CRNI CRNI Infusion Therapy Documentation and Standards Practice Test 5 — Questions and Answers
Question 1: Which professional organization publishes the Infusion Nursing Standards of Practice that serve as the primary reference for infusion nurses in the United States?
- American Nurses Association (ANA)
- Infusion Nurses Society (INS) (Correct answer)
- The Joint Commission (TJC)
- Centers for Disease Control and Prevention (CDC)
Correct answer: Infusion Nurses Society (INS)
The Infusion Nurses Society (INS) publishes the Infusion Nursing Standards of Practice, which is the authoritative reference for infusion therapy practice in the US.
Question 2: A home infusion patient's electronic health record shows the infusion pump delivered 200 mL more than the ordered volume. What is the nurse's first documentation priority?
- Adjust the next dose to compensate for the overage
- Document the discrepancy, patient assessment findings, provider notification, and actions taken, then complete an incident report (Correct answer)
- Document only after contacting the pharmacy to confirm the order
- Note the discrepancy in the next scheduled nursing note
Correct answer: Document the discrepancy, patient assessment findings, provider notification, and actions taken, then complete an incident report
A volume discrepancy is a medication error requiring immediate patient assessment, provider notification, incident reporting, and thorough documentation of the sequence of events.
Question 3: According to INS standards, what must be documented when a PICC line tip position is confirmed by chest radiograph?
- Only the radiologist's name
- The date of X-ray, tip location as reported by radiologist, provider notification of results, and any actions taken (Correct answer)
- That the X-ray was 'negative' without further detail
- The X-ray result is filed separately and does not require nursing documentation
Correct answer: The date of X-ray, tip location as reported by radiologist, provider notification of results, and any actions taken
INS requires nursing documentation to include the date and result of tip verification imaging, who was notified, and any subsequent actions to establish safe line use.
Question 4: A patient on long-term parenteral nutrition develops signs of air embolism. Which documentation sequence is correct?
- Document after the patient is stabilized, focusing only on interventions
- Immediately document the time symptoms were identified, patient position changes, oxygen applied, provider notified, and patient response as events unfold (Correct answer)
- Document only if the patient survives the event
- Complete an incident report first, then add a nursing note at the end of the shift
Correct answer: Immediately document the time symptoms were identified, patient position changes, oxygen applied, provider notified, and patient response as events unfold
Contemporaneous documentation of the time of symptom recognition, emergency interventions, and patient response creates an accurate record and is essential for legal and quality review.
Question 5: Under HIPAA, which practice is appropriate when faxing infusion therapy orders to a home health agency?
- Include full patient demographics on the cover sheet for easy identification
- Use a HIPAA-compliant fax cover sheet with a confidentiality notice and verify the receiving fax number before transmitting (Correct answer)
- Fax without a cover sheet to reduce the amount of PHI transmitted
- Email the order instead because fax is not HIPAA compliant
Correct answer: Use a HIPAA-compliant fax cover sheet with a confidentiality notice and verify the receiving fax number before transmitting
HIPAA requires reasonable safeguards when transmitting PHI, including a confidentiality notice on fax cover sheets and verification of the correct recipient number before sending.
Question 6: A nurse documents 'patient tolerated infusion well' without vital signs or site assessment findings. This type of documentation is considered:
- Sufficient, because it summarizes the infusion episode
- Inadequate, because it lacks objective data required by INS standards and organizational policy (Correct answer)
- Appropriate only for low-risk infusions such as normal saline flushes
- Compliant if cosigned by the supervising nurse
Correct answer: Inadequate, because it lacks objective data required by INS standards and organizational policy
INS standards require objective assessment data including site condition and patient response; subjective summaries without clinical findings do not meet professional documentation standards.
Question 7: Which INS-recommended element differentiates documentation of a vesicant extravasation from routine IV site documentation?
- Only the name of the vesicant drug needs to be added
- Extravasation documentation must include site photograph (when policy allows), estimated volume extravasated, extent of tissue involvement, all interventions, provider notification, and follow-up plan (Correct answer)
- Extravasation is documented identically to infiltration
- The pharmacist documents vesicant extravasations, not the nurse
Correct answer: Extravasation documentation must include site photograph (when policy allows), estimated volume extravasated, extent of tissue involvement, all interventions, provider notification, and follow-up plan
Vesicant extravasation documentation requires additional elements beyond standard site documentation because of the potential for serious tissue injury and medical-legal significance.
CRNI CRNI Infusion Therapy Documentation and Standards Practice Test 5
Which professional organization publishes the Infusion Nursing Standards of Practice that serve as the primary reference for infusion nurses in the United States?