Details of TEST BANK FOR PHILLIPS-S MANUAL OF I.V. THERA-PEUTICS EVIDENCE-BASED PRACTICE FOR INFUSION THERAPYChapter 1: Professional Practice Concepts for
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Multiple Choice Identify the choice that best completes the statement or answers the question.
1. A nurse is attempting to initiate I.V. therapy for a client diagnosed with gastroenteritis. The client is combative and resists the nurse’s efforts to start the I.V. Which action by the nurse would result in an intentional tort? A. Failing to document the client’s combativeness B. Refusing to wear gloves while starting the I.V. C. Failing to report the client’s combativeness to a physician D. Starting an I.V. on a coherent client against the client’s wishes
2. A nurse who is caring for clients understands that he or she should provide care that meets at least the minimum standards of practice for nursing. Which phrase regarding standards of practice is most accurate? A. Standards of practice focus on the care provider and define needed activities and behaviors. B. Standards of practice focus on the recipient of care and describe the outcomes of care. C. Standards of practice are written laws enacted by the legislature. D. Standards of practice are the result of the performance of a function or process.
3. Which incident would cause a nurse to be named as a defendant in a malpractice suit?
A. The nurse notes blood return noted in a peripheral IV catheter line. B. The nurse reports early signs of infection from a peripheral line inserted by a nurse on another unit
C. The nurse places two peripheral IV catheters in a patient requiring emergency IV fluids, but only uses one
D. The nurse records nerve damage caused by a peripheral IV catheter inserted the previous shift nurse
4. The intravenous route is the most commonly used infusion route. The nurse notes that a client diagnosed with metastatic cancer is receiving an intraosseous infusion. Should the nurse question the healthcare pro- vider’s order? A. Yes; the healthcare provider is not following INS recommendations. B. No; the nurse should never question the healthcare provider’s order when it comes to chemother- apy. C. Yes; this route of infusion is dangerous and not accepted by the INS. D. No; other routes might be appropriate for administration in certain situations and with selected fluids and medications.
5. Which competency assessment method is acceptable for nursing competencies which will occur 1 | P a g eonce per year in the skilled nursing facility?
A. Client Evaluation
B. Clinical Data
C. Sentinel Event Report
D. Skills Checklist
6. One of the primary values of the INS designation of CRNI (certified registered nurse, infusion) is to:
A. Protect the public
B. Attain competence
C. Reflect a measurable goal
D. Hold nurses accountable
7. Which problem-solving approach to clinical practice is the nurse manager applying when
determining patient preference and values for successful clinical outcomes?
A. Effective health-care practice
B. Evidence-based practice (EBP)
C. Answering a burning clinical question
D. One’s own clinical expertise
8. Seven days ago the PICC nurse inserted a PICC line into the right forearm of a client diagnosed with
cancer. When the nurse checks the client's site today, which nursing process outcome is
determined?
A. Evaluating cancer treatment
B. Implementing asepsis maintenance
C. Planning for complication prevention
D. Discussing prior cancer therapy
9. Which compensatory model has been applied if the hospitalization rate for CLABSIs (central line-
associated bloodstream infections) decreased significantly over the last quarter?
A. VBP
B. HHRP
C. HAC
D. HHVBP
10. When called as an expert witness in an upcoming case, the nurse manager employs which
techniques?
A. Examines evidence and give advice
B. Reviews charts and assesses jury selection
C. Gives deposition and notifies lawyers of discrepancies
D. Testifies and establishes standards of care
Multiple Response
2 | P a g eIdentify one or more choices that best complete the statement or answer the question.
1. A nurse is caring for multiple clients in a rehabilitation facility. During the shift, the nurse notes
that several clients are on high-risk medications. According to the Risk Evaluation and
Mitigation Strategy (REMS) program, when can the U.S. Food and Drug Administration
(FDA) require a REMS? (Se- lect all that apply.)
A. Before FDA drug approval
B. After FDA drug approval
C. During a client evaluation
D. At an ethics committee meeting
E. After client informed consent
2. A new infusion clinic is being started. The nursing supervisor of the new clinic must conform to
specific standards of practice when developing nursing policies and procedures for the
new program. To which organizational standards of practice must the nurse manager
adhere? (Select all that apply.)
A. Centers for Disease Control and Prevention (CDC) guidelines
B. Infusion Nurses Society (INS) standards
C. American Medical Association (AMA) standards
D. Oncology Nursing Society (ONS) standards
E. U.S. Food and Drug Administration (FDA)
3. A staff nurse is serving on a hospital’s quality-assurance improvement task force. On which
quality- assurance improvement models is the task force most likely to focus? (Select
all that apply.)
A. Standards of care
B. Standards of practice
C. Performance improvement
D. Continuous quality improvement
E. Total Quality Management (TQM)
4. Which methods should the nurse use to evaluate achievement of client outcomes prior to
discharge? (Select all that apply.)
A. Collect data to determine whether standards were met.
B. Identify controllable or uncontrollable variables.
C. Determine the cause of the problem by comparing actual care with established standards.
D. Re-evaluate to determine whether corrective action is effective and improvement in
service is obtained.
E. Contact The Joint Commission (JCAHO) Web site for standards.
5. While caring for a client, a nurse administers an incorrect dose of medication, causing the client to
become ill. The nurse reports the incident to the nurse manager on the unit. The nurse
manager then notifies risk management. Which risk-management strategies should be used
3 | P a g eby the nurse in this situation? (Select all that apply.)
