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CLINICAL NURSING SKILLS AND TECHNIQUES COMPREHENSIVE EXAMINATION TEST COMPLETE QUESTIONS AND CORRECT ANSWERS

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CLINICAL NURSING SKILLS AND TECHNIQUES COMPREHENSIVE EXAMINATION TEST COMPLETE QUESTIONS AND CORRECT ANSWERS

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CLINICAL NURSING SKILLS AND
TECHNIQUES COMPREHENSIVE
EXAMINATION TEST COMPLETE
QUESTIONS AND CORRECT ANSWERS

●● Types of IV fluids
Answer: Hypotonic fluids move fluid from the blood vessels into the
tissues. The major concern is that blood pressure can drop.
Isotonic fluids do not cause major fluid shifts. They are commonly used
for volume replacement, but they increase risk for fluid overload in
cardiac and renal patients.
Hypertonic fluids pull fluid from the tissues into the blood vessels. They
carry a high risk for fluid overload, pulmonary edema, and heart failure.


●● Fluid volume excess and deficit
Answer: -Signs of excess fluid include:
Weight gain, intake greater than output, crackles or rhonchi, edema,
shortness of breath, and worsening oxygenation. Your IV slides note that
1 kg = 2.2 lb = about 1 L of fluid, which is important for daily weight
interpretation.
Patients at high risk for fluid overload include older adults, renal
patients, and heart failure patients.
-Signs of fluid volume deficit include:

,Concentrated urine, low blood pressure, fever, flat veins, sluggish
capillary refill, poor skin turgor, thirst, weight loss, dry skin/mucous
membranes, elevated sodium, and elevated hematocrit.


●● Peripheral vs. central vascular access devices
Answer: Peripheral IVs are short-term access devices that end in smaller
peripheral vessels. They require clean gloves and principles of sterility.
Central lines end in a central vessel and are used for therapies that
require reliable or long-term access. Examples include short central
catheters, PICCs, tunneled catheters, and implanted ports.


●● IV and Central Line
Answer: Wear gloves when locating a vein. The slides specifically ask
whether the nurse "messed up" by applying the tourniquet and palpating
without gloves, and the answer is yes. Gloves should be worn when
locating a vein.
Clean the site with CHG or 70% alcohol, allow proper drying time,
insert bevel up, anchor the vein below the site, and maintain sterility of
supplies and connectors.
IV site assessment
The RN should assess the IV site at least every 4 hours. Watch for
infiltration, phlebitis, infection, pain, redness, swelling, leaking,
coolness, warmth, or loss of patency.
Dressing changes

, Transparent IV dressings are changed every 7 days or PRN. Opaque
dressings are changed every 2 days or PRN. Clean skin with CHG or
70% alcohol and allow about 20 seconds of drying time.
IV risk reduction
Because IV therapy can expose the nurse to blood, use PPE, needleless
devices, biohazard/sharps containers, and hepatitis B immunization.
Follow hand hygiene, the rights of medication administration, and
infection prevention.
Central line key points
Central lines carry greater infection risk than peripheral IVs. Prevent
central line-associated bloodstream infection by using strict aseptic
technique, scrubbing the hub, maintaining sterile dressing integrity, and
assessing the site.


●● Terms to Know
Answer: CLABSI: central line-associated bloodstream infection PICC:
peripherally inserted central catheter
Port: implanted vascular access device
Lumen: pathway within the catheter for fluid or medication
Flush: solution used to maintain catheter patency Patency: catheter is
open and functioning


●● The 7 rights of medication administration
Answer: Right medication Right dose Right route Right time Right
patient Right documentation Right indication

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