Deck 2: Vascular Access

Question 1

This federal law aims to prevent accidental needle stick injuries and blood exposure during specimen processing.

A)The Hazard Communication Standard
B)The Safety Needle Act
C)The Blood borne Pathogen Standard.
D)The Universal Precaution Standard

Answer 1

The Safety Needle Act

Question 2

"All equipment that contains needles must have a system to single-handedly permanently resheath the needle." Is the above a federal requirement of healthcare employers?

Answer 2

True

Question 3

The first step of the venipuncture procedure is:

A)Select a puncture site.
B)Select the proper equipment.
C)Check the requisition for special instructions. (time-specific tests)
D)Identify the patient. (Right patient)

Answer 3

Identify the patient. (Right patient)

Question 4

Which of the following maybe found on equipment check forms?

A)Tachometer readings and lot expiration dates.
B)Daily refrigerator temperatures.
C)Vacuum strengths.
D)All of the above.

Question 5

What is the difference between capillary blood and venous blood?

A)There is not any difference.
B)Capillary blood is a mixture of arterial and venous blood.
C)Capillary blood is a mixture of capillary and arterial blood.

Question 6

What does respondeat superior mean, and what is the purpose?

A)It means "let the master answer," and holds the employer responsible for the actions of the employees.
B)It means "first, do no harm," and holds the healthcare worker responsible for the safety and wellbeing of the patient.
C)It means "responsibility of the individual," and holds the patient responsible for his own safety within reasonable measure.

Question 7

A senior nurse is explaining the procedure for arterial puncture to a new nurse. She is explaining to the new nurse the sign to watch for to confirm the needle is in the artery. Which of the following terms refers to this sign?

A)Allen test
B)Flashback
C)Patient crying out in pain.

Question 8

Standard Precautions are:

A)Guidelines designed to prevent transmission of infection from any source of body fluid, except sweat, in healthcare settings.
B)Guidelines designed to prevent transmission of infection by blood and body fluids in healthcare settings.
C)Guidelines designed to prevent transmission of infection by a known source of infection.

Question 9

A nurse is working in the ER when an unconscious patient is received from rescue paramedics, without family members in attendance. The nurse performs a stat draw for several tests, while the entire ER team begins lifesaving treatment. This is an example of what form of consent?

A)Informed consent
B)Implied consent
C)Good Samaritan act

Question 10

Is the umbilical artery a possible site for arterial blood collection in an infant?

Question 11

A nurseTech is working in the ER when an unconscious patient is brought in with a massive hemorrhagic injury. A card is found in the patient's wallet indicating the patient's wishes in the event she is unable to speak for herself. The card indicates she would not want transfusion of blood products. What is this card known as and which type of consent does it cancel out?

A)Advance directive/informed consent
B)Advance directive/implied consent
C)Advance directive/Good Samaritan act

Question 12

The appropriate time for labeling a patient specimen is:

A)Before the blood is drawn
B)After all blood has been collected for the day
C)Immediately after collection
D)None of the above

Question 13

Is a splash-proof face shield necessary to enter a contact isolation room?

Question 14

What is the maximum size of a lancet intended for use on an infant?

A).5 mm
B)1.0 mm
C)2.0 mm
D)2.4 mm

Question 15

Standard precautions include the use of ___________ when touching or exposure to body fluid is anticipated.

A)Hand washing.
B)Gloves.
C)Gowns.
D)All of the above.

Question 16

The purpose of an incident report is:

A)To get your story in before the patient does.
B)Report an incident.
C)Tell on a co-worker anonymously.
D)Admit wrong doing in writing.

Question 17

A patient has just returned from a radiology test that included an IV injection of dye. The nurse collects the blood specimen and notes the radiographic test and time it was performed on the requisition form. Why did the nurse do this?

A)To inform the lab of possible adulterants.
B)To inform the lab of a procedure that may affect the blood test.
C)To inform the lab of other departments involved in the patients care.
D)To inform the lab of possible time delays.

Question 18

Which of the following is the "proper order of draws"?

A)Red top, yellow top, light blue top, additive tubes
B)Light blue top, red top, additive tubes
C)Hey, trick question! None of these answers is right!
D)Yellow top, light blue top, red top, additive tubes.

