BSN 266 - WEEK 3: ADMINISTERING IV MEDICATIONS &
ASSESSMENT MEASURES EXAM
2026 UPDATE | QUESTIONS AND ANSWERS | ALREADY PASSED
Course: BSN 266 - Professional Nursing Practice | Week 3
Date: July 2026 | Total Questions: 40 | Total Points: 100 (2.5 pts each)
Select the BEST answer for each question. Each question is worth 2.5 points.
SECTION 1: IV Site Assessment, Catheter Selection, & Insertion Principles (Q1–Q10)
Q1: A nurse is selecting a peripheral IV catheter for an adult patient who will receive intermittent antibiotic
therapy for 7 days. According to 2026 INS Standards, which gauge and length is MOST appropriate?
A. 24-gauge, 3/4 inch
B. 22-gauge, 1 inch [CORRECT]
C. 18-gauge, 1.25 inches
D. 14-gauge, 2 inches
Correct Answer: B
A 22-gauge, 1-inch catheter is appropriate for most adult peripheral IV therapy, including intermittent antibiotics, balancing
flow capability with patient comfort and vein integrity. An 18G is unnecessarily large for antibiotic therapy. A 24G is too small
for viscous medications. A 14G is reserved for trauma or rapid large-volume resuscitation.
Q2: A nurse is assessing an IV site using the Visual Infusion Phlebitis (VIP) score. The site is erythematous
with a palpable venous cord extending 2 cm proximal to the insertion site. Pain is reported as 3/10. What is
the VIP score, and what action is required?
A. VIP score 1; continue monitoring
B. VIP score 2; discontinue the IV and restart at a new site
C. VIP score 3; discontinue the IV immediately, restart at a new site, and document [CORRECT]
D. VIP score 4; apply a warm compress and reassess in 4 hours
Correct Answer: C
A palpable venous cord (VIP score 3) with erythema warrants immediate discontinuation and restart at a new site per INS 2026
standards. VIP score 1-2 may be monitored or the line changed at the next scheduled replacement. A score of 4 includes
advanced signs like purulent drainage. Warm compress without discontinuation (D) is unsafe when a venous cord is present.
Q3: According to the 2026 INS Standards, which technique is required for peripheral IV insertion to
minimize infection risk?
A. Clean technique with non-sterile gloves
B. Aseptic Non-Touch Technique (ANTT) using sterile gloves and a no-touch approach to the catheter
hub [CORRECT]
C. Hand hygiene only, without gloves
D. Sterile field including full body draping
Correct Answer: B
ANTT is the 2026 INS standard for IV insertion and maintenance, combining hand hygiene, sterile gloves, and a no-touch
approach to critical components (catheter hub, tip). Clean technique (A) is insufficient for vascular access. Hand hygiene alone
(C) lacks barrier protection. Full body draping (D) is required for central line insertion, not peripheral IVs.
, Q4: A nursing student is preparing to insert a peripheral IV. Which vein is the preferred first-choice site for
an adult patient according to current evidence?
A. Dorsal venous arch of the hand
B. Dorsal venous arch of the foot
C. Forearm veins (cephalic or basilic) [CORRECT]
D. Femoral vein
Correct Answer: C
The forearm (cephalic or basilic veins) is the preferred first-choice site for adult peripheral IVs due to vein stability, larger
diameter, lower risk of complications, and patient comfort with arm mobility. Hand veins are second-line due to smaller size
and higher mobility. Foot veins carry high infection risk. The femoral vein is a central access site, not a peripheral option.
Q5: A patient has a left-sided mastectomy with lymph node dissection. The nurse needs to start a peripheral
IV. Which site should be AVOIDED?
A. Right forearm
B. Right hand
C. Left arm [CORRECT]
D. Right dorsal foot
Correct Answer: C
The arm ipsilateral to a mastectomy with lymph node dissection must be avoided for venipuncture and IV placement due to the
significantly increased risk of lymphedema and infection. The contralateral arm and alternative sites should be used instead.
Q6: In 2026, what is the recommended maximum dwell time for a short peripheral IV catheter in an adult
patient per INS Standards?
A. 48 hours
B. 72 hours
C. 96 hours
D. No routine replacement; assess clinically and replace based on clinical indication [CORRECT]
Correct Answer: D
The 2026 INS Standards recommend against routine scheduled replacement of peripheral IVs (no fixed 72- or 96-hour rule).
Instead, IVs should be assessed at each shift and replaced only when clinically indicated (complications, infiltration, phlebitis,
or therapy completion), supported by evidence showing routine replacement does not reduce infection rates.
Q7: A nurse is using ultrasound-guided peripheral IV placement for a patient with difficult venous access.
Which statement is TRUE regarding this 2026 advance?
A. Ultrasound guidance eliminates the need for hand hygiene
B. Ultrasound-guided IV insertion improves first-attempt success rates and reduces complications in
patients with difficult access [CORRECT]
C. Ultrasound should only be used for central line placement
D. Ultrasound-guided IVs do not require sterile technique
Correct Answer: B
Ultrasound-guided peripheral IV insertion is a 2026 standard of practice for difficult venous access, improving first-attempt
success and reducing patient discomfort and complications. It does not replace hand hygiene (A) or aseptic technique (D), and
its use has expanded well beyond central lines (C).
Q8: A nurse assesses an IV site and notes swelling, coolness, and blanched skin at the insertion site. The
patient reports discomfort but no redness or warmth. Which complication is MOST likely?
