CRNI - Certified Registered Nurse Infusion Exam — Questions and Answers

Question 1: What does 'KVO' (Keep Vein Open) refer to in IV therapy, and what is a typical KVO rate?

A bolus flush technique using 10 mL NS
A very slow infusion rate (typically 10–30 mL/hour) used to maintain catheter patency between medication administrations (Correct answer)
A high infusion rate of 200 mL/hour to maintain patency
An alarm setting on infusion pumps

Correct answer: A very slow infusion rate (typically 10–30 mL/hour) used to maintain catheter patency between medication administrations

KVO (Keep Vein Open) is a very slow infusion rate, typically 10–30 mL/hour, used to maintain catheter patency and IV access between scheduled medication administrations.

Question 2: Which filter is required when administering platelet transfusions?

Standard 170–260 micron blood filter (Correct answer)
No filter is needed for platelets
0.2-micron in-line filter
1.2-micron lipid-compatible filter

Correct answer: Standard 170–260 micron blood filter

Platelets must be transfused through a standard 170–260 micron blood filter to remove clots and debris; 0.2-micron filters trap platelets and are contraindicated.

Question 3: When a positive-pressure needleless connector is used, what technique is required when disconnecting a syringe after flushing to prevent blood reflux?

Disconnect the syringe while maintaining positive pressure by continuing gentle pressure on the plunger during disconnection (Correct answer)
Clamp the IV line after disconnecting the syringe
Disconnect rapidly to prevent pressure equalization
Aspirate slightly before disconnecting to create a vacuum

Correct answer: Disconnect the syringe while maintaining positive pressure by continuing gentle pressure on the plunger during disconnection

Positive-pressure connectors require maintaining forward pressure on the plunger during syringe disconnection to ensure the connector mechanism expels blood rather than drawing it back.

Question 4: When should the site of a venous access device be changed?

Every 48 to 72 hours or as clinically indicated (Correct answer)
When the patient requests it.
Every 24 hours.
Only once a week.

Correct answer: Every 48 to 72 hours or as clinically indicated

Peripheral intravenous catheter (PIV) sites should be changed every 48 to 72 hours, or as clinically indicated, to minimize the risk of infection and phlebitis. This guideline helps prevent bacterial colonization and vein irritation associated with prolonged catheter dwell times. However, if any signs of complication like redness, pain, or swelling appear, the site must be changed immediately regardless of the scheduled interval.

Question 5: A patient's IV catheter becomes positional — fluids run only when the arm is in a specific angle. What is the most appropriate action?

Remove the catheter and insert a new one at a different site (Correct answer)
Flush with heparin and attempt to improve patency
Increase the infusion pressure
Reposition and tape the arm to maintain flow

Correct answer: Remove the catheter and insert a new one at a different site

A positional catheter often indicates the tip is against a vessel wall or the catheter is kinked, and the safest intervention is removal and re-insertion at a new site.

Question 6: Which gauge peripheral IV catheter is preferred for rapid fluid resuscitation in an adult trauma patient?

22-gauge catheter in the forearm
24-gauge catheter in the hand
16-gauge or larger catheter in the antecubital fossa (Correct answer)
18-gauge catheter in the dorsal foot

Correct answer: 16-gauge or larger catheter in the antecubital fossa

Large-bore (16-gauge or larger) peripheral catheters in large antecubital veins allow the maximum flow rates needed for rapid volume resuscitation in trauma.

Question 7: When removing a peripheral IV catheter, what is the correct post-removal action to prevent hematoma formation?

Apply a warm compress immediately
Apply firm, direct pressure for at least 2–3 minutes (Correct answer)
Apply a tourniquet proximal to the site
Massage the site to disperse any blood

Correct answer: Apply firm, direct pressure for at least 2–3 minutes

Firm, direct pressure for 2–3 minutes (longer for anticoagulated patients) is the standard to achieve hemostasis and prevent hematoma after IV catheter removal.

Question 8: Which of the following is the most appropriate method to administer fluids to a patient with fluid loss due to vomiting?

Oral fluids only.
Only electrolyte tablets.
IV fluids (Correct answer)
Only water intake.

