Question 1

In what category of fluids does a 0.45% sodium chloride intravenous solution belong?

Accepted Answer

Answer reason: 0.45% NaCl (half-normal saline) has osmolality below plasma, so it is a hypotonic IV solution.

Question 2

A nurse is performing a venipuncture on an older adult client whose veins are difficult. Which of the following actions should the nurse take?

Accepted Answer

Answer reason: For difficult venous access, avoid cool compresses (vasoconstriction) and elevation (reduces venous filling). A gentle tap can help dilate and locate a vein. Raising the catheter to a 30° angle increases risk of going through fragile veins; use a lower angle.

Question 3

What is the correct angle for IV injection?

Accepted Answer

Answer reason: Peripheral IV cannulation is done at a shallow angle, typically 10–30 degrees; among the options, 30 degrees is correct. 90° is for IM and 45° is for subcutaneous injections.

Question 4

Which of the following gauge sizes is typically associated with pink-colored IV cannulas?

Accepted Answer

Answer reason: Standard peripheral IV color coding associates pink with 20-gauge catheters. These are commonly used for routine infusions and blood sampling, balancing flow with vessel preservation. 16G and 12G are much larger gauges for rapid fluid or blood resuscitation, and 22G (blue) is smaller for fragile veins. Therefore, pink corresponds to 20G.

Question 5

Which Cannula size is used for infants?

Accepted Answer

Answer reason: Infants have small, fragile peripheral veins, so the smallest practical gauge should be used to minimize trauma while permitting adequate flow. A 24‑gauge cannula is the standard choice for neonates and young infants for maintenance fluids and most medications. A 26‑gauge may be used for extremely small or preterm neonates, whereas 18‑ and 20‑gauge catheters are intended for adults or rapid, high-volume infusions.

Question 6

For IV cannula insertion in adults, the angle is usually?

Accepted Answer

Answer reason: Peripheral IV cannulation is begun with the needle bevel up at a shallow angle—about 15–30°—to enter the superficial vein without puncturing through the posterior wall. Once flashback is seen, the angle is lowered and the catheter advanced. Steeper angles such as 45°, 60°, or 90° increase the risk of transfixing the vein and are not recommended for routine adult IV insertion.

Question 7

Intravenous injections are usually given at what angle?

Accepted Answer

Answer reason: For peripheral IV venipuncture, the needle is inserted bevel-up at a shallow angle, typically 15–30°, to enter the superficial vein without puncturing through the opposite wall. A 45° angle is used more commonly for subcutaneous injections when needed, and 90° is typical for intramuscular injections. Therefore, 15–25° is the best choice among the options.

Question 8

Which among the following is an example of an isotonic intravenous solution?

Accepted Answer

Answer reason: Lactated Ringer's is an isotonic crystalloid with an osmolarity close to plasma and is commonly used for fluid resuscitation. Dextrose 10% is hypertonic. 0.45% NaCl is hypotonic. Dextrose normal saline (D5NS) is considered hypertonic in the bag.

Question 9

Ringer’s Lactate Intravenous infusion solution does not contain which of the following?

Accepted Answer

Answer reason: Lactated Ringer’s contains sodium, chloride, potassium, and calcium with lactate as a buffer. It does not contain bicarbonate; instead the lactate is metabolized (primarily in the liver) to bicarbonate, exerting an alkalinizing effect. Therefore sodium, chloride, and potassium are present, while bicarbonate is not.

Question 10

A physician orders Lactated Ringer Solution to infuse at 125 cc/hour. This is an example of which type of solution?

Accepted Answer

Answer reason: Lactated Ringer’s is a balanced crystalloid with an osmolarity close to plasma, so it is classified as isotonic. Isotonic solutions primarily expand the extracellular/intravascular volume without causing significant fluid shifts across cell membranes. LR is commonly used for fluid resuscitation and perioperative replacement because of this property.

Question 11

Which fluid is most preferred for initial burn resuscitation?

