What are the elements of a written order for IV therapy? a. The type of solution to be infused b. The type and amount of solution and the rate of infusion c. The rate of infusion and type of solution d. The type and amount of solution

B. The type and amount of solution and the rate of infusion (pg. 101)

Which of the following should you tell the patient prior to initiating IV therapy? a. The procedure and rationale for IV therapy b. Approximately how long the IV will be in place c. What the patient should or should not do to facilitate IV therapy d. All of the these

D. All of the these: The procedure and rationale for IV therapy Approximately how long the IV will be in place What the patient should or should not do to facilitate IV therapy (pg. 103)

For what items should you check the medical record prior to starting an IV infusion? a. Patient allergies to medications or solutions to be infused b. Patient height and weight c. Conditions that may affect placement of the IV d. Patient allergies to medications or solutions to be infused AND conditions that may affect placement of the IV

D. Patient allergies to medications or solutions to be infused AND conditions that may affect placement of the IV (pg. 105)

When should you verify patient identification?a. Only when hanging the first IV container b. When you initiate IV therapy and each time you hang a new IV fluid container c. Only when you hang an IVPB medication d. Only when you administer oral medications

B. When you initiate IV therapy and each time you hang a new IV fluid container (pg. 106)

Monitoring of IV therapy includes which of the following? a. Observation of the IV insertion site b. Checking the fluid container to determine if the correct amount of fluid has infused c. Verifying that the pump settings are correct d. All of the these

D. All of the these Observation of the IV insertion site Checking the fluid container to determine if the correct amount of fluid has infused Verifying that the pump settings are correct (pg. 106)

What are the general rules for IV insertion site selection? a. Start distally and avoid the patient's dominant hand b. Start proximally and avoid the patient's dominant hand c. Start proximally and use the patient's dominant hand d. Start distally and use the patient's dominant hand

A. Start distally and avoid the patient's dominant hand (pg. 107, 108)

What is the purpose of the valves that are located in the veins? a. Valves keep blood flowing away from the heart and enable blood to flow against the force of gravity. b. Valves keep blood flowing away from the heart and keep blood from flowing against the force of gravity. c. Valves keep blood flowing toward the heart and enable blood to flow against the force of gravity. d. Valves keep blood flowing toward the heart and keep blood from flowing against the force of gravity.

C. Valves keep blood flowing toward the heart and enable blood to flow against the force of gravity. (pg. 109)

Which of the following would be contraindicated as a site for IV insertion? a. A section of vein that is straightb. A vein that has a firm, round appearance or feel c. An area where the vein crosses over a joint d. A section of vein that is straight and a vein that has a firm, round appearance or feel

C. An area where the vein crosses over a joint (pg. 109)

Which of the following is/are a good first choice for IV therapy because they are distal on the extremity? a. Dorsal metacarpal veins b. Cephalic veins c. Basilic vein d. Median antebrachial vein

A. Dorsal metacarpal veins (pg. 111)

What factors help to determine the type and size of IV catheter you choose to start an IV? a. Physician's order and purpose for the IV b. Patient age and medical status c. Availability of viable veins d. All of these factors

D. All of these factors Physician's order and purpose for the IV Patient age and medical status Availability of viable veins (Pg. 114)

As you are selecting equipment and supplies to start an IV, you find that you are unfamiliar with the IV catheter that is available. You have never used it before. What should you do? a. Go ahead and use it to start the IV b. Ask someone else to start the IV because you have never used this catheter before c. Ask someone to show you how to use the catheter before attempting to start the IV d. Ask someone else to start the IV because you have never used this catheter before AND ask someone to show you how to use the catheter before attempting to start the IV

D. Ask someone else to start the IV because you have never used this catheter before AND ask someone to show you how to use the catheter before attempting to start the IV (pg. 115)

When preparing the IV solution bag and tubing, what steps do you take? a. Spike the bag, close the flow regulator, and flush the tubing b. Close the flow regulator, spike the bag, fill the drip chamber, and flush the tubing c. Fill the drip chamber, flush the tubing, and close the flow regulatord. Close the flow regulator, fill the drip chamber, spike the bag, and flush the tubing

B. Close the flow regulator, spike the bag, fill the drip chamber, and flush the tubing (pg. 115)

What can you do that may help in locating a vein in patients not receiving chemotherapy or anticoagulants? a. Gently tap veins using the pads of your fingersb. Apply warm, moist compresses to the arm c. Both gently tap veins using the pads of your fingers AND apply warm, moist compresses to the arm d. Neither gently tap veins using the pads of your fingers NOR apply warm, moist compresses to the arm

