Nua 120 Chapter 5

Front 1

What are the elements of a written order for IV therapy?

a. The type of solution to be infused

b. The type and amount of solution and the rate of infusion

c. The rate of infusion and type of solution

d. The type and amount of solution

Back 1

B. The type and amount of solution and the rate of infusion (pg. 101)

Front 2

Which of the following should you tell the patient prior to initiating IV therapy?

a. The procedure and rationale for IV therapy

b. Approximately how long the IV will be in place

c. What the patient should or should not do to facilitate IV therapy

d. All of the these

Back 2

D. All of the these:

The procedure and rationale for IV therapy

Approximately how long the IV will be in place

What the patient should or should not do to facilitate IV therapy

(pg. 103)

Front 3

For what items should you check the medical record prior to starting an IV infusion?

a. Patient allergies to medications or solutions to be infused

b. Patient height and weight

c. Conditions that may affect placement of the IV

d. Patient allergies to medications or solutions to be infused AND conditions that may affect placement of the IV

Back 3

D. Patient allergies to medications or solutions to be infused AND conditions that may affect placement of the IV (pg. 105)

Front 4

When should you verify patient identification?

a. Only when hanging the first IV container

b. When you initiate IV therapy and each time you hang a new IV fluid container

c. Only when you hang an IVPB medication

d. Only when you administer oral medications

Back 4

B. When you initiate IV therapy and each time you hang a new IV fluid container (pg. 106)

Front 5

Monitoring of IV therapy includes which of the following?

a. Observation of the IV insertion site

b. Checking the fluid container to determine if the correct amount of fluid has infused

c. Verifying that the pump settings are correct

d. All of the these

Back 5

D. All of the these

Observation of the IV insertion site

Checking the fluid container to determine if the correct amount of fluid has infused

Verifying that the pump settings are correct (pg. 106)

Front 6

What are the general rules for IV insertion site selection?

a. Start distally and avoid the patient's dominant hand

b. Start proximally and avoid the patient's dominant hand

c. Start proximally and use the patient's dominant hand

d. Start distally and use the patient's dominant hand

Back 6

A. Start distally and avoid the patient's dominant hand (pg. 107, 108)

Front 7

What is the purpose of the valves that are located in the veins?

a. Valves keep blood flowing away from the heart and enable blood to flow against the force of gravity.

b. Valves keep blood flowing away from the heart and keep blood from flowing against the force of gravity.

c. Valves keep blood flowing toward the heart and enable blood to flow against the force of gravity.

d. Valves keep blood flowing toward the heart and keep blood from flowing against the force of gravity.

Back 7

C. Valves keep blood flowing toward the heart and enable blood to flow against the force of gravity. (pg. 109)

Front 8

Which of the following would be contraindicated as a site for IV insertion?

a. A section of vein that is straight

b. A vein that has a firm, round appearance or feel

c. An area where the vein crosses over a joint

d. A section of vein that is straight and a vein that has a firm, round appearance or feel

Back 8

C. An area where the vein crosses over a joint (pg. 109)

Front 9

Which of the following is/are a good first choice for IV therapy because they are distal on the extremity?

a. Dorsal metacarpal veins

b. Cephalic veins

c. Basilic vein

d. Median antebrachial vein

Back 9

A. Dorsal metacarpal veins (pg. 111)

Front 10

Which of the following accommodate(s) large-gauge IV catheters?

a. Digital dorsal veins

b. Dorsal metacarpal veins

c. Cephalic vein

d. Scalp veins

Back 10

C. Cephalic vein (pg. 111)

Front 11

What factors help to determine the type and size of IV catheter you choose to start an IV?

a. Physician's order and purpose for the IV

b. Patient age and medical status

c. Availability of viable veins

d. All of these factors

Back 11

D. All of these factors

Physician's order and purpose for the IV

Patient age and medical status

Availability of viable veins

(Pg. 114)

Front 12

As you are selecting equipment and supplies to start an IV, you find that you are unfamiliar with the IV catheter that is available. You have never used it before. What should you do?

a. Go ahead and use it to start the IV

b. Ask someone else to start the IV because you have never used this catheter before

c. Ask someone to show you how to use the catheter before attempting to start the IV

d. Ask someone else to start the IV because you have never used this catheter before AND ask someone to show you how to use the catheter before attempting to start the IV

Back 12

D. Ask someone else to start the IV because you have never used this catheter before AND ask someone to show you how to use the catheter before attempting to start the IV (pg. 115)