Accepted Answer

Answer reason: Lactated Ringer’s is the recommended crystalloid for initial burn resuscitation (e.g., Parkland formula) because its electrolyte composition closely approximates plasma and the lactate acts as a buffer for metabolic acidosis. Large-volume normal saline can cause hyperchloremic metabolic acidosis. D5W and D10 are hypotonic/free-water solutions after metabolism and do not provide adequate intravascular volume expansion for resuscitation.

Question 12

What is the angle range for intravenous injection in the hand vein?

Accepted Answer

Answer reason: Peripheral IV cannulation in superficial hand veins is performed with the needle bevel up at a shallow angle, typically about 10–30 degrees to the skin. This permits entry into the superficial vein without transfixing it. Steeper angles (40–90 degrees) are used for deeper targets or intramuscular injections and increase the risk of piercing through the vein. Therefore, the correct range is 10–30 degrees.

Question 13

Which colour cannula is 24 gauge?

Accepted Answer

Answer reason: IV cannula sizes are color-coded: 24-gauge is yellow and is a small-bore catheter commonly used for pediatrics or fragile veins and slower infusions. By comparison, 22-gauge is blue, 20-gauge is pink, and 18-gauge is green. Thus, the 24G cannula corresponds to yellow.

Question 14

Which fluid is best in burn resuscitation?

Accepted Answer

Answer reason: For initial burn shock resuscitation, the preferred crystalloid is Lactated Ringer’s, as used in formulas like the Parkland regimen. LR is a balanced isotonic solution that better matches extracellular fluid losses and helps limit hyperchloremic metabolic acidosis compared with large-volume normal saline. D5W is not appropriate for intravascular volume expansion in acute resuscitation, and albumin is typically deferred until later (after the first 12–24 hours) when capillary leak improves.

Question 15

Which IV line is used for chemotherapy drugs?

Accepted Answer

Answer reason: Chemotherapy agents are often vesicants/irritants and can cause severe tissue injury if extravasation occurs, making reliable high-blood-flow access essential. Central venous access (e.g., PICC or other central lines) reduces the risk of infiltration and allows safer administration of concentrated or prolonged infusions. Peripheral IVs are generally avoided for vesicant chemotherapy unless specific protocols and agents permit. Arterial lines are for monitoring and blood sampling, not medication infusion.

Question 16

After IV cannulation, within how many days should the cannula be changed?

Accepted Answer

Answer reason: Peripheral intravenous (IV) cannulas are routinely replaced every 72–96 hours to reduce the risk of catheter-related infection and phlebitis, unless there are clinical indications to change it sooner (e.g., signs of infection, infiltration, occlusion, or patient discomfort). Evidence-based guidelines support this time frame as a balance between infection prevention and avoiding unnecessary venipunctures.

Question 17

The nurse is monitoring the status of a client's fat emulsion (lipid) infusion and notes that the infusion is 1 hour behind. Which action should the nurse take?

Accepted Answer

Answer reason: IV lipid emulsions should be administered at the prescribed rate because rapid infusion can increase the risk of adverse effects (e.g., fat overload, respiratory compromise) and can worsen intolerance. Being behind schedule is not a reason to “catch up” by increasing the rate unless a provider specifically changes the order. The safest nursing action is to verify the infusion is running correctly at the ordered rate (and then assess for problems such as IV patency, pump function, or interruptions). Options that speed up the infusion to make up time introduce unnecessary risk without an order.

Question 18

A nurse notes a patient's IV site is red, warm, and painful with a red streak up the arm. What is the best action?

Accepted Answer

Answer reason: Redness, warmth, pain, and streaking indicate thrombophlebitis. The IV must be discontinued immediately to prevent complications, and a warm compress promotes circulation and comfort.

Question 19

Which complication follows rapid IV potassium infusion?

