HomeFree NORCET Exams Preparation Series NORCET Exams Preparation Series - Day 1 ( IV Therapy And Blood Transfusion ) September 13, 2026 0 NORCET Nursing Foundation – IV Therapy & Blood Transfusion Test 01 • 50 MCQs • 50 Marks • 30 Minutes Clinical + Scenario-Based Questions Student Details Full Name Email Start Test Test Progress 30:00 Q1. Which of the following is an isotonic IV solution? A. 0.45% Normal saline B. 0.9% Normal saline C. 3% Normal saline D. 0.225% Normal saline Answer: B. 0.9% Normal saline 0.9% sodium chloride is an isotonic crystalloid commonly used for intravascular volume replacement and fluid administration. Q2. Which IV fluid is classified as a hypertonic solution? A. 0.9% NaCl B. Lactated Ringer's solution C. 3% NaCl D. 5% Dextrose in water after metabolism Answer: C. 3% NaCl 3% sodium chloride is hypertonic and is used in selected clinical situations such as severe symptomatic hyponatremia under careful monitoring. Q3. Which IV solution is commonly classified as hypotonic? A. 0.45% NaCl B. 0.9% NaCl C. 3% NaCl D. 5% NaCl Answer: A. 0.45% NaCl 0.45% sodium chloride is hypotonic relative to plasma and causes water to move toward the intracellular compartment. Q4. A patient with severe dehydration requires rapid intravascular volume replacement. Which type of fluid is generally appropriate initially? A. Isotonic crystalloid B. Hypotonic solution only C. Sterile water IV D. Hypertonic saline in every case Answer: A. Isotonic crystalloid Isotonic crystalloids such as 0.9% saline or balanced crystalloids are commonly used for initial intravascular volume replacement when clinically indicated. Q5. Which finding is most suggestive of IV infiltration? A. Warmth and purulent drainage B. Cool, pale, swollen tissue around the IV site C. Red streak extending from the vein D. Fever with chills Answer: B. Cool, pale, swollen tissue around the IV site Infiltration occurs when a non-vesicant IV solution leaks into surrounding tissue. The site is often cool, pale, swollen and uncomfortable. Q6. A patient receiving IV therapy develops redness, warmth, tenderness and a palpable cord along the vein. Which complication is most likely? A. Infiltration B. Phlebitis C. Fluid overload D. Hemorrhage Answer: B. Phlebitis Phlebitis is inflammation of the vein and may present with pain, erythema, warmth and a palpable venous cord. Q7. What is the priority action when IV infiltration is identified? A. Increase the infusion rate B. Stop the infusion C. Massage the site vigorously D. Continue monitoring without intervention Answer: B. Stop the infusion The infusion should be stopped promptly to prevent further fluid accumulation in the tissue. Further management depends on the solution and institutional protocol. Q8. A patient develops swelling and pain at an IV site after administration of a vesicant medication. What complication should the nurse suspect? A. Extravasation B. Phlebitis only C. Dehydration D. Hypoglycemia Answer: A. Extravasation Extravasation is leakage of a vesicant medication into surrounding tissue and can cause serious tissue injury. Immediate management is required according to the drug-specific protocol. Q9. Which finding is most concerning for fluid overload during IV therapy? A. Dry mucous membranes B. Crackles and increasing respiratory distress C. Poor skin turgor D. Thirst Answer: B. Crackles and increasing respiratory distress Pulmonary congestion from fluid overload can cause crackles, dyspnea, falling oxygen saturation and other signs of respiratory compromise. Q10. Before starting an IV infusion, which action is most important for preventing medication or fluid administration errors? A. Confirm the prescription and patient identity B. Ask another patient for confirmation C. Start the infusion before checking the label D. Skip documentation Answer: A. Confirm the prescription and patient identity Correct patient identification, prescription verification, medication/fluid verification and appropriate safety checks are essential before administration. Q11. An IV order is 1000 mL over 8 hours. What infusion rate should be programmed on the pump? A. 80 mL/hr B. 100 mL/hr C. 125 mL/hr D. 150 mL/hr Answer: C. 125 mL/hr Rate = Volume ÷ Time = 1000 ÷ 8 = 125 mL/hr. Q12. An IV set has a drop factor of 20 gtt/mL. An order is for 500 mL over 4 hours. What