
Table of Contents
Subtopic 1: Fundamentals of Safe IV Therapy with Calcium, Potassium, and Fluid Infusion 2
Subtopic 2: Monitoring and Complications of IV Calcium, Potassium, and Fluid Therapy .. 11
Subtopic 3: Administration Techniques and Nursing Responsibilities in IV Calcium,
Potassium, and Fluid Therapy ...................................................................................... 20
Subtopic 4: Patient Education and Safety Measures in IV Electrolyte and Fluid Therapy .... 29
Subtopic 5: Emergency Management of IV Electrolyte Imbalances ................................. 38
Subtopic 6: IV Equipment, Infusion Pumps, and Safety Checks in Electrolyte and Fluid
Therapy ...................................................................................................................... 48
Subtopic 7: IV Site Selection, Care, and Prevention of Complications in Electrolyte and
Fluid Therapy .............................................................................................................. 57
Subtopic 8: Monitoring and Documentation of IV Electrolyte and Fluid Therapy ............... 66
Subtopic 9: Complications and Troubleshooting during IV Electrolyte and Fluid Therapy .. 75
Subtopic 10: Patient Education and Discharge Planning for IV Electrolyte and Fluid Therapy
.................................................................................................................................. 84
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Subtopic 1: Fundamentals of Safe IV Therapy with
Calcium, Potassium, and Fluid Infusion
1. A nurse is preparing to administer IV potassium chloride to a patient. Which of the
following actions is most important before starting the infusion?
A) Verify the patient's blood glucose level
B) Check the patient's serum potassium level
C) Assess the patient's urine output
D) Measure the patient’s blood pressure
Correct answer: C) Assess the patient's urine output
Rationale: Adequate urine output (usually >30 mL/hr) is essential before administering
potassium because potassium is primarily excreted by the kidneys. Poor urine output
increases the risk of hyperkalemia.
2. When administering IV calcium gluconate, the nurse must be cautious because:
A) It can cause hypocalcemia if infused too quickly
B) It can cause vein irritation and tissue necrosis if extravasation occurs
C) It may cause cardiac arrhythmias if administered rapidly
D) It has no effect on blood pressure
Correct answer: C) It may cause cardiac arrhythmias if administered rapidly
Rationale: Rapid administration of calcium gluconate can cause serious cardiac
arrhythmias. It should be infused slowly and with cardiac monitoring.
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3. Which of the following fluid types is most appropriate to treat a patient with hypovolemia
due to dehydration?
A) 0.9% Normal Saline (Isotonic)
B) 3% Sodium Chloride (Hypertonic)
C) 0.45% Normal Saline (Hypotonic)
D) Lactated Ringer’s Solution (Isotonic)
Correct answer: D) Lactated Ringer’s Solution (Isotonic)
Rationale: Lactated Ringer’s is isotonic and often preferred for fluid resuscitation as it
closely mimics plasma and replenishes electrolytes lost in dehydration.
4. What is the safest maximum concentration of potassium chloride in peripheral IV
therapy?
A) 40 mEq/100 mL
B) 80 mEq/100 mL
C) 10 mEq/100 mL
D) 20 mEq/50 mL
Correct answer: C) 10 mEq/100 mL
Rationale: Peripheral IVs can safely receive potassium chloride at a maximum
concentration of 10 mEq/100 mL to minimize vein irritation and risk of phlebitis.
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5. A patient receiving IV calcium is exhibiting bradycardia and hypotension. What is the
nurse’s priority action?
A) Increase the rate of the calcium infusion
B) Stop the infusion immediately and notify the provider
C) Administer an antihypertensive medication
D) Encourage deep breathing exercises
Correct answer: B) Stop the infusion immediately and notify the provider
Rationale: Bradycardia and hypotension may indicate calcium toxicity or overdose; the
infusion must be stopped immediately and medical assistance sought.
6. The nurse notices redness and swelling around an IV site used for potassium infusion.
What is the best nursing action?
A) Apply a warm compress and continue infusion
B) Slow the infusion rate and monitor the site
C) Stop the infusion and remove the IV catheter
D) Elevate the limb and check vital signs
Correct answer: C) Stop the infusion and remove the IV catheter
Rationale: Redness and swelling indicate phlebitis or infiltration. The potassium infusion
must be stopped to prevent tissue damage.
