Deck 15: Infusion Therapy

Question 1

The nurse wants to find written standards for IV therapy.The nursing manager suggests that the nurse investigate publications from which resource?

A) IV Therapy Nursing Society
B) Infusion Nurses Society
C) Nurse's State Board of Nursing
D) Hospital's IV solutions vendor

Answer 1

Infusion Nurses Society

Question 2

Before the administration of intravenous fluid,it is most important for the nurse to obtain which information from the health care provider's orders?

A) Intravenous catheter size
B) Osmolarity of the solution
C) Vein to be used for therapy
D) Specific type of IV fluid

Answer 2

Specific type of IV fluid

Question 3

To prevent infection when infusing an intermittent "piggyback" line,which intervention does the nurse implement?

A) Backpriming the secondary container from the primary line
B) Detaching and capping the secondary line after use
C) Using a new secondary container with each drug infused
D) Using sterile gloves when administering medication

Answer 3

Backpriming the secondary container from the primary line

Question 4

When assessing the client's peripheral IV site,the nurse observes a streak of red along the vein path and palpates a 4-cm venous cord.What is the most accurate documentation of this finding?

A) Grade 3 phlebitis at IV site
B) Infection at IV site
C) Thrombosed area at IV site
D) Infiltration at IV site

Question 5

A client is admitted to the hospital for excessive nausea and vomiting,and a blood pressure of 90/50 mm Hg.A catheter of which gauge is most appropriate for the nurse to choose for this client's peripheral IV?

A) 24
B) 22
C) 20
D) 18

Question 6

A client who has just had an IV started in the right cephalic vein tells the nurse that the wrist and the hand below the IV site feel like "pins and needles." Which action by the nurse is best?

A) Document the finding and continue to monitor the IV site.
B) Check for the presence of a strong blood return.
C) Discontinue the IV and restart it at another site.
D) Elevate the extremity above the level of the heart.

Question 7

Which IV order does the nurse question?

A) Flush Groshong catheter with 10 mL normal saline every 8 hours.
B) Infuse 20 mEq potassium chloride in 1000 mL D₅W at 50 mL/hr.
C) Infuse 500 mL normal saline over 1 hour.
D) Infuse 0.9% normal saline at keep vein open (KVO) rate.

Question 8

In examining a peripheral IV site,the nurse observes a red streak along the length of the vein,and the vein feels hard and cordlike.What action by the nurse takes priority?

A) Applying continuous heat
B) Continuing to monitor site
C) Elevating the extremity
D) Removing the catheter

Question 9

The nurse is assessing several clients receiving intravenous therapy.Which client situation requires immediate intervention?

A) Completion of an intermittent medication into a Groshong catheter
B) Physician's order to discontinue a peripheral intravenous catheter
C) Nonaccessed implanted port placed 1 month ago without problem
D) Peripheral IV catheter dated 5 days ago used for once-daily antibiotics

Question 10

A client is to receive 10 days of antibiotic therapy for urosepsis.The nurse plans to insert which type of intravenous catheter?

A) Hickman
B) Midline
C) Nontunneled central
D) Short peripheral

Question 11

After discontinuing a nontunneled,percutaneous central catheter,it is most important for the nurse to record which information?

A) Application of a sterile dressing
B) Length of the catheter
C) Occurrence of venospasms
D) Type of ointment used to seal the tract

Question 12

The nurse is caring for four clients receiving IV therapy.Which client does the nurse assess first?

A) Client with a newly inserted peripherally inserted central catheter (PICC) line waiting for x-ray
B) Client with a peripheral catheter for intermittent infusions
C) Older adult client with a nonaccessed implanted port
D) Older adult client with normal saline infusion

Question 13

A nursing administrator is concerned about the incidence of complications related to IV therapy,including bloodstream infection.Which action by the administrator would have the biggest impact on decreasing complications?

A) Investigate initiating a dedicated IV team.
B) Require inservice education for all RNs.
C) Limit IV starts to the most experienced nurses.
D) Perform quality control testing on skin preparation products.

Question 14

The home care nurse is about to administer intravenous medication to the client and reads in the chart that the peripherally inserted central catheter (PICC)line in the client's left arm has been in place for 4 weeks.The IV is patent,with a good blood return.The site is clean and free from manifestations of infiltration,irritation,and infection.Which action by the nurse is most appropriate?

A) Notify the physician.
B) Administer the prescribed medication.
C) Discontinue the PICC line.
D) Switch the medication to the oral route.

Question 15

A client who is having a tunneled central venous catheter inserted begins to report chest pain and difficulty breathing.What action does the nurse take first?

A) Administer the PRN pain medication.
B) Prepare to assist with chest tube insertion.
C) Place a sterile dressing over the IV site.
D) Place the client in the Trendelenburg position.

Question 16

When an IV pump alarms because of pressure,what action does the nurse take first?

