Module 10: Med Admin: IV Therapy (Week of 10/16)

Question 1

1. After changing the intravenous (IV) tubing on a patient’s primary infusion, the nurse notes air bubbles in the tubing. How would the nurse remove them?

A. Begin the process again.
B. Add more fluid to the drip chamber.
C. Inject a syringe of saline into the tubing to vent the air bubbles.
D. Close the clamp, stretch the tubing downward, and flick the tubing.

Answer 1

D. Close the clamp, stretch the tubing downward, and flick the tubing.

Question 2

. Which action can the nurse take to minimize the patient’s risk for infection when applying new tubing to a primary IV infusion?

A. Using aseptic technique throughout the process
B. Changing the tubing each shift
C. Changing the tubing at the same time a new primary fluid bag is hung when possible
D. Using aseptic technique and changing the tubing at the same time a new primary fluid bag is hung are both appropriate to minimize the patient’s risk for infection

Answer 2

D. Using aseptic technique and changing the tubing at the same time a new primary fluid bag is hung are both appropriate to minimize the patient’s risk for infection

Question 3

3. While changing a patient’s hospital gown, the extension set on the IV infusion becomes disconnected and ends up on the bed linens. What would the nurse do?

A. Reconnect the extension set.
B. Clean the end with an alcohol swab and reconnect it.
C. Pull the IV from the site and insert a new catheter.
D. Change the extension set tubing.

Answer 3

D. Change the extension set tubing.

Question 4

4. What would the nurse do to ensure the correct administration of gravity drip intravenous (IV) fluid after changing the tubing on a patient’s primary infusion?

A. Change the tubing with each new infusion bag.
B. Wear clean treatment gloves when changing the tubing.
C. Recheck the drip rate by counting the drops for 1 full minute.
D. Assess the condition of the patient’s insertion site for possible infiltration.

Answer 4

C. Recheck the drip rate by counting the drops for 1 full minute.

Question 5

5. Which instruction would the nurse give to nursing assistive personnel (NAP) when caring for a patient who is receiving IV fluids?

A. “If the IV tubing gets disconnected, quickly reconnect it for me and let me know.”
B. “It’s okay for you to turn off the pump alarm when it beeps.”
C. “Let me know when the IV bag is almost empty.”
D. “Please check the IV site for me and let me know if it’s tender.”

Answer 5

C. “Let me know when the IV bag is almost empty.”

Question 6

1. Which instruction to nursing assistive personnel (NAP) reflects the nurse’s correct understanding of the NAP’s role in caring for a patient receiving intravenous (IV) fluids by gravity drip?

A. “Assess the IV site frequently for signs of inflammation.”
B. “Be sure not to obscure the insertion site with the dressing.”
C. “Let me know when you notice that the IV bag contains less than 100 mL.”
D. “Tell the patient to notify me if the IV site is painful, swollen, or red.”

Answer 6

C. “Let me know when you notice that the IV bag contains less than 100 mL.”

Question 7

2. The provider has ordered that a patient be 1000 mL of IV normal saline to run over 12 hours. What is the first step in the calculation of the rate of infusion?

A. Calculate the hourly volume of normal saline the patient should receive.
B. Determine the drop factor of the tubing that will be used for the infusion.
C. Calculate the drops per minute at which the tubing will be regulated.
D. Determine the drops per mL that the tubing will deliver.

Answer 7

A. Calculate the hourly volume of normal saline the patient should receive.

Question 8

3. The provider orders that a patient be given 1000 mL of IV normal saline to run over 10 hours. The drop factor of the selected tubing is 15. What is the correct rate of infusion in drops per minute?

A. 25 drops/minute
B. 30 drops/minute
C. 35 drops/minute
D. 40 drops/minute

Answer 8

A. 25 drops/minute

Question 9

4. The nurse receives an order to infuse 1000 mL of D5W at 125 mL continuously. Which of the following actions by the nurse indicates correct interpretation of this order?

A. Infusing D5W 1000 mL for 8 hours and then discontinuing the infusion
B. Infusing D5W at a rate of 125 mL/hr for 24 hours and then discontinuing the infusion
C. Infusing D5W at a rate of 125 mL/hr until the health care provider changes the order
D. Calling the health care provider to clarify the order

Answer 9

C. Infusing D5W at a rate of 125 mL/hr until the health care provider changes the order

Question 10

5. Which action by the nurse helps to ensure patient safety when administering IV fluids by gravity to very young children?

A. Using microdrip tubing for the infusion
B. Using macrodrip tubing for the infusion
C. Using a volume-control device for the infusion
D. Not infusing more than 25 mL/hour of IV fluids

Answer 10

C. Using a volume-control device for the infusion, enhances patient safety by preventing an accidental fluid bolus that causes circulatory overload.

Question 11

1. The nurse consistently observes that the positioning of a confused patient’s arm has a direct effect on the flow rate of the intravenous (IV) solution. What might the nurse do to ensure infusion of the patient’s IV fluid at a consistent rate?

A. Restart the IV in another location less affected by the patient’s positioning.
B. Include this information in the shift report regarding this patient.
C. Assess the flow rate every 1 to 2 hours.
D. Instruct the patient to avoid positioning the arm in ways that alter the flow rate.

Answer 11

A. Restart the IV in another location less affected by the patient’s positioning.

Question 12

2. Which instruction might the nurse give to nursing assistive personnel (NAP) regarding the care of a patient with a venous access device?

A. “Assess the IV site frequently for signs of inflammation.”
B. “Be sure not to obscure the insertion site with the dressing.”
C. “Let me know if you notice that the dressing has become damp.”
D. “Make sure the patient knows to notify me if the IV site becomes painful, swollen, or red.”