Accepted Answer

Answer reason: Rapid IV potassium administration can acutely raise serum potassium, precipitating dangerous cardiac conduction changes (peaked T waves, widened QRS) and malignant dysrhythmias. Severe hyperkalemia can rapidly progress to ventricular fibrillation or asystole, resulting in cardiac arrest. For this reason, potassium is never given IV push and is infused at controlled rates with cardiac monitoring when indicated. The other options are less characteristic and not the primary life-threatening complication of rapid IV potassium.

Question 20

Which solution is the only one compatible with the administration of blood products?

Accepted Answer

Answer reason: 0.9% normal saline is the standard compatible IV solution for priming blood tubing and co-infusing with blood products because it is isotonic and does not cause hemolysis or clotting. Dextrose-containing solutions (e.g., D5W) can lead to red blood cell hemolysis and RBC aggregation. Lactated Ringer’s contains calcium, which can interact with citrate anticoagulant in stored blood and increase the risk of clot formation in the line. Hypotonic solutions like 0.45% saline can promote osmotic swelling and hemolysis of red blood cells.

Question 21

A patient with a potassium level of 2.9 mEq/L is prescribed potassium chloride, 40 mEq I.V. The patient only has a peripheral I.V. The nurse should administer this medication?

Accepted Answer

Answer reason: With a peripheral IV, potassium chloride must be diluted and infused slowly to prevent vein irritation/phlebitis and to reduce the risk of dangerous dysrhythmias. A typical maximum rate for peripheral IV potassium is about 10 mEq/hr, so 40 mEq should take roughly 4 hours. Rapid IV push administration (e.g., over 5 minutes) is unsafe and can cause fatal arrhythmias. A central line may allow higher rates in emergencies with monitoring, but it is not required when an appropriate peripheral rate is used.

Question 22

After IV cannulation, within how many days should the cannula be changed?

Accepted Answer

Answer reason: Traditional NCLEX-style guidance recommends routine replacement of peripheral IV cannulas every 72–96 hours to reduce the risk of phlebitis and infection. Although many institutions now follow a “clinically indicated” policy, exam questions typically expect the 72–96-hour interval as the standard answer.

Question 23

IV infusion has stopped with cool, puffy swelling around the site. This suggests?

Accepted Answer

Answer reason: Coolness, pallor, and puffy edema at the IV insertion site with a slowed or stopped infusion are classic findings of infiltration (IV fluid leaking into surrounding tissue). Phlebitis typically causes warmth, redness, tenderness, and a palpable cord along the vein rather than cool swelling. Air embolism presents with acute respiratory/cardiovascular symptoms, not localized edema at the site. Atherosclerosis is a chronic arterial disease and does not explain an acute IV site change.

Question 24

18 G Intravenous canula is used for?

Accepted Answer

Answer reason: An 18-gauge IV cannula is a large-bore catheter that allows higher flow rates, making it appropriate for rapid infusion of fluids and for blood product transfusion. Blood components are more viscous than many IV medications and benefit from a wider lumen to reduce shear stress and ensure adequate flow. IV medications can often be given through smaller gauges, while subcutaneous injections do not use an IV cannula. Newborns typically require much smaller gauges (e.g., 22–24G), not 18G.

Question 25

What is the best IV site for an emergency blood transfusion?

Accepted Answer

Answer reason:  Antecubital vein For an emergency blood transfusion, a large, easily accessible peripheral vein that can accommodate a large-bore cannula is preferred to maximize flow rate and reduce hemolysis risk. The antecubital veins (e.g., median cubital/cephalic) are typically larger and more robust than dorsal hand veins and are commonly used for rapid infusion. Foot veins are generally avoided due to higher risk of complications and poorer flow, and scalp veins are mainly considered in infants/children when other access is difficult. Therefore, the antecubital vein is the best site among the options for rapid transfusion.

Question 26

A nurse is caring for a patient with dehydration. Which IV fluid is most appropriate?

