1.
What is the purpose of valves in veins?
Correct Answer
C. To prevent backflow of blood as it travels through the body.
Explanation
The purpose of valves in veins is to prevent backflow of blood as it travels through the body. Veins carry blood back to the heart, and the valves ensure that blood flows in one direction, preventing it from flowing backward. This is important because backflow can lead to pooling of blood and inefficient circulation. The valves act as gatekeepers, opening to allow blood to flow forward and closing to prevent it from flowing backward.
2.
What is the best choice of cannula size?
Correct Answer
C. The smallest gauge to accommodate therapy.
Explanation
The best choice of cannula size is the smallest gauge that can accommodate therapy. This is because using a smaller gauge minimizes trauma to the patient's tissues and reduces the risk of complications such as bleeding or infection. Additionally, a smaller gauge cannula may be more comfortable for the patient and easier to insert. Choosing the smallest gauge that still allows for the necessary therapy ensures optimal patient care.
3.
When a patient who needs an IV has cold extremities and few visible or small veins, which of the following techniques is acceptable to help improve the likelihood of a successful IV insertion?
Correct Answer
B. Apply warm packs to the extremity for 5-10 minutes.
Explanation
When a patient has cold extremities and few visible or small veins, applying warm packs to the extremity for 5-10 minutes can help improve blood flow and dilate the veins, making them more visible and easier to access for IV insertion. This technique helps to warm up the extremity and increase the likelihood of a successful IV insertion. Turning up the heat in the room or blowing warm air on the extremity may provide temporary warmth but may not be as effective in improving vein visibility. Allowing the tourniquet to remain in place for a few minutes does not directly address the issue of cold extremities and may not improve vein visibility.
4.
After applying the tourniquet, if the vein feels hard or rope-like, what should you do?
Correct Answer
C. Select another site.
Explanation
If the vein feels hard or rope-like after applying the tourniquet, it indicates that the vein may not be suitable for an IV insertion. Selecting another site would be the best course of action in order to find a vein that is more suitable for the procedure.
5.
What is the first step in preparing the IV site?
Correct Answer
A. Wash your hands
Explanation
The first step in preparing the IV site is to wash your hands. This is important to ensure proper hygiene and prevent the spread of any germs or infections to the patient. By washing your hands, you remove any dirt, bacteria, or other contaminants that may be present on your hands, reducing the risk of introducing them into the IV site. It is a crucial step in maintaining a sterile environment and ensuring the safety of the patient.
6.
What is the second step in preparing the IV site?
Correct Answer
A. Put on gloves
Explanation
The second step in preparing the IV site is to put on gloves. This is important to maintain proper hygiene and prevent the spread of infection. Gloves create a barrier between the healthcare provider's hands and the patient's skin, reducing the risk of contamination. By wearing gloves, the healthcare provider can safely handle equipment and perform procedures without directly touching the patient's site, ensuring a sterile environment.
7.
While in the process of inserting an IV, which of the following is NOT acceptable?
Correct Answer
B. A device may be reused as long as it is in the same site as the original attempt
Explanation
The correct answer is "a device may be reused as long as it is in the same site as the original attempt." Reusing a device for IV insertion is not acceptable as it can increase the risk of infection and contamination. It is important to use a new, sterile device for each IV insertion to ensure patient safety and prevent the spread of infection.
8.
How can you verify that you have entered the vein with the IV catheter?
Correct Answer
C. You observe a flashback of blood.
Explanation
When inserting an IV catheter, one way to verify that you have entered the vein is by observing a flashback of blood. This means that once the needle punctures the vein, blood will flow back into the catheter, indicating successful placement. This visual confirmation ensures that the catheter is indeed inside the vein and not in the surrounding tissue.
9.
What would be an indication that your IV insertion attempt was not successful?
Correct Answer
D. All of the above
Explanation
All of the above options indicate that the IV insertion attempt was not successful. If the insertion site begins to bruise, it suggests that there may have been damage to the surrounding tissues during the insertion process. If the insertion site does not flush easily, it indicates that the catheter may not be properly positioned within the vein or that there may be a blockage. Lastly, if the site swells when fluids are flushed through, it suggests that there may be infiltration or extravasation of fluids into the surrounding tissues, indicating an unsuccessful insertion.
10.
After 2 unsuccessful attempts at insertion of an IV, what is the best thing for a healthcare professional to do?
Correct Answer
C. Consult another professional to initiate therapy.
Explanation
After 2 unsuccessful attempts at insertion of an IV, the best thing for a healthcare professional to do is to consult another professional to initiate therapy. This is because multiple unsuccessful attempts may indicate that the healthcare professional is unable to successfully insert the IV, and it would be best to seek assistance from someone with more expertise in order to ensure the patient receives the necessary therapy in a timely manner.
11.
When securing the hub of the IV cannula to the skin, it is very important to:
Correct Answer
A. Ensure that the tape does not cover the insertion site.
Explanation
When securing the hub of the IV cannula to the skin, it is important to ensure that the tape does not cover the insertion site. This is because covering the insertion site with tape can make it difficult to monitor the site for signs of infection or infiltration. It is necessary to have a clear view of the insertion site to assess for any complications and to ensure proper care and maintenance of the IV cannula.
