CRNI Patient Assessment and Monitoring Practice Test 2

Question 1

What is the recommended frequency for peripheral IV site assessment in an adult patient?

Accepted Answer

Every 1-2 hours for continuous infusions, and before, during, and after each intermittent infusion

Answer

Current INS standards recommend peripheral IV site assessment every 1-2 hours for patients receiving continuous infusions. For intermittent infusions, the site should be assessed before, during, and after each infusion. More frequent assessment is needed for vesicant medications, patients with altered sensation, and pediatric patients.

Question 2

A patient receiving IV vancomycin develops flushing of the face, neck, and trunk. What assessment should the nurse perform first?

Accepted Answer

Assess the infusion rate, as this reaction is typically rate-related (Red Man Syndrome) rather than a true allergy

Answer

Red Man Syndrome (vancomycin flushing reaction) is a histamine-mediated response typically caused by rapid infusion. The nurse should first assess the current infusion rate because slowing the rate usually resolves symptoms. This is not a true allergy but a rate-dependent reaction. The minimum infusion time for vancomycin is usually 60 minutes per gram.

Question 3

Which assessment tool is used to evaluate the degree of phlebitis at a peripheral IV site?

Accepted Answer

Visual Infusion Phlebitis (VIP) Scale

Answer

The Visual Infusion Phlebitis (VIP) Scale is the standardized assessment tool for evaluating phlebitis severity at peripheral IV sites. It grades phlebitis from 0 (no symptoms) to 5 (advanced thrombophlebitis with purulent drainage), based on objective observable signs including erythema, pain, palpable cord, streak formation, and purulence.

Question 4

A patient receiving a blood transfusion develops dyspnea, bilateral crackles on auscultation, and distended neck veins. Which complication is most likely?

Accepted Answer

Transfusion-associated circulatory overload (TACO)

Answer

The triad of dyspnea, bilateral pulmonary crackles, and jugular vein distention indicates fluid overload consistent with TACO. This occurs when the transfusion rate or volume exceeds the patient's cardiac capacity. Unlike TRALI (which presents with non-cardiogenic pulmonary edema and hypotension), TACO presents with hypertension and signs of volume overload.

Question 5

What is the primary assessment parameter for monitoring a patient receiving continuous IV heparin therapy?

Accepted Answer

Activated partial thromboplastin time (aPTT) or anti-Xa level

Answer

The aPTT (or anti-Xa level) is the primary laboratory parameter for monitoring continuous IV unfractionated heparin therapy. aPTT is checked 6 hours after initiation and after each dose change to verify therapeutic anticoagulation. The target aPTT range (typically 1.5-2.5 times normal) varies by institution and clinical indication.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Patient Assessment and Monitoring Practice Test 2