Intravenous Therapy Practice Test 4
Intravenous Therapy NCLEX Practice Test
Intravenous Therapy is a key topic within the NCLEX test plan, located under Physiological Integrity → Pharmacological and Parenteral Therapies → Intravenous Therapy. This section manages IV fluids, site assessment, and complication prevention to maintain vascular integrity. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 4th part of the Intravenous Therapy series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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Intravenous Therapy Practice Test 4
The nurse is monitoring the status of a client's fat emulsion (lipid) infusion and notices that the infusion is 1 hour behind. Which action should the nurse take?
- Adjust the infusion rate to catch up over the next hour.
- Increase the infusion rate to catch up over the next 2 hours.
- Ensure that the fat emulsion infusion rate is infusing at the prescribed rate.
- Adjust the infusion rate to run wide open until the solution is back on time.
Explanation: Answer reason: IV lipid emulsions should be infused at an ordered rate because rapid infusion increases the risk of adverse effects such as fat overload syndrome and metabolic/respiratory complications. When an infusion is behind schedule, the safe first step is to verify the pump settings and assess for causes (e.g., occlusion, infiltration, tubing/pump error) rather than compensating by speeding up delivery. “Catching up” by increasing the rate or running the infusion wide open can deliver an unintended bolus and exceed recommended hourly limits. Maintaining the prescribed rate supports safe, controlled administration and prompts correction of the underlying issue.
The nurse is assessing a client's peripheral intravenous (IV) site after completion of a vancomycin infusion and notes that the area is reddened, warm, painful, and slightly edematous proximal to the insertion point of the IV catheter. At this time, which action by the nurse is best?
- Check for the presence of blood return.
- Remove the IV site and restart at another site.
- Document the findings and continue to monitor the IV site.
- Call the health care provider (HCP) and request that the vancomycin be given orally.
Explanation: Answer reason: The findings (redness, warmth, pain, and edema tracking proximal to the insertion site) are most consistent with phlebitis and/or infiltration related to peripheral IV therapy. The safest immediate nursing action is to stop using the affected vein by discontinuing the catheter, because continuing infusion can worsen tissue injury and inflammation. Restarting at a new site preserves venous access while preventing further damage at the compromised site. Merely checking for blood return or continuing to monitor delays definitive management, and requesting oral vancomycin is not an appropriate first response because it does not address the local IV complication and oral vancomycin is typically reserved for specific indications (e.g., C. difficile colitis).
Which of the following injection should not mixed with dopamine for infusion through a central line?
- Potassium chloride
- Calcium gluconate
- Soda bicarbonate
- Dobutamine
Explanation: Answer reason: Dopamine is unstable in alkaline solutions, and sodium bicarbonate raises pH, which can inactivate the catecholamine and/or cause incompatibility in the line. This can lead to reduced therapeutic effect and potential line occlusion. In contrast, electrolytes like potassium chloride are commonly Y-sited with many fluids when verified compatible and do not have the same strong alkalinizing effect that drives dopamine instability.
A patient with ventricular tachycardia has been ordered to receive IV (intravenous) lidocaine. What does the nurse dilute the lidocaine solution with?
- Normal Saline 0.9%.
- 5% Dextrose in water.
- Normal Saline 0.45%.
- Lactated Ringers.
Explanation: Answer reason: IV lidocaine infusions are prepared in compatible diluents to maintain drug stability and prevent precipitation or loss of potency during administration. Dextrose 5% in water is a standard compatible diluent for lidocaine continuous infusion used for ventricular dysrhythmias. Using an incompatible solution risks reduced therapeutic effect or infusion complications, which is especially unsafe when treating ventricular tachycardia. Normal saline or lactated Ringer’s may be used for many IV drugs, but for lidocaine infusion D5W is the commonly specified compatible diluent in clinical practice and exam references.
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