CRNI Managing Infusion Complications 2

Question 1

A patient with a central venous catheter suddenly develops unilateral facial and arm swelling. What complication should the nurse suspect?

Accepted Answer

Superior vena cava syndrome from catheter-related thrombosis

Answer

Unilateral facial and arm swelling suggests catheter-related deep vein thrombosis with obstruction of venous return, potentially progressing to SVC syndrome.

Question 2

What is the FIRST action when infiltration of a non-vesicant solution is suspected?

Accepted Answer

Stop the infusion and disconnect the IV tubing

Answer

The first priority is to stop the infusion to prevent further fluid accumulation in the surrounding tissue, then disconnect and assess the site.

Question 3

Which sign differentiates mechanical phlebitis from chemical phlebitis?

Accepted Answer

Mechanical phlebitis typically occurs within 24-48 hours of insertion and relates to catheter size and movement

Answer

Mechanical phlebitis develops early (24-48 hours) from physical irritation of the vein by the catheter, while chemical phlebitis relates to the pH, osmolality, or composition of the infusate.

Question 4

A patient with a PICC line reports inability to flush the catheter. After repositioning the arm, flushing is successful. What is the likely cause?

Accepted Answer

Positional occlusion from catheter tip against the vessel wall

Answer

Positional occlusion occurs when the catheter tip rests against the vessel wall, blocking flow in certain positions but resolving with repositioning.

Question 5

What is the appropriate intervention for a suspected air embolism during central line tubing change?

Accepted Answer

Place the patient in left lateral Trendelenburg position and administer 100% oxygen

Answer

Left lateral Trendelenburg position traps air in the right atrium apex, preventing it from entering the pulmonary vasculature, while 100% oxygen helps absorb the air.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Managing Infusion Complications 2