IV Therapy Cert Exam Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q21A patient receiving 3 percent sodium chloride develops confusion, muscle twitching, and seizures. Which complication is most likely occurring?
✓ Correct answer: D. Hypernatremia
3 percent sodium chloride is a hypertonic solution that can cause rapid shifts in sodium levels. These neurological symptoms indicate hypernatremia from too rapid correction or overinfusion, causing cellular dehydration in the brain.
Q22Which IV solution is classified as isotonic and most appropriate for treating hypovolemia in a trauma patient?
✓ Correct answer: C. 0.9 percent sodium chloride
0.9 percent sodium chloride (normal saline) is an isotonic crystalloid solution with osmolarity similar to blood plasma. It is the first-line fluid for volume resuscitation in trauma because it expands intravascular volume without causing fluid shifts between compartments.
Q23A nurse is preparing to administer furosemide and gentamicin through the same IV line. What is the most appropriate action?
✓ Correct answer: B. Flush the line with normal saline between medications
Furosemide and gentamicin are incompatible when mixed together as they form a precipitate. The line must be flushed with normal saline between administrations to prevent chemical incompatibility and ensure patient safety.
Q24Which adverse effect requires immediate discontinuation of a vancomycin infusion?
✓ Correct answer: A. Red man syndrome with flushing and hypotension
Red man syndrome is a histamine-mediated reaction to rapid vancomycin infusion characterized by flushing, pruritus, and hypotension affecting the face, neck, and upper torso. The infusion must be stopped immediately and the provider notified.
Q25A patient with cerebral edema requires a hypertonic solution to reduce intracranial pressure. Which solution should be selected?
✓ Correct answer: D. 3 percent sodium chloride
3 percent sodium chloride is a hypertonic solution with higher osmolarity than plasma. It draws fluid from the interstitial and intracellular spaces into the vascular space, thereby reducing cerebral edema and intracranial pressure.
Q26Which electrolyte must be diluted and administered slowly via infusion pump, never as IV push, due to risk of cardiac arrest?
✓ Correct answer: C. Potassium chloride
Potassium chloride must always be diluted and infused slowly via pump because rapid administration or bolus injection can cause fatal cardiac arrhythmias and cardiac arrest. Direct IV push of potassium is never appropriate.
Q27What is the primary mechanism of action of lactated Ringer's solution in treating metabolic acidosis?
✓ Correct answer: B. Lactate is converted to bicarbonate, buffering excess acid
Lactated Ringer's contains lactate, which is metabolized by the liver to bicarbonate. This bicarbonate acts as a buffer to neutralize excess hydrogen ions, thereby correcting metabolic acidosis and restoring normal pH balance.
Q28A patient receiving D5W (5 percent dextrose in water) continuously for 24 hours is at risk for which complication?
✓ Correct answer: A. Hyponatremia
D5W is initially isotonic but becomes hypotonic once dextrose is metabolized. Prolonged infusion causes fluid to shift into cells, diluting extracellular sodium and resulting in hyponatremia with symptoms such as confusion and lethargy.
Q29Which medication class requires monitoring for phlebitis and should be infused through a large vein or central line when possible?
✓ Correct answer: D. Vesicant chemotherapy agents
Vesicant chemotherapy agents cause severe tissue damage if extravasated and are highly irritating to vessel walls, leading to phlebitis. They should be administered through large veins or preferably central lines to minimize risk.
Q30Before administering IV calcium gluconate, the nurse should assess for concurrent infusion of which incompatible solution?
✓ Correct answer: C. Sodium bicarbonate
Calcium gluconate is incompatible with sodium bicarbonate and forms a precipitate when mixed. The two should never be infused through the same line simultaneously, as this creates a chemical incompatibility hazard.
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