PNR 202/PNR202 Exam 1 V2 | Intravenous
Therapy Q&A with Rationale | Fortis College
1. A nurse is preparing to administer a unit of packed red blood cells to a patient. Which size
of intravenous catheter is most appropriate to prevent hemolysis and ensure adequate flow?
A. 24-gauge
B. 22-gauge
C. 27-gauge
D. 18-gauge
Correct Answer: D
Explanation: An 18-gauge catheter is preferred for blood transfusions because the large
diameter prevents damage to the red blood cells. Using a smaller gauge, such as a 22 or 24,
increases the risk of hemolysis during the administration process. In emergency situations
where rapid volume replacement is needed, large-bore access is critical for patient safety.
2. The nurse observes that a patient’s peripheral IV site is cool to the touch, swollen, and the
infusion has slowed. Which complication should the nurse document?
A. Phlebitis
B. Infiltration
C. Thrombophlebitis
D. Extravasation
,Correct Answer: B
Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the surrounding
subcutaneous tissue, causing coolness and edema. Phlebitis is typically characterized by
warmth and redness, which differentiates it from infiltration. The nurse must immediately
stop the infusion and remove the catheter to prevent further tissue compression.
3. Which of the following intravenous solutions is classified as hypotonic?
A. 0.45% Sodium Chloride
B. 0.9% Sodium Chloride
C. Lactated Ringer’s
D. 5% Dextrose in 0.9% Sodium Chloride
Correct Answer: A
Explanation: 0.45% Sodium Chloride (half-normal saline) is a hypotonic solution because
it has a lower osmolarity than plasma. These solutions cause fluid to shift from the
intravascular space into the intracellular space, causing cells to swell. This type of fluid is
commonly used for patients experiencing cellular dehydration.
4. A patient is receiving 3% Sodium Chloride for severe hyponatremia. The nurse should
monitor closely for signs of which complication?
A. Dehydration
B. Hypovolemic shock
, C. Fluid volume overload
D. Hypoglycemia
Correct Answer: C
Explanation: Hypertonic solutions like 3% Sodium Chloride pull fluid from the cells into
the vascular space, increasing the risk of circulatory overload. The nurse must assess for
symptoms such as crackles in the lungs, shortness of breath, and jugular venous distention.
Frequent monitoring of serum sodium levels is also necessary to prevent rapid
neurological shifts.
5. What is the first action a nurse should take if a patient develops sudden chest pain,
dyspnea, and cyanosis during IV therapy?
A. Administer a bolus of normal saline.
B. Increase the IV flow rate to maintain blood pressure.
C. Place the patient in the Left Trendelenburg position.
D. Encourage the patient to cough and deep breathe.
Correct Answer: C
Explanation: These symptoms are indicative of an air embolism, which is a life-threatening
emergency. Placing the patient in the Left Trendelenburg position helps trap the air in the
right atrium and prevents it from entering the pulmonary artery. The nurse should also
notify the provider immediately and administer oxygen.
Therapy Q&A with Rationale | Fortis College
1. A nurse is preparing to administer a unit of packed red blood cells to a patient. Which size
of intravenous catheter is most appropriate to prevent hemolysis and ensure adequate flow?
A. 24-gauge
B. 22-gauge
C. 27-gauge
D. 18-gauge
Correct Answer: D
Explanation: An 18-gauge catheter is preferred for blood transfusions because the large
diameter prevents damage to the red blood cells. Using a smaller gauge, such as a 22 or 24,
increases the risk of hemolysis during the administration process. In emergency situations
where rapid volume replacement is needed, large-bore access is critical for patient safety.
2. The nurse observes that a patient’s peripheral IV site is cool to the touch, swollen, and the
infusion has slowed. Which complication should the nurse document?
A. Phlebitis
B. Infiltration
C. Thrombophlebitis
D. Extravasation
,Correct Answer: B
Explanation: Infiltration occurs when non-vesicant IV fluid leaks into the surrounding
subcutaneous tissue, causing coolness and edema. Phlebitis is typically characterized by
warmth and redness, which differentiates it from infiltration. The nurse must immediately
stop the infusion and remove the catheter to prevent further tissue compression.
3. Which of the following intravenous solutions is classified as hypotonic?
A. 0.45% Sodium Chloride
B. 0.9% Sodium Chloride
C. Lactated Ringer’s
D. 5% Dextrose in 0.9% Sodium Chloride
Correct Answer: A
Explanation: 0.45% Sodium Chloride (half-normal saline) is a hypotonic solution because
it has a lower osmolarity than plasma. These solutions cause fluid to shift from the
intravascular space into the intracellular space, causing cells to swell. This type of fluid is
commonly used for patients experiencing cellular dehydration.
4. A patient is receiving 3% Sodium Chloride for severe hyponatremia. The nurse should
monitor closely for signs of which complication?
A. Dehydration
B. Hypovolemic shock
, C. Fluid volume overload
D. Hypoglycemia
Correct Answer: C
Explanation: Hypertonic solutions like 3% Sodium Chloride pull fluid from the cells into
the vascular space, increasing the risk of circulatory overload. The nurse must assess for
symptoms such as crackles in the lungs, shortness of breath, and jugular venous distention.
Frequent monitoring of serum sodium levels is also necessary to prevent rapid
neurological shifts.
5. What is the first action a nurse should take if a patient develops sudden chest pain,
dyspnea, and cyanosis during IV therapy?
A. Administer a bolus of normal saline.
B. Increase the IV flow rate to maintain blood pressure.
C. Place the patient in the Left Trendelenburg position.
D. Encourage the patient to cough and deep breathe.
Correct Answer: C
Explanation: These symptoms are indicative of an air embolism, which is a life-threatening
emergency. Placing the patient in the Left Trendelenburg position helps trap the air in the
right atrium and prevents it from entering the pulmonary artery. The nurse should also
notify the provider immediately and administer oxygen.