Accepted Answer

Answer reason: Normal saline (0.9% NaCl) 0.9% normal saline is an isotonic crystalloid that stays primarily in the intravascular and interstitial spaces, making it appropriate for volume replacement in dehydration/hypovolemia. D5W becomes hypotonic after dextrose is metabolized and provides mostly free water, so it is not ideal for initial volume resuscitation. Lactated Ringer’s is also isotonic and can be used for volume replacement, but normal saline is a standard first-line choice for uncomplicated dehydration and is compatible with many clinical situations.

Question 27

The nurse is working in Day Surgery and preparing to insert an IV line for a client. Which action is the priority during the insertion process?

Accepted Answer

Answer reason: Palpating the selected site for the presence of veins. Palpation and assessment of the intended site is the key priority to ensure the vein is suitable (patent, resilient, and appropriately sized) and to reduce complications such as infiltration, phlebitis, or failed cannulation. Choosing a site near a joint is incorrect because joint movement increases dislodgement and infiltration risk. Elevation generally decreases venous engorgement (dilation is better achieved with dependency/warmth), and a tourniquet should be snug enough to impede venous return but not applied tightly enough to occlude arterial flow or cause injury.

Question 28

A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep vein thrombosis. The nurse is told that the client's activated partial thromboplastin time (aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30 seconds. The nurse identifies these results as characteristic of which description?

Accepted Answer

Answer reason: Within the therapeutic range. With IV unfractionated heparin, the aPTT is typically targeted to about 1.5–2.5 times the client’s baseline (or control), depending on institutional protocol. The baseline aPTT is 30 seconds, so a therapeutic target would be roughly 45–75 seconds. An aPTT of 65 seconds falls within this therapeutic window, indicating appropriate anticoagulation for DVT treatment.

Question 29

A nurse is preparing to give a blood transfusion. Which solution should the nurse use to prime the blood administration set?

Accepted Answer

Answer reason: Normal saline 0.9% normal saline is the only compatible IV solution for priming blood administration tubing and for running with packed RBCs because it maintains isotonicity and does not cause hemolysis or clotting. Dextrose-containing solutions can hemolyze red blood cells. Lactated Ringer’s contains calcium, which can bind citrate anticoagulant in blood products and promote clot formation in the tubing; hypotonic solutions like half normal saline are also not used with blood.

Question 30

True or False Nurses should always administer IV potassium rapidly to correct hypokalemia?

Accepted Answer

Answer reason: False Rapid IV potassium administration can precipitate dangerous cardiac dysrhythmias and cardiac arrest, so it must be diluted and infused via a controlled pump within recommended rate limits. Potassium is a high-alert medication and typically requires ongoing ECG monitoring in higher-risk situations and reassessment of serum potassium and renal function. The urgency and route depend on severity, symptoms, and ability to tolerate oral replacement, not an “always rapid” approach.

Question 31

While a patient with ascites is receiving albumin, the planned therapeutic effect will be greater if the nurse regulates the infusion to flow?

Accepted Answer

Answer reason: Albumin is a colloid that increases plasma oncotic pressure and pulls fluid from the interstitial/third space back into the intravascular compartment. Infusing it slowly helps reduce the risk of circulatory overload and pulmonary edema as intravascular volume expands. Restricting additional oral/IV fluids helps prevent worsening volume overload while allowing the oncotic effect of albumin to mobilize ascitic fluid more effectively. Rapid infusion and liberal fluid intake both increase the chance of fluid shifts leading to hypertension, dyspnea, and heart failure exacerbation.

Question 32

What’s the best IV site for an emergency blood transfusion?

Accepted Answer

Answer reason: In an emergency transfusion, the priority is rapid delivery of high-volume blood products through a large, high-flow peripheral vein that can accommodate a large-bore catheter. The antecubital fossa veins are typically larger and more accessible for quick cannulation than dorsal hand, foot, or scalp veins, allowing faster infusion with lower resistance. Distal sites (hand/foot) are smaller and more prone to infiltration/occlusion and slower flow, and scalp veins are mainly reserved for infants/limited access situations.