A) Check for kinking of the catheter.
B) Flush the catheter with a thrombolytic enzyme.
C) Get a new infusion pump.
D) Remove the IV catheter.

Question 17

What information is most important to teach the client going home with a peripherally inserted central catheter (PICC)line?

A) "Avoid carrying your grandchild with the arm that has the IV."
B) "Be sure to place the arm with the IV in a sling during the day."
C) "Flush the IV line with normal saline daily."
D) "You can use the arm with the IV for most of the activities of daily living."

Question 18

The RN assigned a new nurse to a client who was receiving chemotherapy through an intravenous extension set attached to a Huber needle.Which information about disconnecting the Huber needle is most important for the RN to provide to the new nurse?

A) "Apply topical anesthetic cream to the area after discontinuing the system."
B) "Be aware of a rebound effect when discontinuing the system."
C) "Be sure to flush the system with saline after removing the Huber needle."
D) "Place pressure over the site to prevent bleeding."

Question 19

The nurse finishes administering an intermittent medication through a Groshong catheter.What is the nurse's next action?

A) Clamping the catheter
B) Flushing the line with saline
C) Flushing with heparin
D) Removing the access needle

Question 20

Which infusion device does the nurse select for the older adult client with a medical diagnosis of "dehydration"?

A) Cassette pump
B) Elastomeric balloons
C) Volumetric controller
D) Syringe pump

Question 21

The nurse has just performed an IV start on a client.After the catheter has been threaded its full length in the client's vein,which action does the nurse perform next?

A) Secure the IV with a securement device or tape.
B) Dispose of the IV needle in the sharps container.
C) Engage the safety mechanism of the IV catheter
D) Note the date and time of the dressing application over the insertion site.

Question 22

What action does the nurse take to prevent infection in the older adult receiving IV therapy?

A) Applying skin protectant before applying the dressing
B) Avoiding the use of alcohol pads when removing tape
C) Shaving the skin before attempting the venipuncture
D) Using maximum friction to cleanse the skin

Question 23

Five days after the start of intraperitoneal therapy,the client reports abdominal pain and "feeling warm." The nurse prepares to assess the client further for evidence of which condition?

A) Allergic reaction
B) Bowel obstruction
C) Catheter lumen occlusion
D) Infection

Question 24

The nurse is caring for a client with a radial arterial catheter.Which assessment takes priority?

A) Amount of pressure in fluid container
B) Date of catheter tubing change
C) Checking for heparin in infusion container
D) Presence of an ulnar pulse

Question 25

A new nurse is securing the connections on a new IV administration set connected to a peripherally inserted central catheter (PICC)line with tape.Which action by the precepting nurse is most appropriate?

A) Make sure the tape being used is from a sterile IV start kit.
B) Stop the nurse and confirm that the Luer-Lok connections are tight.
C) Help the new nurse document the set change appropriately.
D) Show the new nurse how to turn back the corner of the tape for easy removal.

Question 26

A new nurse is preparing to start an IV on a client who is dehydrated and needs significant fluid volume.The new nurse selects a butterfly needle for the infusion.What action by the supervising nurse is best?

A) Help the new nurse with the procedure as needed.
B) Make sure the new nurse has the correct dressing.
C) Stop the new nurse and review the procedure in private.
D) Get the ultrasonic vein finder to help illuminate veins.

Question 27

A client is receiving an infusion of amiodarone (Cordarone),and the nurse notes that the client's arm has begun to blister around the IV site.This manifestation is consistent with which condition?

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

Question 28

Which assessment finding for a client with a peripherally inserted central catheter (PICC)line requires immediate attention?

A) Initial dressing over site is 3 days old.
B) Line has been in for 4 weeks.
C) A securement device is absent.
D) Upper extremity swelling is noted.

Question 29

When assessing a client's peripheral IV site,the nurse notices edema and tenderness above the site.What action does the nurse take first?

A) Apply cold compresses to the IV site.
B) Elevate the extremity on a pillow.
C) Flush the catheter.
D) Stop the infusion of IV fluids.

Question 30

A client is to receive a blood transfusion.Before the transfusion,what action by the nurse takes priority?

A) Verifying the client's identity
B) Ensuring that the blood bank has enough blood
C) Establishing a peripheral IV site
D) Feeding the client before starting the blood

Question 31

The nurse preparing to insert an IV on an older adult client notices that the client's skin is extremely fragile.Which action by the nurse is best?

A) Use a blood pressure cuff to cause the vein to distend.
B) Slap the skin vigorously to cause the vein to rise.
C) Place a gauze pad under the tourniquet before tightening.
D) Avoid the use of a tourniquet if the vein is already hard.

Question 32

The nurse is caring for a client with an intraosseous catheter placed in the leg 20 hours ago.Which assessment is of greatest concern?

A) Length of time catheter is in place
B) Poor vascular access in upper extremities
C) Affected leg cool to touch
D) Site of intraosseous catheter placement

Question 33

A nurse is preparing to administer two drugs at the same time to a client via a double-lumen midline catheter.Which action by the nurse is most important?