NCLEX RN Exam Bank: Safe IV Therapy, Calcium,
Potassium, and Fluid Infusion
Table of Contents
Subtopic 1: Fundamentals of Safe IV Therapy with Calcium, Potassium, and Fluid Infusion 2
Subtopic 2: Monitoring and Complications of IV Calcium, Potassium, and Fluid Therapy .. 11
Subtopic 3: Administration Techniques and Nursing Responsibilities in IV Calcium,
Potassium, and Fluid Therapy ...................................................................................... 20
Subtopic 4: Patient Education and Safety Measures in IV Electrolyte and Fluid Therapy .... 29
Subtopic 5: Emergency Management of IV Electrolyte Imbalances ................................. 38
Subtopic 6: IV Equipment, Infusion Pumps, and Safety Checks in Electrolyte and Fluid
Therapy ...................................................................................................................... 48
Subtopic 7: IV Site Selection, Care, and Prevention of Complications in Electrolyte and
Fluid Therapy .............................................................................................................. 57
Subtopic 8: Monitoring and Documentation of IV Electrolyte and Fluid Therapy ............... 66
Subtopic 9: Complications and Troubleshooting during IV Electrolyte and Fluid Therapy .. 75
Subtopic 10: Patient Education and Discharge Planning for IV Electrolyte and Fluid Therapy
.................................................................................................................................. 84
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Subtopic 1: Fundamentals of Safe IV Therapy with
Calcium, Potassium, and Fluid Infusion
1. A nurse is preparing to administer IV potassium chloride to a patient. Which of the
following actions is most important before starting the infusion?
A) Verify the patient's blood glucose level
B) Check the patient's serum potassium level
C) Assess the patient's urine output
D) Measure the patient’s blood pressure
Correct answer: C) Assess the patient's urine output
Rationale: Adequate urine output (usually >30 mL/hr) is essential before administering
potassium because potassium is primarily excreted by the kidneys. Poor urine output
increases the risk of hyperkalemia.
2. When administering IV calcium gluconate, the nurse must be cautious because:
A) It can cause hypocalcemia if infused too quickly
B) It can cause vein irritation and tissue necrosis if extravasation occurs
C) It may cause cardiac arrhythmias if administered rapidly
D) It has no effect on blood pressure
Correct answer: C) It may cause cardiac arrhythmias if administered rapidly
Rationale: Rapid administration of calcium gluconate can cause serious cardiac
arrhythmias. It should be infused slowly and with cardiac monitoring.
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3. Which of the following fluid types is most appropriate to treat a patient with hypovolemia
due to dehydration?
A) 0.9% Normal Saline (Isotonic)
B) 3% Sodium Chloride (Hypertonic)
C) 0.45% Normal Saline (Hypotonic)
D) Lactated Ringer’s Solution (Isotonic)
Correct answer: D) Lactated Ringer’s Solution (Isotonic)
Rationale: Lactated Ringer’s is isotonic and often preferred for fluid resuscitation as it
closely mimics plasma and replenishes electrolytes lost in dehydration.
4. What is the safest maximum concentration of potassium chloride in peripheral IV
therapy?
A) 40 mEq/100 mL
B) 80 mEq/100 mL
C) 10 mEq/100 mL
D) 20 mEq/50 mL
Correct answer: C) 10 mEq/100 mL
Rationale: Peripheral IVs can safely receive potassium chloride at a maximum
concentration of 10 mEq/100 mL to minimize vein irritation and risk of phlebitis.
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5. A patient receiving IV calcium is exhibiting bradycardia and hypotension. What is the
nurse’s priority action?
A) Increase the rate of the calcium infusion
B) Stop the infusion immediately and notify the provider
C) Administer an antihypertensive medication
D) Encourage deep breathing exercises
Correct answer: B) Stop the infusion immediately and notify the provider
Rationale: Bradycardia and hypotension may indicate calcium toxicity or overdose; the
infusion must be stopped immediately and medical assistance sought.
6. The nurse notices redness and swelling around an IV site used for potassium infusion.
What is the best nursing action?
A) Apply a warm compress and continue infusion
B) Slow the infusion rate and monitor the site
C) Stop the infusion and remove the IV catheter
D) Elevate the limb and check vital signs
Correct answer: C) Stop the infusion and remove the IV catheter
Rationale: Redness and swelling indicate phlebitis or infiltration. The potassium infusion
must be stopped to prevent tissue damage.
