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LPN IV Therapy Questions and Answers
2025 with EXPLANATIONS
(Ch 01 Quiz) 1. What percentage of body weight is attributed to ECF? A. 5% B. 10% C. 20% D. 40% - C. 20%
- ECF makes up about 20% of body weight. (Ch 01 Quiz) 2. Which type of solution raises serum osmolarity and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment? A. Isotonic B. Solvent C. Hypotonic D. Hypertonic - D. Hypertonic
- The higher osmolarity of hypertonic solutions draws fluid into the intravascular compartment.
(Ch 01 Quiz) 3. Which electrolyte participates in neurotransmitter release at synapses? A. Calcium B. Magnesium C. Phosphorus D. Chloride - A. Calcium
- Calcium participates in neurotransmitter release at synapses. (Ch 01 Quiz) 4. Intravascular infections can be prevented by which of the following precautions? A. Securing the venous access device with gauze B. Changing insertion sites according to facility policy C. Applying the tourniquet 6" to 8" (15 to 20 cm) above the insertion site D. Washing your hands after inserting the device - B. Changing insertion sites according to facility policy
- Intravascular infection can be prevented by alternating insertion sites. (Ch 01 Quiz) 5. When capillary blood pressure exceeds colloid osmotic pressure: A. water and diffusible solutes leave the capillaries and circulate into the ISF. B. water and diffusible solutes return to the capillaries. C. there's no change.
- The I.V. route allows therapeutic levels to be achieved rapidly. (Ch 04 Quiz) 3. Loading dose, lock-out interval, and maintenance doses are basic to: A. I.V. therapy. B. PCA therapy. C. continuous I.V. morphine drips. D. TPN. - B. PCA therapy.
- These concepts are basic to PCA therapy. (Ch 04 Quiz) 4. A patient receiving I.V. therapy has redness at the I.V. site. The patient denies feeling pain at the area. These findings suggest what degree of phlebitis? A. 4+ B. 3+ C. 2+ D. 1+ - D. 1+
- According to the Intravenous Nurses Society Revised Standards of Practice, phlebitis that involves erythema with or without pain is classified as 1+. (Ch 04 Quiz) 5. Elderly patients are more prone to which complications of I.V. therapy?
A. Hypersensitivity B. Phlebitis C. Infection D. Extravasation - B. Phlebitis
- Because many elderly patients have fragile veins, they're more prone to phlebitis and infiltration. (Ch 04 Quiz) 6. The one way to prevent extravasation is by: A. using a high-pressure pump to infuse vesicants. B. using a small vein to insert the access device. C. using a gauze dressing over the insertion site. D. using an existing I.V. catheter only after patency has been assured. - D. using an existing I.V. catheter only after patency has been assured.
- An existing I.V. catheter should only be used after its patency has been assessed. If the catheter isn't patent, perform a new venipuncture to ensure correct catheter placement and vein patency. (Ch 01 Review) Objectives of I.V. therapy: -
- To restore and maintain fluid and electrolyte balance
- To provide medications and chemotherapeutic agents
- To transfuse blood and blood products
- To deliver parenteral nutrients and nutritional supplements
body) and intravascular fluid (blood plasma) (Ch 01 Review) Electrolyte functions: -
- Conducts current that's necessary for cell function
- Includes sodium and chloride (major extracellular electrolytes), potassium and phosphorus (major intracellular electrolytes), calcium, and magnesium (Ch 01 Review) Fluid and electrolyte balance: -
- Fluid balance involves the kidneys, heart, liver, adrenal glands, pituitary glands, and nervous system.
- Fluid volume and concentration are regulated by the interaction of antidiuretic hormone (regulates water retention) and aldosterone (retains sodium and water).
- The thirst mechanism helps regulate water volume.
- Fluid movement is influenced by membrane permeability and colloid osmotic and hydrostatic pressures.
- Water and solutes move across capillary walls by capillary filtration and reabsorption. (Ch 01 Review) Types of I.V. solutions: Isotonic solutions -
- Have the same osmolarity or tonicity as serum and other body fluids
- Include lactated Ringer's and normal saline
- Indicated for hypovolemia
(Ch 01 Review) Types of I.V. solutions: Hypertonic solutions -
- Have a higher osmolarity than serum and cause fluid to be pulled from the interstitial and intracellular compartments into the blood vessels
- Include dextrose 5% in half-normal saline and dextrose 5% in lactated Ringer's
- Used to reduce risk of edema, stabilize blood pressure, and regulate urine output (Ch 01 Review) Types of I.V. solutions: Hypotonic solutions -
- Have a lower serum osmolarity and cause fluid to shift out of the blood vessels into the cells and interstitial spaces
- Include half-normal saline, 0.33% sodium chloride, and dextrose 2.5%
- Used when diuretic therapy dehydrates cells or for hyperglycemic conditions (Ch 01 Review) I.V. delivery methods: -
- Continuous infusion provides constant therapeutic drug level, fluid therapy, or parenteral nutrition.
- Intermittent infusion administers drugs over a specified time.
- Direct injection is used for a single-dose drug or solution. (Ch 01 Review) Administration sets: -
- Assess flow rates more frequently in patients who are critically ill, those with conditions that might be exacerbated by fluid overload, pediatric patients, elderly patients, and those receiving a drug that can cause tissue damage if infiltration occurs. (Ch 01 Review) Professional and legal standards: -
- Events that may result in lawsuits include administration of the wrong dosage or solution, use of an incorrect route of administration, inappropriate placement of an I.V. line, and failure to monitor for such problems as adverse reactions, infiltration, and dislodgment of I.V. equipment.
