CRNI CRNI Patient Assessment and Monitoring Practice Test 4

Question 1

A patient receiving IV vancomycin develops flushing, erythema, and pruritus on the face, neck, and upper torso. What is this reaction called and what is the appropriate intervention?

Accepted Answer

Red Man Syndrome; slow the infusion rate and premedicate with diphenhydramine

Answer

Red Man Syndrome is a rate-related reaction to vancomycin characterized by flushing and erythema of the upper body, managed by slowing the infusion and premedication with antihistamines.

Question 2

When assessing a PICC line insertion site, the nurse notes the arm circumference has increased by 3 cm compared to the baseline. What condition does this most likely indicate?

Accepted Answer

Deep vein thrombosis (DVT)

Answer

A significant increase in arm circumference above baseline is a cardinal sign of deep vein thrombosis associated with PICC line placement.

Question 3

A patient's central venous pressure (CVP) is 2 mmHg. Which clinical finding would be consistent with this value?

Accepted Answer

Flat neck veins in the supine position

Answer

A CVP of 2 mmHg is below normal (8–12 mmHg) indicating hypovolemia, which presents with flat neck veins when supine.

Question 4

Which parameter is most important to assess before administering a hyperosmolar solution such as TPN through a peripheral IV catheter?

Accepted Answer

Osmolarity of the solution

Answer

Solutions with osmolarity greater than 900 mOsm/L should not be administered peripherally due to risk of phlebitis and vessel damage.

Question 5

A patient has a tunneled cuffed central venous catheter. During assessment, the nurse is unable to aspirate blood from any lumen. The infusion is running without difficulty. What is the most likely cause?

Accepted Answer

Fibrin sheath formation allowing flow but not aspiration

Answer

A fibrin sheath or tail can form at the catheter tip, acting as a one-way valve that allows infusion but prevents aspiration.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI CRNI Patient Assessment and Monitoring Practice Test 4