LPN IV Therapy and Fluid Management

Question 1

A client's IV site is red, warm, painful, and has a palpable cord along the vein. The LPN should document this as:

Accepted Answer

Phlebitis

Answer

Infiltration

Answer

Thrombosis

Answer

Cellulitis

Question 2

A client receiving IV vancomycin develops flushing, erythema, and pruritus on the face and neck during the infusion. The LPN recognizes this as:

Accepted Answer

Red Man Syndrome — an infusion-rate reaction requiring slowing the infusion

Answer

An anaphylactic allergic reaction requiring epinephrine

Answer

Vancomycin toxicity requiring the dose to be held

Answer

A normal expected side effect requiring no intervention

Question 3

The LPN is calculating an IV flow rate. An order reads: Infuse 1,000 mL 0.9% NaCl over 8 hours. The drip factor is 20 gtts/mL. What is the correct flow rate in gtts/min?

Accepted Answer

42 gtts/min

Answer

20 gtts/min

Answer

30 gtts/min

Answer

50 gtts/min

Question 4

A client is receiving a blood transfusion. After 15 minutes, the client develops a temperature of 38.7°C (101.7°F), chills, and back pain. The LPN's first action is:

Accepted Answer

Stop the transfusion immediately, keep the IV line open with normal saline, and notify the charge nurse

Answer

Slow the transfusion rate and monitor closely

Answer

Administer acetaminophen and continue the transfusion

Answer

Increase the transfusion rate to complete the unit quickly before the reaction worsens

Question 5

A client has a peripheral IV infusing. The nurse notices the infusion site is cool, pale, puffy, and non-painful. The LPN documents this as:

Accepted Answer

Infiltration

Answer

Phlebitis grade 2

Answer

Extravasation of a vesicant

Answer

Local infection

Question 6

A client is prescribed D5W (5% dextrose in water) 500 mL IV. The LPN understands this solution is classified as:

Accepted Answer

Isotonic in the bag, but becomes hypotonic once infused as the dextrose is metabolized

Answer

Hypertonic, pulling fluid from tissues into the vascular space

Answer

Isotonic that distributes evenly throughout the body without shifting fluid

Answer

Hypertonic in the bag but isotonic once dextrose is metabolized

Question 7

The LPN is flushing a client's intermittent IV access device (saline lock) before medication administration. The appropriate flushing technique is:

Accepted Answer

Flush with 3–5 mL normal saline, administer medication, then flush with 3–5 mL normal saline (SASH if heparin ordered)

Answer

Flush with heparin 100 units/mL before and after medication

Answer

Use sterile water to flush the saline lock before medication

Answer

Flush with 10 mL D5W before each medication to prevent precipitate

Question 8

A client with heart failure is receiving IV fluids ordered at 250 mL/hr. Two hours into the infusion, the client develops worsening dyspnea and oxygen saturation drops from 98% to 91%. The LPN should:

Accepted Answer

Slow the IV infusion, sit the client upright, apply oxygen, and immediately notify the charge nurse

Answer

Continue the infusion as ordered and reassess in 1 hour

Answer

Increase the IV rate to improve cardiac output

Answer

Remove the IV line and call the provider for new orders

Question 9

A client requires a central venous catheter (CVC) insertion. Which position and preparation reduces air embolism risk during insertion?

Accepted Answer

Place in Trendelenburg position (head lower than feet) and have the client hold breath during insertion

Answer

Elevate the head of bed 45 degrees and have the client perform the Valsalva maneuver

Answer

Place the client flat and have them breathe deeply during needle insertion

Answer

Sit the client at 90 degrees and turn the head toward the insertion site

Question 10

A client is receiving potassium chloride (KCl) 40 mEq IV. The LPN knows that this infusion must:

Accepted Answer

Never exceed a rate of 10–20 mEq/hour for peripheral IV infusion

Answer

Be given as an IV bolus for rapid correction of severe hypokalemia

Answer

Be mixed in D5W to prevent vein irritation

Answer

Be administered undiluted through a central line