Correct answer: IV fluids

For a patient experiencing significant fluid loss due to vomiting, IV fluids are the most appropriate method of administration. Oral fluids may not be tolerated or absorbed quickly enough, especially if vomiting is persistent. IV fluids allow for rapid rehydration and electrolyte replenishment directly into the bloodstream, effectively correcting fluid deficits and preventing complications.

Question 9: Which IV solution is generally avoided in premature neonates due to the risk of kernicterus?

IV solutions containing benzyl alcohol as a preservative (Correct answer)
Potassium chloride-containing solutions
Lactated Ringer's solution
Normal saline with 5% dextrose

Correct answer: IV solutions containing benzyl alcohol as a preservative

Benzyl alcohol, used as a preservative in some IV solutions and medications, is toxic to premature neonates and is associated with 'gasping syndrome' and kernicterus.

Question 10: What is the first step in preparing a medication for intravenous administration?

Verifying the patient's identity.
Preparing the IV equipment.
Reading the medication order. (Correct answer)
Mixing the medication with saline.

Correct answer: Reading the medication order.

The very first and most critical step in preparing any medication, especially for IV administration, is to accurately read and interpret the medication order. This ensures the correct drug, dose, route, time, and patient are identified, preventing potential errors before any physical preparation begins and adhering to the 'five rights' of medication administration.

Question 11: Which antiseptic is recommended for skin preparation before peripheral IV insertion?

Povidone-iodine only
>0.5% chlorhexidine gluconate in alcohol (preferred) or 70% isopropyl alcohol (Correct answer)
Benzalkonium chloride solution
Isopropyl alcohol 70% alone

Correct answer: >0.5% chlorhexidine gluconate in alcohol (preferred) or 70% isopropyl alcohol

CDC and INS guidelines recommend >0.5% chlorhexidine gluconate in alcohol as the preferred skin antiseptic for vascular access site preparation.

Question 12: Which of the following should be considered before starting an IV medication infusion?

The patient’s diet preferences.
The patient’s current medications for oral administration.
The patient’s hydration status. (Correct answer)
The patient’s ability to walk.

Correct answer: The patient’s hydration status.

Before starting an IV medication infusion, it's important to assess the patient's hydration status. This helps determine the appropriate fluid volume and rate for the infusion, as well as how the medication might be distributed and excreted in the body. The patient's hydration status can significantly impact the effectiveness and safety of IV therapy.

Question 13: What is the significance of monitoring the patient's respiratory rate during IV therapy?

It helps assess the patient's oxygenation status (Correct answer)
It helps in measuring the patient’s hydration status.
It determines the patient’s blood pressure.
It is irrelevant in IV therapy.

Correct answer: It helps assess the patient's oxygenation status

Monitoring the patient's respiratory rate during IV therapy is significant because it helps assess their oxygenation status. Changes in respiratory rate can indicate respiratory distress, which might be a symptom of fluid overload, an allergic reaction, or other systemic complications. This vital sign provides crucial insight into the patient's overall well-being and helps detect potential issues early.

Question 14: A patient receiving TPN develops a fever, chills, and elevated WBC. The TPN bag appears cloudy. What is the most appropriate action?

Discontinue the TPN infusion, retain the bag for culture, and insert a new IV with fresh TPN after physician evaluation (Correct answer)
Reduce TPN rate and reassess in 2 hours
Filter the TPN through a 0.2-micron filter and continue
Continue TPN and administer antipyretics

Correct answer: Discontinue the TPN infusion, retain the bag for culture, and insert a new IV with fresh TPN after physician evaluation

A cloudy TPN bag with systemic signs of infection suggests contamination; the infusion must be stopped, the bag retained for culture, and new TPN obtained after medical evaluation.

Question 15: A patient develops redness, warmth, and swelling along the vein 2 cm proximal to the IV site. Which complication is most likely?

Thrombosis
Phlebitis (Correct answer)
Air embolism
Infiltration

Correct answer: Phlebitis

Phlebitis is characterized by redness, warmth, pain, and swelling along the course of the vein due to inflammation of the vessel wall.

Question 16: Which of the following is a recommended strategy to reduce CLABSI (central line-associated bloodstream infection) rates?

