Deck 28: Intravenous and Vascular Access Therapy

Question 1

What should be the next action by the nurse,once the over-the-needle catheter (ONC)has been inserted through the skin and into the vein?

A) Loosen the stylet for removal
B) Check for blood return in the flashback chamber
C) Stabilize the catheter and release the tourniquet
D) Advance the catheter until the hub rests at the insertion site

Answer 1

Check for blood return in the flashback chamber

Question 2

What is an appropriate technique for the nurse to implement when changing the dressing of a peripheral IV site?

A) Wear sterile gloves to remove the old dressing
B) Keep one finger over the IV catheter until the tape is replaced
C) Cleanse with an antiseptic solution in a circular manner toward the site
D) Tape the connection between the IV catheter port and the tubing

Answer 2

Keep one finger over the IV catheter until the tape is replaced

Question 3

Established standards for routine replacement of peripheral IV catheters and intravenous administration sets have recommended a maximum of _____ hours to reduce IV fluid contamination and prevent catheter site complications.

A) 24
B) 48
C) 72
D) 84

Answer 3

72

Question 4

A nurse needs to specifically prevent air emboli that may result from IV therapy.What should the nurse make sure to do to prevent air emboli?

A) Use a needleless system
B) Prime the tubing completely
C) Check for medication compatibility
D) Select a larger-gauge needle or catheter

Question 5

What should the nurse do when discontinuing a peripheral IV?

A) Withdraw the catheter quickly
B) Keep the hub perpendicular to the skin
C) Apply pressure to the site for 1 minute
D) Inspect the catheter for intactness after removal

Question 6

The nurse is preparing to hang an intravenous (IV)bag of D?NS with 20 mEq of potassium chloride (KCl)at 100 mL/hour.What is true about IV administration?

A) Isotonic fluids are used to reduce extracellular volume
B) Hypertonic solutions usually are given to patients with pulmonary edema
C) KCl should never be given by IV push
D) KCl is rarely added to IV solutions

Question 7

The nurse is caring for a patient who receives intermittent intravenous antibiotic therapy.Between doses,the nurse uses intravenous fluid to keep the vein patent.At what infusion rate should he/she set the IV to achieve that goal?

A) 50 mL/hour
B) 75 mL/hour
C) 15 mL/hour
D) 5 mL/hour

Question 8

What should the nurse do once she/he recognizes that the patient has phlebitis at his IV site?

A) Reduce the IV flow rate
B) Elevate the affected extremity
C) Place a moist warm compress over the site
D) Adjust the additive in the current IV

Question 9

The patient has an IV ordered to infuse at 1000 mL over 10 hours.The infusion set has a calibration of 15 gtt/mL.The nurse regulates the infusion at:

A) 20 gtt/min
B) 25 gtt/min
C) 30 gtt/min
D) 32 gtt/min

Question 10

What should the nurse do upon noting bleeding around a dressing at an IV insertion site?

A) Discontinue the IV
B) Assess the insertion site
C) Leave the dressing intact, but reinforce it
D) Elevate and apply warm compresses to the extremity

Question 11

How often should primary intermittent IV sets be changed?

A) No more often than every 72 hours
B) At least every 72 hours
C) With each IV bag change
D) Every 24 hours

Question 12

While assessing the patient's IV infusion,the nurse notes that it is infusing slower than it should be.What should the nurse do first?

A) Discontinue the IV
B) Increase the rate of the infusion
C) Observe for fluid overload
D) Check the position of the IV fluid and extremity

Question 13

How often does the Centers for Disease Control and Prevention (CDC)recommend changing the tubing on continuously running IVs?

A) At least every 72 hours
B) Every 24 hours
C) No more often than every 72 hours
D) With each IV solution bag change

Question 14

Which of the following steps is necessary when a patient is prepared for IV insertion?

A) Shaving the hair from the site
B) Selecting a proximal site in an extremity
C) Applying a tourniquet 4 to 6 inches above the selected site
D) Vigorously taping and massaging the selected vein

Question 15

The order is for the patient to receive 500 mL over 4 hours.The nurse has an electronic infusion device (EID)in place that provides for the regulation of hourly infusion.The IV tubing available is 10 gtt/mL.What is the setting for the infusion device?

A) 125 mL/hour
B) 500 mL/hour
C) 21 gtt/min
D) 32 gtt/min

Question 16

Which patient would a nurse anticipate would be a candidate for a peripherally inserted central catheter (PICC)?

A) An older adult who is having cataracts removed
B) A perinatal patient who is having a prolonged labor
C) A neonate who is requiring extended antibiotic therapy
D) An adolescent who is having surgery for the reduction of a fracture

Question 17

The patient is expected to require intravenous therapy for several years as treatment for a chronic disease process.Which of the following would be the best choice for venous access in this patient?

A) Peripherally inserted central catheter (PICC)
B) Nontunneled percutaneous central venous catheter
C) Subcutaneous implanted port
D) Peripheral IV

Question 18

While assessing the patient,the nurse recognizes that special caution should be taken with the IV infusion because of fluid volume excess when the nurse notes the presence of:

A) Poor skin turgor
B) Crackles in the lungs
C) Decreased blood pressure
D) Dry skin and mucous membranes

Question 19

The nurse is assisting the physician during the insertion of a central line into the subclavian vein.How should the nurse cleanse the area?