Question 33

A nurse is caring for a patient receiving IV fluids. The patient suddenly develops swelling at the IV site, pain, and the area feels cool to touch. What is the best initial action?

Accepted Answer

Answer reason: These findings (swelling, pain, coolness) are most consistent with IV infiltration/extravasation. The priority is to prevent further fluid/medication from entering surrounding tissue, so the infusion must be stopped immediately. After stopping, the nurse would typically disconnect/aspirate if appropriate, remove the IV catheter per policy, elevate the extremity, and apply warm or cold compresses based on the solution and facility protocol. Provider notification may be needed for vesicants or significant injury but is not the first action.

Question 34

Scenario: A nurse is starting a new IV line on a patient receiving vancomycin. Which is the best site selection to reduce the risk of phlebitis?

Accepted Answer

Answer reason: Vancomycin is a vesicant/irritant that increases the risk of chemical phlebitis, so using a larger, straighter vein in the forearm helps improve hemodilution and reduces endothelial irritation. Forearm veins also allow better catheter stabilization and lower movement at the insertion site than hand or antecubital sites, decreasing mechanical phlebitis. The AC fossa is prone to kinking and irritation with elbow flexion, and dorsal hand veins are smaller and more fragile. Lower-extremity peripheral IV sites are generally avoided due to higher complication risk (e.g., thrombophlebitis) unless no upper-extremity access is available.

Question 35

Scenario: While administering IV fluids, the patient reports burning at the site and the nurse notices swelling and coolness. What is the first nursing action?

Accepted Answer

Answer reason: Burning, swelling, and coolness at an IV site are classic findings of infiltration/extravasation, indicating fluid is entering surrounding tissue rather than the vein. The priority is to immediately stop the infusion to prevent further tissue injury and worsening edema/compartment pressure. After stopping the IV, the nurse can elevate the extremity and apply appropriate compresses per policy and the type of infusate, and then restart IV access at a different site if needed.

Question 36

A nurse is caring for a client receiving IV dopamine for cardiogenic shock. Which finding requires immediate attention?

Accepted Answer

Answer reason: Dopamine is a vasoactive catecholamine, and infiltration/extravasation can cause intense local vasoconstriction leading to tissue ischemia and necrosis. This is a time-sensitive complication requiring immediate intervention (stop infusion, manage per protocol, and assess for antidote such as phentolamine when ordered). The other findings are expected or not immediately dangerous in cardiogenic shock on dopamine: improved urine output suggests better perfusion, BP 100/60 may be acceptable depending on target MAP, and HR 95 is not severe tachycardia.

Question 37

A nurse is administering potassium chloride (KCl) IV to a patient with hypokalemia. Which action is correct?

Accepted Answer

Answer reason: IV potassium is a high-alert medication because rapid administration can precipitate dangerous dysrhythmias and cardiac arrest. A controlled infusion rate of 10 mEq/hr is the standard maximum for routine peripheral IV replacement to reduce myocardial irritability and venous irritation. IV push potassium is unsafe and contraindicated due to the risk of sudden lethal hyperkalemia at the heart. The key nursing action is safe IV administration parameters rather than opioid-like monitoring for respiratory depression.

Question 38

Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working?

Accepted Answer

Answer reason: A smaller-than-expected drop indicates the pump is under-infusing or not delivering the programmed basal rate (e.g., occlusion, malfunction, or incorrect programming). By contrast, a 50 mL remaining volume at noon reflects a 50 mL decrease, which could occur with basal infusion plus patient-initiated PRN doses and does not by itself prove pump failure. Patient-reported pain or IV-site discomfort are important assessments, but they do not directly verify whether the pump’s mechanical delivery is occurring as programmed.