C. Both gently tap veins using the pads of your fingers AND apply warm, moist compresses to the arm (pg. 116,117)

Which of the following should you include in your documentation after you complete inserting an IV catheter? a. Insertion site, size of catheter, and number of attempts b. Type of fluid, rate of infusion c. Patient response d. All of these

D. All of these Insertion site, size of catheter, and number of attempts Type of fluid, rate of infusion Patient response (pg. 121)

What are special considerations when starting an IV in a geriatric patient? a. The skin is thinner and superficial veins are weaker and prone to infiltration.b. The skin is less elastic and the geriatric patient has less subcutaneous tissue. c. Older adults may be more prone to fluid overload.d. All of these.

D. All of these. The skin is thinner and superficial veins are weaker and prone to infiltration. The skin is less elastic and the geriatric patient has less subcutaneous tissue. Older adults may be more prone to fluid overload. (pg. 122, 123)

Which technique for facilitation of initiation of IV therapy is helpful in children? a. Immobilization by holding or wrapping b. Multiple tourniquets c. Warm compresses d. "Slapping" the vein to distend it

A. Immobilization by holding or wrapping (pg. 123)

It is essential to adhere to standard precautions and aseptic technique when starting an IV. True/False

TRUE You must adhere to standard precautions and aseptic technique when starting an IV. (pg. 100)

You do not need to check the physician's order prior to starting an IV. True/False

FALSE It is important to check the physician's order prior to starting an IV. (pg. 101)

Before starting an IV, you should properly identify the patient who is to receive the IV. True/False

TRUE JCAHO Patient Safety Standards require that the patient be properly identified prior to administering medications or performing any procedure. (pg. 102)

Psychological preparation of the patient prior to initiating IV therapy should include a thorough explanation of the procedure and why the IV is needed and what the patient should or should not do to facilitate the procedure. True/False

TRUE Psychological preparation of the patient prior to initiating IV therapy should include a thorough explanation of the procedure and why the IV is needed and what the patient should or should not do to facilitate the procedure. (pg. 103)

To change the patient's gown, you can disconnect the tubing from the IV catheter. True/False

FALSE The IV tubing should never be disconnected from the IV catheter because it compromises sterility and may allow air to enter the line. (pg. 104)

You must follow the four rights of medication administration when administering IV medications and solutions. True/False

FALSE You must follow the seven rights of medication administration when administering IV medications and solutions. (pg. 105)

Mr. Cruise has cellulitis in his right upper arm. You may start his IV in the lower right arm. True/False

FALSE You should not start an IV distal to cellulitis. (pg. 105)

You identified Mr. Cruise when you started his IV. It is not necessary to complete the patient identification procedure again when you change the fluid container. True/False

FALSE You should complete the patient identification process each time you administer a new IV container. (pg. 105)

You need to administer an antibiotic to Mr. Cruise. When you check the MAR for Ms. Holmes you find she is to receive an IV medication at the same time. You may prepare them both at the same time and then administer them. True/False

FALSE You should never prepare dosed of IV medication for more than one patient at a time. You should complete the entire procedure for each patient individually to prevent medication errors. (pg. 106)

When choosing an IV site, you should start distally and avoid the dominant hand. True/False

TRUE When choosing an IV site, you should start distally and avoid the dominant hand. (pg. 107, 108)

Although antecubital veins are easy to access, they should be used as a last resort or in emergency situations because the patient must keep the arm straight to prevent the IV from occluding. True/False

TRUE Although antecubital veins are easy to access, they should be used as a last resort or in emergency situations because the patient must keep the arm straight to prevent the IV from occluding. (pg. 109, 110)

The patient's age, medical status, and location of viable veins will assist you in determining the appropriate IV catheter to use to start an IV. True/False

TRUE The patient's age, medical status, and location of viable veins will assist you in determining the appropriate IV catheter to use to start an IV. (pg. 114)

Prior to starting the IV, you must flush the IV administration set to remove most of the air. True/False

FALSE Prior to starting the IV, you must flush the IV administration set to remove all of the air. (pg. 115)

To locate a vein in patients receiving chemotherapy or anticoagulants, you should use an inflated blood pressure cuff rather than a tourniquet to distend the vein. In addition, you should never "tap" the veins.True/False

TRUE To locate a vein in patients receiving chemotherapy or anticoagulants, you should use an inflated blood pressure cuff rather than a tourniquet to distend the vein. In addition, you should never "slap" the veins. (pg. 117)

Once you remove the needle from the over-the-needle IV catheter, you may reinsert it to reposition the catheter in the patient's arm. True/False