Question 19

What is the purpose(s) of the medical record?

A)To provide legal documentation that the patient, hospital, or health care workers can use as evidence in court proceedings.
B)To document the chronological order of the patient's care.
C)To document communication between the physician and members of the healthcare team.
D)All of the above.

Question 20

For which of the following test(s) should alcohol wipes NOT be used when drawing samples?

A)ETOH level
B)Complete blood count
C)Blood cultures
D)A and C

Question 21

Which of the following terms refers to improper or unskillful care of a patient by a health care worker, any unreasonable lack of skill, and/or professional misconduct?

A)Assault.
B)Slander
C)Malpractice
D)Battery

Question 22

What is the disadvantage of using the radial artery for arterial puncture?

A)There is not a disadvantage; it is the first choice for arterial puncture.
B)It lies close to the medial nerve.
C)It is small.
D)It is not easily palpable.

Question 23

Which is larger, a 22-gauge needle or a 18-gauge needle?

A)The 22-gauge needle is larger.
B)The 18-gauge needle is larger.

Question 24

Blood-borne pathogens are:

A)Disease-producing organisms.
B)Often found in blood and body fluids of infected patients.
C)Organisms that can be spread by sharps injuries.
D)All of the above

Question 25

In hypothesis testing, the area of the curve in which it is unlikely a researcher will obtain means is called the rejection region (or region of unlikely values). What conclusions are drawn when obtained values fall in the rejection region?

A)The experiment was unsuccessful and needs to be redesigned
B)Null hypothesis is rejected; there are differences between groups
C)Null hypothesis is rejected; there are no statistically significant differences between groups
D)Null hypothesis is accepted; there are no statistically significant differences between groups

Question 26

The disintegration or destruction of red blood cells along with subsequent rupture of the cell membrane and release of the cell contents, is the definition of which of the following terms?

A)Homeostasis.
B)Hemolysis.
C)Hemostasis.

Question 27

A nurse is using a butterfly syringe, tube adaptor, and pediatric tubes to collect blood from an adult patient with very fragile veins. Has the nurse made a mistake by doing this?

Question 28

Which of the following situations would be reported as a sentinel event, according to the Joint Commission?

A)A patient who received surgery on the wrong part of the body
B)A patient developing a stage II pressure wound during surgery
C)A patient who received an extra dose of antibiotic before surgery
D)A patient who developed a wound infection postoperatively

Question 29

What is glycolysis?

A)The additive used to preserve glucose in blood.
B)The destruction of red blood cells.
C)The process of breaking down glucose for energy.

Question 30

An amendment created to ensure accurate laboratory results was passed in 1988 and enacted in 1992; it applies to every American clinical laboratory. What is the name of this amendment?

A)Patient Bill of Rights
B)Clinical Laboratory Improvement Amendment
C)HIPPA

Question 31

Why is careful documentation and monitoring of the amount of draws and total volume of blood drawn, from a premature infant necessary?

A)It is not necessary.
B)To prevent unnecessary pain and testing.
C)It is not the nurse's responsibility.
D)To prevent complications related to blood volume depletion.

Question 32

What is the difference between the effects of asking a patient to hold a fist while applying a tourniquet, and the effects of applying warmth to a potential puncture site? Choose all that apply.

A)Application of heat engorges venous blood vessels, making palpitation easier
B)Application of heat causes dilation of blood vessels, allowing veins to fill with more blood
C)Holding a fist while a tourniquet is applied engorges venous blood vessels, making palpitation easier
D)Holding a fist while a tourniquet is applied causes dilation of blood vessels, allowing veins to fill with more blood
E)None of the above

Question 33

Where is the cephalic vein located?

A)In the antecubital area, on the outside of the arm.
B)In the antecubital area, on the inner side of the arm.
C)In the antecubital area, near the center of the arm.
D)On the hand.

Question 34

Where is a bevel of the needle located?

A)The point of the needle.
B)The inside of the needle.
C)The end of the needle that attaches to the hub of a syringe.