Question 39

The nurse monitors a client receiving potassium chloride via intravenous infusion and notices a red lump and swelling on one side of the arm. What is the most appropriate nursing action?

Accepted Answer

Answer reason: Potassium chloride is a vesicant/irritant, so localized redness, swelling, and a lump at the IV site suggests infiltration or phlebitis with risk of tissue injury. The priority is to immediately stop the infusing agent and discontinue the IV at that site to prevent further extravasation and worsening damage. Merely slowing the rate does not address the underlying loss of venous access integrity and allows continued exposure. Compresses may be used as a secondary intervention per protocol after stopping the infusion, but they are not the first/most appropriate action while the irritant is still running.

Question 40

The size of intravenous cannula used for neonates is?

Accepted Answer

Answer reason: A higher gauge number corresponds to a smaller external diameter, reducing venous trauma and lowering the risk of infiltration and phlebitis. In routine neonatal peripheral access, 24G is commonly selected because it balances ease of placement with adequate flow for typical maintenance fluids/medications. Larger-bore options (18–22G) are generally unnecessarily traumatic for neonatal veins and are reserved for exceptional circumstances where rapid high-volume resuscitation is required and access permits.

Question 41

You are caring for a patient who has been in a multiple trauma that has lead to severe blood loss. What type of device will you need to acquire to transfuse several units of blood quickly?

Accepted Answer

Answer reason: This is achieved with a pressure-assisted rapid infuser/infusion control device, which is specifically used to administer multiple units quickly during trauma resuscitation. A blood warmer is important to prevent hypothermia and dysrhythmias during massive transfusion, but it does not by itself ensure rapid delivery. Cardiac monitoring and pulse oximetry are supportive monitoring tools and do not accomplish the task of fast blood administration.

Question 42

A client who has a DVT is receiving a heparin infusion. Current lab values include aPTT of 40 seconds. Which of the following actions should the nurse implement?

Accepted Answer

Answer reason: Therapeutic IV unfractionated heparin is titrated to reach a target aPTT above baseline (commonly about 1.5–2.5 times control), indicating adequate anticoagulation to prevent clot extension. An aPTT of 40 seconds is typically subtherapeutic in most institutional protocols, so the infusion rate should be increased per the heparin nomogram to achieve the target range. Holding or decreasing the infusion is reserved for supratherapeutic aPTT or active bleeding, where hemorrhage risk outweighs benefit. Leaving the rate unchanged when subtherapeutic increases the risk of DVT propagation and embolization.

Question 43

A client who received chemotherapy through a peripherally inserted central catheter (PICC) 3 days ago reports pain and discomfort above the insertion site. Which of the following best describes this complication?

Accepted Answer

Answer reason: This is more consistent with a thrombotic complication than with local tissue leakage, because infiltration/extravasation typically causes swelling, tightness, and changes at or around the infusion site during/soon after infusion rather than proximal venous tenderness. Phlebitis alone involves venous inflammation (tenderness, warmth, erythema), but PICCs have a notable risk of catheter-associated thrombosis, making the combined process the best descriptor. The location “above” the site supports involvement of the vein pathway rather than subcutaneous tissue at the puncture site.

Question 44

Cannula size used in newborn baby is?

Accepted Answer

Answer reason: A 24-gauge catheter is commonly used in newborns because it fits small veins and reduces mechanical irritation compared with larger-bore cannulas. Larger gauges like 18G or 20G are typically reserved for rapid volume resuscitation in older children/adults and are generally inappropriate for routine neonatal IV access. Using a smaller gauge also improves the chance of successful cannulation and longer dwell time in neonatal peripheral lines.

Question 45

Which of these medication orders for a patient with a pulmonary embolism is more important to clarify with the prescribing physician before administration?