Front 13

When preparing the IV solution bag and tubing, what steps do you take?

a. Spike the bag, close the flow regulator, and flush the tubing

b. Close the flow regulator, spike the bag, fill the drip chamber, and flush the tubing

c. Fill the drip chamber, flush the tubing, and close the flow regulator

d. Close the flow regulator, fill the drip chamber, spike the bag, and flush the tubing

Back 13

B. Close the flow regulator, spike the bag, fill the drip chamber, and flush the tubing (pg. 115)

Front 14

What can you do that may help in locating a vein in patients not receiving chemotherapy or anticoagulants?

a. Gently tap veins using the pads of your fingers

b. Apply warm, moist compresses to the arm

c. Both gently tap veins using the pads of your fingers AND apply warm, moist compresses to the arm

d. Neither gently tap veins using the pads of your fingers NOR apply warm, moist compresses to the arm

Back 14

C. Both gently tap veins using the pads of your fingers AND apply warm, moist compresses to the arm (pg. 116,117)

Front 15

What is the maximum time you should leave the tourniquet in place when searching for a suitable vein for IV therapy?

a. 4 minutes

b. 2 minutes

c. 1 minute

d. 5 minutes

Back 15

B. 2 minutes (pg. 117)

Front 16

Which of the following is the correct method to cleanse the site prior to initiating IV therapy?

a. Circular

b. Counter Clockwise

c. Back and forth

d. Random

Back 16

A. Circular (pg. 118)

Front 17

Which of the following should you include in your documentation after you complete inserting an IV catheter?

a. Insertion site, size of catheter, and number of attempts

b. Type of fluid, rate of infusion

c. Patient response

d. All of these

Back 17

D. All of these

Insertion site, size of catheter, and number of attempts

Type of fluid, rate of infusion

Patient response

(pg. 121)

Front 18

What are special considerations when starting an IV in a geriatric patient?

a. The skin is thinner and superficial veins are weaker and prone to infiltration.

b. The skin is less elastic and the geriatric patient has less subcutaneous tissue.

c. Older adults may be more prone to fluid overload.

d. All of these.

Back 18

D. All of these.

The skin is thinner and superficial veins are weaker and prone to infiltration.

The skin is less elastic and the geriatric patient has less

subcutaneous tissue.

Older adults may be more prone to fluid overload.

(pg. 122, 123)

Front 19

How should you regulate IVs for geriatric patients?

a. Manual regulation

b. IV infusion pump

c. Gravity drip

d. Roller clamp regulation

Back 19

B. IV infusion pump (Pg. 123)

Front 20

In which of these special populations could you use multiple tourniquets to facilitate distension of veins?

a. Geriatric patients

b. Obese patients

c. Pediatric patients

d. None of these

Back 20

B. Obese patients (pg. 123)

Front 21

Which technique for facilitation of initiation of IV therapy is helpful in children?

a. Immobilization by holding or wrapping

b. Multiple tourniquets

c. Warm compresses

d. "Slapping" the vein to distend it

Back 21

A. Immobilization by holding or wrapping (pg. 123)

Front 22

It is essential to adhere to standard precautions and aseptic technique when starting an IV.

True/False

Back 22

TRUE

You must adhere to standard precautions and aseptic technique when starting an IV. (pg. 100)

Front 23

You do not need to check the physician's order prior to starting an IV.

True/False

Back 23

FALSE

It is important to check the physician's order prior to starting an IV. (pg. 101)

Front 24

Before starting an IV, you should properly identify the patient who is to receive the IV.

True/False

Back 24

TRUE

JCAHO Patient Safety Standards require that the patient be properly identified prior to administering medications or performing any procedure. (pg. 102)

Front 25

Psychological preparation of the patient prior to initiating IV therapy should include a thorough explanation of the procedure and why the IV is needed and what the patient should or should not do to facilitate the procedure.

True/False

Back 25

TRUE

Psychological preparation of the patient prior to initiating IV therapy should include a thorough explanation of the procedure and why the IV is needed and what the patient should or should not do to facilitate the procedure. (pg. 103)

Front 26

To change the patient's gown, you can disconnect the tubing from the IV catheter.

True/False

Back 26

FALSE

The IV tubing should never be disconnected from the IV catheter because it compromises sterility and may allow air to enter the line. (pg. 104)

Front 27

You must follow the four rights of medication administration when administering IV medications and solutions.

