N322 Flash cards Q&A
Which action would the nurse perform to best ensure effective insertion of a venous
access device into a patient's arm?
A. Anchor the vein by placing a thumb 1 to 2 inches below the site.
B. Insert the device tip at a 45-degree angle distal to the proposed site.
C. Place the patient's left arm in a dependent position for 5 minutes before assessment.
D. Apply a tourniquet to the left antecubital fossa 8 to 12 inches above the proposed
site. - (correct answer)ANSWER: Anchor the vein by placing a thumb 1 to 2 inches
below the site.
Rational:
Anchoring the vein by placing a thumb 1 to 2 inches below the site stabilizes the vein,
increasing the possibility of a successful insertion. The angle of insertion should be 10
to 30 degrees. Placing the patient's arm in a dependent position is directed toward
improving visualization of the vein. Applying a tourniquet to the left antecubital fossa is
directed toward improving visualization of the vein and should be applied 4 to 6 inches
above the site.
How might the nurse prepare a patient to anticipate some discomfort when inserting a
venous access device?
A. Insert the access device as quickly as possible
B. Instruct the patient to expect a sharp, quick stick
C. Apply a topical anesthetic to the area before inserting the device
D. Promise that the procedure will not hurt once the device has been inserted. - (correct
answer)Answer: Instruct the patient to expect a sharp, quick stick.
Rational:
Educating the patient to have reasonable expectations about the possible discomfort
will best prepare him or her for it. Inserting the access device as quickly as possible will
not prepare the patient regarding what to expect. Applying a topical anesthetic will
reduce the likelihood of pain; however, this is not routinely done when inserting a
venous access device. It is inappropriate to make such a promise.
,Which of the following technique(s) is/are best for minimizing a patient's risk for injury
when inserting a venous access device?
A. Inserting the needle with the bevel up
B. Using a vein on the dorsal surface of the arm
C. Holding the skin taut directly below the site
D. All of the above - (correct answer)Answer: All of the above
Rational:
All of these actions will minimize injury to the patient. Inserting the needle bevel-up
minimizes vein trauma by the needle itself. Use of adequate veins reduces the chance
for rupture. Holding the skin taut directly below the site will decrease drag on insertion.
The nurse is inserting an over-the-needle catheter into a newly admitted patient. What
will the nurse do after confirming blood return?
A. Loosen or remove the tourniquet.
B. Advance the catheter 1 inch into the vein.
C. Lower the catheter until it is flush with the skin.
D. Thread the catheter into the vein up to the hub. - (correct answer)Answer: Lower the
catheter until it is flush with the skin.
Rational:
Lowering the catheter until it is flush with the skin minimizes the risk of passing the
needle through the opposite vessel wall. The tourniquet is loosened or removed later in
the procedure. This is done later in the procedure. Threading the catheter into the vein
up to the hub is done later in the procedure.
Which instruction might the nurse give to nursing assistive personnel (NAP) regarding
the care of a patient with an intravenous access device?
A. "Assess the IV site frequently for signs of inflammation."
, B. "Be sure not to obscure the insertion site with the dressing."
C. "Let me know when you notice that the IV bag contains less than 100 milliliters."
D. "Explain the symptoms of infection to the patient." - (correct answer)Answer:"Let me
know when you notice that the IV bag contains less than 100 milliliters."
Rational:
The task of reporting when the level of fluid in the IV bag is low may be delegated to
NAP. Assessment skills may not be delegated to NAP. The skill of IV dressing
application may not be delegated to NAP. Patient education may not be delegated to
NAP.
When caring for a patient who has a CVAD, which sign may indicate infection at the
insertion site?
A. Occlusion alarm sounds on infusion pump
B. Patient's oral temperature gradually increases
C. Patient's neck veins become distended
D. The nurse cannot achieve blood return - (correct answer)Answer: Patient's oral
temperature gradually increases
Rational:
A progressive elevation in the patient's temperature may indicate an infection. The
sounding of an occlusion alarm is more likely an indication of an occlusion. Neck vein
distention is more likely an indication of catheter migration. Inability to achieve blood
return is more likely an indication of an occlusion.
While palpating the skin around a patient's CVAD insertion site, the nurse elicits a
crackling sound. What might this finding indicate?
