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1. When using an intravenous catheter the best angle to use for insertion into the vein is:
a.10-15 degrees
b. 30-45 degrees
c. 60-75 degrees

2. Which of these microorganisms are frequently responsible for causing sepsis in a patient receiving IV therapy:
a. Staphylococcus aureus
b. Klebsiella pneumoniae
c. Candida albicans

3.What information should be included on the dressing covering an IV site?
a. Patients initials
b. Gauge of the catheter
c. The time of insertion

4. The antecubital fossa should be AVOIDED when administering antineoplastics:
a. Because the radial nerve and artery may be damaged
b. Subcutaneous infiltration is more difficult to visualize
c. Blood samples are best done in this area

5. The dorsal metacarpal veins should be AVOIDED in elderly patients because:
a. The tortuous nature of these veins makes them difficult to cannulate
b. It is difficult to distinguish them from arteries that are in this area
c. Securing the catheter may be inadequate due to thin skin and lack of supportive tissue

6. Which of these measures should be AVOIDED in a hypertensive patient prior inserting an IV:
a. Tapping or flicking the selected vein
b. Having the patient open and close the fist
c. Applying a tourniquet

7. Inserting a central venous catheter via the subclavian route, What measure will reduce the chances of air embolism?
a. Place patient in trendelenburg position
b. Abduct the patient’s arm on the side being cannulated.
c. Position a towel roll under the patient’s shoulder blade

8. After the insertion of a PICC line, what should the nurse do to confirm that it is in the proper location?
a. Obtain a chest x-ray
b. Flush the line with 30 cc of normal saline
c. Observe for blood return when aspirating the line

9. A patient with phlebitis graded 1+ would show:
a. Localized pain and erythema
b. Localized edema and streak formation
c. Localized warmth and palpable cord

10. Which of these methods best describes the technique for the INDIRECT method of inserting an IV?
a. Place needle bevel up, insert into the vein in the direction of the venous flow
b. Estimate the depth of the vein, then insert IV into the vein from a slightly distal location
c. Insert IV through the side of the vein until a blood flash back is seen

11. What can happen when a nurse aspirates an IV that appears to be occluded?
a. The vein collapses causing trauma to the vessel wall
b. Embolization of small-infected thrombi, causing septicemia
c. Fibrin clot propagation causing further clot formation of the vessel

12. While turning a patient in bed the Broviac catheter falls out, from a legal standpoint the nurse should write an incident report for:
a. To record the events for the hospital legal files
b. To have a report in the patient’s record in the event of a lawsuit being files
c. To explain the nurse’s role in the incident to the hospital’s legal department

13. When you discontinue an IV, the nurse should document in the patient’s record:
a. The vital signs
b. The size of the cannula that was removed
c. The condition of the IV site

14. When drawing a blood sample from a Groshong catheter, the nurse would take which of these actions?
a. Clamp the catheter before and after the specimen is removed
b. Use a vacutainer to withdraw the specimen
c. Flush the catheter with 20ml of normal saline after the specimen is removed

15. According to the CDC, if a nurse contaminates the hands with blood, he/she should:
a. Wash hands with soap and water
b. Clean blood with 70% isopropyl alcohol
c. Soak hands in Betadine for at least two minutes

16. You need to give TPN to a 10year old what is the best infusion times?
a. For a 6-hour period twice a day
b. For a 12 hour period during the night
c. For a 24-hour period three times per week

17. A patient needs maintenance IV fluids, How many milliliters per hour should the patient receive if he weighs187 lb (85kg) and has a body surface of 2m2.

Use the following formula to calculate: 24hour fluid maintenance = 1500ml/m2 of body surface area

a. 94
b. 125
c. 170

18.In order to prevent a hemolytic transfusion reaction, which of these measures should the nurse take?
a. Identify the patient’s blood type and start the transfusion slowly, monitor for 15 minutes
b. Give the patient Tylenol 30 minutes prior to the transfusion and monitor the vital signs
c. Use a leukocyte removal filter in addition to the standard filter

19. If you have to delay a transfusion more than 30 minutes and the blood has already arrived on the unit, the nurse should:
a. Store the blood in a specimen refrigerator
b. Keep the blood locked in the medication room
c. Return the blood to the blood bank

20. A patient with reduced renal function is receiving aminoglycoside antibiotics IV. To monitor the peak blood level, you should draw the blood how many minutes after the completion of the drug administration?
a. 0-15
b. 30-60
c. 90-120

21. To avoid vascular irritation from IV medications, the nurse should:
a. Choose the vessel in the lower extremity, which will have an adequate blood volume
b. Choose the vessel at the proximal end of the upper extremity, so that subsequent punctures may be done more distally in the smaller vessels
c. Choose a cannula smaller than the lumen of the vein to allow for adequate dilution of the drug with the circulating blood

22. You need to draw a Dilantin level on a patient receiving the drug through the IV, At what time do you draw the blood?
a. Immediately before the next Dilantin dose is administered
b. Directly after the Dilantin dose has been given
c. One hour after the Dilantin dose has been absorbed

23. An infant with a two-day history of vomiting and diarrhea is unresponsive and pale; an IV cannot be started, which of these routes should be attempted next to secure venous access?
a. Femoral cut down
b. Percutaneous external jugular
c. Intraosseous

24. When giving Demerol IV, the nurse should:
a. Dilute the drug in normal saline prior to administering
b. Monitor the patient’s serum amylase level after giving the drug
c. Check the patient’s urine output prior giving the drug

25. When delivering narcotics through an epidural catheter, which of these measures is essential?
a. The medication and normal saline flush must be preservative free
b. The patient must remain in strict bed rest
c. The medication needs to be mixed with a local anesthetic prior to injection

26. Which of these statements on TPN is accurate?
a. The treatment is expensive because of the costly equipment
b. The risk of acquiring a nosocomial infection at home is less than in the hospital
c. The patient is likely to be more emotionally unstable at home than in the hospital

27. A 16 month old child is to receive an IV, How should the nurse protect the site?
a. An armboard and a transparent dressing on the IV site
b. A snug fitting stretch gauze dressing disguising the insertion site
c. A jacket restraint which can be attached to the bed frame and a pair of hand mittens

28. To provide adequate pressure to achieve a maximum flow rate for an IV that is infusing via gravity, the nurse should keep the IV container suspended, How high above the insertion site?
a. 1.5 feet
b. 3 feet
c. 4 feet

29. A doctor orders 100ml of D5 and 0.45% of sodium chloride, to be infused at 75ml per hour. The tubing drop factor is 15drops/ml. How many drops per minute should the nurse infuse?
a. 19
b. 25
c. 75

30. Which drop factor is consistent with a micro drip IV administration set?
a. 10 drops = 1ml
b. 20 drops = 1ml
c. 60 drops = 1ml