LPN IV Therapy and Fluid Management 2 — Questions and Answers
Question 1: A patient's IV site shows redness, warmth, and a palpable cord along the vein. Which condition does this describe?
- Infiltration
- Phlebitis (Correct answer)
- Air embolism
- Extravasation
Correct answer: Phlebitis
Phlebitis presents with redness, warmth, swelling, and a palpable cord (hardened vein) along the IV site.
Question 2: The LPN is hanging a new IV bag of D5W. Which electrolyte imbalance is a risk with prolonged D5W infusion?
- Hyperkalemia
- Hypernatremia
- Hyponatremia (Correct answer)
- Hypercalcemia
Correct answer: Hyponatremia
Prolonged D5W infusion can dilute serum sodium levels, leading to hyponatremia (dilutional).
Question 3: A patient receiving IV potassium chloride reports burning at the IV site. What is the priority nursing action?
- Stop the infusion and remove the IV
- Slow the infusion rate (Correct answer)
- Apply a warm compress over the site
- Dilute the solution further
Correct answer: Slow the infusion rate
Slowing the infusion rate reduces the burning sensation; potassium is irritating to veins and must never be given as an IV push.
Question 4: Which IV fluid is classified as an isotonic crystalloid solution?
- 0.45% NaCl
- D5W
- 0.9% NaCl (Correct answer)
- 3% NaCl
Correct answer: 0.9% NaCl
0.9% NaCl (normal saline) is isotonic, with an osmolarity close to plasma (~308 mOsm/L).
Question 5: A patient develops sudden dyspnea, hypotension, and a 'churning' heart sound during IV therapy. Which complication is most likely?
- Fluid overload
- Air embolism (Correct answer)
- Septicemia
- Phlebitis
Correct answer: Air embolism
Air embolism presents with sudden dyspnea, hypotension, chest pain, and a characteristic 'millwheel' murmur.
Question 6: When calculating IV flow rate using a standard macrodrip tubing (10 gtt/mL), how many drops per minute are needed to infuse 500 mL over 4 hours?
- 12 gtt/min
- 21 gtt/min (Correct answer)
- 35 gtt/min
- 42 gtt/min
Correct answer: 21 gtt/min
500 mL ÷ 4 hr = 125 mL/hr; 125 × 10 ÷ 60 = 20.8 ≈ 21 gtt/min.
Question 7: The LPN notes that a patient's urine output has been less than 30 mL/hour for 2 consecutive hours during IV fluid therapy. What should the nurse do first?
- Increase the IV rate immediately
- Assess the patient for signs of dehydration or fluid overload (Correct answer)
- Document the finding and continue monitoring
- Insert a urinary catheter
Correct answer: Assess the patient for signs of dehydration or fluid overload
Urine output below 30 mL/hr may indicate inadequate perfusion or fluid imbalance, requiring immediate patient assessment before any intervention.
LPN IV Therapy and Fluid Management 2
A patient's IV site shows redness, warmth, and a palpable cord along the vein.
Which condition does this describe?