- Professional and legal standards are defined by state nurse practice acts, federal regulations, and facility policy.
- To be eligible for reimbursement, compliance with standards of regulators is necessary. (Ch 01 Review) Documentation of I.V therapy When therapy is initiated, label the dressing on the catheter insertion site and the fluid container according to facility policy and procedures, and document: -
- size, length, and type of device
- name of person inserting the device
- date and time
- site location
- type of dressing
- condition of site
- type of solution and any additives used
- flow rate
- use of an electronic infusion device or other type of flow controller
- complications
- patient response
- nursing interventions
- patient teaching and evidence of patient understanding
- number of attempts. (Ch 01 Review) Maintenance Documentation for I.V. therapy maintenance includes: -
- site care provided
- dressing changes
- tubing and solution changes
- teaching and evidence of patient understanding. (Ch 01 Review) Discontinued Documentation for discontinuing I.V. therapy includes: -
- May cause solution and drug incompatibilities
- May lead to poor vascular access
- Can produce immediate adverse reactions (Ch 04 Review) I.V. administration methods Direct injection: -
- Drug injected directly into an intermittent infusion device or through an existing I.V. line
- Drug injected slowly (unless specified) to prevent adverse reactions and vein trauma (Ch 04 Review) I.V. administration methods Intermittent infusion: -
- Drug administered over a specified interval
- Drug delivered through a piggyback line, saline lock, or volume-control set (Ch 04 Review) I.V. administration methods Continuous infusion: -
- Drug delivery regulated over an extended time
- Drug delivered through a primary or secondary line (Ch 04 Review) PCA therapy: -
- Analgesic delivery controlled by the patient
- Overdose prevented by lock-out interval
- Patient uses fewer opioids for pain relief (Ch 04 Review) PCA therapy Monitoring: -
- Patient monitored for respiratory depression
- Patient monitored for decreased blood pressure (Ch 04 Review) PCA therapy Assessment: -
- Infiltration into surrounding tissues (Ch 04 Review) PCA therapy Potential complications: -
- Infiltration
- Extravasation
- Phlebitis
- Infection (Ch 04 Review) Detecting phlebitis:
- vancomycin
- amphotericin B. Large doses of potassium chloride (40 mEq/L or more), amino acids, dextrose solutions (10% or more), and multivitamins can also cause phlebitis. (Ch 02 Quiz) 1. The first step in performing a routine venipuncture is to: A. prepare the venipuncture site. B. dilate the vein. C. use a local anesthetic. D. attach the tubing to the device. - B. dilate the vein. The sequence in performing the venipuncture is to dilate the vein and then prepare the site. An anesthetic may or may not be used. (Ch 02 Quiz) 2. When applying a transparent dressing, it's important to: A. stretch the dressing as much as possible. B. cover the site and the tubing. C. tuck the dressing around and under the hub. D. always use a gauze dressing with the transparent dressing. - C. tuck the dressing around and under the hub Tucking the dressing in this manner will make the site occlusive to microorganisms. Stretching the dressing will cause itching, and the tubing should never be covered.
(Ch 02 Quiz) 3. Which of the following is the preferred and most accessible site for a venous access device in the infant under age 6 months? A. Foot B. Hand C. Antecubital fossa D. Scalp - D. Scalp Although all of these sites are favorable, the scalp veins are the most accessible. (Ch 02 Quiz) 4. Your patient has swelling at the I.V. site, discomfort, burning, decreased skin temperature, and blanching around the site. These are signs of which of the following I.V. complications? A. Phlebitis B. Infiltration C. Occlusion D. Air embolism - B. Infiltration Swelling at the I.V. site, discomfort, burning, decreased skin temperature, and blanching around the site may indicate infiltration. (Ch 02 Quiz) 5. Which peripheral venipuncture site should be used as a last
- checking the practitioner's orders
- ordering supplies and equipment
- labeling solutions and tubing
- documenting nursing interventions. (Ch 02 Review) Peripheral I.V. therapy is ordered when venous access is needed for: -
- surgery
- transfusions
- emergency care
- maintaining hydration
- restoring fluid and electrolyte balance
- providing fluids for resuscitation
- administering I.V. medications or nutrients. (Ch 02 Review) Preparing for venipuncture and infusion: -
- Check the patient's medical record for allergies, disease history, and his current diagnosis and care plan.
- Review the practitioner's orders and the patient's laboratory studies.
- Describe the procedure to the patient and provide patient teaching.
- Provide privacy, and then have the patient
put on a gown and remove all jewelry.
- Position the patient comfortably.
- Select the appropriate insertion site, venous access device, solution container, and administration set according to the therapy required. Then obtain an infusion pump.
- Label the container correctly and attach the administration set as appropriate. (Ch 02 Review) Performing a venipuncture: -
- Dilate the vein, apply a tourniquet as appropriate, and prepare the access site.
- Stabilize the vein, and then position the venous access device with the bevel side up.
- Insert the device using a smooth, steady motion.
- Collect blood samples using appropriate equipment, and secure the venous access device.
- Document the procedure in the appropriate areas (such as the progress notes, intake and output flowsheets, or the patient's chart or medication sheet) according to your facility's policy (Ch 02 Review) Maintaining peripheral I.V. therapy: -
- Focus on preventing complications.
- Discontinue the infusion when therapy is completed.
- Change a gauze dressing every 48 hours.
- Change the I.V. solution container when due or every 24 hours.
