CRNI Pediatric Infusion Therapy Practice Test 2 — Questions and Answers
Question 1: What is the most important consideration when selecting an infusion pump for pediatric therapy?
- Cost-effectiveness
- Ability to deliver in increments of 0.1 mL/hr or less (Correct answer)
- Portability for ambulation
- Compatibility with large-bore tubing
Correct answer: Ability to deliver in increments of 0.1 mL/hr or less
The ability to deliver fluid in very small increments (0.1 mL/hr or less) is the most critical feature of a pediatric infusion pump. This precision prevents fluid overload and ensures accurate medication dosing, which is essential given the narrow therapeutic margins in children.
Question 2: A pediatric patient receiving total parenteral nutrition (TPN) develops hyperglycemia. What is the most likely cause?
- Excessive lipid emulsion concentration
- Dextrose concentration exceeding the child's glucose utilization rate (Correct answer)
- Inadequate amino acid content
- Calcium-phosphate precipitation
Correct answer: Dextrose concentration exceeding the child's glucose utilization rate
Hyperglycemia in pediatric TPN patients is most commonly caused by a dextrose concentration that exceeds the child's glucose utilization rate. Children have variable glucose tolerance, and infusion rates must be carefully titrated starting at lower concentrations.
Question 3: What is the maximum recommended dextrose concentration for peripheral IV infusion in pediatric patients?
- 5%
- 10%
- 12.5% (Correct answer)
- 20%
Correct answer: 12.5%
The maximum recommended dextrose concentration for peripheral infusion in pediatric patients is 12.5%. Higher concentrations are hyperosmolar and can cause vein irritation, phlebitis, and tissue necrosis if infiltration occurs. Concentrations above 12.5% require central venous access.
Question 4: Which assessment finding in a pediatric patient most strongly suggests infiltration at the IV site?
- Warmth and erythema along the vein
- Cool, pale, and edematous tissue around the insertion site (Correct answer)
- Purulent drainage at the insertion site
- Palpable venous cord proximal to the site
Correct answer: Cool, pale, and edematous tissue around the insertion site
Cool, pale, and edematous tissue around the insertion site is the hallmark of infiltration, indicating that IV fluid is leaking into the surrounding tissue. This differs from phlebitis, which presents with warmth and erythema, or infection, which shows purulent drainage.
Question 5: When using a volume-control set (burette) for pediatric infusion, what is the primary safety advantage?
- It warms the fluid to body temperature
- It limits the maximum volume that can infuse at one time (Correct answer)
- It filters particulate matter
- It reduces the risk of air embolism
Correct answer: It limits the maximum volume that can infuse at one time
A volume-control set (burette) limits the maximum volume that can infuse at one time by allowing the nurse to fill only a small measured amount. This provides a critical safety mechanism against accidental fluid overload in pediatric patients if the pump malfunctions or the rate is set incorrectly.
Question 6: What is the recommended flush volume for a peripheral IV catheter in a pediatric patient weighing less than 10 kg?
- 10 mL normal saline
- 5 mL normal saline
- 1-2 mL normal saline (Correct answer)
- 3 mL heparin flush
Correct answer: 1-2 mL normal saline
For pediatric patients weighing less than 10 kg, the recommended flush volume is typically 1-2 mL of normal saline. Using larger volumes could contribute to fluid overload in small patients. The flush should be sufficient to clear the catheter lumen without exceeding safe volume limits.
CRNI Pediatric Infusion Therapy Practice Test 2
What is the most important consideration when selecting an infusion pump for pediatric therapy?