PNR 202/PNR202 Exam 4 V2 | Intravenous
Therapy Q&A with Rationale | Fortis College
1. A nurse is caring for a patient receiving an isotonic intravenous solution. Which of the
following solutions is classified as isotonic?
A. 0.9% Sodium Chloride
B. 0.45% Sodium Chloride
C. 3% Sodium Chloride
D. 10% Dextrose in Water
Correct Answer: A
Explanation: Isotonic solutions have the same osmolarity as body fluids and do not cause
fluid shifts between compartments. 0.9% Sodium Chloride, also known as Normal Saline, is
the most common isotonic solution used for volume replacement. This solution is ideal for
patients with extracellular fluid volume deficits.
2. While assessing a patient’s IV site, the nurse notes redness, warmth, and a palpable cord
along the vein. Which complication does this suggest?
A. Infiltration
B. Extravasation
C. Hematoma
D. Phlebitis
,Correct Answer: D
Explanation: Phlebitis is the inflammation of a vein characterized by pain, warmth, and
redness along the vein path. The presence of a ‘palpable cord’ is a hallmark sign of
advanced phlebitis stages. Immediate action includes stopping the infusion and removing
the catheter.
3. A patient is prescribed a hypotonic IV solution. What is the primary physiological effect of
this fluid type?
A. It causes fluid to move from the intravascular space into the intracellular space.
B. It pulls water out of the cells into the bloodstream.
C. It maintains the current fluid balance without shifting water.
D. It increases the osmotic pressure of the plasma.
Correct Answer: A
Explanation: Hypotonic solutions have a lower osmolarity than plasma, causing water to
move into the cells to equalize concentration. This is often used to treat cellular
dehydration by rehydrating the cells. Nurses must monitor for signs of cerebral edema
when administering these fluids.
4. What is the recommended gauge size for a peripheral IV catheter intended for routine
blood transfusions in an adult?
A. 24-gauge
B. 18-gauge
, C. 22-gauge
D. 26-gauge
Correct Answer: B
Explanation: An 18-gauge catheter is preferred for blood transfusions to allow for rapid
flow and to prevent hemolysis of red blood cells. While a 20-gauge may be used if an 18 is
not possible, smaller gauges increase the risk of cell damage. Proper gauge selection
ensures the integrity of the blood product during administration.
5. A nurse suspects a patient is experiencing fluid volume overload. Which clinical
manifestation supports this finding?
A. Flat neck veins
B. Crackles heard in the lungs
C. Decreased blood pressure
D. Dry mucous membranes
Correct Answer: B
Explanation: Fluid volume overload occurs when the cardiovascular system cannot handle
the volume of IV fluids. Crackles in the lungs indicate pulmonary edema, a serious
consequence of fluid excess. Other signs include distended neck veins, hypertension, and
shortness of breath.
Therapy Q&A with Rationale | Fortis College
1. A nurse is caring for a patient receiving an isotonic intravenous solution. Which of the
following solutions is classified as isotonic?
A. 0.9% Sodium Chloride
B. 0.45% Sodium Chloride
C. 3% Sodium Chloride
D. 10% Dextrose in Water
Correct Answer: A
Explanation: Isotonic solutions have the same osmolarity as body fluids and do not cause
fluid shifts between compartments. 0.9% Sodium Chloride, also known as Normal Saline, is
the most common isotonic solution used for volume replacement. This solution is ideal for
patients with extracellular fluid volume deficits.
2. While assessing a patient’s IV site, the nurse notes redness, warmth, and a palpable cord
along the vein. Which complication does this suggest?
A. Infiltration
B. Extravasation
C. Hematoma
D. Phlebitis
,Correct Answer: D
Explanation: Phlebitis is the inflammation of a vein characterized by pain, warmth, and
redness along the vein path. The presence of a ‘palpable cord’ is a hallmark sign of
advanced phlebitis stages. Immediate action includes stopping the infusion and removing
the catheter.
3. A patient is prescribed a hypotonic IV solution. What is the primary physiological effect of
this fluid type?
A. It causes fluid to move from the intravascular space into the intracellular space.
B. It pulls water out of the cells into the bloodstream.
C. It maintains the current fluid balance without shifting water.
D. It increases the osmotic pressure of the plasma.
Correct Answer: A
Explanation: Hypotonic solutions have a lower osmolarity than plasma, causing water to
move into the cells to equalize concentration. This is often used to treat cellular
dehydration by rehydrating the cells. Nurses must monitor for signs of cerebral edema
when administering these fluids.
4. What is the recommended gauge size for a peripheral IV catheter intended for routine
blood transfusions in an adult?
A. 24-gauge
B. 18-gauge
, C. 22-gauge
D. 26-gauge
Correct Answer: B
Explanation: An 18-gauge catheter is preferred for blood transfusions to allow for rapid
flow and to prevent hemolysis of red blood cells. While a 20-gauge may be used if an 18 is
not possible, smaller gauges increase the risk of cell damage. Proper gauge selection
ensures the integrity of the blood product during administration.
5. A nurse suspects a patient is experiencing fluid volume overload. Which clinical
manifestation supports this finding?
A. Flat neck veins
B. Crackles heard in the lungs
C. Decreased blood pressure
D. Dry mucous membranes
Correct Answer: B
Explanation: Fluid volume overload occurs when the cardiovascular system cannot handle
the volume of IV fluids. Crackles in the lungs indicate pulmonary edema, a serious
consequence of fluid excess. Other signs include distended neck veins, hypertension, and
shortness of breath.
