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Quizzes > Health & Medicine

IV Therapy Practice Questions: NCLEX Quiz

Quick, free IV fluids quiz with instant results and brief rationales.

Editorial: Review CompletedCreated By: Ian ReesUpdated Aug 24, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for IV therapy quiz on a golden yellow background

Use this quiz to practice IV therapy and gauge your grasp of IV fluids, solutions, and safe infusion care. You will get instant results with short rationales to guide your study. Keep building skills with drip rate calculation practice, review the drip rate formula, and round out your review with nclex perfusion practice.

What is the primary purpose of peripheral intravenous therapy?
To perform continuous heart monitoring
To provide long-term nutritional support
To continuously monitor blood pressure
To deliver medications and fluids directly into the bloodstream
Peripheral IV therapy allows rapid administration of medications, fluids, and electrolytes directly into the bloodstream to achieve prompt therapeutic effects. It is not intended for continuous cardiac monitoring or long-term nutritional support. It is one of the most common routes for medication delivery in acute care.
How often should peripheral IV administration tubing be replaced according to CDC guidelines?
Every 96 hours (4 days)
Every 24 hours
Every 48 hours
Every 72 hours
CDC guidelines recommend routine replacement of peripheral IV administration sets no more frequently than every 96 hours, unless the system is compromised. This helps reduce infection risk while avoiding unnecessary interruptions.
Which clinical sign is most indicative of IV infiltration?
Palpable cord along the vein with sharp pain
Redness, warmth, and tender vein along the catheter
Cool skin temperature, blanching, and edema at the site
Leaking of blood at the insertion site
Infiltration occurs when non-vesicant solution enters surrounding tissue, causing coolness, blanching, and swelling. Phlebitis presents with warmth and redness, while thrombosis shows a palpable cord.
Which catheter gauge is most appropriate for rapid infusion of blood products?
18 gauge
20 gauge
22 gauge
16 gauge
A 16-gauge catheter is preferred for rapid blood transfusion to minimize hemolysis and ensure adequate flow. Smaller gauges may slow transfusion and increase hemolysis risk.
A microdrip IV set delivers how many drops per milliliter?
10 drops per mL
15 drops per mL
12 drops per mL
60 drops per mL
Microdrip tubing is calibrated to deliver 60 drops per mL, which allows for more precise low-volume infusions, especially important for pediatrics or critical care.
Which of the following solutions is isotonic to human plasma?
0.45% sodium chloride
3% sodium chloride
0.9% sodium chloride (normal saline)
5% dextrose in water (D5W)
Normal saline (0.9% NaCl) is isotonic to plasma, preventing fluid shifts between vascular and cellular spaces. Hypotonic and hypertonic solutions can move water into or out of cells.
How often should an IV infusion site be assessed in acute care settings?
Every 2 hours
Every 4 hours
Every hour
Every 8 hours
Nursing standards recommend hourly assessment of IV sites for signs of complications such as infiltration, phlebitis, and infection. Frequent checks help identify issues early.
What is the primary use of colloid solutions such as albumin?
Long-term nutritional support
Correction of metabolic acidosis
Replacement of electrolytes
Rapid intravascular volume expansion
Colloid solutions contain large molecules that remain in the vascular space, drawing fluid in and expanding plasma volume rapidly. They are not used primarily for electrolyte correction.
Which site is generally preferred for peripheral IV insertion in a preschool-aged child?
Dorsal hand veins
Antecubital fossa
Scalp veins
Foot veins
The dorsal hand veins are preferred in preschool children because they are accessible, visible, and less restrictive to movement than scalp or foot veins.
When should an intact IV site dressing be changed?
Every 24 hours
Only when it becomes loose or soiled
Every shift
Weekly
According to infection control guidelines, transparent IV dressings should only be changed when the integrity is compromised (e.g., loose or soiled) rather than at fixed intervals.
What is the first nursing action when infiltration is suspected?
Slow the infusion rate and observe
Elevate the extremity only
Stop the infusion and remove the catheter
Apply a cold compress and continue infusion
At the first sign of infiltration, the infusion must be stopped and the catheter removed to prevent tissue damage. Warm or cold compresses can be applied afterward based on the solution type.
Which findings at an IV site are most consistent with phlebitis?
Coolness, blanching, and swelling
Presence of vesicles and tissue necrosis
Redness, warmth, and pain along the vein
Leaking of fluid at insertion site
Phlebitis presents with inflammation signs such as redness, warmth, and tenderness along the vein. Infiltration and extravasation produce other findings.
Which lumen of a triple-lumen central venous catheter is recommended for administration of total parenteral nutrition (TPN)?
Proximal lumen
Medial lumen
Any lumen may be used
Distal lumen
The distal lumen is largest and designed for hyperosmolar solutions like TPN to reduce risk of precipitation. It offers the highest flow rate.
What is the earliest clinical sign of an air embolism from an IV line?
Hypotension
Bradycardia
Chest rash