12.
It is NOT the best choice to use a gauze dressing in which of the following patient care situations?
Correct Answer
C. When the IV needs to be viewed routinely.
Explanation
Using a gauze dressing when the IV needs to be viewed routinely is not the best choice because gauze can obstruct the view of the IV site and make it difficult to assess for any signs of infection or complications. In this situation, a transparent or clear dressing would be more appropriate as it allows for easy visualization of the IV site while still providing protection and maintaining a sterile environment.
13.
After flushing a saline/heparin lock device, why is it important to clamp the connection tubing prior to removing the syringe?
Correct Answer
A. Positive pressure prevents backflow of blood into the cannula and can increase patency of your IV.
Explanation
When a saline/heparin lock device is flushed, positive pressure is created in the tubing. This positive pressure prevents the backflow of blood into the cannula, which can occur if the connection tubing is not clamped. This backflow of blood can lead to clotting and blockage of the IV, reducing its patency. Therefore, it is important to clamp the connection tubing before removing the syringe to maintain the positive pressure and prevent backflow of blood, thus increasing the patency of the IV.
14.
What information is important to include on the label of the IV dressing?
Correct Answer
D. All of the above
Explanation
All of the information mentioned on the label of the IV dressing is important. The date and time of IV initiation help in tracking the duration of IV therapy and identifying any potential complications. The initials of the professional who initiated the IV are crucial for accountability and communication purposes among the healthcare team. Including all of this information ensures proper documentation and facilitates continuity of care.
15.
What do you do before leaving the patient's room after initiating IV access?
Correct Answer
A. Wash your hands
Explanation
Before leaving the patient's room after initiating IV access, it is important to wash your hands. This is a crucial step in infection control and helps to prevent the spread of pathogens. By washing your hands, you can remove any potential contaminants and reduce the risk of transmitting infections to yourself or other patients.
16.
What is the final step after completion of a venipuncture?
Correct Answer
B. Document your actions and how the procedure was tolerated
Explanation
After completing a venipuncture, it is important to document your actions and how the procedure was tolerated. This documentation serves as a record of the procedure and provides valuable information for future reference. It includes details such as the date and time of the venipuncture, the vein used, any complications encountered, and how the patient reacted to the procedure. This documentation ensures accuracy, accountability, and continuity of care, allowing healthcare professionals to monitor the patient's progress and make informed decisions regarding their treatment.
17.
What is the most important step when discontinuing IV therapy?
Correct Answer
C. Inspect the condition of the catheter tip and notify the physician immediately if any damage is noted.
Explanation
The most important step when discontinuing IV therapy is to inspect the condition of the catheter tip and notify the physician immediately if any damage is noted. This is crucial because a damaged catheter can lead to complications such as infection or infiltration of medication into the surrounding tissues. By inspecting the catheter tip and notifying the physician, appropriate measures can be taken to address any issues and ensure the patient's safety and well-being.
18.
It is not necessary to wear gloves when discontinuing an IV since there is no risk of exposure to blood or body fluids.
Correct Answer
B. False
Explanation
When discontinuing an IV, there is a risk of exposure to blood or body fluids, especially if the IV site is not properly cleaned or if the patient has a bloodborne infection. Wearing gloves is essential to protect oneself from potential contamination and to maintain proper infection control protocols. Therefore, the statement that it is not necessary to wear gloves when discontinuing an IV is false.
19.
In order to prevent needle sticks and exposure to HIV and other bloodborne pathogens, it is of utmost importance that healthcare professionals dispose of all used IV catheters and cannulas in the proper containers.
Correct Answer
A. True
Explanation
Healthcare professionals need to dispose of used IV catheters and cannulas in proper containers to prevent needle sticks and exposure to bloodborne pathogens like HIV. This is crucial for the safety of both the professionals and patients. By disposing of these items correctly, the risk of accidental needle sticks and transmission of infections can be minimized. Therefore, the statement "In order to prevent needle sticks and exposure to HIV and other bloodborne pathogens, it is of utmost importance that healthcare professionals dispose of all used IV catheters and cannulas in the proper containers" is true.
20.
What is the primary function of veins?
Correct Answer
A. To carry blood from the body to the heart.
Explanation
Veins are blood vessels that carry blood back to the heart from the body. They have one-way valves that prevent the backward flow of blood and rely on muscle contractions to help propel the blood towards the heart. This function is essential for maintaining proper circulation and ensuring that deoxygenated blood is returned to the heart to be reoxygenated.
21.
What is the first step in the insertion of a peripheral IV line or saline lock?
Correct Answer
B. Obtain a physician's order.
Explanation
The first step in the insertion of a peripheral IV line or saline lock is to obtain a physician's order. This is necessary to ensure that the procedure is authorized by a medical professional and is appropriate for the patient's condition. Obtaining a physician's order also helps to ensure that the correct type and size of IV catheter is used, as well as any specific instructions or precautions that may be necessary. Once the physician's order is obtained, the healthcare provider can proceed with the other steps of the insertion process, such as cleaning the insertion site with an antiseptic.