is the approximate flow rate? A. 21 gtt/min B. 42 gtt/min C. 60 gtt/min D. 83 gtt/min Answer: B. 42 gtt/min (500 × 20) ÷ 240 minutes = 41.67, rounded to approximately 42 gtt/min. Q13. Which device is used to regulate the precise volume and rate of many IV infusions? A. Infusion pump B. Stethoscope C. Pulse oximeter D. Sphygmomanometer Answer: A. Infusion pump An infusion pump can deliver fluids or medications at a programmed rate and is especially useful when accurate controlled infusion is required. Q14. Which site is generally preferred for peripheral IV cannulation in an adult when appropriate? A. A suitable distal upper-extremity vein B. An infected area C. An area over a joint whenever avoidable D. An area with burns Answer: A. A suitable distal upper-extremity vein For adult peripheral access, an appropriate distal upper-extremity vein is commonly preferred when clinically suitable. Infected, burned or compromised areas should be avoided. Q15. During IV cannulation, the nurse observes blood return in the catheter. What does this generally indicate? A. The catheter may have entered the vein B. The catheter is definitely in an artery C. The patient has fluid overload D. The catheter must immediately be removed in every case Answer: A. The catheter may have entered the vein Blood return or flashback can indicate successful entry into the vessel. The catheter is then advanced according to the approved technique. Q16. A patient receiving IV fluids suddenly develops dyspnea, hypertension and bilateral crackles. What is the priority concern? A. Fluid overload B. Dehydration C. Infiltration only D. Constipation Answer: A. Fluid overload Dyspnea, crackles and hypertension during IV therapy can indicate fluid overload with pulmonary congestion and require prompt assessment and intervention. Q17. Which blood component is primarily used to increase oxygen-carrying capacity? A. Packed red blood cells B. Platelets C. Fresh frozen plasma D. Cryoprecipitate Answer: A. Packed red blood cells Packed red blood cells increase red-cell mass and oxygen-carrying capacity and are commonly used for clinically significant anemia or blood loss when transfusion is indicated. Q18. Which blood component is most appropriate for a patient with significant thrombocytopenia and bleeding risk when platelet transfusion is indicated? A. Packed RBCs B. Platelets C. Albumin D. Normal saline Answer: B. Platelets Platelet transfusion is used in selected patients with low platelet counts or platelet dysfunction when clinically indicated. Q19. Fresh frozen plasma primarily provides: A. Red blood cells B. Clotting factors C. Platelets only D. White blood cells only Answer: B. Clotting factors Fresh frozen plasma contains multiple plasma coagulation factors and may be used for selected coagulation factor deficiencies or bleeding associated with coagulopathy. Q20. Cryoprecipitate is particularly rich in which component? A. Fibrinogen B. Red blood cells C. Sodium D. Albumin only Answer: A. Fibrinogen Cryoprecipitate is concentrated in fibrinogen and also contains factor VIII, von Willebrand factor and factor XIII. Q21. Before starting a blood transfusion, which action is essential? A. Verify patient identity and blood component according to institutional procedure B. Start transfusion without checking the unit C. Warm every blood unit in a microwave D. Add medication directly to the blood bag Answer: A. Verify patient identity and blood component according to institutional procedure Correct patient identification, compatibility checks and verification of the blood product are critical steps before transfusion. Q22. Which IV fluid is generally compatible with packed red blood cells for transfusion when a compatible IV solution is required? A. 0.9% sodium chloride B. 5% dextrose in water C. 0.45% sodium chloride D. Sterile water Answer: A. 0.9% sodium chloride 0.9% sodium chloride is commonly used with blood components. Dextrose-containing solutions may cause red-cell hemolysis, while hypotonic solutions can also be inappropriate. Q23. A nurse is preparing to administer packed RBCs. Which solution should generally NOT be infused through the same line with blood? A. 0.9% sodium chloride B. Dextrose-containing solution C. Normal saline used according to protocol D. Compatible saline solution Answer: