A nurse is collecting data from a client who is receiving IV therapy. The nurse suspects fluid infiltration. Which of the following findings should the nurse expect at the insertion site?

Erythema

Edema

Blood

Pruritus

Answer and Explanation

The Correct Answer is B

A. Erythema is a sign of infection or irritation, not fluid infiltration. Fluid infiltration typically does not cause redness or inflammation.

B. Edema is correct. Fluid infiltration occurs when the IV catheter becomes displaced and the fluid leaks into the surrounding tissue, causing swelling (edema. at the insertion site.

C. Blood would suggest either an accidental dislodging of the catheter or a complication such as hematoma formation, but it is not a sign of fluid infiltration.

D. Pruritus (itching) is typically associated with an allergic reaction, not fluid infiltration.

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Correct Answer is B

Explanation

A. Ringing in the ears (tinnitus) is incorrect. Tinnitus is not a common adverse effect of propranolol. This symptom is more commonly associated with ototoxic medications, such as certain antibiotics or diuretics.

B. Bradycardia is correct. Propranolol is a beta-blocker that reduces heart rate and blood pressure by blocking beta-adrenergic receptors. One of its primary adverse effects is bradycardia (slow heart rate., which can lead to dizziness, fatigue, or hypotension.

C. Hypertension is incorrect. Propranolol is used to treat hypertension, not cause it. By reducing cardiac output and suppressing sympathetic nervous system activity, propranolol generally lowers blood pressure.

D. Headache is incorrect. While some clients might experience headaches due to changes in blood pressure, headache is not a primary adverse effect of propranolol.

A. Ankle B. Shoulder C. Knee D. Metacarpophalangeal

Correct Answer is B

Explanation

A. Ankle is incorrect. The ankle is a hinge joint, which allows for movement in one plane (up and down), not the multidirectional movement characteristic of a ball and socket joint.

B. Shoulder is correct. The shoulder joint is a ball and socket joint. This type of joint allows for movement in multiple directions, including flexion, extension, abduction, adduction, rotation, and circumduction.

C. Knee is incorrect. The knee is a hinge joint, allowing for flexion and extension but not the wide range of motion that a ball and socket joint offers.

D. Metacarpophalangeal is incorrect. The metacarpophalangeal joints (knuckles) are condyloid joints, which allow for movement in two planes but not the full rotational movement of a ball and socket joint.

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A nurse is collecting data from a client who is receiving IV therapy. The nurse suspects fluid infiltration. Which of the following findings should the nurse expect at the insertion site?

Nursing Test Bank

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