CRNI Managing Infusion Complications Questions and Answers

Question 1

A patient with a newly placed non-tunneled central venous catheter in the subclavian vein suddenly becomes dyspneic, hypotensive, and tachycardic during an IV tubing change.
The CRNI suspects an air embolism.
What is the PRIORITY nursing intervention?

Accepted Answer

Place the patient in the Trendelenburg position on their left side.

Answer

Administer high-flow oxygen via a non-rebreather mask.

Answer

Immediately obtain a stat portable chest x-ray.

Answer

Place the patient in a high-Fowler's position to ease breathing.

Question 2

A CRNI is assessing a peripheral IV site and notes pain at the access site, erythema, streak formation, and a palpable venous cord measuring approximately 1 inch. According to the Infusion Nurses Society (INS) Phlebitis Scale, how should the nurse grade this finding?

Accepted Answer

Grade 3

Answer

Grade 2

Answer

Grade 1

Answer

Grade 4

Question 3

A nurse is administering an IV push medication rapidly. The patient suddenly complains of a severe headache, dizziness, and a 'fluttering' feeling in their chest. The patient appears flushed and becomes hypotensive. The CRNI should recognize these symptoms as characteristic of which systemic infusion complication?

Accepted Answer

Speed shock

Answer

Anaphylactic reaction

Answer

Circulatory overload

Answer

Pyrogenic reaction

Question 4

During a routine dressing change for a patient's PICC line, the CRNI notes that the external catheter length has increased by 4 cm compared to the documented insertion length. The patient also reports occasionally hearing a 'gurgling' sound in their ear on the side of the catheter insertion. Which of the following is the most likely complication?

Accepted Answer

Catheter migration

Answer

Catheter fracture

Answer

Venous thrombosis

Answer

Pinch-off syndrome

Question 5

A patient with a peripheral IV complains of sudden, sharp pain radiating up their arm during the infusion of a room-temperature antibiotic. The infusion has slowed significantly despite no signs of infiltration or phlebitis. Which action is most appropriate to manage a suspected venous spasm?

Accepted Answer

Apply a warm compress to the vein above the insertion site.

Answer

Increase the infusion rate to push past the spasm.

Answer

Apply a cold compress to the area.

Answer

Re-site the catheter in a larger vein immediately.

Question 6

A CRNI is caring for a patient whose central venous access device (CVAD) is determined to have a thrombotic occlusion after mechanical causes have been ruled out. Which intervention is the standard of care for this complication?

Accepted Answer

Administering a thrombolytic agent like alteplase per institutional protocol.

Answer

Flushing the catheter with a 10 mL syringe using forceful pressure.

Answer

Replacing the entire central venous access device.

Answer

Instilling 0.1 N hydrochloric acid into the catheter.

A patient with a newly placed non-tunneled central venous catheter in the subclavian vein suddenly becomes dyspneic, hypotensive, and tachycardic during an IV tubing change.The CRNI suspects an air embolism.What is the PRIORITY nursing intervention?

A patient with a newly placed non-tunneled central venous catheter in the subclavian vein suddenly becomes dyspneic, hypotensive, and tachycardic during an IV tubing change.
The CRNI suspects an air embolism.
What is the PRIORITY nursing intervention?