A. Catheter occlusion
B. Infection
C. Skin erosion
Which action would the nurse perform to best ensure effective insertion of a venous
access device into a patient's arm?
A. Anchor the vein by placing a thumb 1 to 2 inches below the site.
B. Insert the device tip at a 45-degree angle distal to the proposed site.
C. Place the patient's left arm in a dependent position for 5 minutes before assessment.
D. Apply a tourniquet to the left antecubital fossa 8 to 12 inches above the proposed
site. - (correct answer)ANSWER: Anchor the vein by placing a thumb 1 to 2 inches
below the site.
Rational:
Anchoring the vein by placing a thumb 1 to 2 inches below the site stabilizes the vein,
increasing the possibility of a successful insertion. The angle of insertion should be 10
to 30 degrees. Placing the patient's arm in a dependent position is directed toward
improving visualization of the vein. Applying a tourniquet to the left antecubital fossa is
directed toward improving visualization of the vein and should be applied 4 to 6 inches
above the site.
How might the nurse prepare a patient to anticipate some discomfort when inserting a
venous access device?
A. Insert the access device as quickly as possible
B. Instruct the patient to expect a sharp, quick stick
C. Apply a topical anesthetic to the area before inserting the device
D. Promise that the procedure will not hurt once the device has been inserted. - (correct
answer)Answer: Instruct the patient to expect a sharp, quick stick.
Rational:
Educating the patient to have reasonable expectations about the possible discomfort
will best prepare him or her for it. Inserting the access device as quickly as possible will
not prepare the patient regarding what to expect. Applying a topical anesthetic will
reduce the likelihood of pain; however, this is not routinely done when inserting a
venous access device. It is inappropriate to make such a promise.
,Which of the following technique(s) is/are best for minimizing a patient's risk for injury
when inserting a venous access device?
A. Inserting the needle with the bevel up
B. Using a vein on the dorsal surface of the arm
C. Holding the skin taut directly below the site
D. All of the above - (correct answer)Answer: All of the above
Rational:
All of these actions will minimize injury to the patient. Inserting the needle bevel-up
minimizes vein trauma by the needle itself. Use of adequate veins reduces the chance
for rupture. Holding the skin taut directly below the site will decrease drag on insertion.
The nurse is inserting an over-the-needle catheter into a newly admitted patient. What
will the nurse do after confirming blood return?
A. Loosen or remove the tourniquet.
B. Advance the catheter 1 inch into the vein.
C. Lower the catheter until it is flush with the skin.
D. Thread the catheter into the vein up to the hub. - (correct answer)Answer: Lower the
catheter until it is flush with the skin.
Rational:
Lowering the catheter until it is flush with the skin minimizes the risk of passing the
needle through the opposite vessel wall. The tourniquet is loosened or removed later in
the procedure. This is done later in the procedure. Threading the catheter into the vein
up to the hub is done later in the procedure.
Which instruction might the nurse give to nursing assistive personnel (NAP) regarding
the care of a patient with an intravenous access device?
A. "Assess the IV site frequently for signs of inflammation."
, B. "Be sure not to obscure the insertion site with the dressing."
C. "Let me know when you notice that the IV bag contains less than 100 milliliters."
D. "Explain the symptoms of infection to the patient." - (correct answer)Answer:"Let me
know when you notice that the IV bag contains less than 100 milliliters."
Rational:
The task of reporting when the level of fluid in the IV bag is low may be delegated to
NAP. Assessment skills may not be delegated to NAP. The skill of IV dressing
application may not be delegated to NAP. Patient education may not be delegated to
NAP.
When caring for a patient who has a CVAD, which sign may indicate infection at the
insertion site?
A. Occlusion alarm sounds on infusion pump
B. Patient's oral temperature gradually increases
C. Patient's neck veins become distended
D. The nurse cannot achieve blood return - (correct answer)Answer: Patient's oral
temperature gradually increases
Rational:
A progressive elevation in the patient's temperature may indicate an infection. The
sounding of an occlusion alarm is more likely an indication of an occlusion. Neck vein
distention is more likely an indication of catheter migration. Inability to achieve blood
return is more likely an indication of an occlusion.
While palpating the skin around a patient's CVAD insertion site, the nurse elicits a
crackling sound. What might this finding indicate?
A. Catheter occlusion
B. Infection
C. Skin erosion
