VA-BC Infusion Therapy & Solutions 1 — Questions and Answers
Question 1: What is the maximum osmolarity threshold above which an IV solution should be administered through a central venous access device rather than a peripheral catheter?
- 500 mOsm/L
- 600 mOsm/L
- 900 mOsm/L (Correct answer)
- 1200 mOsm/L
Correct answer: 900 mOsm/L
Solutions exceeding 900 mOsm/L are hypertonic enough to damage peripheral veins and must be infused through a central venous access device.
Question 2: Which IV solution is considered isotonic and most closely approximates the osmolarity of human blood (approximately 285–295 mOsm/L)?
- D5W (5% Dextrose in Water)
- 0.9% Normal Saline (Correct answer)
- 0.45% Normal Saline
- D10W (10% Dextrose in Water)
Correct answer: 0.9% Normal Saline
0.9% Normal Saline has an osmolarity of approximately 308 mOsm/L, making it isotonic and safe for peripheral infusion.
Question 3: When administering total parenteral nutrition (TPN) with an osmolarity greater than 900 mOsm/L, which vascular access device is most appropriate?
- Short peripheral IV catheter
- Midline catheter
- Central venous catheter (Correct answer)
- Arterial line
Correct answer: Central venous catheter
TPN with high osmolarity requires a central venous catheter to allow dilution in the high-flow superior vena cava and prevent peripheral vein damage.
Question 4: Which of the following IV solutions is classified as hypotonic?
- Lactated Ringer's
- 0.9% Normal Saline
- 0.45% Normal Saline (Correct answer)
- D5NS
Correct answer: 0.45% Normal Saline
0.45% Normal Saline has an osmolarity of approximately 154 mOsm/L, which is below the isotonic range and classified as hypotonic.
Question 5: A nurse is preparing to administer two IV antibiotics simultaneously. What is the primary concern when mixing IV medications in the same line without a compatible flush between them?
- Increased infusion cost
- Drug incompatibility causing precipitation or inactivation (Correct answer)
- Prolonged infusion time only
- Catheter tip displacement
Correct answer: Drug incompatibility causing precipitation or inactivation
Mixing incompatible IV medications can cause precipitation, inactivation, or toxic byproducts, reducing therapeutic efficacy and potentially harming the patient.
Question 6: To prevent bacterial proliferation, a unit of packed red blood cells (PRBCs) must be infused within what maximum time frame from initiation?
- 2 hours
- 4 hours (Correct answer)
- 6 hours
- 8 hours
Correct answer: 4 hours
Blood products must be infused within 4 hours of initiation per AABB and INS standards to prevent bacterial growth at room temperature.
Question 7: Which IV solution should be used exclusively for flushing lines and tubing before and after blood product administration?
- D5W
- Lactated Ringer's
- 0.9% Normal Saline (Correct answer)
- 0.45% Normal Saline
Correct answer: 0.9% Normal Saline
Only 0.9% Normal Saline is compatible with blood products; D5W can cause hemolysis and Lactated Ringer's contains calcium that can promote clot formation.
VA-BC Infusion Therapy & Solutions 1
What is the maximum osmolarity threshold above which an IV solution should be administered through a central venous access device rather than a peripheral catheter?