CRNI Principles of Practice 4 — Questions and Answers
Question 1: A patient's IV infusion rate is ordered at 125 mL/hr. The nurse notices the infusion has been running at 150 mL/hr for the past 2 hours. What is the FIRST nursing action?
- Slow the infusion to the correct rate and continue monitoring
- Stop the infusion immediately and notify the physician
- Recalculate the rate and document the discrepancy
- Assess the patient for signs of fluid overload, then correct the rate (Correct answer)
Correct answer: Assess the patient for signs of fluid overload, then correct the rate
Patient safety requires assessing for harm before correcting the rate and documenting the incident.
Question 2: Which principle BEST describes the infusion nurse's responsibility when a manufacturer's device instructions conflict with facility policy?
- Follow facility policy because it supersedes manufacturer guidelines
- Follow manufacturer instructions as they are legally binding
- Escalate to risk management and suspend use until clarified (Correct answer)
- Use clinical judgment to determine the safest approach for each patient
Correct answer: Escalate to risk management and suspend use until clarified
Conflicts between manufacturer instructions and facility policy must be escalated to risk management to ensure patient safety and legal compliance.
Question 3: A patient refuses to allow the nurse to change their PICC dressing that is due for a routine change. The site appears clean with no signs of infection. What should the nurse do?
- Change the dressing anyway to prevent infection risk
- Document the refusal, educate the patient on risks, and respect their decision (Correct answer)
- Notify the physician to obtain a court order
- Remove the PICC line since the patient is non-compliant
Correct answer: Document the refusal, educate the patient on risks, and respect their decision
Competent patients have the right to refuse treatment; the nurse must document the refusal and provide education about risks.
Question 4: According to INS standards, how frequently should short peripheral IV catheters be assessed in adults?
- Every 8 hours
- Every 12 hours
- Every 4 hours or with each patient interaction (Correct answer)
- Once per shift
Correct answer: Every 4 hours or with each patient interaction
INS standards recommend assessment of short peripheral IV catheters every 4 hours or with each patient interaction to detect complications early.
Question 5: Which action BEST demonstrates evidence-based practice in infusion nursing?
- Following the same protocols used for the past 10 years because they have proven effective
- Implementing a new technique because a colleague recommends it
- Consulting current INS standards and peer-reviewed literature when updating protocols (Correct answer)
- Adopting a vendor's recommended practice because they provide in-service training
Correct answer: Consulting current INS standards and peer-reviewed literature when updating protocols
Evidence-based practice requires integrating current best evidence from peer-reviewed literature and professional standards into clinical decision-making.
Question 6: A home infusion nurse discovers that a patient has been reusing single-use supplies to save money. What is the PRIORITY nursing intervention?
- Report the patient to the billing department for insurance fraud
- Educate the patient on infection risks and explore financial assistance options (Correct answer)
- Discontinue infusion therapy until proper supplies are obtained
- Document the finding and notify the physician without further action
Correct answer: Educate the patient on infection risks and explore financial assistance options
The priority is patient safety through education about risks, while also addressing the underlying financial barrier through available assistance programs.
Question 7: Which statement BEST reflects the scope of practice for a Certified Registered Nurse Infusion (CRNI)?
- CRNI certification authorizes independent prescribing of infusion therapies
- CRNI practice is defined by certification, state nurse practice acts, and facility policies (Correct answer)
- CRNI certification expands the nurse's scope beyond state board regulations
- CRNI practice scope is solely determined by the certifying body (INCC)
Correct answer: CRNI practice is defined by certification, state nurse practice acts, and facility policies
Scope of practice for a CRNI is governed by the intersection of specialty certification, state nurse practice acts, and individual employer policies.
CRNI Principles of Practice 4
A patient's IV infusion rate is ordered at 125 mL/hr.
The nurse notices the infusion has been running at 150 mL/hr for the past 2 hours.
What is the FIRST nursing action?