22.
When is the ideal time to use a winged infusion set (butterfly needle)?
Correct Answer
C. For patients with fragile veins
Explanation
The ideal time to use a winged infusion set (butterfly needle) is for patients with fragile veins. This is because the butterfly needle has a smaller gauge and a shorter length, which reduces the risk of causing damage or discomfort to the patient's veins. Using a butterfly needle can make the process of inserting the needle and withdrawing blood or administering medication easier and less painful for patients with fragile veins.
23.
In which of the following circumstances would one choose an over-the-needle catheter over a winged infusion set for IV insertion?
Correct Answer
D. An infant who needs antibiotic therapy for possible sepsis.
Explanation
An over-the-needle catheter would be chosen over a winged infusion set for IV insertion in the case of an infant who needs antibiotic therapy for possible sepsis. This is because an over-the-needle catheter provides better stability and control during insertion, which is important when dealing with delicate veins in infants. The catheter also allows for the administration of larger volumes of fluids or medications, which may be necessary in the treatment of sepsis. The other options, such as knee replacement surgery, CT scan, or tonsillectomy, do not require the same level of precision or volume administration as the treatment of sepsis in an infant.
24.
If a patient is expected to need multiple IVs or an extended hospitalization, where is it best to choose for the first IV?
Correct Answer
A. Antecubital fossa
Explanation
The antecubital fossa is the best location to choose for the first IV because it is a convenient and easily accessible site for venipuncture. It is located in the bend of the arm, where the veins are large and close to the surface, making it easier to insert the IV needle and administer fluids or medications. Additionally, the antecubital fossa is less prone to movement compared to other areas like the hand or forearm, reducing the risk of dislodgement or complications. Therefore, selecting the antecubital fossa for the first IV is the most practical and efficient choice.
25.
Which of the following veins should be avoided when initiating an IV?
Correct Answer
D. Veins in the arm of a dialysis AV fistula.
Explanation
Veins in the arm of a dialysis AV fistula should be avoided when initiating an IV because the AV fistula is a surgically created connection between an artery and a vein that is used for dialysis. The AV fistula is essential for the dialysis process and should not be compromised by inserting an IV needle into the vein.
26.
When preparing to insert the needle into the skin, the bevel should be:
Correct Answer
B. Up
Explanation
When preparing to insert the needle into the skin, the bevel should be up. This is because the bevel is the slanted opening at the tip of the needle, and when it is facing up, it allows for easier penetration into the skin. This positioning also helps to minimize tissue damage and provides a smoother insertion. Placing the bevel up also ensures that the medication or fluid being administered is properly delivered into the intended area.
27.
What step would you take if you have attempted IV access and are unsure of proper placement?
Correct Answer
C. Pull the catheter back a few millimeters and check for blood return
Explanation
If you have attempted IV access and are unsure of proper placement, pulling the catheter back a few millimeters and checking for blood return is the appropriate step to take. This is because if the catheter is not properly placed within a vein, there may not be any blood return when it is pulled back slightly. Checking for blood return helps to ensure that the catheter is in the correct position before proceeding with IV infusion.
28.
When using a transparent semi-permeable membrane dressing on an IV site, it is important to avoid:
Correct Answer
D. All of the above
Explanation
When using a transparent semi-permeable membrane dressing on an IV site, it is important to avoid cleansing the site before applying the dressing because it can disrupt the integrity of the skin and increase the risk of infection. Smoothing the dressing from the center to the edges should also be avoided as it can cause wrinkles or bubbles, which may compromise the adherence of the dressing and create a potential site for bacteria to enter. Applying tape around the edges of the dressing should be avoided as well because it can cause skin irritation and damage when removing the tape. Therefore, all of the above options should be avoided when using a transparent semi-permeable membrane dressing on an IV site.
29.
A transparent semi-permeable dressing applied over gauze is considered a gauze dressing and should be changed every 48 hours.
Correct Answer
B. False
Explanation
A transparent semi-permeable dressing is not considered a gauze dressing. It is a different type of dressing that allows for visualization of the wound while still providing a barrier to protect it. These dressings are typically designed to be left in place for longer periods, usually up to 7 days, before changing. Therefore, the statement that it should be changed every 48 hours is incorrect.
30.
Which of the following materials are necessary when preparing to start an IV?
Correct Answer
B. IV start kit, IV catheter, and saline flush.
Explanation
When preparing to start an IV, it is necessary to have an IV start kit, IV catheter, and saline flush. An IV start kit contains all the necessary equipment for starting an IV, including a tourniquet, antiseptic solution, and dressings. The IV catheter is the needle that is inserted into the vein to administer fluids or medications. The saline flush is used to flush the catheter and ensure it is properly functioning. Gloves, gown, eye protection, and mask may be used for personal protection, but they are not specific to starting an IV.