B. Dextrose-containing solution Dextrose-containing IV solutions can contribute to red-cell hemolysis and are generally not infused through the same blood administration line. Q24. Which medication should generally NOT be added directly to a blood product? A. Any medication unless specifically approved as compatible B. Normal saline C. Blood-compatible solution D. Nothing should ever be checked Answer: A. Any medication unless specifically approved as compatible Medications should not be added to blood components unless compatibility and institutional policy specifically permit it. A separate IV line is generally preferred for medications when needed. Q25. A patient develops chills and fever shortly after a blood transfusion begins. What should the nurse do first? A. Increase the transfusion rate B. Stop the transfusion and assess the patient C. Ignore the symptoms D. Restart the same blood immediately Answer: B. Stop the transfusion and assess the patient Fever and chills may indicate a transfusion reaction. The transfusion should be stopped promptly and the patient assessed according to the transfusion-reaction protocol. Q26. During a transfusion, the patient develops fever, chills and flank pain. Which reaction should be strongly suspected? A. Acute hemolytic transfusion reaction B. Simple dehydration C. Hypoglycemia only D. Constipation Answer: A. Acute hemolytic transfusion reaction Fever, chills, back/flank pain, hypotension, hemoglobinuria and other systemic findings can occur with acute hemolytic transfusion reactions. Q27. A patient develops urticaria and itching during a blood transfusion but has no respiratory distress or hypotension. What type of reaction is most likely? A. Mild allergic transfusion reaction B. Acute hemolytic reaction C. Circulatory overload only D. Septic shock Answer: A. Mild allergic transfusion reaction Pruritus and urticaria without systemic instability are characteristic of a mild allergic reaction. The transfusion should be managed according to institutional protocol. Q28. Which symptom is particularly suggestive of transfusion-associated circulatory overload (TACO)? A. Pulmonary edema and respiratory distress after transfusion B. Isolated itching C. Local IV swelling only D. Mild hunger Answer: A. Pulmonary edema and respiratory distress after transfusion TACO results from circulatory volume overload and can cause dyspnea, pulmonary edema, hypertension and other signs of volume excess. Q29. A patient develops acute respiratory distress and hypoxemia within hours of transfusion, without evidence of circulatory overload. Which complication should be considered? A. TRALI B. Mild allergic reaction C. Infiltration D. Phlebitis Answer: A. TRALI Transfusion-related acute lung injury (TRALI) is characterized by acute respiratory distress and hypoxemia after transfusion and is not explained by circulatory overload. Q30. Which action is appropriate when a serious transfusion reaction is suspected? A. Continue the transfusion at a slower rate without assessment B. Stop the transfusion and maintain IV access with appropriate compatible fluid according to protocol C. Discard all documentation D. Give the remaining blood to another patient Answer: B. Stop the transfusion and maintain IV access with appropriate compatible fluid according to protocol The transfusion should be stopped, the patient assessed, IV access maintained appropriately, and the blood bank/medical team notified according to institutional policy. Q31. Why are baseline vital signs obtained before blood transfusion? A. To establish a comparison for detecting changes during transfusion B. Only for documentation purposes C. To determine blood group D. To replace compatibility testing Answer: A. To establish a comparison for detecting changes during transfusion Baseline temperature, pulse, respiratory rate and blood pressure help the nurse identify changes that may indicate a transfusion reaction. Q32. A nurse begins a blood transfusion. Why is close observation especially important during the initial period? A. Serious reactions can occur early in the transfusion A. Blood becomes saline after 10 minutes A. The patient's blood group changes A. The blood must be shaken continuously Answer: A. Serious reactions can occur early in the transfusion Close monitoring early in transfusion helps