Question 35

A nurse is changing a client's abdominal dressing. A nursing assistant enters the room and informs the nurse that the IV fluid ordered for another client, who is experiencing difficulty breathing, has just arrived from the pharmacy. The nurse's most appropriate action is to:

A)Drape the client's abdomen, administer the IV fluid to the dyspneic client, and finish the treatment.
B)Ask the nursing assistant to find another nurse to administer the IV fluid, finish the treatment, and check on the respiratory rate of the dyspneic client.
C)Ask the nursing assistant to teach deep breathing exercises to dyspneic client until she's free to administer the IV.
D)Finish cleansing the wound, apply the sterile dressing, and administer IV fluid to the dyspneic client.

Question 36

A nurse notes that the site of the client's intravenous catheter is edematous and cool. Which of the following nursing actions is not appropriate for this client?

A)Removing the intravenous catheter immediately
B)Rubbing or massaging the infiltrated area
C)Elevating the affected extremity
D)Application of warm or cool compresses over the site

Question 37

Where is the antecubital fossa located?

A)The bend of the elbow, front of the arm.
B)The bend of the elbow, back of the arm.
C)The bend of the elbow, outer side of arm.
D)The bend of the elbow, inner side of arm.

Question 38

Generally, where and how is a tourniquet applied for a venipuncture procedure?

A)Midway between the shoulder and bend of elbow. Applied with enough pressure to compress and engorge the vein.
B)Three inches above venipuncture site. Applied with enough pressure to slow or stop blood flow.
C)Two inches above venipuncture site. Applied with enough pressure to compress and engorge the vein.
D)Midway between the shoulder and bend of elbow. Applied with enough pressure to slow or stop blood flow.

Question 39

A hospital supervisor is preparing for an evaluation of health care service quality on the surgical and medical wards of the hospital. The evaluators inspected the nursing staff's compliance with the standards and criteria provided by the hospital and accrediting agency. This method of quality assurance is called:

A)Retrospective
B)Concurrent
C)Introspective
D)Perspective

Question 40

An elderly client admitted in the intensive care unit suddenly experienced acute respiratory distress. This occurred while the nurse was infusing the IV meds via central line. Before placing the client on 100% oxygen, the nurse should first:

A)Discontinue the IV infusion.
B)Place the client in a left lateral position.
C)Place the client in a Trendelenburg's position.
D)Ask permission from the physician to remove the catheter.

Question 41

What is the difference between serum and plasma?

A)There is not a difference.
B)Serum contains proteins and no clotting factors; plasma contains serum and clotting factors.
C)Serum contains clotting factors; plasma contains serum and proteins.
D)Serum and plasma contain clotting factors. Serum also contains proteins; plasma also contains lymph fluid.

Question 42

A nurse is making the initial rounds for the IV fluids of clients assigned to her care. The nurse notes that the client in Room 312, a 23-year-old student admitted for hemorrhagic fever, is complaining of difficulty breathing with productive cough. The nursing assessment shows swelling of the arms and crackles. How should the nurse have prevented this?

A)Elevate the head of bed.
B)Closely monitor oral fluid intake.
C)Use infusion pumps to reduce the risk of rapid fluid infusion.
D)Monitor daily weights and I&O to appropriately adjust the IV infusion.

Question 43

In which of the following situations can the nurse release client information without obtaining the client's consent first?

A)A member of the research team is inquiring about a client who is a subject of a clinical trial.
B)A documentary film is doing a story on the client.
C)The client has a communicable and infectious respiratory disease.
D)The client's relative who is a physician in the same hospital asks for information.

Question 44

A nurse is administering vasopressin IV to a patient with bleeding esophageal varices. When evaluating the therapeutic effect of this drug on the patient's condition, the nurse should check for:

A)Increased pulse rate
B)Increased hemostasis
C)Increased urine output
D)Increased blood pressure

Question 45

As the nurse is making her rounds, she notes that a client's intravenous site is cool, slightly edematous, and painful. When the vein proximal to the IV site is occluded by the nurse, the IV fluid continues to flow. The nurse determines that which of the following complications is being experienced by the client?

