CRNI Principles of Practice 5 — Questions and Answers
Question 1: A nurse is asked to administer an infusion using a technique she has never performed before. What is the MOST appropriate response?
- Proceed carefully using general infusion knowledge
- Decline and document inability to perform the skill
- Request supervised training or preceptorship before performing independently (Correct answer)
- Ask a colleague to demonstrate once and then proceed independently
Correct answer: Request supervised training or preceptorship before performing independently
Nurses must practice within their competency level and seek supervised training before independently performing unfamiliar procedures.
Question 2: Which organization publishes the Infusion Therapy Standards of Practice that serve as the primary reference for CRNI exam content?
- 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 Therapy Standards of Practice, which is the primary reference standard for infusion nursing.
Question 3: A nurse notices a colleague consistently skipping hand hygiene before accessing central lines. What is the MOST appropriate action?
- Report the colleague to the state nursing board immediately
- Address the behavior directly with the colleague and report ongoing non-compliance to a supervisor (Correct answer)
- Ignore it since it is not your patient's care
- Document the observations without taking any direct action
Correct answer: Address the behavior directly with the colleague and report ongoing non-compliance to a supervisor
Nurses have a professional and ethical obligation to address unsafe practices directly and escalate to supervisors if the behavior continues.
Question 4: When obtaining informed consent for placement of a PICC line, which element is MOST critical for the nurse to ensure the patient understands?
- The specific brand of catheter that will be used
- The risks, benefits, and alternatives to the procedure (Correct answer)
- The nurse's level of experience with PICC insertions
- The estimated cost of the procedure and insurance coverage
Correct answer: The risks, benefits, and alternatives to the procedure
Valid informed consent requires that the patient understands the procedure's risks, benefits, and available alternatives.
Question 5: A patient receiving home IV antibiotics reports the infusion pump is alarming with an 'occlusion' message. The nurse is unable to visit in person immediately. What is the BEST initial guidance?
- Instruct the patient to increase the pump pressure setting
- Tell the patient to manually push fluid through the line to clear the occlusion
- Advise the patient to stop the infusion and flush the line per protocol; nurse will call back shortly (Correct answer)
- Instruct the patient to remove and reinsert the catheter
Correct answer: Advise the patient to stop the infusion and flush the line per protocol; nurse will call back shortly
Stopping the infusion and flushing the line per protocol is the safest interim step while the nurse arranges further assessment.
Question 6: Which practice BEST supports a culture of safety in infusion therapy?
- Assigning blame to individuals when errors occur to deter future mistakes
- Encouraging near-miss reporting without fear of punitive consequences (Correct answer)
- Limiting error reporting to events that cause patient harm
- Keeping incident reports confidential from quality improvement teams
Correct answer: Encouraging near-miss reporting without fear of punitive consequences
A culture of safety is built on non-punitive reporting of near misses and errors to enable systemic learning and improvement.
Question 7: An infusion nurse is caring for a patient who speaks limited English. Which action is MOST consistent with ethical and legal standards?
- Use a family member who is present as the interpreter for convenience
- Use simple words and gestures since the procedure is routine
- Obtain a qualified medical interpreter before providing education or obtaining consent (Correct answer)
- Proceed with care and provide written materials in English for later review
Correct answer: Obtain a qualified medical interpreter before providing education or obtaining consent
Federal law (Title VI) and ethical standards require the use of qualified medical interpreters to ensure informed consent and effective patient education.
CRNI Principles of Practice 5
A nurse is asked to administer an infusion using a technique she has never performed before.
What is the MOST appropriate response?