identify potentially serious reactions promptly. Follow the monitoring schedule required by institutional policy. Q33. Which blood group is commonly described as the universal red-cell donor group in emergency contexts when ABO compatibility is required? A. AB positive B. O negative C. A positive D. B negative Answer: B. O negative O-negative red cells lack A, B and Rh(D) antigens and are commonly used when emergency red-cell transfusion is required before the patient's type is known. Actual transfusion decisions follow blood-bank protocols. Q34. Which blood group is commonly considered the universal plasma donor group? A. O B. A C. AB D. Rh-negative only Answer: C. AB AB plasma does not contain anti-A or anti-B antibodies, making AB plasma broadly compatible as donor plasma in appropriate circumstances. Q35. What is the main purpose of crossmatching before transfusion? A. To determine the patient's blood pressure B. To assess compatibility between donor red cells and recipient plasma C. To measure serum glucose D. To calculate IV flow rate Answer: B. To assess compatibility between donor red cells and recipient plasma Crossmatching helps identify incompatibility between donor red blood cells and recipient antibodies before transfusion. Q36. A patient with severe anemia is prescribed packed RBCs. Which outcome best indicates that the transfusion is achieving its intended effect? A. Improved oxygen-carrying capacity and clinical symptoms B. Increased platelet count only C. Decreased clotting factors D. Increased serum sodium only Answer: A. Improved oxygen-carrying capacity and clinical symptoms Packed RBCs increase red-cell mass and oxygen-carrying capacity. Clinical response and laboratory findings are assessed as appropriate. Q37. A patient with thrombocytopenia has active bleeding. Which component is most directly intended to improve platelet availability? A. Packed RBCs B. Platelets C. FFP D. Cryoprecipitate only Answer: B. Platelets Platelet components provide functional platelets and are used when platelet replacement is clinically indicated. Q38. A patient receiving a blood transfusion complains of sudden chest tightness and difficulty breathing. What is the nurse's priority? A. Stop the transfusion and assess airway and breathing B. Increase the blood flow rate C. Leave the patient alone D. Document it after the transfusion ends Answer: A. Stop the transfusion and assess airway and breathing Acute respiratory symptoms may indicate a serious transfusion reaction. Stop the transfusion and immediately assess and support airway and breathing while following emergency protocol. Q39. A patient develops hypotension, fever and chills during transfusion. Which action should the nurse avoid? A. Stopping the transfusion B. Assessing vital signs C. Continuing the blood to finish the unit without evaluation D. Notifying the appropriate clinical team Answer: C. Continuing the blood to finish the unit without evaluation Potential transfusion reactions require immediate evaluation. Continuing the transfusion without assessment may worsen the patient's condition. Q40. Which assessment is particularly important when monitoring a patient receiving large-volume IV therapy? A. Respiratory status and lung sounds B. Hair color C. Visual acuity only D. Nail length Answer: A. Respiratory status and lung sounds Large-volume IV therapy can contribute to fluid overload. Monitoring respiratory status, oxygen saturation, lung sounds and other fluid-balance indicators is important. Q41. Which finding at a peripheral IV site requires prompt nursing assessment? A. Pain, redness and swelling B. Intact dressing with no symptoms C. Normal infusion with no discomfort D. Patent line with no abnormal findings Answer: A. Pain, redness and swelling Pain, erythema and swelling can indicate infiltration, phlebitis, extravasation or another complication and require assessment. Q42. During IV therapy, the infusion suddenly stops and the pump alarms for downstream occlusion. What should the nurse do first? A. Assess the tubing, catheter and IV site for obstruction or complication B. Ignore the alarm C. Increase the pressure indefinitely D. Disconnect everything without assessment Answer: A. Assess the tubing, catheter and IV site for obstruction or complication An occlusion alarm requires assessment