Accepted Answer

Answer reason: Heparin is a high-alert IV anticoagulant that should be ordered using a weight-based protocol (e.g., units/kg/hr) and titrated to aPTT/anti-Xa targets to prevent fatal bleeding or under-anticoagulation. A flat rate without the patient’s weight and titration parameters is unsafe and requires clarification before starting the infusion. In contrast, morphine IV can be given within an ordered dose range while monitoring respiratory status, and warfarin may be initiated for longer-term anticoagulation without the same immediate titration requirements. Cephalexin is not a standard PE therapy but is not inherently dangerous from the order format alone compared with a non-protocol heparin infusion.

Question 46

The emergency department (ED) nurse cares for an adult client with suspected shock who is prescribed a large volume of sodium chloride (normal saline). The nurse plans on starting which gauge peripheral vascular access device?

Accepted Answer

Answer reason: A larger-bore peripheral IV (lower gauge number) provides less resistance and supports faster infusion of large volumes of isotonic crystalloid. An 18-gauge catheter is a standard large-bore choice for adult resuscitation when 16-gauge is not offered, enabling efficient bolus administration. Smaller catheters like 22–26 gauge significantly limit flow and are better suited for slow infusions or fragile veins, not high-volume resuscitation.

Question 47

Infant with a body weight of 10 kg is kept NPO for surgery. How much IV fluid should be administered per hour to this infant?

Accepted Answer

Answer reason: For the first 10 kg of body weight, the rate is 4 mL/kg/hr. At 10 kg, this equals 4 × 10 = 40 mL/hr. The 80 mL/hr choice aligns with using the 100/50/20 daily method without correctly converting or with an incorrect doubling of the hourly rate, so it is not consistent with standard maintenance calculations.

Question 48

A 6-year-old female client is in need of an intravenous line and fluid infusion. Which over-the-needle intravenous catheter is an appropriate size for this client?

Accepted Answer

Answer reason: Pediatric IV therapy prioritizes selecting the smallest gauge that will reliably deliver the prescribed fluids while minimizing vessel trauma and infiltration risk. A 20-gauge catheter is commonly appropriate for school-aged children for routine fluid infusion because it balances adequate flow with a size that fits smaller peripheral veins. Larger-bore catheters (18, 16, 14 gauge) are typically reserved for rapid volume resuscitation, major trauma, or situations requiring very high flow rates and are often too large for typical pediatric peripheral access. Using an unnecessarily large catheter increases pain, venous irritation, and the likelihood of failed insertion or complications.

Question 49

A client receives an intravenous fluid infusion at a rate of 20 milliliters per hour. The tubing attached to the bag of fluid is microdrip tubing. How many drops per milliliter does this tubing provide?

Accepted Answer

Answer reason: Microdrip (microgtt) IV tubing has a standardized drop factor used for precise low-rate infusions. The drop factor for microdrip sets is 60 drops per mL, which allows the mL/hr rate to match gtt/min numerically (e.g., 20 mL/hr equals 20 gtt/min). The other values (10, 12, 15) are typical macrodrip tubing drop factors used for faster infusions and are not considered microdrip. Therefore the correct drop factor for microdrip tubing is 60 gtt/mL.

Question 50

When inserting an intravenous needle peripherally, the nurse should insert the needle at which angle?

Accepted Answer

Answer reason: Peripheral IV cannulation uses a shallow insertion angle to enter a superficial vein without piercing through the posterior wall. Starting around 15–30° allows the catheter tip to access the vein lumen when a flashback is obtained, after which the angle is lowered to advance safely. Steeper angles increase the risk of transfixing the vein and causing infiltration or hematoma. This is a core technique/safety question about proper IV insertion mechanics and complication prevention.

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In what category of fluids does a 0.45% sodium chloride intravenous solution belong?

A nurse is performing a venipuncture on an older adult client whose veins are difficult. Which of the following actions should the nurse take?

What is the correct angle for IV injection?

Which of the following gauge sizes is typically associated with pink-colored IV cannulas?

Which Cannula size is used for infants?

For IV cannula insertion in adults, the angle is usually?

Intravenous injections are usually given at what angle?

