Deck 12: Venous Access

Question 1

The nurse needs to draw multiple laboratory samples from a client. Which sample should be drawn first?

A) Blood cultures
B) Electrolytes
C) CBC
D) Clotting panel

Answer 1

Blood cultures

Question 2

The new nurse is inserting a peripheral IV line on a client. Which action demonstrates that the nurse needs to review the correct technique?

A) Covers the insertion site with a transparent dressing
B) Applies antibacterial ointment at the insertion site
C) Allows the skin cleanser to dry before the venipuncture
D) Stabilizes the hub of the IV catheter with a securement device

Answer 2

Applies antibacterial ointment at the insertion site

Question 3

A client reports that the fluid in the IV is making the hand "turn cold." What action by the nurse is best?

A) Provide the client a warm compress for the hand.
B) Switch to infusing warmed IV fluids.
C) Discontinue the IV and look for another site.
D) Assess the IV site for infiltration.

Answer 3

Assess the IV site for infiltration.

Question 4

The nurse understands that the normal saline solution (0.9% NS) is often used to rehydrate clients due to which property?

A) They are inexpensive and readily available.
B) They do not cause net movement of fluid or solutes.
C) They contain adequate amounts of glucose.
D) They are less prone to infiltrating.

Question 5

Which statement by the student about IV tubing sets shows good understanding?

A) The primary set is the only one that runs on a pump.
B) The primary set has longer tubing and needleless ports.
C) The secondary tubing is too short to run through a pump.
D) The secondary tubing is for medications that aren't critical.

Question 6

A nurse is working with IVs in several clients. Which action by the nurse demonstrates a need to review this material?

A) Scrubs the hub on a primary IV line for 30 seconds
B) Changes the IV tubing and dressing after 48 hours
C) Taps the IV tubing to remove any air bubbles
D) Uses gloves when working with an IV

Question 7

A nurse has hung a secondary medication as an IV piggyback into a primary line being run on an infusion pump. The piggyback attaches to the primary tubing above the pump. The piggyback is not infusing properly. What action does the nurse take?

A) Lowers the piggyback below the level of the pump
B) Stops the primary infusion and runs the piggyback by gravity
C) Lowers the primary infusion bag so that it is below the piggyback
D) Makes sure the two bags are hanging at the same height

Question 8

A new nurse is preparing to administer an IV push medication. After drawing the medication up, determining how fast to push the medication, identifying the client, performing hand hygiene, and assessing the IV site, the nurse gives the medication. What step would an experienced nurse include that the new nurse forgot?

A) Checking for compatibilities
B) Documentation of administration
C) Preparing the IV piggyback bag
D) Stopping a running IV infusion

Question 9

What does the nurse understand about an autologous transfusion?

A) It comes from a random donor.
B) It is pooled from several donors.
C) The donor has a similar genetic background.
D) It is the client's own blood.

Question 10

A client in the Emergency Department is hemorrhaging severely and needs immediate blood transfusion. What type of blood can this client safely receive without being crossmatched to it?

A) A
B) B
C) AB
D) O

Question 11

When collecting blood samples with a butterfly needle and vacutainer, what disadvantage is the nurse aware of?

A) No visible flash back
B) Vacuum may have too much pressure for fragile veins.
C) Only can draw a small amount of blood
D) Slow process; blood may clot

Question 12

The nurse needs to hang an isotonic IV solution. Which solution will the nurse choose?

A) 10% dextrose in water (D10W)
B) 0.9% NaCl in water (Normal saline, NS)
C) 0.45% NaCl in water (1/2 NS)
D) 5% Dextrose in 1/2 Normal saline (D5 1/2 NS)

Question 13

The nurse caring for a client who has hemophilia understands the client will receive transfusions of which blood product?

A) Whole blood
B) Packed red blood cells
C) Fresh frozen plasma
D) Cryoprecipitate

Question 14

A client is receiving a transfusion of packed red blood cells and reports chills, fever, and back pain. What action by the nurse is best?

A) Administer acetaminophen or ibuprofen.
B) Obtain a heating pad for the back pain.
C) Obtain an oxygen saturation.
D) Stop the transfusion immediately.

Question 15

A client with heart failure is to receive a transfusion of 2 units of packed red blood cells. What action by the nurse is best?

A) Transfuse the blood over the maximum time allowed.
B) Premedicate the client with diphenhydramine.
C) Collect a urine sample after the transfusion has finished.
D) Draw blood for a type and crossmatch first.

Question 16

The provider left an order for a client to receive 1000 mL of normal saline solution over 6 hours. The student nurse sets the pump to run at 145 mL/hour. What action by the faculty is best?

A) Tells the student a pump is not necessary
B) Watches the student set the pump rate
C) Tells the student to recalculate the rate
D) Gives the student a secondary IV set

Question 17

What information does the nurse give the client about delayed transfusion reactions?

A) They usually cause shortness of breath.
B) They don't occur for 48 to 72 hours.
C) They can cause back pain and fever.
D) Only patients with heart disease are at risk.

Question 18

During handoff report, the nurse is informed that a client has had an extravasation. What does the nurse understand about this condition?

A) Fluid from the IV leaked out of the vein.
B) Blood cells around the IV site ruptured.
C) The veins have become hardened.
D) Tissue-damaging fluid leaked out of the vein.

Question 19

The nurse is hanging an IV piggyback with 100 mL with a microdrop tubing set. The infusion is to go over 60 minutes. How many drops per minute would deliver the rate correctly?

A) 30 drops/minute
B) 60 drops/minute
C) 100 drops/minute
D) 120 drops/minute

Question 20

The nurse is hanging an IV piggyback with 100 mL with a macrodrop tubing set (drop factor 20). The infusion is to go over 60 minutes. How many drops per minute would deliver the rate correctly?

A) 10 drops/minute
B) 20 drops/minute
C) 23.3 drops/minute
D) 33.3 drops/minute

Question 21

Which techniques will encourage a vein to dilate in preparation for a blood draw? (Select all that apply.)

A) Hold the extremity below the level of the heart.
B) Have the patient make a fist and release it repeatedly.
C) Tap the vein lightly or stroke it in a distal direction.
D) Apply cool, wet compresses for 10 minutes.
E) Put on a tourniquet 2 or 3 minutes before venipuncture.

Question 22

The nurse is selecting a vein for an IV. What characteristics are most desirable? (Select all that apply.)

A) Straight
B) Not over a joint
C) Has many valves
D) Distal
E) Stabilized in connective tissue

Question 23

A nurse is administering an infusion of packed red blood cells. What actions does the nurse take in order to complete this procedure? (Select all that apply.)

A) Start the transfusion within 30 minutes of obtaining the blood.
B) Ensure a signed consent form is on the chart.
C) Take vital signs every 10 minutes until the transfusion is done.
D) Finish the transfusion within 4 hours.
E) Briefly warm the blood in a warm water bath before infusing.

Question 24

When administering platelets, what actions does the nurse take? (Select all that apply.)

A) Uses standard blood transfusion tubing
B) Leaves the platelets at room temperature
C) Starts the transfusion as soon as the platelets arrive
D) Infuses the platelets over 30 to 60 minutes
E) Runs the platelets with the packed cells if possible

Question 25

A client is having a serious blood transfusion reaction. What actions does the nurse take? (Select all that apply.)

A) Stop the transfusion immediately
B) Keep the IV open by infusing the normal saline
C) Notify the provider right away
D) Bag the blood and tubing to send to the blood bank
E) Call the Rapid Response Team