Chapter 38. Peripheral IV Therapy
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing intravenous (IV) push meperidine (Demerol) through a free-flowing IV line and notes
a hazy appearance in the tubing. It is necessary to
1. Stop the infusion.
2. Discontinue the IV site.
3. Put all doses of meperidine on hold.
4. Notify the supervisor.
2. The nurse is providing care for a patient with an allergy to corn. Which of the following solutions, if ordered
by the physician, would the nurse question?
1. 0.9% sodium chloride (NS)
2. 0.45% sodium chloride (1/2NS)
3. Dextrose 5% in water (D5W)
4. Lactated Ringer’s (LR)
3. The nurse is providing care for a patient who is receiving a blood transfusion. Pre-transfusion vital signs
blood pressure (BP), 144/78 mm Hg; temperature (T), 98.4°F; pulse (P), 86; respirations (R), 14. Now,
were
approximately an hour after the transfusion was initiated, the patient’s vital signs are BP, 168/92 mm Hg; P,
98; R, 20. Next, the nurse should
1. Record the vital signs.
2. Listen to the patient’s breath sounds.
3. Notify the physician.
4. Slow the transfusion rate.
4. Which of the following intravenous solutions is most similar to the electrolyte content of the blood?
1. 0.22% sodium chloride (1/4NS)
2. Dextrose 5% in 0.45% sodium chloride (D5 1/2NS)
3. Dextrose 5% in water (D5W)
4. Lactated Ringer’s (LR)
5. The nurse is providing care to a patient who was admitted with a suspected Coumarin overdose. Which of the
following blood products will most likely be included in the patient’s plan of care?
1. Cryoprecipitate
2. Fresh frozen plasma
3. Whole blood
4. Albumin
6. The nurse who is caring for a patient with an infusion of D5 1/2NS 1000 mL with 20 mEq KCL at 100
mL/hr notes that there is slight swelling at the insertion site and no blood return when aspirating at the
injection port closest to the IV site. Which of the following problems does the nurse suspect?
1. Air embolism
2. Fluid overload
3. Infiltration
4. Thrombophlebitis
7. The nurse is caring for a patient who reports that the intravenous (IV) site is sore. The nurse notes swelling
and tenderness at the site, as well as a red streak up the arm. The nurse’s care should include
1. Applying an ice pack to the area.
, 2. Discontinuing the IV and applying warm packs.
3. Requesting a new order for IV antibiotics to be infused at the site.
4. Sending the IV catheter and tubing to the laboratory for analysis.
8. The nurse is providing care for a patient who has a central line and a suspected air embolism. The best action
by the nurse is to
1. Elevate the head of the bed.
2. Place telemetry leads on the patient’s chest.
3. Instruct the patient to bear down.
4. Place the patient on her left side in Trendelenburg position.
9. The nurse asks a nursing student to help initiate a transfusion. Which of the following would require
immediate intervention?
1. The patient’s blood type is A-positive, and the student’s blood type is A-negative.
2. The tubing is hanging and primed with D5 LR.
3. The student is using Y-tubing for the transfusion.
4. The student verifies the patient’s name, birth date, and blood identification tags.
10. The nurse assumes responsibility for a blood transfusion that was initiated 2.5 hours ago. The patient is
tolerating the procedure well, and there is roughly 50% of the blood remaining. The best action by the nurse
is to
1. Increase the transfusion rate.
2. Stop the infusion and return the unused blood to the blood bank.
3. Chart the current vital signs.
4. Notify the charge nurse.
11. When administering medication via intravenous (IV) push, the nurse
1. Must administer the medication quickly to assure that it takes effect rapidly.
2. Must research the length of time over which the medication must be administered.
3. Must ensure that the medication remains undiluted before administering it.
4. May delegate the administration to an LVN or LPN.
12. A nurse knows that a patient who needs an IV to provide simple water replacement because of lack of fluid
intake should be given
1. An isotonic solution.
2. A hypertonic solution.
3. A hypotonic solution.
4. Plain water.
13. A nurse knows that there is a risk for cerebral edema, increased intracranial pressure, rupture of brain cells,
and death if there is an infusion of an excessive volume of
1. Isotonic solution.
2. Hypertonic solution.
3. Hypotonic solution.
4. Any of the above.
14. A nurse knows that if a patient needs intravenous (IV) fluid replacement because of low blood volume, he or
she should be given
1. An isotonic solution.
2. A hypertonic solution.
3. A hypotonic solution.
4. Any of the above.
, 15. A nurse will correctly administer which of the following IV solutions via a central vein rather than a
peripheral vein?
