Question 1

Which needle is used to access implanted infusion devices?
A) Jamshidi
B) Huber
C) Gigli
D) Crutchfield

Accepted Answer

The Huber needle is specifically designed for accessing implanted infusion devices, such as ports and pumps. It has a blunt, angled tip that helps prevent damage to the device and surrounding tissue. The other options listed (Jamshidi, Gigli, and Crutchfield) are all types of needles used for other medical procedures, such as bone marrow biopsy or neurosurgery.

Question 2

The nurse assesses a patient's right hand IV site to be infiltrated.Appropriate nursing actions include: (Select all that apply.)
A) stopping the infusion.
B) attempting to aspirate the medication.
C) elevating the affected limb.
D) checking capillary refill.
E) removing the catheter as directed by policy.

Accepted Answer

A,C,D,E

Question 3

Which technique by the nurse accurately maintains asepsis of a peripheral IV access device?
A) Wear gloves when hanging all IV solutions.
B) Apply a topical antibiotic ointment to the insertion site.
C) Change fluid administration sets according to institutional policy.
D) Flush with heparin before use.

Accepted Answer

Changing fluid administration sets according to institutional policy is necessary to prevent the growth of microorganisms in the IV line and maintain asepsis. It is also recommended to clean the insertion site with an antiseptic solution before insertion and during dressing changes. Wearing gloves is important for protection but not specifically for maintaining asepsis of the IV line. Applying topical antibiotic ointment to the insertion site is not recommended as it can increase the risk of bacterial resistance and may interfere with the assessment of infection. Flushing with heparin before use is not necessary for maintaining asepsis.

Question 4

Which potential complication will the nurse expect in patients with a venous access device?
A) Circulatory overload
B) Extravasation
C) Infection
D) Pain

Accepted Answer

Venous access devices increase the risk of infection due to the presence of a foreign body within the bloodstream. While pain, circulatory overload, and extravasation are all potential complications, infection is the most commonly observed complication.

Question 5

What is the composition of hypotonic intravenous solutions such as 0.45% NaCl?
A) Fewer dissolved particles than blood
B) Approximately the same number of dissolved particles as blood
C) Higher concentrations of dissolved particles than blood
D) Electrolytes and dextrose

Accepted Answer

Hypotonic solutions have fewer dissolved particles than blood. 0.45% NaCl is a hypotonic solution as it contains lower concentrations of sodium chloride than blood.

Question 6

A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions.Which type of intravenous (IV)access device will likely be used?
A) Peripheral venous access device
B) Midline catheter
C) Winged needle venous access device
D) Implantable venous infusion port

Accepted Answer

Implantable venous infusion ports are the most appropriate choice for prolonged chemotherapy infusions as they allow for reliable and long-term venous access with less risk of infection and less discomfort for the patient compared to peripheral venous access devices, midline catheters, or winged needle venous access devices.

Question 7

The nurse notes that a patient with cardiac disease has IV heparin infusing and that it is behind by 2 hours.What is the best nursing action?
A) Increase the IV rate and recheck in 1 hour.
B) Change the infusion rate to TKO.
C) Discontinue the solution using aseptic technique.
D) Contact the healthcare provider for consultation.

Accepted Answer

Since heparin is a medication that requires close monitoring and has the potential for serious complications, such as bleeding, it is important to notify the healthcare provider for further instructions. Neither increasing the rate nor changing it to TKO would be appropriate without guidance from the provider. Discontinuing the solution would also not be appropriate without orders, as this could result in thrombosis or other complications.

Question 8

Following the insertion of a central venous access device,the nurse notes a weak,thready pulse and decreased blood pressure.The patient complains of shortness of breath and palpitations.Which action will the nurse take first?
A) Place the patient on the left side.
B) Reassess vital signs.
C) Stop the infusion.
D) Verify placement of the device.

Accepted Answer

The symptoms suggest an air embolism, a potential complication of central venous access device insertion. Placing the patient on the left side (left lateral decubitus position) helps trap the air in the right atrium and prevents it from entering the pulmonary circulation, which can be life-threatening.

