LPN IV Therapy and Fluid Management 3 — Questions and Answers
Question 1: Which IV access site is MOST appropriate for a patient who needs a long-term continuous infusion of a vesicant chemotherapy agent?
- Peripheral IV in the antecubital fossa
- Central venous catheter (CVC) (Correct answer)
- Scalp vein in an adult
- Short peripheral catheter in the hand
Correct answer: Central venous catheter (CVC)
Vesicant drugs must be infused via a central venous catheter to reduce the risk of severe tissue damage from extravasation.
Question 2: A patient receiving IV fluids develops crackles in the lungs, jugular vein distention, and sudden weight gain. What complication is occurring?
- Dehydration
- Hypovolemia
- Circulatory overload (Correct answer)
- Septicemia
Correct answer: Circulatory overload
Crackles, JVD, and rapid weight gain are classic signs of circulatory (fluid) overload from excessive IV fluid infusion.
Question 3: The nurse is preparing to change IV tubing. How often should standard primary IV administration sets be routinely changed per CDC guidelines?
- Every 24 hours
- Every 48 hours
- Every 96 hours (Correct answer)
- Every 7 days
Correct answer: Every 96 hours
CDC guidelines recommend changing primary and secondary administration sets no more frequently than every 96 hours (4 days) unless clinically indicated.
Question 4: A patient with a peripheral IV complains of pain, and the nurse notices the infusion is not flowing well. The area is cool and pale with swelling. Which condition is present?
- Phlebitis
- Infiltration (Correct answer)
- Thrombosis
- Air embolism
Correct answer: Infiltration
Infiltration occurs when IV fluid leaks into surrounding tissue, causing coolness, pallor, swelling, and impaired flow.
Question 5: Which laboratory value should the LPN monitor most closely in a patient receiving a rapid infusion of 0.9% NaCl?
- Blood glucose
- Serum sodium (Correct answer)
- Serum potassium
- Serum calcium
Correct answer: Serum sodium
Rapid infusion of normal saline can elevate serum sodium, requiring close monitoring to detect hypernatremia.
Question 6: The LPN notes that a patient's PICC line dressing is moist and the site appears red. What is the priority action?
- Apply an additional dressing over the existing one
- Reinforce the dressing and notify the RN
- Remove and replace the dressing using sterile technique (Correct answer)
- Flush the PICC line and continue monitoring
Correct answer: Remove and replace the dressing using sterile technique
A compromised PICC dressing must be removed and replaced using sterile technique immediately to prevent central line-associated bloodstream infection (CLABSI).
Question 7: Which action is MOST important before administering any IV medication through a peripheral IV site?
- Confirm the medication is at room temperature
- Check the IV site for patency and signs of infiltration (Correct answer)
- Verify the IV bag has at least 50 mL remaining
- Prime the tubing with the medication
Correct answer: Check the IV site for patency and signs of infiltration
Verifying IV site patency ensures medication delivers properly and prevents extravasation or infiltration injury.
LPN IV Therapy and Fluid Management 3
Which IV access site is MOST appropriate for a patient who needs a long-term continuous infusion of a vesicant chemotherapy agent?