Test Bank for Phillips’s Manual of I.V.
Therapeutics; Evidence-Based Practice for
Infusion Therapy
8th Edition Lisa Gorski
,Table of Contents
An Overview of Professional Practice Issues and Infusion Therapy
Infection Prevention and Occupational Risks
Fundamentals of Fluid and Electrolyte Balance
Parenteral Solutions
Infusion Equipment
Peripheral I.V. Catheters: Initiation and Maintenance of Peripheral Infusion Therapy
Phlebotomy Techniques
Central Venous Access
Complications of Infusion Therapy: Peripheral and Central Vascular Access Devices
Infusion Medication Safety, Methods, and Routes
Transfusion Therapy
Parenteral Nutrition
,Chapter 1: Professional Practice Concepts for Infusion Therapy
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A nurse is attempting to initiate I.V. therapy for a client diagnosed with gastroenteritis. The client is
combative and resists the nurse’s efforts to start the I.V. Which action by the nurse would result in
an intentional tort?
A. Failing to document the client’s combativeness
B. Refusing to wear gloves while starting the I.V.
C. Failing to report the client’s combativeness to a physician
D. Starting an I.V. on a coherent client against the client’s wishes
2. A nurse who is caring for clients understands that he or she should provide care that meets at least the
minimum standards of practice for nursing. Which phrase regarding standards of practice is most
accurate?
A. Standards of practice focus on the care provider and define needed activities and behaviors.
B. Standards of practice focus on the recipient of care and describe the outcomes of care.
C. Standards of practice are written laws enacted by the legislature.
D. Standards of practice are the result of the performance of a function or process.
3. Which incident would cause a nurse to be named as a defendant in a malpractice suit?
A. The nurse notes blood return noted in a peripheral IV catheter line.
B. The nurse reports early signs of infection from a peripheral line inserted by a nurse on another
unit
C. The nurse places two peripheral IV catheters in a patient requiring emergency IV fluids, but only
uses one
D. The nurse records nerve damage caused by a peripheral IV catheter inserted the previous shift
nurse
4. The intravenous route is the most commonly used infusion route. The nurse notes that a client diagnosed with
metastatic cancer is receiving an intraosseous infusion. Should the nurse question the healthcare pro-
vider’s order?
A. Yes; the healthcare provider is not following INS recommendations.
B. No; the nurse should never question the healthcare provider’s order when it comes to chemother-
apy.
C. Yes; this route of infusion is dangerous and not accepted by the INS.
D. No; other routes might be appropriate for administration in certain situations and with selected
fluids and medications.
,5. Which competency assessment method is acceptable for nursing competencies which will occur once per
year in the skilled nursing facility?
A. Client Evaluation
B. Clinical Data
C. Sentinel Event Report
D. Skills Checklist
6. One of the primary values of the INS designation of CRNI (certified registered nurse, infusion) is to:
A. Protect the public
B. Attain competence
C. Reflect a measurable goal
D. Hold nurses accountable
7. Which problem-solving approach to clinical practice is the nurse manager applying when determining patient
preference and values for successful clinical outcomes?
A. Effective health-care practice
B. Evidence-based practice (EBP)
C. Answering a burning clinical question
D. One’s own clinical expertise
8. Seven days ago the PICC nurse inserted a PICC line into the right forearm of a client diagnosed with cancer.
When the nurse checks the client's site today, which nursing process outcome is determined?
A. Evaluating cancer treatment
B. Implementing asepsis maintenance
C. Planning for complication prevention
D. Discussing prior cancer therapy
9. Which compensatory model has been applied if the hospitalization rate for CLABSIs (central line-associated
bloodstream infections) decreased significantly over the last quarter?
A. VBP
B. HHRP
C. HAC
D. HHVBP
10. When called as an expert witness in an upcoming case, the nurse manager employs which techniques?
A. Examines evidence and give advice
B. Reviews charts and assesses jury selection
C. Gives deposition and notifies lawyers of discrepancies
D. Testifies and establishes standards of care
,Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. A nurse is caring for multiple clients in a rehabilitation facility. During the shift, the nurse notes that several
clients are on high-risk medications. According to the Risk Evaluation and Mitigation Strategy
(REMS) program, when can the U.S. Food and Drug Administration (FDA) require a REMS? (Se-
lect all that apply.)
A. Before FDA drug approval
B. After FDA drug approval
C. During a client evaluation
D. At an ethics committee meeting
E. After client informed consent
2. A new infusion clinic is being started. The nursing supervisor of the new clinic must conform to specific
standards of practice when developing nursing policies and procedures for the new program. To
which organizational standards of practice must the nurse manager adhere? (Select all that apply.)
A. Centers for Disease Control and Prevention (CDC) guidelines
B. Infusion Nurses Society (INS) standards
C. American Medical Association (AMA) standards
D. Oncology Nursing Society (ONS) standards
E. U.S. Food and Drug Administration (FDA)
3. A staff nurse is serving on a hospital’s quality-assurance improvement task force. On which quality-
assurance improvement models is the task force most likely to focus? (Select all that apply.)
A. Standards of care
B. Standards of practice
C. Performance improvement
D. Continuous quality improvement
E. Total Quality Management (TQM)
4. Which methods should the nurse use to evaluate achievement of client outcomes prior to discharge? (Select
all that apply.)
A. Collect data to determine whether standards were met.
B. Identify controllable or uncontrollable variables.
C. Determine the cause of the problem by comparing actual care with established standards.
D. Re-evaluate to determine whether corrective action is effective and improvement in service is
obtained.