1. 15% dextrose
2. 10% dextrose
3. 5% dextrose
4. 3% sodium chloride
16. The nurse asks the patient about allergies before cleansing the skin with which of the following solutions?
1. 10% povidone-iodine
2. 2% tincture of iodine
3. 2% aqueous chlorhexidine gluconate
4. 70% isopropyl alcohol
17. Before preparing the equipment to administer peripheral venipuncture, the nurse correctly washes her hands
for at least
1. 1 minute.
2. 45 seconds.
3. 30 seconds.
4. 15 seconds.
18. A nurse is planning the care of a diverse group of patients. He will plan to monitor the rate of infusion and
assess the condition of an IV site every 2 hours for which of the following patients?
1. A 4-year-old child
2. A 38-year-old woman
3. A 72-year-old man
4. A 42-year-old who is prone to circulatory fluid overload
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. The nurse who is working on a medical-surgical floor recognizes that vesicant precautions should be taken
with which of the following? Select all that apply.
1. Ampicillin sodium (ampicillin)
2. Potassium chloride
3. Promethazine (Phenergan)
4. Vancomycin (Vancocin)
5. Gentamicin sulfate (gentamicin)
2. The presence of phlebitis is indicated by which of the following? Select all that apply.
1. Swelling and redness noted at the site
2. The site being warm to the touch
3. The patient reporting burning along the vein
4. The site appearing bruised
5. The vein feeling soft and spongy on palpation
3. The nurse is providing care to a patient who is receiving a blood transfusion and who becomes acutely short
of breath and anxious within a few minutes of the nurse’s initiating the transfusion. Which of the following
actions will be included in the nurse’s care? Select all that apply.
1. Frequent checks of the vital signs
2. Stopping the blood transfusion and notifying the physician
3. Sending tubing and unused blood to the blood bank
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing intravenous (IV) push meperidine (Demerol) through a free-flowing IV line and notes
a hazy appearance in the tubing. It is necessary to
1. Stop the infusion.
2. Discontinue the IV site.
3. Put all doses of meperidine on hold.
4. Notify the supervisor.
2. The nurse is providing care for a patient with an allergy to corn. Which of the following solutions, if ordered
by the physician, would the nurse question?
1. 0.9% sodium chloride (NS)
2. 0.45% sodium chloride (1/2NS)
3. Dextrose 5% in water (D5W)
4. Lactated Ringer’s (LR)
3. The nurse is providing care for a patient who is receiving a blood transfusion. Pre-transfusion vital signs
blood pressure (BP), 144/78 mm Hg; temperature (T), 98.4°F; pulse (P), 86; respirations (R), 14. Now,
were
approximately an hour after the transfusion was initiated, the patient’s vital signs are BP, 168/92 mm Hg; P,
98; R, 20. Next, the nurse should
1. Record the vital signs.
2. Listen to the patient’s breath sounds.
3. Notify the physician.
4. Slow the transfusion rate.
4. Which of the following intravenous solutions is most similar to the electrolyte content of the blood?
1. 0.22% sodium chloride (1/4NS)
2. Dextrose 5% in 0.45% sodium chloride (D5 1/2NS)
3. Dextrose 5% in water (D5W)
4. Lactated Ringer’s (LR)
5. The nurse is providing care to a patient who was admitted with a suspected Coumarin overdose. Which of the
following blood products will most likely be included in the patient’s plan of care?
1. Cryoprecipitate
2. Fresh frozen plasma
3. Whole blood
4. Albumin
6. The nurse who is caring for a patient with an infusion of D5 1/2NS 1000 mL with 20 mEq KCL at 100
mL/hr notes that there is slight swelling at the insertion site and no blood return when aspirating at the
injection port closest to the IV site. Which of the following problems does the nurse suspect?
