Deck 18: Intravenous Therapy

Question 1

To select a vein for an initial IV site,the best place to begin in a left-handed patient would be the:

A) Antecubital vein of the right arm
B) Antecubital vein of the left arm
C) Right forearm
D) Left forearm

Answer 1

Right forearm

Question 2

The nurse explains that a major advantage of IV therapy is that drugs administered via the IV route:

A) Can better be maintained at a therapeutic blood level
B) Is less expensive than oral route
C) Is safer than administering by oral or intramuscular (IM) route
D) Has a lower incidence of allergy than other routes

Answer 2

Can better be maintained at a therapeutic blood level

Question 3

Using an IV infusion system that delivers 60 drops/ml,the nurse hangs a 500-ml bag of normal saline (NS)at 8 AM.The physician has ordered a rate of 20 ml/hr.The nurse will set the roller clamp to deliver:

A) 10 gtts/min
B) 20 gtts/min
C) 25 gtts/min
D) 30 gtts/min

Answer 3

20 gtts/min

Question 4

The nurse assesses an area where an IV had been recently changed.The area has redness,swelling,and warmth,which are characteristics of:

A) Infiltration and air embolus
B) Inflammation and possible phlebitis
C) Blood loss and hemorrhage
D) Embolus from the former catheter

Question 5

An older adult patient is assessed by the nurse as showing signs of fluid volume excess,which are:

A) Redness, warmth, and drainage of fluid at the IV site
B) Redness, warmth, and tenderness at the IV site
C) Complaints of shortness of breath and pounding pulse
D) Puffiness of face, dyspnea, and pain at the IV site

Question 6

The nurse charts signs of infected phlebitis as:

A) Rupture of the cannula with a lump under the skin
B) Pale, cool skin with swelling at the puncture site
C) Firm, cool, raised, painful area at the puncture site; oozing and purulent drainage
D) Puncture site red, warm, with an oozing drainage

Question 7

The nurse is carefully checking IV sites for signs of infiltration,which are:

A) Burning sensation, pain, and puffy
B) Pain, heat, and puffy
C) Burning sensation and no feeling at the site
D) Red streak up the arm

Question 8

In making out the assignment for the evening shift,the licensed practical nurse (LPN)is careful to assign IV rounds to be performed:

A) Every 15 minutes
B) Every 30 minutes
C) Every 60 minutes
D) Twice per shift

Question 9

The nurse explains that caloric sources in IVs come from:

A) Electrolytes
B) Dextrose
C) Vitamins
D) Water

Question 10

Using an IV infusion system that delivers 60 drops/ml,the nurse hangs a 1000-ml bag of 5% dextrose in water (D?W),which the physician has ordered to infuse at 80 ml/hr.It is now 10 AM.The nurse anticipates that the IV will need to be changed at:

A) 6 PM
B) 8 PM
C) 8:30 PM
D) 10:30 PM

Question 11

An IV administration of doxycyclin (Vibramycin)has extravagated.After stopping the IV,the nurse should:

A) Notify the physician, and restart the IV in another site.
B) Restart the IV at another site, and document the extravasation.
C) Flush NS through cannula at the insertion site.
D) Discard the IV tubing and the IV bag.

Question 12

The physician orders a hypertonic IV for an extremely edematous patient.The nurse anticipates that the IV preparation will be:

A) D5W in NS
B) Lactated Ringer' solution
C) D5W in 0.25 NS
D) 10% glucose in water

Question 13

When removing a central catheter,the nurse should instruct the patient to:

A) Lean forward and cough.
B) Take a deep breath and bear down.
C) Breathe deeply through the mouth.
D) Lie on the right side.

Question 14

When the nurse is to give a piggyback IV push medication to a patient who is receiving a continuous infusion,the nurse injects the medication:

A) Into the hanging IV bag
B) Directly into the insertion cannula after temporarily disconnecting the IV bag
C) Into the port nearest to the insertion site to ensure quick delivery
D) Into the port nearest to the IV bag for less painful administration

Question 15

The nurse is choosing an IV cannula for an older adult patient and will choose the smallest size that will deliver the appropriate fluid,which is a cannula of:

A) 12 gauge
B) 14 gauge
C) 18 gauge
D) 22 gauge

Question 16

The physician orders an infusion of 1000 ml of 5% dextrose in 0.45 NS to be completed in 8 hours.The IV delivery system's drop factor is 20 gtts.The nurse should set the electronic infusion pump to deliver ______________ ml/hr?