Which among the following is an example of an isotonic intravenous solution?

Ringer’s Lactate Intravenous infusion solution does not contain which of the following?

A physician orders Lactated Ringer Solution to infuse at 125 cc/hour. This is an example of which type of solution?

Which fluid is most preferred for initial burn resuscitation?

What is the angle range for intravenous injection in the hand vein?

Which colour cannula is 24 gauge?

Which fluid is best in burn resuscitation?

Which IV line is used for chemotherapy drugs?

After IV cannulation, within how many days should the cannula be changed?

The nurse is monitoring the status of a client's fat emulsion (lipid) infusion and notes that the infusion is 1 hour behind. Which action should the nurse take?

A nurse notes a patient's IV site is red, warm, and painful with a red streak up the arm. What is the best action?

Which complication follows rapid IV potassium infusion?

Which solution is the only one compatible with the administration of blood products?

A patient with a potassium level of 2.9 mEq/L is prescribed potassium chloride, 40 mEq I.V. The patient only has a peripheral I.V. The nurse should administer this medication?

After IV cannulation, within how many days should the cannula be changed?

IV infusion has stopped with cool, puffy swelling around the site. This suggests?

18 G Intravenous canula is used for?

What is the best IV site for an emergency blood transfusion?

A nurse is caring for a patient with dehydration. Which IV fluid is most appropriate?

The nurse is working in Day Surgery and preparing to insert an IV line for a client. Which action is the priority during the insertion process?

A nurse is preparing to give a blood transfusion. Which solution should the nurse use to prime the blood administration set?

True or False Nurses should always administer IV potassium rapidly to correct hypokalemia?

While a patient with ascites is receiving albumin, the planned therapeutic effect will be greater if the nurse regulates the infusion to flow?

What’s the best IV site for an emergency blood transfusion?

A nurse is caring for a patient receiving IV fluids. The patient suddenly develops swelling at the IV site, pain, and the area feels cool to touch. What is the best initial action?

Scenario: A nurse is starting a new IV line on a patient receiving vancomycin. Which is the best site selection to reduce the risk of phlebitis?

Scenario: While administering IV fluids, the patient reports burning at the site and the nurse notices swelling and coolness. What is the first nursing action?

A nurse is caring for a client receiving IV dopamine for cardiogenic shock. Which finding requires immediate attention?

A nurse is administering potassium chloride (KCl) IV to a patient with hypokalemia. Which action is correct?

Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working?

The nurse monitors a client receiving potassium chloride via intravenous infusion and notices a red lump and swelling on one side of the arm. What is the most appropriate nursing action?

The size of intravenous cannula used for neonates is?

You are caring for a patient who has been in a multiple trauma that has lead to severe blood loss. What type of device will you need to acquire to transfuse several units of blood quickly?

A client who has a DVT is receiving a heparin infusion. Current lab values include aPTT of 40 seconds. Which of the following actions should the nurse implement?

A client who received chemotherapy through a peripherally inserted central catheter (PICC) 3 days ago reports pain and discomfort above the insertion site. Which of the following best describes this complication?

Cannula size used in newborn baby is?

Which of these medication orders for a patient with a pulmonary embolism is more important to clarify with the prescribing physician before administration?

The emergency department (ED) nurse cares for an adult client with suspected shock who is prescribed a large volume of sodium chloride (normal saline). The nurse plans on starting which gauge peripheral vascular access device?

Infant with a body weight of 10 kg is kept NPO for surgery. How much IV fluid should be administered per hour to this infant?

A 6-year-old female client is in need of an intravenous line and fluid infusion. Which over-the-needle intravenous catheter is an appropriate size for this client?

A client receives an intravenous fluid infusion at a rate of 20 milliliters per hour. The tubing attached to the bag of fluid is microdrip tubing. How many drops per milliliter does this tubing provide?

When inserting an intravenous needle peripherally, the nurse should insert the needle at which angle?

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