CRNI Patient Assessment and Monitoring Practice Test Flashcards
6 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CRNI Patient Assessment and Monitoring Practice Test flashcards as text
Which assessment finding in a patient receiving IV potassium chloride at 20 mEq/hr would require immediate intervention?
Answer: New-onset peaked T waves on the cardiac monitor
Peaked T waves on the cardiac monitor are an early sign of hyperkalemia, which can rapidly progress to life-threatening cardiac arrhythmias including ventricular fibrillation and asystole. The infusion must be stopped immediately, a stat potassium level drawn, and the provider notified. Cardiac monitoring must continue until the potassium level normalizes.
What is the recommended assessment for patients receiving IV iron dextran for the first time?
Answer: Administer a test dose and monitor for 30-60 minutes for signs of anaphylaxis including urticaria, dyspnea, and hypotension
IV iron dextran carries a risk of anaphylaxis, and a test dose (typically 25 mg or 0.5 mL) must be administered first with monitoring for 30-60 minutes. The nurse must assess for urticaria, pruritus, dyspnea, chest tightness, hypotension, and other signs of anaphylaxis. Emergency equipment and epinephrine must be immediately available.
A patient on continuous IV insulin infusion has a blood glucose of 45 mg/dL. What is the priority assessment and intervention?
Answer: Stop the insulin infusion immediately, assess the patient's neurologic status, and administer IV dextrose as ordered
A blood glucose of 45 mg/dL represents severe hypoglycemia requiring immediate intervention. The insulin infusion must be stopped, the patient assessed for neuroglycopenic symptoms (confusion, seizures, loss of consciousness), and IV dextrose (typically D50W 25 mL or D10W) administered per protocol. Glucose should be rechecked every 15 minutes until stable.
Which physical assessment finding indicates possible catheter-related sepsis in a patient with a central venous catheter?
Answer: Fever greater than 38.3°C with chills, tachycardia, and hypotension without another identifiable source
Fever above 38.3°C with chills, tachycardia, and hypotension in a patient with a CVC and no other identifiable infection source strongly suggests catheter-related bloodstream infection (CRBSI). Blood cultures (both peripheral and through the catheter) should be obtained immediately, empiric antibiotics started, and catheter removal considered.
What assessment should be performed on a patient's arm before PICC line insertion?
Answer: Bilateral arm circumference measurement, vein assessment with ultrasound, and evaluation of the arm for contraindications
Pre-PICC assessment includes bilateral arm circumference measurements (for post-insertion DVT comparison), ultrasound evaluation of vein size and patency (to select the optimal vein and catheter size for appropriate catheter-to-vein ratio), and assessment for contraindications such as lymphedema, AV fistula, mastectomy, or skin infections.
A patient receiving IV amiodarone develops blue-gray skin discoloration at the peripheral IV site. What does this assessment finding indicate?
Answer: Chemical phlebitis and possible extravasation requiring immediate site assessment and catheter discontinuation
Blue-gray discoloration at a peripheral IV site during amiodarone infusion indicates chemical phlebitis from the medication's low pH and irritant properties. This requires immediate assessment for extravasation, discontinuation of the peripheral IV, and transition to central venous access if continued amiodarone therapy is needed.