Sudden dyspnea and respiratory distress
Dyspnea and respiratory distress often appear first as air emboli obstruct pulmonary blood flow. Cardiovascular changes may follow.
What position is recommended for a patient with a suspected venous air embolism?
High Fowler's position
Supine with head flat
Right lateral decubitus
Trendelenburg and left lateral decubitus
The left lateral decubitus and Trendelenburg position trap air in the right atrium, preventing it from entering pulmonary circulation.
Where should the tip of a peripherally inserted central catheter (PICC) ideally reside?
Mid-upper arm vein
Right atrium
Lower superior vena cava at the cavoatrial junction
Brachiocephalic vein
Optimal PICC placement is at the cavoatrial junction in the lower SVC to ensure rapid dilution of infusate and minimize vein irritation.
Which solution is considered hypertonic?
0.9% sodium chloride
0.45% sodium chloride
5% dextrose in water (D5W)
5% dextrose in 0.9% sodium chloride
D5 in NS is hypertonic, drawing fluid out of cells into the vascular space. Hypotonic and isotonic solutions have different osmolarities.
Which patient is at highest risk for fluid volume overload with an isotonic infusion?
A patient with chronic diarrhea
A patient with acute dehydration
A patient with congestive heart failure
A healthy adult volunteer
Patients with CHF have reduced cardiac output and cannot tolerate excess fluid, making isotonic infusions a risk for overload.
What is the recommended maximum hang time for a lipid emulsion (IV fat emulsion) infusion?
48 hours
24 hours
12 hours
18 hours
Lipid emulsions should be hung for no longer than 24 hours to minimize infection risk and preserve emulsion integrity.
Calculate the IV flow rate: 500 mL of IV fluid over 4 hours using a 15 gtt/mL set. What is the flow rate in drops per minute?
30 gtt/min
33 gtt/min
32 gtt/min
31 gtt/min
Flow rate = (Total mL × Drip factor) ÷ Total minutes = (500 × 15) ÷ 240 = 31.25 ? 31 gtt/min.
Which finding differentiates extravasation from simple infiltration?
Swelling at the site
Vesicle formation or tissue necrosis
Cool skin temperature
Blanching of the skin
Extravasation involves vesicant agents that cause tissue necrosis and blistering, unlike simple infiltration which causes coolness and swelling without tissue damage.
Which infusion rate requires the use of microdrip tubing for accurate delivery?
250 mL per hour
100 mL per hour
500 mL per hour
15 mL per hour
Microdrip tubing (60 gtt/mL) is used for low infusion rates (usually under 50 mL/hr) to ensure accuracy. Higher rates use macrodrip sets.
What is the correct filter size for blood product administration sets?
170 - 260 microns
300 microns
150 microns
40 microns
Blood transfusion sets utilize a 170 - 260 micron filter to trap clots and debris while allowing blood cells to pass. Smaller filters can slow transfusion.
What volume of normal saline is most appropriate for locking a newly placed central venous catheter lumen?
2 mL
5 mL
10 mL
20 mL
A 10 mL normal saline flush is recommended for central lines to ensure patency and clear residual medication. Smaller volumes may not clear the lumen fully.
Which antidote is indicated for extravasation of a vasoconstrictive agent like norepinephrine?
Nitroprusside
Phentolamine
Hydrocortisone
Epinephrine
Phentolamine, an alpha-blocker, is injected locally to counteract vasoconstriction and prevent tissue necrosis caused by extravasated vasopressors.
Which sign is the earliest indicator of a catheter-related bloodstream infection?
Fever and chills
Headache
Rash along the chest
Bradycardia
Fever and chills are common early signs of catheter-related bloodstream infection due to microbial entry at the catheter site. Other signs may appear later.
How often should the transparent dressing covering a peripherally inserted central catheter (PICC) be changed if intact and not soiled?
Every 14 days
Every 5 days
Every 3 days
Every 7 days
PICC dressings should be replaced every 7 days if the dressing and site are intact and free of drainage, per Infusion Nurses Society guidelines.
In patient-controlled analgesia (PCA), what does a 10-minute lockout interval mean?
The patient must wait 10 minutes between doses
The infusion bag must be changed every 10 minutes
The dose is delivered over 10 minutes
The pump alarms every 10 minutes
A 10-minute lockout interval prevents additional doses from being delivered more frequently than every 10 minutes, reducing overdose risk while allowing pain control.
You need to infuse potassium chloride 20 mEq in 500 mL NS at a rate of 10 mEq per hour. What is the infusion rate in mL per hour?
300 mL/hr
150 mL/hr
250 mL/hr
200 mL/hr
Rate (mL/hr) = (Desired mEq/hr × Total volume mL) ÷ Total mEq = (10 × 500) ÷ 20 = 250 mL/hr.
Which IV medication must be diluted in dextrose rather than normal saline due to compatibility?
Amphotericin B
Heparin
Regular insulin
Diazepam
Amphotericin B is incompatible with saline and must be reconstituted in 5% dextrose to maintain stability and reduce precipitation.
A patient with a latex allergy requires a central line dressing change. Which precaution is most important?
Only use mask and gown
Use non-latex sterile gloves and supplies
No need for gloves if dressing is intact
Use powdered latex gloves
Patients with latex allergy require non-latex sterile gloves and supplies to prevent allergic reactions during dressing changes. Powdered latex gloves pose a high risk.
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Study Outcomes