E. Contact The Joint Commission (JCAHO) Web site for standards.
,5. While caring for a client, a nurse administers an incorrect dose of medication, causing the client to become
ill. The nurse reports the incident to the nurse manager on the unit. The nurse manager then notifies
risk management. Which risk-management strategies should be used by the nurse in this situation?
(Select all that apply.)
A. Documentation
B. Physical assessment
C. Unusual occurrence reports
D. Professional liability insurance
E. Systemic analysis of serious adverse events
6. When nurses provide care to clients, nursing actions are governed by established standards of nursing care, as
well as both state and federal laws. Which are sources of law? (Select all that apply.)
A. Constitution
B. Statutes
C. State Nurse Practice Acts
D. Joint Commission standards
E. Centers for Disease (CDC) standards.
7. The nursing supervisor of a new infusion clinic must conform to specific standards of practice when
developing nursing policies and procedures for the new program. Which INS risk management strat-
egies help decrease the risk of potential liability to the new clinic? (Select all that apply.)
A. Analysis of unusual occurrences
B. Root cause analysis of sentinel events
C. Evaluation of all patient data and surveys
D. Comprehensive and thorough documentation
E. Reduction of CLABSI related complications
8. While taking care of a client with multiple sclerosis, the infusion nurse inadvertently gives the client too
much alemtuzumab by infusing longer than the recommended two hours. The nurse is proven negli-
gent by which elements of the malpractice claim? (Select all that apply.)
A. The nurse has a duty to provide safe, effective treatment.
B. The nurse allows the client’s family to watch the infusion.
C. The client suffers difficulty breathing and chills during the infusion.
D. A breach of care occurs because the nurse administered too much medication.
E. The nurse should have offered the P.O. form of alemtuzumab.
9. With in-depth knowledge of community resources, which skill will help the home care infusion nurse provide
, the best care? (Select all that apply.)
A. Meticulous evidence-based care
B. Interprofessional communication and collaboration
C. Appropriate parenteral nutrition and IV medication
D. Ability to write home infusion therapy policy and procedures
E. Safe, effective, and competent care
10. A nurse fails to document that an injectable heparin has been given to a client for two weeks. Upon
investigation it is determined that the heparin was not given and the nurse was reported to the state
board of nursing. Which type of law is the state board using? (Select all that apply.)
A. Public law
B. Administrative law
C. Common law
D. Constitutional law
E. Statutory law
,Chapter 1: Professional Practice Concepts for Infusion Therapy
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A nurse is attempting to initiate I.V. therapy for a client diagnosed with gastroenteritis. The client is
combative and resists the nurse’s efforts to start the I.V. Which action by the nurse would result in
an intentional tort?
A. Failing to document the client’s combativeness
B. Refusing to wear gloves while starting the I.V.
C. Failing to report the client’s combativeness to a physician
D. Starting an I.V. on a coherent client against the client’s wishes
ANS: D
Page: 28
Feedback
A. Failure to document does not result in direct injury or harm to a client and is,
therefore, not an intentional tort.
B. Refusing to wear gloves may inadvertently result in injury or harm, but is not
considered an intentional tort.
C. Failure to report the behavior to a physician does not result in direct injury or
harm to the client and is not considered an intentional tort.
D. Intentional torts include assault and battery, false imprisonment, using restraints
as a form of false imprisonment, defamation of character, and breach of confi-
dentiality.
2. A nurse who is caring for clients understands that he or she should provide care that meets at least the
minimum standards of practice for nursing. Which phrase regarding standards of practice is most
accurate?
A. Standards of practice focus on the care provider and define needed activities and behaviors.
B. Standards of practice focus on the recipient of care and describe the outcomes of care.
C. Standards of practice are written laws enacted by the legislature.
D. Standards of practice are the result of the performance of a function or process.
ANS: A
Page: 16
Feedback
A. Standards of practice are criteria for measuring performance against the optimal
achievable degree of clinical excellence. These standards are formulated to
communicate expectations of nursing practice. Agencies are influential in devel-
oping standards of practice.
B. Standards of practice criteria focus on the care provider, not the care recipient
, C. Standards of practice are evidence-based guidelines, policies, or protocols not
written laws.
D. Standards of practice may occur in response to unanswered questions, limited
research, and/or performance issues; not necessarily the result of the perfor-
mance or process.
3. Which incident would cause a nurse to be named as a defendant in a malpractice suit?
A. The nurse notes blood return noted in a peripheral IV catheter line.
B. The nurse reports early signs of infection from a peripheral line inserted by a nurse on another
unit
C. The nurse places two peripheral IV catheters in a patient requiring emergency IV fluids, but only
uses one
D. The nurse records nerve damage caused by a peripheral IV catheter inserted the previous shift
nurse
ANS: D
Page: 29
Feedback
A. Blood return at the catheter site is normal.
B. Reporting early signs of infection is expected.
C. Using one peripheral IV catheter may be warranted.
D. The nurse had a duty to do no harm to the client and the client suffered actual
harm or injury.
4. The intravenous route is the most commonly used infusion route. The nurse notes that a client diagnosed with
metastatic cancer is receiving an intraosseous infusion. Should the nurse question the healthcare pro-
vider’s order?
A. Yes; the healthcare provider is not following INS recommendations.
B. No; the nurse should never question the healthcare provider’s order when it comes to chemother-
apy.
C. Yes; this route of infusion is dangerous and not accepted by the INS.
D. No; other routes might be appropriate for administration in certain situations and with selected
fluids and medications.
ANS: D
Page: 3
Feedback
A. Infusion Nurses Society (INS) Standards, infusion therapy is provided with at-
tention to safety and quality with individualized care that is collaborative, cultur-
ally sensitive, and age appropriate.
B. If there are questions about care the nurse (and client) should feel comfortable