of the tubing, clamps, catheter and insertion site. Do not simply increase pressure without identifying the cause. Q43. Which factor can increase the risk of IV infiltration? A. Fragile veins and poor catheter stabilization B. Properly secured catheter C. Regular assessment D. Appropriate catheter selection Answer: A. Fragile veins and poor catheter stabilization Fragile veins, catheter movement and inadequate stabilization can increase the risk of infiltration and other IV complications. Q44. A patient has a history of heart failure and is prescribed IV fluids. Which nursing action is particularly important? A. Closely monitor fluid balance and signs of overload B. Give the fluid as rapidly as possible regardless of the prescription C. Avoid all vital signs D. Encourage unrestricted fluid intake automatically Answer: A. Closely monitor fluid balance and signs of overload Patients with cardiac dysfunction may be more vulnerable to fluid overload. Strict monitoring of intake/output, weight, respiratory status and other relevant findings is important. Q45. A blood unit arrives on the ward. The nurse notices that the patient's name on the blood product label does not match the identification information. What should the nurse do? A. Transfuse it if the blood group looks correct B. Do not transfuse; resolve the identification discrepancy according to protocol C. Change the label manually D. Ask the patient to choose Answer: B. Do not transfuse; resolve the identification discrepancy according to protocol Patient-product identification errors can cause life-threatening incompatibility reactions. The discrepancy must be resolved before transfusion. Q46. A nurse accidentally discovers that the blood product has been stored outside the required conditions. What is the safest action? A. Transfuse it immediately B. Return/handle it according to blood-bank policy and do not transfuse until cleared C. Place it in a household refrigerator and use it D. Shake it vigorously Answer: B. Return/handle it according to blood-bank policy and do not transfuse until cleared Blood components require controlled storage conditions. A product with questionable storage must be handled according to blood-bank policy before use. Q47. Which observation would most strongly suggest an acute hemolytic transfusion reaction? A. Flank/back pain with fever and chills B. Mild hunger C. Improved hemoglobin D. Warm hands only Answer: A. Flank/back pain with fever and chills Acute hemolysis can produce fever, chills, back or flank pain, hypotension, hemoglobinuria and other serious findings. Q48. A patient receiving packed RBCs develops dark or reddish urine and severe back pain. What is the priority nursing response? A. Stop the transfusion and initiate the transfusion-reaction protocol B. Increase the transfusion rate C. Give another unit immediately D. Ignore the urine color Answer: A. Stop the transfusion and initiate the transfusion-reaction protocol Hemoglobinuria and severe back pain are concerning for acute hemolysis. Stop the transfusion, maintain appropriate IV access and follow the emergency transfusion-reaction protocol. Q49. A patient develops wheezing, facial swelling and hypotension during a blood transfusion. Which condition is most concerning? A. Severe allergic/anaphylactic reaction B. Mild infiltration C. Simple phlebitis D. Mild dehydration Answer: A. Severe allergic/anaphylactic reaction Wheezing, facial swelling and hypotension are signs of a potentially life-threatening anaphylactic reaction. Stop the transfusion and activate emergency management immediately. Q50. A nurse is caring for a patient during blood transfusion. Which principle is most important throughout the procedure? A. Patient identification, compatibility verification and continuous clinical monitoring B. Speed is more important than monitoring C. Vital signs are unnecessary after starting the transfusion D. Any IV solution can be mixed with blood Answer: A. Patient identification, compatibility verification and continuous clinical monitoring Safe transfusion practice depends on correct patient-product identification, compatibility verification, appropriate administration technique and careful monitoring for adverse reactions. Submit Test Test Result Retry Test Tags: Free NORCET Exams Preparation Series Facebook Twitter