  1. Understand Fundamental IV Therapy Concepts -

    Gain a clear grasp of the principles behind intravenous administration, including fluid types, infusion rates, and indications tested in NCLEX questions IV therapy.

  2. Analyze and Troubleshoot Common IV Complications -

    Identify and manage issues such as infiltration, phlebitis, and occlusions using strategies practiced in our intravenous therapy quiz.

  3. Apply Proper IV Infusion Techniques -

    Demonstrate correct setup of infusion equipment, aseptic technique, and rate calculations to ensure safe delivery of IV fluids.

  4. Evaluate Patient Responses to IV Therapy -

    Interpret patient assessments and lab values to monitor efficacy and detect adverse reactions during IV therapy.

  5. Practice NCLEX IV Infusion Questions -

    Build confidence with targeted NCLEX IV infusion questions and IV therapy practice questions that mirror exam-style scenarios.

  6. Review and Enhance IV Therapy Skills -

    Use results from the IV therapy review quiz to pinpoint knowledge gaps and strengthen your mastery before taking the NCLEX exam.

Cheat Sheet

  1. IV Drip Rate Calculations -

    Master the formula (Volume in mL × Drop Factor) ÷ Time in minutes = gtt/min to safely administer fluids. For example, 500 mL over 4 hours with a 15 gtt/mL set equals (500×15)÷240=31 gtt/min; remember "VDT" (Volume, Drops, Time) as a quick mnemonic. Consistent practice with sample problems from university nursing labs boosts speed and accuracy.

  2. Types of IV Solutions -

    Differentiate isotonic (0.9% NaCl), hypotonic (0.45% NaCl) and hypertonic (D5NS) fluids by osmolality and clinical use (e.g., isotonic for volume resuscitation). Use the "IHH" mnemonic (Isotonic - Hypotonic - Hypertonic) to recall relative tonicity. Refer to hospital policy and pharmacology texts like USP guidelines for safe ordering and administration.

  3. Site Assessment & Infiltration Recognition -

    Regularly inspect IV sites for swelling, coolness, pain or blanching as early signs of infiltration or extravasation. Apply R.I.C.E. (Rest, Ice, Compression, Elevation) for infiltration and report vesicant infiltration per institutional protocols. The Infusion Nurses Society (INS) recommends documenting every 1 - 2 hours to catch issues early.

  4. Central vs. Peripheral Line Management -

    Understand differences in lumen access, infection risk and maximum infusion rates: central lines handle hypertonic solutions and long-term therapy, while peripheral lines are for short-term use. Use the "SASH" protocol (Saline - Administer - Saline - Heparin) for patency checks on central devices per CDC guidelines. Always use a 10 mL syringe or larger for flushing to reduce IV line pressure.

  5. Compatibility, Y-Site Infusions & Tubing Changes -

    Check drug compatibility charts before Y-site administration to avoid precipitation or inactivation - refer to hospital pharmacy or Trissel's handbook. Change continuous IV tubing every 72 - 96 hours and lipid tubing every 24 hours according to CDC recommendations to minimize infection risk. Label tubing with date/time to streamline compliance and safety audits.

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