LVN IV Therapy & Fluid Management 3 — Questions and Answers
Question 1: A patient is receiving D5W 1000 mL IV. As the dextrose is metabolized, this solution becomes functionally equivalent to which type of fluid?
- Isotonic saline
- Hypertonic solution
- Free water (hypotonic) (Correct answer)
- Colloid solution
Correct answer: Free water (hypotonic)
Once dextrose is metabolized, D5W leaves only free water, making it effectively a hypotonic solution that distributes throughout all body compartments.
Question 2: The physician orders potassium chloride 40 mEq in 100 mL NS to infuse over 1 hour. What is the priority nursing action before administration?
- Verify the patient has adequate urine output (Correct answer)
- Administer via IV push for fastest delivery
- Refrigerate the solution until infusion time
- Give a fluid bolus of 500 mL NS first
Correct answer: Verify the patient has adequate urine output
Adequate urine output (≥30 mL/hr) confirms renal function, preventing dangerous hyperkalemia from KCl administration.
Question 3: When inserting a peripheral IV catheter, at what angle should the needle initially enter the skin?
- 5–10 degrees
- 15–30 degrees (Correct answer)
- 45 degrees
- 90 degrees
Correct answer: 15–30 degrees
A 15–30 degree angle is recommended for peripheral IV insertion to enter the vein without passing through the posterior wall.
Question 4: A patient has a central venous catheter (CVC). When changing the IV tubing, the patient should be positioned in which manner to prevent air embolism?
- High Fowler's with head elevated
- Trendelenburg or flat with Valsalva maneuver (Correct answer)
- Sitting upright with legs dangling
- Prone position
Correct answer: Trendelenburg or flat with Valsalva maneuver
Trendelenburg position or flat with a Valsalva maneuver increases intrathoracic pressure to prevent air from entering the central venous system.
Question 5: Which solution is hypertonic and draws fluid from cells into the vascular space?
- 0.9% NaCl
- Lactated Ringer's
- 3% NaCl (Correct answer)
- D5W
Correct answer: 3% NaCl
3% NaCl is a hypertonic solution with higher osmolality than plasma, pulling fluid from the intracellular and interstitial spaces into the vasculature.
Question 6: A patient receiving IV vancomycin develops flushing, erythema, and hypotension during the infusion. Which syndrome is most likely occurring?
- Anaphylaxis
- Red Man Syndrome (Correct answer)
- Septic shock
- Transfusion reaction
Correct answer: Red Man Syndrome
Red Man Syndrome is a non-immune infusion reaction to vancomycin characterized by flushing, erythema on the neck and face, and hypotension due to rapid infusion.
Question 7: Which finding would indicate that a patient's IV site should be discontinued and restarted?
- Blood return present when the catheter is aspirated
- Infusion flowing freely without resistance
- Swelling and coolness at the insertion site (Correct answer)
- Patient reports mild pressure at the site during flushing
Correct answer: Swelling and coolness at the insertion site
Swelling and coolness at the IV site indicate infiltration, where fluid is infusing into tissue rather than the vein.
LVN IV Therapy & Fluid Management 3
A patient is receiving D5W 1000 mL IV.
As the dextrose is metabolized, this solution becomes functionally equivalent to which type of fluid?