Chapter 28: Intravenous and Vascular Access Therapy

Chapter 28: Intravenous and Vascular Access Therapy

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is caring for a patient receiving antineoplastic medications intravenously. The nurse discovers that the intravenous site is red, edematous, and painful. The nurse knows that antineoplastic medications are vesicant medications and documents that the patient has experienced which of the following events?

ANS:  B

When a vesicant medication infiltrates the tissue, this is called an extravasation. Occlusion refers to a thrombus or fibrin sheath that impedes the flow of IV fluids. Phlebitis occurs with redness surrounding the vein, and extravasation leads to trauma within the vein

DIF:    Cognitive Level: Application           REF:   Text reference: p. 735

OBJ:   Define the key terms used in the skills of intravenous therapy.

TOP:   Assessment of IV Site                      KEY:  Nursing Process Step: Diagnosis

MSC:  NCLEX: Physiological Integrity

2. 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.

ANS:  D

Established standards for routine replacement of peripheral IV catheters and intravenous administration sets have recommended a maximum of 96 hours to reduce IV fluid contamination and prevent catheter site complications.

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 695 |Text reference: p. 716

OBJ:   Discuss complications of IV therapy.

TOP:   Replacement of IV Catheters and Administration Sets

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

3. 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 which condition?

ANS:  B

Auscultation of crackles or rhonchi in the lungs may signal fluid buildup in the lungs caused by fluid volume excess. Poor skin turgor is common with fluid volume deficit. The pinched skin stays elevated for several seconds (tenting). This may be an indication of the need for IV therapy. Decreased blood pressure may indicate fluid volume deficit caused by a decrease in stroke volume. This may indicate the need for IV therapy. Dry skin and mucous membranes may indicate dehydration.

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 698 |Text reference: p. 707

OBJ:   Discuss complications of IV therapy.

TOP:   Fluid Volume Excess                       KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity

4. The 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?

ANS:  B

Prime the infusion tubing by filling it with IV solution. Be certain that the tubing is clear of air and air bubbles. Large air bubbles can act as emboli. A needleless system does not specifically prevent the introduction of air emboli. Medication incompatibility may lead to crystallization of the medication and may cause emboli to form from precipitate. It will not lead, however, to air embolism. Catheter size does not contribute to emboli formation.

DIF:    Cognitive Level: Application           REF:   Text reference: p. 700

OBJ:   Discuss complications of IV therapy.                                 TOP:   Air Embolism

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Physiological Integrity

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

ANS:  C

Apply a flat tourniquet around the arm, above the antecubital fossa or 4 to 6 inches (10 to 15 cm) above the proposed insertion site. Do not shave the area. Shaving may cause microabrasions and may predispose to infection. Use the most distal site in the nondominant arm, if possible. Vigorous friction and multiple taping of the veins, especially in older adults, may cause hematoma and/or venous constriction.

DIF:    Cognitive Level: Application           REF:   Text reference: p. 701

OBJ:   Explain how to prepare the patient and the family for IV therapy.

TOP:   Applying a Tourniquet                     KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity