CRNI CRNI Infusion Pump Technology and Safety Practice Test 5 — Questions and Answers
Question 1: A patient receiving TPN via a multi-channel pump has one channel alarming 'downstream occlusion.' What is the PRIORITY nursing action?
- Increase the infusion rate on the affected channel
- Assess the IV site and catheter for kinking, clot, or positional obstruction (Correct answer)
- Switch TPN to peripheral IV access immediately
- Silence the alarm and reassess in 30 minutes
Correct answer: Assess the IV site and catheter for kinking, clot, or positional obstruction
A downstream occlusion alarm requires immediate assessment of the catheter and IV site to identify and resolve the source of obstruction before resuming infusion.
Question 2: What is the primary purpose of 'drug library guardrails' in a smart infusion pump?
- To automatically calculate weight-based dosing without nurse input
- To prevent infusion of incompatible medications simultaneously
- To enforce pre-set dose limits that reduce programming errors and ADEs (Correct answer)
- To log infusion data for billing purposes only
Correct answer: To enforce pre-set dose limits that reduce programming errors and ADEs
Drug library guardrails establish hard and soft dose limits that intercept programming errors at the point of care, directly reducing adverse drug events.
Question 3: When caring for a pediatric patient, a nurse must consider which pump feature most critical to preventing fluid overload?
- Extended battery life
- Small-volume delivery accuracy with micro-rate capability (Correct answer)
- Wireless connectivity for remote programming
- High-pressure occlusion limit
Correct answer: Small-volume delivery accuracy with micro-rate capability
Pediatric patients require very small, precise volumes; pumps with micro-rate accuracy (e.g., 0.1 mL/hr) are essential to prevent fluid overload in small bodies.
Question 4: An infusion pump's DERS (dose error reduction software) is set for heparin. The nurse programs 1,200 units/hr but the limit is 1,000 units/hr. What happens?
- The pump delivers 1,000 units/hr automatically
- A hard limit alert fires and the pump will not run until the dose is corrected (Correct answer)
- The pump delivers the programmed 1,200 units/hr and logs the override
- The pump requests a pharmacist PIN before proceeding
Correct answer: A hard limit alert fires and the pump will not run until the dose is corrected
Exceeding a hard limit triggers an alert that prevents infusion from starting; the nurse must reprogram a value within the allowed range before the pump will run.
Question 5: Which infusion pump type is BEST suited for delivering highly viscous medications such as lipid emulsions?
- Peristaltic volumetric pump (Correct answer)
- Elastomeric balloon pump
- Patient-controlled analgesia (PCA) pump
- Ambulatory syringe pump with fine-bore tubing
Correct answer: Peristaltic volumetric pump
Peristaltic volumetric pumps generate enough mechanical force to reliably deliver viscous fluids like lipid emulsions through standard IV tubing.
Question 6: A nurse is using a PCA pump for postoperative pain management. Which parameter DIRECTLY limits the total opioid dose the patient can self-administer over 4 hours?
- Demand dose
- Lockout interval
- 4-hour dose limit (Correct answer)
- Basal rate
Correct answer: 4-hour dose limit
The 4-hour dose limit is a cumulative cap programmed into the PCA pump that prevents the patient from receiving more than the prescribed maximum opioid dose in that time period.
Question 7: During biomedical equipment inspection, a technician finds the pump's flow accuracy has drifted beyond manufacturer specifications. What is the appropriate action before returning the pump to clinical use?
- Recalibrate the pump per manufacturer protocol and retest before returning to service (Correct answer)
- Place a warning label on the pump and continue use for non-critical infusions
- Return the pump to service after a simple cleaning
- Increase the programmed rate to compensate for the drift
Correct answer: Recalibrate the pump per manufacturer protocol and retest before returning to service
Pumps with accuracy drift must be recalibrated and verified to meet specifications before clinical use to ensure patient safety and regulatory compliance.
CRNI CRNI Infusion Pump Technology and Safety Practice Test 5
A patient receiving TPN via a multi-channel pump has one channel alarming 'downstream occlusion.' What is the PRIORITY nursing action?