FALSE You should never reinsert the needle from an over-the-needle IV catheter to reposition the catheter while it is in the patient's arm. The needle can shear off the catheter tip and cause an embolus. (pg. 119, 120)

Documentation of the IV insertion procedure should include the insertion site, number of attempts, cannula size, type of fluid, rate of infusion, patient response, and signature and title of person starting the IV. True/False

TRUE Documentation of the IV insertion procedure should include the insertion site, number of attempts, cannula size, type of fluid, rate of infusion, patient response, and signature and title of person starting the IV. (pg. 121)

The geriatric patient often has thin skin, less subcutaneous tissue, and weaker veins, which makes it more difficult to start an IV and stabilize the cannula, as well as increasing the risk for infiltration. True/False

TRUEThe geriatric patient often has thin skin, less subcutaneous tissue, and weaker veins, which makes it more difficult to start an IV and stabilize the cannula, as well as increasing the risk for infiltration. (pg. 122)

Because of the risk for fluid overload, IVs should be manually regulated in the older adult. True/False

FALSE Because of the risk for fluid overload, IVs should be regulated using an infusion pump in the older adult. (pg. 123)

Using multiple tourniquets in an obese patient may facilitate locating a suitable vein. You should progress proximally from the most distal joint to distend the veins. True/False

FALSE Using multiple tourniquets in an obese patient may facilitate locating a suitable vein. You should progress distally from the most proximal joint to distend the veins. (pg. 123)

When starting an IV in a small child, the parents can assist by restraining the child. True/False

FALSEParents should comfort their child during the insertion of an IV. They should never be expected to restrain their child. (pg. 123)