Question 9

A patient is admitted with hypovolemia resulting from lack of fluid intake and requires an infusion of isotonic fluids.Which IV solution will the nurse administer? A) D₅0.2 NS B) D₅W C) 0.45 NS D) 0.9 NS

Accepted Answer

The patient needs an isotonic solution to treat hypovolemia resulting from lack of fluid intake. 0.9% normal saline (0.9 NS) is an isotonic solution and the best choice for this patient.

Question 10

The nurse determines that an elderly patient's IV of D₅0.2 NS with 20 mEq KCl at 75 mL/hr is running 3 hours behind.After determining the IV site is patent,what action will the nurse take? A) Call the healthcare provider to obtain an order to decrease the IV rate. B) Administer a bolus to make up the deficit. C) Recalculate the flow rate and slowly make up the fluids. D) Maintain the ordered rate.

Accepted Answer

The answer of The nurse determines that an elderly patient's...

Question 11

A patient has a peripherally inserted central catheter (PICC)line inserted to continue IV antibiotic therapy at home.With proper care,how long can this type of venous access device remain in place?
A) 2 months
B) 4 months
C) 6 months
D) 12 months

Accepted Answer

The answer of A patient has a peripherally inserted central...

Question 12

What will the nurse explain when teaching a patient about a PICC line? (Select all that apply.)
A) The catheter may have a single or double lumen.
B) There is greater risk of clotting and infiltration with this type of catheter.
C) The patient will be receiving infusions continuously to ensure patency.
D) The tip of the catheter may be open or valved.
E) The catheter may be used for drawing blood.

Accepted Answer

The answer of What will the nurse explain when teaching...

Question 13

An elderly patient receiving an infusion of an isotonic fluid at 100 mL/hr complains of dyspnea.The nurse notes shallow rapid respirations and a cough that produces frothy sputum.Which is the priority nursing action?
A) Assess the urine output.
B) Elevate the head of the bed.
C) Encourage the patient to cough.
D) Maintain the IV rate.

Accepted Answer

The priority nursing action is to elevate the head of the bed to decrease venous return and relieve the pressure on the patient's chest. This will aid in improving the patient's breathing and reduce the chance of pulmonary edema. Assessing the urine output (A) is important for overall fluid balance but is not the priority in this situation. Encouraging the patient to cough (C) may actually worsen their symptoms as it may increase their workload of breathing. Maintaining the IV rate (D) should be paused until the patient's symptoms have been evaluated and managed.

Question 14

In assessing a patient with a central venous access device,which sign or symptom indicates that the patient is experiencing an air embolism?
A) Chest pain
B) Erythema
C) Frothy sputum
D) Sweating

Accepted Answer

Chest pain is a classic symptom of an air embolism. Other symptoms may include shortness of breath, rapid heart rate, low blood pressure, confusion, and unconsciousness. Erythema, frothy sputum, and sweating are not specifically associated with air embolisms.

Question 15

A diabetic patient requires the administration of insulin continuously at home.Which system would most likely be used in this instance?
A) Central line catheter
B) Microdrip set
C) Piggyback system
D) Syringe pump

Accepted Answer

A diabetic patient requiring continuous insulin administration would benefit most from a syringe pump, as it allows for precise and controlled delivery of insulin over an extended period. A central line catheter, microdrip set, or piggyback system would not be necessary or suitable for this type of treatment.

Question 16

Which condition would the nurse expect to be treated with an isotonic solution?
A) Fluid overload
B) Hemorrhagic shock
C) Cellular dehydration
D) Cerebral edema

Accepted Answer

Isotonic solutions are used to treat conditions where there is a loss of intravascular volume, such as hemorrhagic shock. They are also used to expand intravascular volume and maintain hydration in patients with mild to moderate dehydration. Fluid overload would be treated with a hypotonic solution, cellular dehydration would be treated with a hypertonic solution, and cerebral edema may be treated with a hypertonic or hypotonic solution depending on the cause.

Question 17

The nurse is about to administer a prescribed medication IV push into a patient's Hickman catheter.When providing this medication,the nurse will first:
A) administer the prescribed drug.
B) flush with saline.
C) flush with heparin.
D) prepare a pump.

