IV Calculations Practice Questions

1. A nurse is preparing to administer a primary IV infusion. Which of the following steps should the nurse take first? A. Label the IV tubing. B. Hang the IV bag at the appropriate height. C. Perform hand hygiene and identify the patient. D. Check the IV insertion site for signs of infiltration or phlebitis. Correct Answer: C. Perform hand hygiene and identify the patient. Rationale: Hand hygiene and patient identification are essential initial steps to ensure safety. This process also aligns with universal safety protocols. Other steps follow the initial preparation and assessment. 2. An elderly patient is admitted with dehydration and requires IV therapy. Which consideration is most critical for this patient when administering IV fluids? A. Monitoring the IV site for signs of infiltration. B. Using a hypotonic solution to replace fluids. C. Ensuring the catheter is placed in the lower extremities. D. Increasing the infusion rate to avoid dehydration. Correct Answer: A. Monitoring the IV site for signs of infiltration. Rationale: Elderly patients are at higher risk for infiltration due to fragile veins and decreased skin elasticity. Monitoring for signs of infiltration is crucial for avoiding further complications. Hypotonic solutions and lower extremity placements are not generally recommended, and infusion rates should be carefully monitored to avoid fluid overload. 3. Which of the following IV solutions would be most appropriate for a patient requiring isotonic fluid replacement? A. 0.45% NaCl B. D5W (5% Dextrose in Water) C. D5/0.45% NaCl D. D5/Lactated Ringers Correct Answer: B. D5W (5% Dextrose in Water) Rationale: D5W is an isotonic solution that matches the solute concentration of body fluids, making it suitable for fluid replacement in a patient needing isotonic therapy. Options C and D are hypertonic, and option A is hypotonic. 5. During an IV infusion, the nurse notices the patient’s IV site is cool, pale, and swollen. What complication should the nurse suspect, and what is the first intervention? A. Phlebitis; apply warm compresses. B. Infiltration; stop the infusion immediately. C. Infection; administer antibiotics. D. Allergic reaction; administer antihistamines. Correct Answer: B. Infiltration; stop the infusion immediately. Rationale: Coolness, paleness, and swelling at the site are signs of infiltration, where IV fluid enters the subcutaneous tissue rather than the vein. The nurse should stop the infusion immediately to prevent further tissue damage. 6. The nurse is preparing to administer a secondary IV (IVPB) antibiotic through a primary line. Which of the following actions is essential to ensure proper infusion of the secondary solution? A. Lower the primary bag and raise the secondary bag. B. Use the primary line roller clamp to set the flow rate. C. Open the primary line roller clamp all the way. D. Disconnect the primary line while the secondary infusion is running. Correct Answer: A. Lower the primary bag and raise the secondary bag. Rationale: Raising the secondary bag above the primary bag allows gravity to aid in the infusion of the secondary solution. The primary line roller clamp should be used to set the flow rate, but the primary bag must remain lower than the secondary bag to prevent backflow. IV Therapy part 2: 1. A nurse is preparing to administer a medication via IV push through a primary IV line. Which technique should the nurse use to administer the medication correctly? A. Attach the syringe to the injection port closest to the IV bag and inject slowly. B. Cleanse the injection port, then inject the medication rapidly. C. Attach the syringe to the port closest to the patient, pinch the tubing, inject the medication over the prescribed time, and release. D. Inject the medication directly into the IV catheter without cleansing the port. Correct Answer: C. Attach the syringe to the port closest to the patient, pinch the tubing, inject the medication over the prescribed time, and release. Rationale: The correct method for administering an IV push medication through a primary line is to attach the syringe to the injection port closest to the patient, using the pinch-inject-release (PIR) technique over the recommended time to prevent rapid drug entry. 2. A patient requires an IV push medication through a saline lock. Which sequence should the nurse follow to administer the medication safely? A. Administer medication, saline flush, then alcohol wipe. B. Alcohol wipe, administer medication, then saline flush. C. Saline flush, medication, saline flush. D. Saline flush, saline flush, medication. Correct Answer: C. Saline flush, medication, saline flush. Rationale: The correct sequence for IV push medication administration through a saline lock is to first flush with saline to ensure patency, administer the medication at the prescribed rate, and then flush again to clear the line and lock it with saline. 3. While administering an IV push medication, the nurse is instructed to infuse the medication over two minutes. What should the nurse do if the patient complains of pain at the IV site? A. Stop the infusion immediately and notify the healthcare provider. B. Speed up the infusion to reduce the duration of pain. C. Reassure the patient that mild discomfort is normal. D. Continue infusing at the prescribed rate and assess the IV site. Correct Answer: D. Continue infusing at the prescribed rate and assess the IV site. Rationale: If the patient complains of pain, the nurse should assess the IV site for complications like infiltration or phlebitis while continuing at the prescribed rate. Stopping abruptly or speeding up the infusion could lead to adverse effects. 4. A nurse is preparing to program an infusion pump for a patient who has an order for 1000 mL of 0.9% NaCl to be infused over 8 hours. At what rate should the nurse set the pump? A. 50 mL/hr B. 100 mL/hr C. 125 mL/hr D. 150 mL/hr Correct Answer: B. 100 mL/hr Rationale: To determine the rate, divide the total volume (1000 mL) by the time (8 hours): 1000 mL÷8=100 mL/hr1000 \, \text{mL} \div 8 = 100 \, \ text{mL/hr}1000mL÷8=100mL/hr. 5. After administering an IV push medication, what is the nurse’s next priority action? A. Document the administration and patient’s response immediately. B. Reassess the patient within 30 minutes for any adverse reactions. C. Increase the primary IV flow rate to clear the line. D. Disconnect the primary IV line to observe for side effects. Correct Answer: B. Reassess the patient within 30 minutes for any adverse reactions. Rationale: Monitoring the patient’s response within 30 minutes is essential to detect any potential adverse reactions. Documentation is also important but should be done after patient assessment. 