Answer 12

C. “Let me know if you notice that the dressing has become damp.”

Question 13

3. What might the nurse do to minimize the risk for injury in a patient receiving IV therapy?

A. Regulate the flow rate of the infusion.
B. Assess the patient frequently for pain at the IV site.
C. Monitor the IV site frequently for signs of infiltration and phlebitis.
D. Educate the patient regarding symptoms of infiltration and phlebitis.

Answer 13

A. Regulate the flow rate of the infusion.

Question 14

4. The nurse observes erythema at the insertion site of a patient’s IV infusion device. When asked, the patient denies pain at the site. Using the phlebitis scale, what score does the nurse give the injury?

A. 1
B. 2
C. 3
D. 4

Answer 14

A. 1
The nurse would give this injury a score of 1, which indicates redness at the access site with or without pain.

Question 15

5. A patient’s IV site has developed phlebitis scored as a 4 on the phlebitis scale. What would the nurse do to help treat the site?

A. Apply a cool compress.
B. Apply a warm compress.
C. Apply a pressure dressing.
D. Apply an elastic compression wrap.

Answer 15

B. Apply a warm compress.

Question 16

1. Which instruction reflects the nurse’s correct understanding of the role of nursing assistive personnel (NAP) in caring for a patient receiving an intravenous (IV) antibiotic medication by piggyback?

A. “Assess the IV site frequently for signs of infiltration.”
B. “Let me know immediately if the patient complains of pain at the IV site.”
C. “Notify the physician that the patient is allergic to the medication prescribed.”
D. “Remember to hang the piggyback medication higher than the primary solution.”

Answer 16

B. “Let me know immediately if the patient complains of pain at the IV site.”

Question 17

2. When administering an IV piggyback medication to infuse by gravity, how can the nurse ensure that the medication will flow properly?

A. Use an infusion pump to regulate the flow rate of the piggyback medication.
B. Hang the piggyback medication higher than the primary fluid.
C. Attach the piggyback medication to the most proximal insertion port on the primary tubing.
D. Use a secondary infusion set for the piggyback tubing.

Answer 17

B. Hang the piggyback medication higher than the primary fluid.

Question 18

3. What is the best way to protect a patient from an IV site injury when giving an antibiotic medication by piggyback?

A. Use a site into which a primary solution is already infusing.
B. Assess the IV site before initiating the IV piggyback medication.
C. Select a relatively small vein to infuse the IV medication.
D. Instruct NAP to notify you immediately if the insertion site appears swollen.

Answer 18

B. Assess the IV site before initiating the IV piggyback medication.

Question 19

4. What is the best way to prevent infection and conserve resources when terminating an IV piggyback medication infusion in a patient who also has a primary fluid infusion?

A. Remove the tubing from the primary line Y-site port, and cap the end.
B. Leave both the piggyback tubing and the bag attached to the primary line Y-site port until the next scheduled dose.
C. Place an unopened secondary setup at the bedside, and discard the used one.
D. Change both the primary and secondary tubing upon terminating the piggyback infusion.

Answer 19

B. Leave both the piggyback tubing and the bag attached to the primary line Y-site port until the next scheduled dose.

Question 20

5. Which nursing intervention is most important in ensuring safe infusion of a medication delivered by IV piggyback through a saline lock?

A. Use the most proximal insertion port on the primary tubing.
B. Hang the piggyback solution higher than the primary infusion solution.
C. Use a pump to regulate the infusion rate of the piggyback medication.
D. Flush the saline lock with sodium chloride solution before initiating the infusion.

Answer 20

D. Flush the saline lock with sodium chloride solution before initiating the infusion.

Question 21

1. What would the nurse do to assess a patient’s risk for embolus when removing a venous access device?

A. Inspect the site for redness.
B. Visualize the tip of the IV device.
C. Palpate the site for possible edema.
D. Ask the patient to rate any pain at the site.

Answer 21

B. Visualize the tip of the IV device.

Question 22

2. Which instruction might the nurse give to nursing assistive personnel (NAP) when caring for a patient whose IV access device is to be removed?

A. “Remember to wear gloves to minimize the risk for infection.”
B. “Be sure to keep pressure on the site for at least 2 to 3 minutes.”
C. “Let me know if you notice any bleeding on the site dressing.”
D. “Make sure the patient knows to notify me if the IV site becomes painful.”

Answer 22

C. “Let me know if you notice any bleeding on the site dressing.”

Question 23

3. What might the nurse do to improve a patient’s cooperation during the removal of an IV access device?

A. Describe the entire procedure to the patient.
B. Assure the patient that you will remove the IV catheter quickly.
C. Assure the patient that the procedure will take only about 5 minutes.
D. Tell the patient that the procedure will cause only a slight burning sensation.

Answer 23

A. Describe the entire procedure to the patient.

Question 24

4. Which action will best minimize the patient’s risk for vein injury when removing an IV access device from a patient’s arm?

A. Keep the hub parallel to the skin.
B. Cleanse the site with an antibacterial swab.
C. Cut the dressing to facilitate its removal.
D. Turn the IV tubing roller clamp to the “off” position.

Answer 24

A. Keep the hub parallel to the skin.

Question 25

5. What will the nurse do to prevent possible complications after removing an IV access device in a patient on anticoagulant therapy?

A. Instruct the patient to report immediately any sign of bleeding on the site dressing.
B. Perform hand hygiene and wear clean gloves while removing the device.
C. Encourage the patient to keep a cold compress on the site for 15 minutes.
D. Apply firm pressure to the site with sterile gauze for 10 minutes.

Answer 25

D. Apply firm pressure to the site with sterile gauze for 10 minutes.