1. Air embolism
2. Fluid overload
3. Infiltration
4. Thrombophlebitis
7. The nurse is caring for a patient who reports that the intravenous (IV) site is sore. The nurse notes swelling
and tenderness at the site, as well as a red streak up the arm. The nurse’s care should include
1. Applying an ice pack to the area.
, 2. Discontinuing the IV and applying warm packs.
3. Requesting a new order for IV antibiotics to be infused at the site.
4. Sending the IV catheter and tubing to the laboratory for analysis.
8. The nurse is providing care for a patient who has a central line and a suspected air embolism. The best action
by the nurse is to
1. Elevate the head of the bed.
2. Place telemetry leads on the patient’s chest.
3. Instruct the patient to bear down.
4. Place the patient on her left side in Trendelenburg position.
9. The nurse asks a nursing student to help initiate a transfusion. Which of the following would require
immediate intervention?
1. The patient’s blood type is A-positive, and the student’s blood type is A-negative.
2. The tubing is hanging and primed with D5 LR.
3. The student is using Y-tubing for the transfusion.
4. The student verifies the patient’s name, birth date, and blood identification tags.
10. The nurse assumes responsibility for a blood transfusion that was initiated 2.5 hours ago. The patient is
tolerating the procedure well, and there is roughly 50% of the blood remaining. The best action by the nurse
is to
1. Increase the transfusion rate.
2. Stop the infusion and return the unused blood to the blood bank.
3. Chart the current vital signs.
4. Notify the charge nurse.
11. When administering medication via intravenous (IV) push, the nurse
1. Must administer the medication quickly to assure that it takes effect rapidly.
2. Must research the length of time over which the medication must be administered.
3. Must ensure that the medication remains undiluted before administering it.
4. May delegate the administration to an LVN or LPN.
12. A nurse knows that a patient who needs an IV to provide simple water replacement because of lack of fluid
intake should be given
1. An isotonic solution.
2. A hypertonic solution.
3. A hypotonic solution.
4. Plain water.
13. A nurse knows that there is a risk for cerebral edema, increased intracranial pressure, rupture of brain cells,
and death if there is an infusion of an excessive volume of
1. Isotonic solution.
2. Hypertonic solution.
3. Hypotonic solution.
4. Any of the above.
14. A nurse knows that if a patient needs intravenous (IV) fluid replacement because of low blood volume, he or
she should be given
1. An isotonic solution.
2. A hypertonic solution.
3. A hypotonic solution.
4. Any of the above.
, 15. A nurse will correctly administer which of the following IV solutions via a central vein rather than a
peripheral vein?
1. 15% dextrose
2. 10% dextrose
3. 5% dextrose
4. 3% sodium chloride
16. The nurse asks the patient about allergies before cleansing the skin with which of the following solutions?
1. 10% povidone-iodine
2. 2% tincture of iodine
3. 2% aqueous chlorhexidine gluconate
4. 70% isopropyl alcohol
17. Before preparing the equipment to administer peripheral venipuncture, the nurse correctly washes her hands
for at least
1. 1 minute.
2. 45 seconds.
3. 30 seconds.
4. 15 seconds.
18. A nurse is planning the care of a diverse group of patients. He will plan to monitor the rate of infusion and
assess the condition of an IV site every 2 hours for which of the following patients?
1. A 4-year-old child
2. A 38-year-old woman
3. A 72-year-old man
4. A 42-year-old who is prone to circulatory fluid overload
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. The nurse who is working on a medical-surgical floor recognizes that vesicant precautions should be taken
with which of the following? Select all that apply.
1. Ampicillin sodium (ampicillin)
2. Potassium chloride
3. Promethazine (Phenergan)
4. Vancomycin (Vancocin)
5. Gentamicin sulfate (gentamicin)
2. The presence of phlebitis is indicated by which of the following? Select all that apply.
1. Swelling and redness noted at the site
2. The site being warm to the touch
3. The patient reporting burning along the vein
4. The site appearing bruised
5. The vein feeling soft and spongy on palpation
3. The nurse is providing care to a patient who is receiving a blood transfusion and who becomes acutely short
of breath and anxious within a few minutes of the nurse’s initiating the transfusion. Which of the following
actions will be included in the nurse’s care? Select all that apply.
1. Frequent checks of the vital signs
2. Stopping the blood transfusion and notifying the physician
3. Sending tubing and unused blood to the blood bank
