LVN IV Therapy & Fluid Management 4 — Questions and Answers
Question 1: According to INS guidelines, peripheral IV catheters in adults should be routinely assessed for site rotation every how many hours?
- 24 hours
- 48 hours
- 72–96 hours (Correct answer)
- 7 days
Correct answer: 72–96 hours
INS guidelines recommend assessing peripheral IV sites every 72–96 hours and rotating as needed to prevent phlebitis and infection.
Question 2: A patient receiving IV fluids develops sudden onset dyspnea, crackles, and an S3 heart sound. Which fluid-related complication is most likely?
- Dehydration
- Circulatory overload (TACO) (Correct answer)
- Hypokalemia
- Air embolism
Correct answer: Circulatory overload (TACO)
Transfusion-Associated Circulatory Overload (TACO) or fluid volume excess presents with dyspnea, crackles, and S3 gallop due to too-rapid IV fluid administration.
Question 3: Which action is essential before initiating any blood product transfusion to ensure patient safety?
- Warm the blood to body temperature in a microwave
- Have two nurses verify the patient's name and blood type against the unit label (Correct answer)
- Administer diphenhydramine prophylactically to all patients
- Use a 22-gauge catheter to slow the infusion rate
Correct answer: Have two nurses verify the patient's name and blood type against the unit label
Two-nurse verification of patient identity and blood product compatibility is the critical safety step to prevent potentially fatal transfusion errors.
Question 4: A patient's serum sodium is 128 mEq/L. Which clinical manifestations would the LVN expect?
- Extreme thirst, dry mucous membranes, and confusion
- Nausea, headache, lethargy, and muscle cramps (Correct answer)
- Polyuria, hypertension, and tachycardia
- Tetany, positive Chvostek sign, and seizures
Correct answer: Nausea, headache, lethargy, and muscle cramps
Hyponatremia (Na+ < 135 mEq/L) causes nausea, headache, lethargy, muscle cramps, and in severe cases seizures due to cerebral edema.
Question 5: An IV infusion pump alarm sounds indicating 'occlusion.' What should the LVN check first?
- Increase the infusion rate to overcome resistance
- Check for kinks in the tubing, a closed clamp, or positional obstruction (Correct answer)
- Remove the catheter and apply pressure
- Administer a heparin flush of 10 units/mL
Correct answer: Check for kinks in the tubing, a closed clamp, or positional obstruction
Occlusion alarms most commonly result from kinked tubing, a closed roller clamp, or positional obstruction that the nurse should systematically assess.
Question 6: Which IV solution is used primarily for patients with increased intracranial pressure to reduce cerebral edema?
- Lactated Ringer's
- 0.45% NaCl
- D5W
- Mannitol 20% (Correct answer)
Correct answer: Mannitol 20%
Mannitol is an osmotic diuretic that draws fluid from brain cells into the vasculature, reducing intracranial pressure and cerebral edema.
Question 7: When flushing a saline lock (intermittent IV device), which technique prevents blood reflux into the catheter?
- Flush rapidly with 20 mL of NS
- Use positive pressure technique while withdrawing the syringe (Correct answer)
- Remove the syringe before completing the flush
- Flush only with heparin solution 100 units/mL
Correct answer: Use positive pressure technique while withdrawing the syringe
Positive pressure technique (maintaining forward pressure on the plunger while disconnecting) prevents blood from refluxing back into the catheter lumen.
LVN IV Therapy & Fluid Management 4
According to INS guidelines, peripheral IV catheters in adults should be routinely assessed for site rotation every how many hours?