CRNI Infusion-Related Pharmacology Questions and Answers

Question 1

A patient receiving an initial infusion of a new monoclonal antibody develops urticaria, dyspnea, and hypotension.
After stopping the infusion, which pharmacologic agent should the certified registered nurse infusion (CRNI) anticipate administering as the first-line treatment for this reaction?

Accepted Answer

Subcutaneous or intramuscular epinephrine

Answer

Intravenous diphenhydramine

Answer

A rapid bolus of 0.9% Sodium Chloride

Answer

Intravenous methylprednisolone

Question 2

A CRNI is preparing to administer an intravenous loading dose of phenytoin. Which of the following practices is essential for safe administration to prevent precipitation?

Accepted Answer

Using 0.9% Sodium Chloride as the exclusive solution for dilution and flushing

Answer

Diluting the dose in 5% Dextrose in Water (D5W)

Answer

Administering the drug through a line that has been flushed only with heparin

Answer

Mixing the phenytoin in the same syringe as a benzodiazepine for sedation

Question 3

A patient is prescribed intravenous potassium chloride (KCl) 20 mEq to be added to a 100 mL bag of 0.9% Sodium Chloride. Which action by the nurse is most critical to ensure patient safety during preparation and administration?

Accepted Answer

Ensuring the potassium chloride is thoroughly mixed in the solution bag before infusion.

Answer

Administering the infusion via gravity drip to avoid pump alarms.

Answer

Pushing the KCl directly from a syringe into the patient's IV line for faster effect.

Answer

Using a peripheral catheter smaller than 22-gauge to minimize vein irritation.

Question 4

A patient with a peripherally inserted central catheter (PICC) is receiving a continuous infusion of a vesicant chemotherapy agent. The nurse assesses the site and notes swelling, erythema, and a report of pain at the site, but there is still a brisk blood return. What is the most appropriate interpretation of these findings?

Accepted Answer

An extravasation may be occurring despite the presence of a blood return.

Answer

The patient is experiencing an expected local inflammatory reaction to the medication.

Answer

A fibrin sheath has formed at the catheter tip, causing a partial occlusion.

Answer

The patient is developing a central line-associated bloodstream infection (CLABSI).

Question 5

A patient receiving intravenous vancomycin begins to experience flushing of the face and neck, pruritus, and a macular rash on the upper torso. The patient's vital signs are stable. The CRNI should recognize these symptoms as being characteristic of which infusion-related reaction?

Accepted Answer

Vancomycin infusion reaction

Answer

Anaphylaxis

Answer

Speed shock

Answer

A pyrogenic reaction

Question 6

A CRNI is caring for a patient who develops severe respiratory depression after receiving repeated doses of intravenous hydromorphone. The nurse should be prepared to administer which pharmacologic antagonist to reverse the effects of the medication?

Accepted Answer

Naloxone

Answer

Flumazenil

Answer

Protamine Sulfate

Answer

Acetylcysteine

A patient receiving an initial infusion of a new monoclonal antibody develops urticaria, dyspnea, and hypotension.After stopping the infusion, which pharmacologic agent should the certified registered nurse infusion (CRNI) anticipate administering as the first-line treatment for this reaction?

A patient receiving an initial infusion of a new monoclonal antibody develops urticaria, dyspnea, and hypotension.
After stopping the infusion, which pharmacologic agent should the certified registered nurse infusion (CRNI) anticipate administering as the first-line treatment for this reaction?