6. The nurse is discontinuing a patient’s IV. Which action is correct to ensure patient safety? A. Apply pressure to the IV site with a sterile gauze immediately after removing the catheter. B. Remove the catheter quickly and avoid applying pressure. C. Leave the dressing on without pressure to avoid bleeding. D. Apply an antiseptic solution after removing the catheter but skip gauze pressure. Correct Answer: A. Apply pressure to the IV site with a sterile gauze immediately after removing the catheter. Rationale: Applying pressure with sterile gauze after catheter removal helps prevent bleeding and ensures proper closure of the site. This step is critical in preventing hematoma or further complications. 7. A nurse is educating a patient about the use of an infusion pump. Which statement by the nurse is most accurate? A. “The pump infuses fluids using gravity, so the rate might vary.” B. “The infusion pump has alarms that will alert us if there is an issue.” C. “This pump does not need programming since it infuses automatically.” D. “Infusion pumps are less accurate than gravity-controlled IV therapy.” Correct Answer: B. “The infusion pump has alarms that will alert us if there is an issue.” Rationale: Infusion pumps are designed to administer fluids accurately and will alert the nurse if there is a problem. Gravity-based systems are less controlled, and pumps require programming to achieve the prescribed infusion rate. IV Complications: 1. A patient receiving IV therapy shows signs of infiltration, including swelling, pallor, and coolness around the insertion site. What is the nurse’s first intervention? A. Apply a cold compress to the area to reduce swelling. B. Elevate the extremity and continue to monitor the site. C. Discontinue the IV infusion and catheter. D. Slow down the IV infusion rate to prevent further complications. Correct Answer: C. Discontinue the IV infusion and catheter. Rationale: When signs of infiltration are present, the IV infusion should be stopped immediately, and the catheter should be removed to prevent further leakage of fluid into surrounding tissues. Elevating the extremity can follow as a supportive measure. 2. A nurse is caring for a patient with an IV vesicant medication. The patient’s IV site shows redness, swelling, and signs of extravasation. What is the appropriate intervention? A. Apply a cold compress and discontinue the IV line. B. Flush the IV line with saline and observe for improvement. C. Lower the affected extremity and monitor closely. D. Apply warm compresses and increase the infusion rate. Correct Answer: A. Apply a cold compress and discontinue the IV line. Rationale: In cases of extravasation with vesicant drugs, the IV infusion should be stopped immediately, and cold compresses are often used to minimize tissue damage. Warm compresses should be used only when indicated based on the specific medication. 3. A patient receiving IV therapy suddenly exhibits symptoms of fluid overload, including shortness of breath, distended neck veins, and crackles in the lungs. What is the nurse’s priority action? A. Stop the IV infusion and administer diuretics. B. Slow down the IV infusion and elevate the head of the bed. C. Call the physician and decrease the flow rate. D. Check the patient’s blood pressure and continue the infusion. Correct Answer: B. Slow down the IV infusion and elevate the head of the bed. Rationale: In the case of fluid overload, the priority intervention is to reduce the infusion rate to prevent further overload and to elevate the head of the bed to ease breathing. Diuretics should only be administered if ordered by a physician. 4. A nurse assesses a patient’s IV site and notes redness, warmth, and tenderness along the vein’s path. The patient reports a throbbing sensation at the site. Which complication does this indicate? A. Infiltration B. Extravasation C. Phlebitis D. Hematoma Correct Answer: C. Phlebitis Rationale: Phlebitis is characterized by inflammation, warmth, and tenderness along the vein, often accompanied by pain or throbbing. This is typically due to mechanical or chemical irritation from the IV catheter or infused solution. 5. While discontinuing a patient’s IV line, the nurse observes that the catheter tip appears incomplete. What should the nurse do next? A. Apply pressure to the site and monitor the patient. B. Save the catheter tip and notify the physician. C. Flush the site to ensure no debris remains in the vein. D. Apply a warm compress to prevent further complications. Correct Answer: B. Save the catheter tip and notify the physician. Rationale: An incomplete catheter tip may indicate catheter embolism, which is a serious complication. The nurse should save the catheter tip and contact the physician immediately for further evaluation. 6. A patient receiving IV therapy presents with erythema, heat, and purulent drainage at the insertion site. Systemically, the patient has a fever and chills. What complication is most likely occurring? A. Hematoma B. Cellulitis (infection) C. Phlebitis D. Circulatory overload Correct Answer: B. Cellulitis (infection) Rationale: The presence of erythema, heat, and purulent drainage, along with systemic symptoms like fever and chills, suggests cellulitis or an infection at the catheter site. 7. A nurse notes a small hematoma forming at an IV insertion site after catheter removal. What intervention should the nurse implement? A. Apply a cold compress to reduce bleeding. B. Elevate the extremity to decrease blood flow to the site. C. Apply pressure with a sterile gauze pad until the bleeding stops. D. Massage the area to disperse the hematoma. Correct Answer: C. Apply pressure with a sterile gauze pad until the bleeding stops. Rationale: Applying continuous pressure to the site helps control bleeding and prevent further hematoma formation. Massaging the area is contraindicated as it may worsen the hematoma.