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NUA 120 Chapter 5

Nua 120 Chapter 5

by Sheri-Lavadour, Jun. 2015

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	What are the elements of a written order for IV therapy? a. The type of solution to be infused b. The type and amount of solution and the rate of infusion c. The rate of infusion and type of solution d. The type and amount of solution	B. The type and amount of solution and the rate of infusion (pg. 101)
	Which of the following should you tell the patient prior to initiating IV therapy? a. The procedure and rationale for IV therapy b. Approximately how long the IV will be in place c. What the patient should or should not do to facilitate IV therapy d. All of the these	D. All of the these: The procedure and rationale for IV therapy Approximately how long the IV will be in place What the patient should or should not do to facilitate IV therapy (pg. 103)
	For what items should you check the medical record prior to starting an IV infusion? a. Patient allergies to medications or solutions to be infused b. Patient height and weight c. Conditions that may affect placement of the IV d. Patient allergies to medications or solutions to be infused AND conditions that may affect placement of the IV	D. Patient allergies to medications or solutions to be infused AND conditions that may affect placement of the IV (pg. 105)
	When should you verify patient identification? a. Only when hanging the first IV container b. When you initiate IV therapy and each time you hang a new IV fluid container c. Only when you hang an IVPB medication d. Only when you administer oral medications	B. When you initiate IV therapy and each time you hang a new IV fluid container (pg. 106)
	Monitoring of IV therapy includes which of the following? a. Observation of the IV insertion site b. Checking the fluid container to determine if the correct amount of fluid has infused c. Verifying that the pump settings are correct d. All of the these	D. All of the these Observation of the IV insertion site Checking the fluid container to determine if the correct amount of fluid has infused Verifying that the pump settings are correct (pg. 106)
	What are the general rules for IV insertion site selection? a. Start distally and avoid the patient's dominant hand b. Start proximally and avoid the patient's dominant hand c. Start proximally and use the patient's dominant hand d. Start distally and use the patient's dominant hand	A. Start distally and avoid the patient's dominant hand (pg. 107, 108)
	What is the purpose of the valves that are located in the veins? a. Valves keep blood flowing away from the heart and enable blood to flow against the force of gravity. b. Valves keep blood flowing away from the heart and keep blood from flowing against the force of gravity. c. Valves keep blood flowing toward the heart and enable blood to flow against the force of gravity. d. Valves keep blood flowing toward the heart and keep blood from flowing against the force of gravity.	C. Valves keep blood flowing toward the heart and enable blood to flow against the force of gravity. (pg. 109)
	Which of the following would be contraindicated as a site for IV insertion? a. A section of vein that is straight b. A vein that has a firm, round appearance or feel c. An area where the vein crosses over a joint d. A section of vein that is straight and a vein that has a firm, round appearance or feel	C. An area where the vein crosses over a joint (pg. 109)
	Which of the following is/are a good first choice for IV therapy because they are distal on the extremity? a. Dorsal metacarpal veins b. Cephalic veins c. Basilic vein d. Median antebrachial vein	A. Dorsal metacarpal veins (pg. 111)
	Which of the following accommodate(s) large-gauge IV catheters? a. Digital dorsal veins b. Dorsal metacarpal veins c. Cephalic vein d. Scalp veins	C. Cephalic vein (pg. 111)
	What factors help to determine the type and size of IV catheter you choose to start an IV? a. Physician's order and purpose for the IV b. Patient age and medical status c. Availability of viable veins d. All of these factors	D. All of these factors Physician's order and purpose for the IV Patient age and medical status Availability of viable veins (Pg. 114)
	As you are selecting equipment and supplies to start an IV, you find that you are unfamiliar with the IV catheter that is available. You have never used it before. What should you do? a. Go ahead and use it to start the IV b. Ask someone else to start the IV because you have never used this catheter before c. Ask someone to show you how to use the catheter before attempting to start the IV d. Ask someone else to start the IV because you have never used this catheter before AND ask someone to show you how to use the catheter before attempting to start the IV	D. Ask someone else to start the IV because you have never used this catheter before AND ask someone to show you how to use the catheter before attempting to start the IV (pg. 115)
	When preparing the IV solution bag and tubing, what steps do you take? a. Spike the bag, close the flow regulator, and flush the tubing b. Close the flow regulator, spike the bag, fill the drip chamber, and flush the tubing c. Fill the drip chamber, flush the tubing, and close the flow regulator d. Close the flow regulator, fill the drip chamber, spike the bag, and flush the tubing	B. Close the flow regulator, spike the bag, fill the drip chamber, and flush the tubing (pg. 115)
	What can you do that may help in locating a vein in patients not receiving chemotherapy or anticoagulants? a. Gently tap veins using the pads of your fingers b. Apply warm, moist compresses to the arm c. Both gently tap veins using the pads of your fingers AND apply warm, moist compresses to the arm d. Neither gently tap veins using the pads of your fingers NOR apply warm, moist compresses to the arm	C. Both gently tap veins using the pads of your fingers AND apply warm, moist compresses to the arm (pg. 116,117)
	What is the maximum time you should leave the tourniquet in place when searching for a suitable vein for IV therapy? a. 4 minutes b. 2 minutes c. 1 minute d. 5 minutes	B. 2 minutes (pg. 117)
	Which of the following is the correct method to cleanse the site prior to initiating IV therapy? a. Circular b. Counter Clockwise c. Back and forth d. Random	A. Circular (pg. 118)
	Which of the following should you include in your documentation after you complete inserting an IV catheter? a. Insertion site, size of catheter, and number of attempts b. Type of fluid, rate of infusion c. Patient response d. All of these	D. All of these Insertion site, size of catheter, and number of attempts Type of fluid, rate of infusion Patient response (pg. 121)
	What are special considerations when starting an IV in a geriatric patient? a. The skin is thinner and superficial veins are weaker and prone to infiltration. b. The skin is less elastic and the geriatric patient has less subcutaneous tissue. c. Older adults may be more prone to fluid overload. d. All of these.	D. All of these. The skin is thinner and superficial veins are weaker and prone to infiltration. The skin is less elastic and the geriatric patient has less subcutaneous tissue. Older adults may be more prone to fluid overload. (pg. 122, 123)