True/False

Back 27

FALSE

You must follow the seven rights of medication administration when administering IV medications and solutions. (pg. 105)

Front 28

Mr. Cruise has cellulitis in his right upper arm. You may start his IV in the lower right arm.

True/False

Back 28

FALSE

You should not start an IV distal to cellulitis. (pg. 105)

Front 29

You identified Mr. Cruise when you started his IV. It is not necessary to complete the patient identification procedure again when you change the fluid container.

True/False

Back 29

FALSE

You should complete the patient identification process each time you administer a new IV container. (pg. 105)

Front 30

You need to administer an antibiotic to Mr. Cruise. When you check the MAR for Ms. Holmes you find she is to receive an IV medication at the same time. You may prepare them both at the same time and then administer them.

True/False

Back 30

FALSE

You should never prepare dosed of IV medication for more than one patient at a time. You should complete the entire procedure for each patient individually to prevent medication errors. (pg. 106)

Front 31

When choosing an IV site, you should start distally and avoid the dominant hand.

True/False

Back 31

TRUE

When choosing an IV site, you should start distally and avoid the dominant hand. (pg. 107, 108)

Front 32

Although antecubital veins are easy to access, they should be used as a last resort or in emergency situations because the patient must keep the arm straight to prevent the IV from occluding.

True/False

Back 32

TRUE

Although antecubital veins are easy to access, they should be used as a last resort or in emergency situations because the patient must keep the arm straight to prevent the IV from occluding. (pg. 109, 110)

Front 33

The patient's age, medical status, and location of viable veins will assist you in determining the appropriate IV catheter to use to start an IV.

True/False

Back 33

TRUE

The patient's age, medical status, and location of viable veins will assist you in determining the appropriate IV catheter to use to start an IV. (pg. 114)

Front 34

Prior to starting the IV, you must flush the IV administration set to remove most of the air.

True/False

Back 34

FALSE

Prior to starting the IV, you must flush the IV administration set to remove all of the air. (pg. 115)

Front 35

To locate a vein in patients receiving chemotherapy or anticoagulants, you should use an inflated blood pressure cuff rather than a tourniquet to distend the vein. In addition, you should never "tap" the veins.

True/False

Back 35

TRUE

To locate a vein in patients receiving chemotherapy or anticoagulants, you should use an inflated blood pressure cuff rather than a tourniquet to distend the vein. In addition, you should never "slap" the veins. (pg. 117)

Front 36

Once you remove the needle from the over-the-needle IV catheter, you may reinsert it to reposition the catheter in the patient's arm.

True/False

Back 36

FALSE

You should never reinsert the needle from an over-the-needle IV catheter to reposition the catheter while it is in the patient's arm. The needle can shear off the catheter tip and cause an embolus. (pg. 119, 120)

Front 37

Documentation of the IV insertion procedure should include the insertion site, number of attempts, cannula size, type of fluid, rate of infusion, patient response, and signature and title of person starting the IV.

True/False

Back 37

TRUE

Documentation of the IV insertion procedure should include the insertion site, number of attempts, cannula size, type of fluid, rate of infusion, patient response, and signature and title of person starting the IV. (pg. 121)

Front 38

The geriatric patient often has thin skin, less subcutaneous tissue, and weaker veins, which makes it more difficult to start an IV and stabilize the cannula, as well as increasing the risk for infiltration.

True/False

Back 38

TRUE

The geriatric patient often has thin skin, less subcutaneous tissue, and weaker veins, which makes it more difficult to start an IV and stabilize the cannula, as well as increasing the risk for infiltration. (pg. 122)

Front 39

Because of the risk for fluid overload, IVs should be manually regulated in the older adult.

True/False

Back 39

FALSE

Because of the risk for fluid overload, IVs should be regulated using an infusion pump in the older adult. (pg. 123)

Front 40

Using multiple tourniquets in an obese patient may facilitate locating a suitable vein. You should progress proximally from the most distal joint to distend the veins.

True/False

Back 40

FALSE

Using multiple tourniquets in an obese patient may facilitate locating a suitable vein. You should progress distally from the most proximal joint to distend the veins. (pg. 123)

Front 41

When starting an IV in a small child, the parents can assist by restraining the child.

True/False

Back 41

FALSE

Parents should comfort their child during the insertion of an IV. They should never be expected to restrain their child. (pg. 123)