A) Alcohol usually is used first, followed by chlorhexidine
B) Chlorhexidine usually precedes alcohol
C) The physician scrubs an area using back and forth strokes
D) The antimicrobial solution must be dabbed dry with a sterile towel

Question 20

A pediatric patient has an IV with a microdrip.The order is for 40 mL/hour to infuse.The nurse regulates the microdrip at:

A) 10 gtt/min
B) 20 gtt/min
C) 40 gtt/min
D) 80 gtt/min

Question 21

___________________ is manifested by decreased urine output,dry mucous membranes,decreased capillary refill,a disparity in central and peripheral pulses,tachycardia,hypotension,and shock.

Question 22

The nurse is caring for a patient who will be on long-term antibiotic therapy.The patient has had numerous IVs in the past,but since the upcoming therapy will be long-term,the nurse suggests that a _________________ be inserted.

Question 23

Fluids that have the same osmolality as body fluids are used most often to replace extracellular volume and are known as _______________ fluids.

Question 24

An IV catheter attached to an injection cap to maintain a closed system is known as an ________________.

Question 25

The nurse is caring for a patient who has a peripheral IV.While performing her routine assessment,she notes that the insertion site is pale,cool,and edematous.The patient indicates that the site is also painful to the touch.The nurse recognizes these symptoms as revealing a possible _______________.

Question 26

The nurse is caring for a patient who is receiving IV fluids at a rate of 150 mL per hour.During her assessment,the nurse notes that the patient is having more labored respirations,and that crackles have developed in the patient's lungs.The nurse reduces the IV rate and notifies the physician.She does this while recognizing that the patient is experiencing signs of _______________.

Question 27

The nurse is preparing to start an IV on a 92-year-old patient.The nurse realizes that she may need to take which of the following actions? (Select all that apply.)

A) Avoid using veins in the hand
B) Avoid using veins in the dominant arm
C) Use the largest-gauge catheter possible for maximum flow
D) Avoid using a tourniquet

Question 28

_________________________ pull fluid into the vascular space by osmosis,resulting in an increased vascular volume that possibly will result in pulmonary edema.

Question 29

The nurse is preparing to draw blood from a central venous access device for blood cultures.Which of the following steps is part of that process?

A) Apply sterile gloves
B) Flush the port with 5 to 10 mL of 0.9% sodium chloride
C) Slowly aspirate 5 mL of blood and discard the syringe
D) Use the proximal lumen to draw blood

Question 30

While assessing the patient's IV site,the nurse notes that the site is reddened and warm.The patient states that it is "sore." The nurse recognizes these as signs of ____________.

Question 31

An electronic device that delivers a measured amount of intravenous fluid over a specified period of time (e.g.,100 mL/hr)using positive pressure is called an ___________________.

Question 32

What should the nurse do to decrease the potential for infection related to IV therapy?

A) Use clean technique for dressing changes
B) Change the IV tubing every 12 hours
C) Palpate the insertion site daily through the intact dressing
D) After cleansing the skin, dab dry with a sterile gauze pad

Question 33

Central venous access devices (CVADs)can be used in the home,hospital,and long-term care facilities for patients who require which of the following? (Select all that apply.)

A) Supplemental nutrition
B) Blood and blood products
C) Hemodynamic monitoring
D) Blood sampling
E) None of above

Question 34

The patient is on daily weights and is receiving intravenous therapy.The nurse notices that the patient has gained 2 kg since the previous morning.What else would the nurse expect to observe? (Select all that apply.)

A) Dry skin and mucous membranes
B) Distended neck veins
C) Tenting of the skin
D) Crackles or rhonchi in the lungs

Question 35

For which patients are electronic infusion devices (EID)used? (Select all that apply.)

A) Those who require low hourly rates
B) Those who are at risk for volume overload
C) Those who have impaired renal clearance
D) Those who are receiving fluids that require a specific hourly volume
E) None of above

Question 36

Intravenous pumps that have built-in software programmed from health care pharmacy databases with unit-specific profiles are known as ______________.

Question 37

A nurse suspects that a patient with a vascular access device (VAD)may have an air embolus.What should the nurse do for this patient?

A) Request a venogram
B) Begin anticoagulant therapy
C) Administer a significantly increased amount of fluid
D) Position the patient on the left side with the head slightly elevated

Question 38

Which of the following are CVADs? (Select all that apply.)

A) Implanted subcutaneous ports
B) Peripherally Inserted Central Catheters (PICC) lines
C) Saline locks
D) Heparin locks

Question 39

What should the nurse do upon noting that the patient's IV site is pale,cool,and edematous? (Select all that apply.)

A) Stop the infusion
B) Elevate the extremity
C) Restart a new IV
D) Flush the IV site

Question 40

Which of the following are common causes of needle stick injury? (Select all that apply.)

A) Recapping needles
B) Accessing IV tubing with needles
C) Using needleless systems
D) Disposing of sharps inappropriately

Question 41

An intravenous catheter that is inserted through a large arm vein and is advanced until the tip enters the central venous system is known as a __________________.

Question 42

_________________________are surgically inserted through a tunnel into subcutaneous tissue,usually between the clavicle and the nipple ,into the internal jugular or subclavian vein,with the catheter tip resting in the distal end of the superior vena cava .The subcutaneous tunnel allows the catheter to remain in place for months to years.

Question 43

Intravenous catheters that usually are 6 to 8 inches in length and that are inserted directly through the skin and into the internal or external jugular,subclavian,or femoral veins are known as ____________________.