CRNI Patient Assessment and Monitoring Practice Test

Question 1

What is the primary purpose of performing a comprehensive patient assessment before initiating infusion therapy?

Accepted Answer

To establish baseline data, identify risk factors, and select the most appropriate vascular access and therapy plan

Answer

A comprehensive pre-infusion assessment establishes baseline vital signs, laboratory values, and physical findings against which changes during therapy can be evaluated. It identifies risk factors (age, comorbidities, medications, vein condition, allergies) that influence vascular access selection, solution choice, and monitoring frequency.

Question 2

Which laboratory value is most critical to assess before initiating potassium chloride infusion?

Accepted Answer

Serum potassium level and renal function

Answer

Serum potassium and renal function must be assessed before potassium infusion. Administering potassium to a patient with hyperkalemia or renal failure (impaired potassium excretion) can cause fatal cardiac arrhythmias. The current potassium level guides the replacement dose, and renal function determines the body's ability to handle the potassium load.

Question 3

A nurse is assessing a peripheral IV site using the INS infiltration scale. Grade 3 infiltration is characterized by which findings?

Accepted Answer

Skin blanched, cool to touch, edema 1-6 inches, possible numbness

Answer

Grade 3 infiltration on the INS scale is characterized by skin blanching, cool temperature, edema extending 1-6 inches from the insertion site, and possible numbness. This grade requires immediate catheter removal, limb elevation, and potential additional interventions depending on the infiltrating solution. Grade 4 involves tissue necrosis or circulatory impairment.

Question 4

What assessment findings indicate a positive Allen's test before arterial line placement?

Accepted Answer

The hand flushes pink within 5-7 seconds after releasing the ulnar artery, indicating adequate collateral circulation

Answer

A positive (normal) Allen's test shows the hand flushing pink within 5-7 seconds of releasing the ulnar artery while the radial artery remains compressed. This confirms adequate collateral blood flow through the ulnar artery, making it safe to cannulate the radial artery. A negative (abnormal) test indicates insufficient collateral flow, contraindicating radial artery cannulation.

Question 5

Which vital sign change is the earliest indicator of a systemic transfusion reaction?

Accepted Answer

Temperature increase of 1°C or more above baseline

Answer

A temperature increase of 1°C or more above baseline is typically the earliest detectable sign of a transfusion reaction. Fever can indicate febrile non-hemolytic reaction, hemolytic reaction, or bacterial contamination. This is why vital signs are taken at baseline, 15 minutes into the transfusion, and then per protocol for the remainder.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Patient Assessment and Monitoring Practice Test