Accepted Answer

Before administering any medication through an IV catheter or port, it is important to flush it with saline to ensure there are no blood clots or obstructions, and to assess for proper patency of the device. This is especially important with Hickman catheters, as they are typically used for long-term IV access and can be at higher risk for occlusion. Flushing with heparin may be appropriate if the catheter is not in active use, but it is not the first step when administering medication. A pump may be necessary for certain medications, but this step would come after the catheter has been flushed with saline.

Question 18

A 90-year-old woman is admitted to an acute care facility with the diagnosis of pneumonia.She has a past medical history of diabetes mellitus,hypertension,and right-sided mastectomy.When starting an IV for infusion of antibiotic therapy,the nurse will:
A) insert the IV catheter into the left hand.
B) use a lower extremity vein for insertion.
C) choose the left radial artery for insertion.
D) attempt insertion into the left antecubital space vein.

Accepted Answer

The nurse should attempt insertion into the left antecubital space vein. This area is typically the best choice for IV insertion in older adults and is less likely to cause complications or discomfort, particularly in a patient with a history of mastectomy on the right side. Using a lower extremity vein is not typically recommended due to the increased risk of complications such as deep vein thrombosis. Radial artery insertion is not appropriate for IV therapy.

Question 19

The nurse assesses erythema,warmth,and burning pain along the patient's IV site.Which complication is this patient most likely experiencing?
A) Air embolism
B) Extravasation
C) Phlebitis
D) Pulmonary edema

Accepted Answer

Erythema (redness), warmth, and burning pain are common signs and symptoms of phlebitis, which is inflammation of the vein that can occur as a complication of IV therapy. A) Air embolism would typically present with respiratory distress and other more serious symptoms. B) Extravasation refers to leakage of IV fluid or medication into the surrounding tissues, which can cause swelling, blistering, or tissue damage. D) Pulmonary edema involves accumulation of fluid in the lungs, which can cause shortness of breath, coughing, and chest pain. None of the symptoms described in the question are suggestive of pulmonary edema.

Quiz 11: Parenteral Administration: Intravenous Route

Which needle is used to access implanted infusion devices?

The nurse assesses a patient's right hand IV site to be infiltrated.Appropriate nursing actions include: (Select all that apply.)

Which technique by the nurse accurately maintains asepsis of a peripheral IV access device?

Which potential complication will the nurse expect in patients with a venous access device?

What is the composition of hypotonic intravenous solutions such as 0.45% NaCl?

A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions.Which type of intravenous (IV) access device will likely be used?

The nurse notes that a patient with cardiac disease has IV heparin infusing and that it is behind by 2 hours.What is the best nursing action?

Following the insertion of a central venous access device,the nurse notes a weak,thready pulse and decreased blood pressure.The patient complains of shortness of breath and palpitations.Which action will the nurse take first?

A patient is admitted with hypovolemia resulting from lack of fluid intake and requires an infusion of isotonic fluids.Which IV solution will the nurse administer?

The nurse determines that an elderly patient's IV of D₅0.2 NS with 20 mEq KCl at 75 mL/hr is running 3 hours behind.After determining the IV site is patent,what action will the nurse take?

A patient has a peripherally inserted central catheter (PICC) line inserted to continue IV antibiotic therapy at home.With proper care,how long can this type of venous access device remain in place?

What will the nurse explain when teaching a patient about a PICC line? (Select all that apply.)

An elderly patient receiving an infusion of an isotonic fluid at 100 mL/hr complains of dyspnea.The nurse notes shallow rapid respirations and a cough that produces frothy sputum.Which is the priority nursing action?

In assessing a patient with a central venous access device,which sign or symptom indicates that the patient is experiencing an air embolism?

A diabetic patient requires the administration of insulin continuously at home.Which system would most likely be used in this instance?

Which condition would the nurse expect to be treated with an isotonic solution?

The nurse is about to administer a prescribed medication IV push into a patient's Hickman catheter.When providing this medication,the nurse will first:

A 90-year-old woman is admitted to an acute care facility with the diagnosis of pneumonia.She has a past medical history of diabetes mellitus,hypertension,and right-sided mastectomy.When starting an IV for infusion of antibiotic therapy,the nurse will:

The nurse assesses erythema,warmth,and burning pain along the patient's IV site.Which complication is this patient most likely experiencing?