A) 125
B) 100
C) 85
D) 42

Question 17

In an assessment of a patient who has been receiving intravenous (IV)fluids for the last 6 hours,the nurse finds that the pulse is now bounding,the blood pressure is more than 15 mm Hg higher than the last reading,and pedal edema has developed.The nurse evaluates these signs as associated with:

A) Infiltration of the IV site
B) Vascular fluid volume excess
C) Pulmonary air embolism
D) Phlebitis of the leg veins

Question 18

The nurse has a patient with a tunneled central line with a triple-lumen catheter.The insertion site is covered by an occlusive dressing with yesterday's date.The nurse is to give an IV drug through the central line.The nurse would initially:

A) Use any of the three ports for delivery.
B) Change the occlusive dressing.
C) Affirm catheter placement by withdrawing 3 ml of blood.
D) Check dilution of the drug.

Question 19

As part of a written standard protocol for the unit,the nurse adds that irrigation of an occluded cannula is not recommended.The rationale against performing this procedure is that it may:

A) Damage a venous valve
B) Introduce an air embolus into the line
C) Cause the patient pain
D) Force blood clots into the main bloodstream

Question 20

The patient is to receive ampicillin (Unasyn)IV piggyback in 100 ml of fluid every 8 hours.The main IV of D?W is running at 80 ml/hr and is on time.The nurse's responsibility is to calculate the total 24-hour intake.At the end of the 24-hour shift,how much IV intake will the nurse document that the patient has received?

A) 300 ml
B) 800 ml
C) 1920 ml
D) 2220 ml

Question 21

When the nurse assesses an infiltration at a peripheral IV site,the nurse should: (Place these options in the correct sequence.)

A) Elevate the arm.
B) Apply warm compresses to the area.
C) Restart the infusion.
D) Stop the infusion.
E) Notify the charge nurse.

Question 22

The nurse transcribing orders should clarify the order of:

A) Potassium chloride, 80 mEq in 1000 ml D5W in 24 hours
B) Potassium chloride, 40 mEq IV in 10 ml D5W IV push
C) Potassium chloride, 50 mEq in 500 ml D5W in 4 hours
D) Potassium chloride, 80 mEq in 1000 ml D5W in 12 hours

Question 23

The nurse explains to the patient that the peripheral IV tubing administration set and dressing should be changed every __________ hours.

Question 24

The patient with a subclavian line complains of shortness of breath after an infusion.The patient is diaphoretic and the blood pressure is 168/100 mm Hg,higher than a previous reading of 140/86 mm Hg.The nurse assesses these symptoms as an indication of:

A) Fluid overload from too rapid an infusion
B) Incorrect dilution of the infused drug
C) Infection from faulty aseptic technique
D) Embolus from introduced air or blood clot

Question 25

The nurse is to give an IV push drug through a peripheral intermittent device.The nurse would: (Place these options in the correct sequence.)

A) Clear the device with NS.
B) Flush the device with NS only or a combination of NS and heparin.
C) Check placement of the device.
D) Slowly administer the drug through the device.
E) Check the concentration of the drug.

Question 26

The nurse explains to the patient that,in the event of an accidental needle stick,the nurse should adhere to hospital policy,the usual directives of which are:

A) Antibiotics are taken if infection is present.
B) Blood is drawn from both the nurse and the patient.
C) Repeat blood draws are performed 4 weeks after the stick.
D) Obtain the physician's permission to return to work.
E) An incident report is initiated.

Question 27

The patient has suffered an air embolus.The quick-thinking nurse immediately:

A) Turns the patient to the left side and lowers the head of the bed.
B) Calls the "Code Team."
C) Gives oxygen at 100% in a nonrebreathing mask.
D) Notifies the charge nurse.

Question 28

The older adult patient is quite ill and confused and begins to cry pitifully when the nurse approaches the bed to start an IV.The best action for the nurse at this point would be to:

A) Keep the infusion equipment out of sight as much as possible, talk slowly, and divert the attention of the patient.
B) Inform the patient that the physician has ordered the IV, and calmly continue to prepare the site and start the IV.
C) Give an analgesic as ordered, wait a few minutes, and then proceed.
D) Restrain the patient's arm to a padded arm board, and proceed as directed.

Question 29

When discontinuing an IV,the nurse will:

A) Remove the dressing, remove the catheter, dispose of the used equipment in the sharps container, and chart observations and actions.
B) Observe the site for redness, swelling, and pain, and put on sterile gloves. Remove the dressing catheter and chart the findings and action.
C) Observe the site for redness, swelling, and pain, and put on clean gloves. Remove the dressing and catheter, place a 2 ´ 2 dressing over the site, and chart the findings and action.
D) Observe the site for redness, swelling, and pain, and put on clean gloves. Remove the dressing and catheter; chart the findings and action.