A)Phlebitis
B)Hematoma
C)Infiltration
D)Infection

Question 46

At 9:00 a.m., a nurse finds that a client being infused with 5% dextrose in 0.9% sodium chloride is having difficulty of breathing. On assessment, the nurse notes increased blood pressure, distended jugular veins, and crackles on auscultation. The solution in a 1,000 ml infusion bag was hung at 8:00 a.m. The remaining solution is measured at 600 ml. The nurse's most immediate action is to:

A)Notify the physician
B)Place the client in semi-Fowler's
C)Stop the infusion and contact the physician
D)Stop the infusion and remove the IV catheter

Question 47

A nurse is enrolled in an orientation program regarding clients' rights, confidentiality, and ethical practices in nursing. Which of the following situations is an example of a breach of confidentiality?

A)Release of laboratory results to the client via an encrypted electronic email.
B)Disclosing information for reimbursement of hospital payment.
C)Disclosing the client's disease prognosis to the estranged spouse.
D)Using a reference number to replace the client's name in the medical record.

Question 48

Ana, a 22-year-old student, was admitted for a needle biopsy of a breast mass. A day after the procedure, Ana developed a high fever accompanied by localized redness of the IV site. The physician suspects bacteremia. Which of the following actions could prevent this infection from spreading?

A)Strict hand-washing practice
B)Antibiotic therapy
C)Place the client on isolation
D)Wear full PPE during client contact

Question 49

The following are accurate statements about informed consent except:

A)A nurse can be involved in the informed consent process.
B)A client cannot refuse information, waive the informed consent, and undergo treatment.
C)If a client is mentally incompetent, the next of kin can give consent.
D)A client can withdraw consent any time.

Question 50

A woman in labor is administered with methylergonovine (Methergine) IV. The occurrence of which adverse side effect necessitates immediate intervention?

A)Headache
B)Hypotension
C)Hypertension
D)Tachycardia

Question 51

A nurse has prepared a client for an elective surgical procedure. After administering a pre-op sedative, the nurse notices the consent form was not signed. She asks the client to sign it before going to surgery. Is this the appropriate action? If not, why?

A)No, this is not appropriate or necessary because the client willingly came to the facility for an elective procedure, which implies consent.
B)No, this is not appropriate because the client has received a mind-altering medication (sedative) and is unable to give informed consent.
C)Yes, the consent must be signed before the procedure can begin.

Question 52

Which of the following statements is true regarding sharps counts during the operating procedure?

A)Packages of suture should all be opened onto the sterile field for counting.
B)The scrub nurse should document how many needles are contained within a package at the time of counting.
C)Needles should be counted once at the beginning of the procedure and once at the end.
D)A broken needle should be counted as two sharps because of having two sharp ends.

Question 53

What is the difference between fainting and hypovolemic shock?

A)Hypovolemic shock is a medical emergency.
B)Fainting is a medical emergency.
C)Fainting may be caused by an emotional reaction or pain.
D)A and C

Question 54

What is the most important action a nurse can do to protect themself if they become the target of legal action from a patient?

A)Document all patient assessments, nursing diagnoses and interventions for the patient.
B)Keep a separate notebook for the nurse's own reference of any situations that were questionable.
C)Have adequate professional insurance and access to a good attorney.
D)Both A and B

Question 55

A physician orders regular insulin at 10 units per hour to be administered by IV infusion pump. An IV infusion bag is labeled 100 units of regular insulin in 500 ml of 5% dextrose in water. The nurse prepares to set the infusion pump at how many millimeters per hour?

A)10 ml
B)20 ml
C)50 ml
D)100 ml

Question 56

Which of the following is considered to be a disadvantage of using intravenous anesthesia?

A)Increased risk of nausea and vomiting
B)Laryngospasm may occur with use
C)Dizziness typically occurs during onset
D)Both A and C

Question 57

What is the normal range of central venous pressure when measured with a transducer?

A)2 to 6 mmHg
B)7 to 10 mmHg
C)12 to 20 mmHg
D)25 to 50 mmHg

Question 58

Which of the following is the most important aspect of assessing a patient's readiness for education?