A) Check the two drugs for compatibility.
B) Compare the recommended infusion times.
C) Schedule any post-infusion lab draws.
D) Flush both lumens with saline before starting the infusion.

Question 34

Which client is the best candidate to receive hypodermoclysis for IV therapy?

A) Client requiring 4000 mL normal saline in 24 hours
B) Client with an extensive burn injury
C) Client with allergy to hyaluronidase
D) Client receiving pain management

Question 35

The nurse is caring for a client who is receiving an epidural infusion for pain management.Which action has the highest priority?

A) Assessing the respiratory rate
B) Changing the dressing over the site
C) Using various pain management therapies
D) Weaning the pain medication

Question 36

A nurse is changing the administration set on a client's central venous catheter.Which intervention is most important for the nurse to complete?

A) Have the client hold his breath during the set change.
B) Keep the slide clamp on the catheter extension open.
C) Position the client in a high Fowler's position.
D) Position in the client in a semi-Fowler's position.

Question 37

A nursing student asks why midline catheters need strict sterile dressing changes when short peripheral IVs do not.Which answer by the experienced nurse is most accurate?

A) "Because of the length of time they stay inserted."
B) "They really don't need strict sterile technique."
C) "Because the tip is in the right atrium of the heart."
D) "The tonicity of the fluids used promotes infection."

Question 38

A client has just had a central venous access line inserted.What is the nurse's next action?

A) Beginning the prescribed infusion as soon as possible
B) Confirming placement of the catheter by x-ray
C) Having the infusion team start the IV therapy
D) Confirming that solutions are appropriate for the central line

Question 39

A student nurse is preparing to take a blood pressure (BP)on a client who has a peripheral IV line in the left arm.What instruction by the faculty member is most important?

A) "Use the arm that doesn't have the IV site in it."
B) "Don't inflate the cuff too high if you use the left arm."
C) "Make sure the IV line is secure before taking the BP."
D) "While the BP is taken, a little backflow of the IV is okay."

Question 40

The nurse is preparing to administer an infusion of dopamine (Intropin)using a smart pump.After programming the pump and attaching the IV to the client,what action by the nurse is most important?

A) Start the infusion as ordered.
B) Hand-calculate the infusion rate.
C) Ensure that the pump is plugged in.
D) Place a "time tape" on the IV bag.

Question 41

The nurse is preparing to give a client an IV push medication through an intermittent IV set (saline lock)using a needleless system.Which actions by the nurse are most appropriate?

A) Cleanse the access port vigorously for at least 30 seconds.
B) Use an antimicrobial agent when cleansing the port.
C) Clean the ridges in the Luer-Lok connection well.
D) Rinse the antimicrobial agent off with saline.
E) Allow the antimicrobial agent to dry before using IV.

Question 42

A client is scheduled to receive 1000 mL of normal saline in 24 hours.The nurse should set the infusion pump to deliver how many milliliters per hour? _____________ mL/hr

Question 43

The RN is working with an experienced LPN (licensed practical nurse)who has been assigned several clients receiving IV therapy.What actions guide the RN in delegating aspects of IV therapy to the LPN?

A) Look up and read the State Nurse Practice Act.
B) Check facility policy regarding LPNs and IV therapy.
C) Ask the LPN what he or she is comfortable performing.
D) Supervise the LPN when performing IV therapy.
E) Divide the clients up between the two of them.

Question 44

If a client is to receive an entire 250-mL bag of saline over the next 4 hours and the drop rate of the IV tubing chamber is 15 drops/mL,at what drop rate per minute will the nurse set this IV? ____________ drops/min

Question 45

A client has a peripherally inserted central catheter (PICC)line and the primary nurse is updating the care plan.For which common complications does the nurse assess?

A) Phlebitis
B) Pneumothorax
C) Thrombophlebitis
D) Excessive bleeding
E) Extravasation

Question 46

The nurse is caring for a client admitted yesterday with an intraosseous (IO)infusion after a car crash.Which action by the nurse takes priority?

A) Ensure that the IV flow rate has been recalculated for an IO infusion.
B) Plan to insert another kind of IV line during the shift.
C) Determine which IV medications can be given safely via the IO.
D) Monitor the site and dressings routinely for hemorrhage.

Question 47

The nurse is preparing to flush a PICC line.The protocol specifies using 50 units of heparin.Available is a multidose vial containing heparin,10 units/mL.Which syringe does the nurse use to draw up and administer the heparin?

A)
B)
C)
D)

Question 48

The nurse is preparing to administer a medication IV push.What information does the nurse need to know before beginning the infusion?

A) Any dilution required
B) Rate of administration
C) Compatibility with infusions
D) Other routes of administration
E) Specific monitoring needed

Question 49

The nurse is caring for an older adult client who has been admitted for dehydration and needs IV fluids.Which location does the nurse choose to place a peripheral IV on this client?