Using femoral sites for all long-term central access
Implementation of central line insertion bundles including hand hygiene, maximal barrier precautions, and chlorhexidine antisepsis (Correct answer)
Changing central line dressings daily
Routine guidewire exchange of central catheters every 3 days

Correct answer: Implementation of central line insertion bundles including hand hygiene, maximal barrier precautions, and chlorhexidine antisepsis

Central line insertion bundles — combining hand hygiene, maximal barrier precautions, chlorhexidine skin prep, optimal site selection, and daily necessity review — are the evidence-based strategy to reduce CLABSI.

Question 17: What is the primary purpose of fluid and electrolyte balance in intravenous therapy?

To speed up the metabolic process.
To dilute the bloodstream.
To maintain proper hydration and electrolyte levels (Correct answer)
To reduce the volume of fluid in the body.

Correct answer: To maintain proper hydration and electrolyte levels

The primary purpose of fluid and electrolyte balance in intravenous therapy is to restore and maintain the body's essential hydration and electrolyte levels. IV fluids are administered to correct imbalances caused by dehydration, illness, or surgery, ensuring cells and organs function optimally. This delicate balance is crucial for supporting vital bodily processes and overall patient health.

Question 18: What is the recommended minimum internal diameter (bore) of IV tubing for blood product administration?

Microbore tubing (0.5 mm ID)
Any tubing gauge is acceptable for blood products
Standard extension set tubing (1–2 mm ID)
Blood administration tubing with minimum 2.5–3 mm ID to prevent RBC trauma (Correct answer)

Correct answer: Blood administration tubing with minimum 2.5–3 mm ID to prevent RBC trauma

Blood products require administration sets with an adequate internal diameter to prevent mechanical hemolysis; standard blood tubing with a minimum 2.5–3 mm ID is required.

Question 19: How can excessive fluid intake through intravenous therapy impact the body?

It has no effect on the body.
It can cause a decrease in electrolytes.
It can cause fluid overload (Correct answer)
It leads to dehydration.

Correct answer: It can cause fluid overload

Excessive fluid intake through intravenous therapy can significantly impact the body by causing fluid overload, also known as hypervolemia. This condition occurs when the body retains too much fluid, leading to symptoms like swelling (edema), shortness of breath due to fluid in the lungs, and increased blood pressure. Fluid overload can strain the heart and kidneys, potentially leading to serious complications if not managed promptly.

Question 20: What is the first step in patient assessment during IV therapy?

Obtain a blood sample for testing.
Ask about allergies and previous IV complications (Correct answer)
Measure the blood pressure.
Administer the IV fluids.

Correct answer: Ask about allergies and previous IV complications

The first step in patient assessment during IV therapy is to ask about allergies and any previous IV complications. This crucial initial step helps prevent adverse reactions to medications or materials and identifies potential challenges like difficult venous access or a history of phlebitis. Gathering this information ensures patient safety and guides appropriate site selection and care.

Question 21: Which grading scale is most commonly used to assess the severity of phlebitis at a peripheral IV site?

Both A and B (Correct answer)
Jackson Scale
Visual Infusion Phlebitis Scale
VIP Score

Correct answer: Both A and B

Both the VIP (Visual Infusion Phlebitis) score and the Visual Infusion Phlebitis Scale are widely used tools to grade phlebitis from 0 (no signs) to 5 (advanced phlebitis).

Question 22: What is the primary purpose of an anti-siphon valve in an IV administration set?

To prevent gravity-driven siphoning of IV fluid when the pump is not running or the tubing is unclamped outside the pump (Correct answer)
To regulate backpressure in central venous catheters
To prevent free-flow when the tubing is removed from the pump
To filter air bubbles from the IV line

Correct answer: To prevent gravity-driven siphoning of IV fluid when the pump is not running or the tubing is unclamped outside the pump

Anti-siphon valves prevent uncontrolled gravity-driven flow (siphoning) of IV solution when tubing is inadvertently removed from the pump or the pump stops, preventing accidental fluid or drug bolus.

Question 23: How frequently should hospitalized patients' peripheral IV sites be assessed for complications?