A. Phlebitis
B. Infiltration [CORRECT]
ASSESSMENT MEASURES EXAM
2026 UPDATE | QUESTIONS AND ANSWERS | ALREADY PASSED
Course: BSN 266 - Professional Nursing Practice | Week 3
Date: July 2026 | Total Questions: 40 | Total Points: 100 (2.5 pts each)
Select the BEST answer for each question. Each question is worth 2.5 points.
SECTION 1: IV Site Assessment, Catheter Selection, & Insertion Principles (Q1–Q10)
Q1: A nurse is selecting a peripheral IV catheter for an adult patient who will receive intermittent antibiotic
therapy for 7 days. According to 2026 INS Standards, which gauge and length is MOST appropriate?
A. 24-gauge, 3/4 inch
B. 22-gauge, 1 inch [CORRECT]
C. 18-gauge, 1.25 inches
D. 14-gauge, 2 inches
Correct Answer: B
A 22-gauge, 1-inch catheter is appropriate for most adult peripheral IV therapy, including intermittent antibiotics, balancing
flow capability with patient comfort and vein integrity. An 18G is unnecessarily large for antibiotic therapy. A 24G is too small
for viscous medications. A 14G is reserved for trauma or rapid large-volume resuscitation.
Q2: A nurse is assessing an IV site using the Visual Infusion Phlebitis (VIP) score. The site is erythematous
with a palpable venous cord extending 2 cm proximal to the insertion site. Pain is reported as 3/10. What is
the VIP score, and what action is required?
A. VIP score 1; continue monitoring
B. VIP score 2; discontinue the IV and restart at a new site
C. VIP score 3; discontinue the IV immediately, restart at a new site, and document [CORRECT]
D. VIP score 4; apply a warm compress and reassess in 4 hours
Correct Answer: C
A palpable venous cord (VIP score 3) with erythema warrants immediate discontinuation and restart at a new site per INS 2026
standards. VIP score 1-2 may be monitored or the line changed at the next scheduled replacement. A score of 4 includes
advanced signs like purulent drainage. Warm compress without discontinuation (D) is unsafe when a venous cord is present.
Q3: According to the 2026 INS Standards, which technique is required for peripheral IV insertion to
minimize infection risk?
A. Clean technique with non-sterile gloves
B. Aseptic Non-Touch Technique (ANTT) using sterile gloves and a no-touch approach to the catheter
hub [CORRECT]
C. Hand hygiene only, without gloves
D. Sterile field including full body draping
Correct Answer: B
ANTT is the 2026 INS standard for IV insertion and maintenance, combining hand hygiene, sterile gloves, and a no-touch
approach to critical components (catheter hub, tip). Clean technique (A) is insufficient for vascular access. Hand hygiene alone
(C) lacks barrier protection. Full body draping (D) is required for central line insertion, not peripheral IVs.
, Q4: A nursing student is preparing to insert a peripheral IV. Which vein is the preferred first-choice site for
an adult patient according to current evidence?
A. Dorsal venous arch of the hand
B. Dorsal venous arch of the foot
C. Forearm veins (cephalic or basilic) [CORRECT]
D. Femoral vein
Correct Answer: C
The forearm (cephalic or basilic veins) is the preferred first-choice site for adult peripheral IVs due to vein stability, larger
diameter, lower risk of complications, and patient comfort with arm mobility. Hand veins are second-line due to smaller size
and higher mobility. Foot veins carry high infection risk. The femoral vein is a central access site, not a peripheral option.
Q5: A patient has a left-sided mastectomy with lymph node dissection. The nurse needs to start a peripheral
IV. Which site should be AVOIDED?
A. Right forearm
B. Right hand
C. Left arm [CORRECT]
D. Right dorsal foot
Correct Answer: C
The arm ipsilateral to a mastectomy with lymph node dissection must be avoided for venipuncture and IV placement due to the
significantly increased risk of lymphedema and infection. The contralateral arm and alternative sites should be used instead.
Q6: In 2026, what is the recommended maximum dwell time for a short peripheral IV catheter in an adult
patient per INS Standards?
A. 48 hours
B. 72 hours
C. 96 hours
D. No routine replacement; assess clinically and replace based on clinical indication [CORRECT]
Correct Answer: D
The 2026 INS Standards recommend against routine scheduled replacement of peripheral IVs (no fixed 72- or 96-hour rule).
Instead, IVs should be assessed at each shift and replaced only when clinically indicated (complications, infiltration, phlebitis,
or therapy completion), supported by evidence showing routine replacement does not reduce infection rates.
Q7: A nurse is using ultrasound-guided peripheral IV placement for a patient with difficult venous access.
Which statement is TRUE regarding this 2026 advance?
A. Ultrasound guidance eliminates the need for hand hygiene
B. Ultrasound-guided IV insertion improves first-attempt success rates and reduces complications in
patients with difficult access [CORRECT]
C. Ultrasound should only be used for central line placement
D. Ultrasound-guided IVs do not require sterile technique
Correct Answer: B
Ultrasound-guided peripheral IV insertion is a 2026 standard of practice for difficult venous access, improving first-attempt
success and reducing patient discomfort and complications. It does not replace hand hygiene (A) or aseptic technique (D), and
its use has expanded well beyond central lines (C).
Q8: A nurse assesses an IV site and notes swelling, coolness, and blanched skin at the insertion site. The
patient reports discomfort but no redness or warmth. Which complication is MOST likely?
A. Phlebitis
B. Infiltration [CORRECT]