A)The amount of time before the procedure
B)What procedure the patient is going to have
C)The patient's health status
D)The time of day in which the surgery is scheduled

Question 59

The nurse is in a patients' room, about to collect a blood specimen. During her examination of the patient's arm for a potential site, she observes areas of pinpoint, red dots scattered over both of the patient's arms. What is the clinical name for this phenomenon, and what does the presence of pinpoint red dots indicate?

A)It is known as petechiae, indicating possible excessive bleeding after blood collection.
B)It is known as measles, indicating possible infectious disease exposure.
C)It is known as psoriasis, indicating a possible skin disorder and should be avoided as a potential venipuncture site.

Question 60

A patient is receiving thrombolytic therapy to treat a large clot that has formed as a pulmonary embolism while on the post-surgical unit. The patient begins to bleed profusely from the nose and the intravenous line. What is the nurse's response?

A)Apply direct pressure to major sites of bleeding to induce clotting.
B)Increase the rate of fluid and electrolytes while decreasing the thrombolytic therapy.
C)Apply cold compresses to bleeding sites and assess respiratory function.
D)Stop the thrombolytic therapy completely and notify the physician.

Question 61

A nurse is working in the hospital's blood bank. He is collecting an autologous blood donation from a patient who will have surgery in a few weeks. Because the patient's surgery could involve significant blood loss, she has been coming to the hospital's blood bank every week for the past four weeks. While collecting the blood, the patient complains of feeling faint. The nurse observes that the patient is pale, her skin is cool and clammy, and her breathing appears very rapid and shallow. He immediately clamps the blood collection tubing, covers the patient with a blanket, re-positions the blood donor chair into the Trendelenburg position, and calls for help. Why did the nurse do this?

A)The nurse believes her patient is about to faint.
B)The nurse is overreacting.
C)The nurse has observed the symptoms of hypovolemic shock.
D)The nurse believes her patient is experiencing an allergic reaction.

Question 62

The patient on the operating table has started bleeding from several different orifices, including their mucous membranes and intravenous lines. What type of medication should the nurse administer in this situation?

A)Erythropoietin
B)Benazepril
C)Lactulose
D)Heparin

Question 63

A central venous pressure catheter directly measures the pressure of which portion of the heart?

A)Right atrium
B)Right ventricle
C)Left atrium
D)Left ventricle

Question 64

The nurse is gathering equipment for an arterial puncture. She has gathered the following equipment: heparin solution of 1,000 IU per ml, sterile gauze, betadine wipes, sterile needle, and syringe. What has the nurse forgotten?

A)Container of ice water.
B)Alcohol wipes.
C)Tourniquet.
D)Requisition form.

Question 65

The nurse is aware that their hospital has a policy that allows nursing aides to remove intravenous lines while on the surgical unit. The nurse delegates this task to the aide and the intravenous catheter is removed incorrectly. Who is responsible for this mistake?

A)The hospital, because the policy allowed the procedure.
B)The nurse, because they supervised the procedure.
C)The aide, because they performed the procedure.
D)Both B and C

Question 66

The nurse is preparing to insert an intravenous catheter to administer fluids for a patient who will have surgery. What is the most important factor that affects the nurse's choice of location for this site?

A)The type of cannula to be used
B)The duration of the infusion
C)The condition of the vein for use
D)Both B and C

Question 67

What special precaution should be observed when collecting a specimen for blood cultures?

A)Maintaining aseptic technique.
B)Maintaining postural position.
C)Maintaining calmness.

Question 68

A patient is admitted with severe burns over 50 percent of their body. The nurse inserts an IV to begin fluid administration and for medications. What is the typical process of fluid shift for this type of patient within the first 48 hours?

A)Fluid is pulled out of the blood vessels and into the tissues.
B)Fluid is pulled out of the tissues and into the blood vessels.
C)Fluid maintains equilibrium between the blood vessels and the tissues.
D)Fluid movement depends on the type of burn and the patient's electrolyte status.

Question 69

Which statement is a requirement when managing exposure to blood borne pathogens?

A)Nurses should receive training in handling occupational exposure if there is a risk of coming in contact with blood borne pathogens.
B)Food and drink should be kept on a separate table in the operating suite, away from the patient.
C)A contaminated needle should be carefully recapped before placing it in a biohazard container.
D)Employers are required to provide measures for hand hygiene practices.