Every 8 hours
Once per shift with a minimum of every 8 hours (Correct answer)
Every 4 hours
Every 12 hours

Correct answer: Once per shift with a minimum of every 8 hours

INS standards recommend assessing peripheral IV sites at a minimum of every 8 hours, or per institutional policy that may require more frequent checks.

Question 24: Which of the following correctly describes the 'SASH' flush protocol for peripheral IV catheters?

Saline, Air, Saline, Heparin
Saline, Administer drug, Saline, Heparin (for heparin-lock catheters) (Correct answer)
Sodium chloride, Anticoagulant, Saline, Heparin
Sterile water, Antibiotic, Saline, Hold

Correct answer: Saline, Administer drug, Saline, Heparin (for heparin-lock catheters)

The SASH protocol (Saline-Administer-Saline-Heparin) is used for heparin-lock catheters to confirm patency, administer medication, clear residual drug, and maintain patency with heparin.

Question 25: What is the recommended position of the drip chamber when setting up a primary IV infusion set?

Empty; fluid should be in the tubing only
One-quarter full for slower infusions
Completely full to prevent air entry
Half-full to allow accurate drop counting and prevent air from entering the pump tubing (Correct answer)

Correct answer: Half-full to allow accurate drop counting and prevent air from entering the pump tubing

The drip chamber should be half-full to allow accurate visualization of the drop rate and to prevent air from being drawn into the tubing below the chamber.

Question 26: Which antiseptic solution is preferred for skin antisepsis prior to peripheral IV insertion in adults?

Chlorhexidine gluconate >0.5% in alcohol (Correct answer)
Povidone-iodine 10%
Normal saline
Isopropyl alcohol 70% alone

Correct answer: Chlorhexidine gluconate >0.5% in alcohol

Chlorhexidine gluconate (CHG) >0.5% combined with alcohol is the preferred antiseptic for IV insertion site preparation due to its broad-spectrum efficacy and residual activity.

Question 27: Which IV administration set modification is required for blood products administered to neonates or infants?

In-line 0.2-micron filter to prevent particulate infusion
Use of a blood warmer set only
No modifications required; standard blood tubing is acceptable
Use of microaggregate or leukoreduction filter and blood warmer for small-volume transfusions (Correct answer)

Correct answer: Use of microaggregate or leukoreduction filter and blood warmer for small-volume transfusions

Neonatal and infant transfusions require a leukoreduction or microaggregate filter and often a blood warmer to prevent FNHTR, hypothermia, and CMV transmission.

Question 28: What is the maximum time a unit of packed red blood cells should hang and infuse once it leaves the blood bank?

8 hours
4 hours (Correct answer)
6 hours
2 hours

Correct answer: 4 hours

PRBCs must be infused within 4 hours of leaving the blood bank refrigerator; beyond this, bacterial proliferation risk rises significantly.

Question 29: Which of the following is a key principle of aseptic non-touch technique (ANTT) in IV therapy?

Touch contamination is acceptable if gloves are worn
Key parts and key sites must never be touched or contaminated (Correct answer)
Standard precautions alone are sufficient for all IV procedures
Only sterile gloves are required for all IV procedures

Correct answer: Key parts and key sites must never be touched or contaminated

ANTT requires that key parts (e.g., needle tips, syringe tips) and key sites (e.g., catheter hubs) are identified and protected from touch contamination throughout any IV procedure.

Question 30: What does an occlusion alarm on an infusion pump indicate?

The pump battery is low
Resistance detected in the IV line, suggesting a kinked tubing, closed clamp, or blocked catheter (Correct answer)
The IV bag is empty
Air is detected in the IV line

Correct answer: Resistance detected in the IV line, suggesting a kinked tubing, closed clamp, or blocked catheter

An occlusion alarm indicates the pump sensor has detected abnormal resistance in the delivery line, which may be caused by a kinked tube, closed clamp, positional catheter, or clotted catheter.

CRNI - Certified Registered Nurse Infusion Exam

The CRNI certification exam, administered by the Infusion Nurses Certification Corporation (INCC), validates expertise in intravenous and infusion therapy across principles of practice, vascular access devices, and infusion therapies.

140

Questions

150 min

Time Limit

70%

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