	How should you regulate IVs for geriatric patients? a. Manual regulation b. IV infusion pump c. Gravity drip d. Roller clamp regulation	B. IV infusion pump (Pg. 123)
	In which of these special populations could you use multiple tourniquets to facilitate distension of veins? a. Geriatric patients b. Obese patients c. Pediatric patients d. None of these	B. Obese patients (pg. 123)
	Which technique for facilitation of initiation of IV therapy is helpful in children? a. Immobilization by holding or wrapping b. Multiple tourniquets c. Warm compresses d. "Slapping" the vein to distend it	A. Immobilization by holding or wrapping (pg. 123)
	It is essential to adhere to standard precautions and aseptic technique when starting an IV. True/False	TRUE You must adhere to standard precautions and aseptic technique when starting an IV. (pg. 100)
	You do not need to check the physician's order prior to starting an IV. True/False	FALSE It is important to check the physician's order prior to starting an IV. (pg. 101)
	Before starting an IV, you should properly identify the patient who is to receive the IV. True/False	TRUE JCAHO Patient Safety Standards require that the patient be properly identified prior to administering medications or performing any procedure. (pg. 102)
	Psychological preparation of the patient prior to initiating IV therapy should include a thorough explanation of the procedure and why the IV is needed and what the patient should or should not do to facilitate the procedure. True/False	TRUE Psychological preparation of the patient prior to initiating IV therapy should include a thorough explanation of the procedure and why the IV is needed and what the patient should or should not do to facilitate the procedure. (pg. 103)
	To change the patient's gown, you can disconnect the tubing from the IV catheter. True/False	FALSE The IV tubing should never be disconnected from the IV catheter because it compromises sterility and may allow air to enter the line. (pg. 104)
	You must follow the four rights of medication administration when administering IV medications and solutions. True/False	FALSE You must follow the seven rights of medication administration when administering IV medications and solutions. (pg. 105)
	Mr. Cruise has cellulitis in his right upper arm. You may start his IV in the lower right arm. True/False	FALSE You should not start an IV distal to cellulitis. (pg. 105)
	You identified Mr. Cruise when you started his IV. It is not necessary to complete the patient identification procedure again when you change the fluid container. True/False	FALSE You should complete the patient identification process each time you administer a new IV container. (pg. 105)
	You need to administer an antibiotic to Mr. Cruise. When you check the MAR for Ms. Holmes you find she is to receive an IV medication at the same time. You may prepare them both at the same time and then administer them. True/False	FALSE You should never prepare dosed of IV medication for more than one patient at a time. You should complete the entire procedure for each patient individually to prevent medication errors. (pg. 106)
	When choosing an IV site, you should start distally and avoid the dominant hand. True/False	TRUE When choosing an IV site, you should start distally and avoid the dominant hand. (pg. 107, 108)
	Although antecubital veins are easy to access, they should be used as a last resort or in emergency situations because the patient must keep the arm straight to prevent the IV from occluding. True/False	TRUE Although antecubital veins are easy to access, they should be used as a last resort or in emergency situations because the patient must keep the arm straight to prevent the IV from occluding. (pg. 109, 110)
	The patient's age, medical status, and location of viable veins will assist you in determining the appropriate IV catheter to use to start an IV. True/False	TRUE The patient's age, medical status, and location of viable veins will assist you in determining the appropriate IV catheter to use to start an IV. (pg. 114)
	Prior to starting the IV, you must flush the IV administration set to remove most of the air. True/False	FALSE Prior to starting the IV, you must flush the IV administration set to remove all of the air. (pg. 115)
	To locate a vein in patients receiving chemotherapy or anticoagulants, you should use an inflated blood pressure cuff rather than a tourniquet to distend the vein. In addition, you should never "tap" the veins. True/False	TRUE To locate a vein in patients receiving chemotherapy or anticoagulants, you should use an inflated blood pressure cuff rather than a tourniquet to distend the vein. In addition, you should never "slap" the veins. (pg. 117)
	Once you remove the needle from the over-the-needle IV catheter, you may reinsert it to reposition the catheter in the patient's arm. True/False	FALSE You should never reinsert the needle from an over-the-needle IV catheter to reposition the catheter while it is in the patient's arm. The needle can shear off the catheter tip and cause an embolus. (pg. 119, 120)
	Documentation of the IV insertion procedure should include the insertion site, number of attempts, cannula size, type of fluid, rate of infusion, patient response, and signature and title of person starting the IV. True/False	TRUE Documentation of the IV insertion procedure should include the insertion site, number of attempts, cannula size, type of fluid, rate of infusion, patient response, and signature and title of person starting the IV. (pg. 121)
	The geriatric patient often has thin skin, less subcutaneous tissue, and weaker veins, which makes it more difficult to start an IV and stabilize the cannula, as well as increasing the risk for infiltration. True/False	TRUE The geriatric patient often has thin skin, less subcutaneous tissue, and weaker veins, which makes it more difficult to start an IV and stabilize the cannula, as well as increasing the risk for infiltration. (pg. 122)
	Because of the risk for fluid overload, IVs should be manually regulated in the older adult. True/False	FALSE Because of the risk for fluid overload, IVs should be regulated using an infusion pump in the older adult. (pg. 123)
	Using multiple tourniquets in an obese patient may facilitate locating a suitable vein. You should progress proximally from the most distal joint to distend the veins. True/False	FALSE Using multiple tourniquets in an obese patient may facilitate locating a suitable vein. You should progress distally from the most proximal joint to distend the veins. (pg. 123)
	When starting an IV in a small child, the parents can assist by restraining the child. True/False	FALSE Parents should comfort their child during the insertion of an IV. They should never be expected to restrain their child. (pg. 123)

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