A. Documentation
B. Physical assessment
C. Unusual occurrence reports
D. Professional liability insurance
E. Systemic analysis of serious adverse events
6. When nurses provide care to clients, nursing actions are governed by established standards of
nursing care, as well as both state and federal laws. Which are sources of law? (Select all that
apply.)
A. Constitution
B. Statutes
C. State Nurse Practice Acts
D. Joint Commission standards
E. Centers for Disease (CDC) standards.
7. The nursing supervisor of a new infusion clinic must conform to specific standards of practice when
developing nursing policies and procedures for the new program. Which INS risk
management strat- egies help decrease the risk of potential liability to the new clinic? (Select
all that apply.)
A. Analysis of unusual occurrences
B. Root cause analysis of sentinel events
C. Evaluation of all patient data and surveys
D. Comprehensive and thorough documentation
E. Reduction of CLABSI related complications
8. While taking care of a client with multiple sclerosis, the infusion nurse inadvertently gives the client
too much alemtuzumab by infusing longer than the recommended two hours. The nurse is
proven negli- gent by which elements of the malpractice claim? (Select all that apply.)
A. The nurse has a duty to provide safe, effective treatment.
B. The nurse allows the client’s family to watch the infusion.
C. The client suffers difficulty breathing and chills during the infusion.
D. A breach of care occurs because the nurse administered too much medication.
E. The nurse should have offered the P.O. form of alemtuzumab.
9. With in-depth knowledge of community resources, which skill will help the home care infusion nurse
provide
the best care? (Select all that apply.)
4 | P a g eA. Meticulous evidence-based care
B. Interprofessional communication and collaboration
C. Appropriate parenteral nutrition and IV medication
D. Ability to write home infusion therapy policy and procedures
E. Safe, effective, and competent care
10. A nurse fails to document that an injectable heparin has been given to a client for two weeks.
Upon investigation it is determined that the heparin was not given and the nurse was
reported to the state board of nursing. Which type of law is the state board using? (Select
all that apply.)
A. Public law
B. Administrative law
C. Common law
D. Constitutional law
E. Statutory law
Chapter 1: Professional Practice Concepts for Infusion Therapy
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A nurse is attempting to initiate I.V. therapy for a client diagnosed with gastroenteritis. The client
is combative and resists the nurse’s efforts to start the I.V. Which action by the nurse
would result in an intentional tort?
A. Failing to document the client’s combativeness
B. Refusing to wear gloves while starting the I.V.
C. Failing to report the client’s combativeness to a physician
D. Starting an I.V. on a coherent client against the client’s wishes
ANS: D
Page: 28
Feedback
A.
B.
C.
D.
Failure to document does not result in direct injury or harm to a client
and is, therefore, not an intentional tort.
Refusing to wear gloves may inadvertently result in injury or harm, but
is not considered an intentional tort.
Failure to report the behavior to a physician does not result in direct injury
or
harm to the client and is not considered an intentional tort.
Intentional torts include assault and battery, false imprisonment, using
restraints
as a form of false imprisonment, defamation of character, and breach of
confi- dentiality.
5 | P a g e2. A nurse who is caring for clients understands that he or she should provide care that meets at
least the minimum standards of practice for nursing. Which phrase regarding standards
of practice is most accurate?
A. Standards of practice focus on the care provider and define needed activities and behaviors.
B. Standards of practice focus on the recipient of care and describe the outcomes of care.
C. Standards of practice are written laws enacted by the legislature.
D. Standards of practice are the result of the performance of a function or process.
ANS: A
Page: 16
Feedback
A.
B.
Standards of practice are criteria for measuring performance against the
optimal achievable degree of clinical excellence. These standards are
formulated to communicate expectations of nursing practice. Agencies are
influential in devel- oping standards of practice.
Standards of practice criteria focus on the care provider, not the care
recipient
6 | P a g eC.
D.
Standards of practice are evidence-based guidelines, policies, or
protocols not written laws.
Standards of practice may occur in response to unanswered questions,
limited research, and/or performance issues; not necessarily the result
of the perfor- mance or process.
3. Which incident would cause a nurse to be named as a defendant in a malpractice suit?
A. The nurse notes blood return noted in a peripheral IV catheter line.
B. The nurse reports early signs of infection from a peripheral line inserted by a nurse on
another unit
C. The nurse places two peripheral IV catheters in a patient requiring emergency IV fluids,
but only uses one
D. The nurse records nerve damage caused by a peripheral IV catheter inserted the
previous shift nurse
ANS: D
Page: 29
Feedback
A.
B.
C.
D.
Blood return at the catheter site is normal.
Reporting early signs of infection is expected.
Using one peripheral IV catheter may be warranted.
The nurse had a duty to do no harm to the client and the client
suffered actual harm or injury.
4. The intravenous route is the most commonly used infusion route. The nurse notes that a client
diagnosed with metastatic cancer is receiving an intraosseous infusion. Should the nurse
question the healthcare pro- vider’s order?
A. Yes; the healthcare provider is not following INS recommendations.
B. No; the nurse should never question the healthcare provider’s order when it comes to
chemother- apy.
C. Yes; this route of infusion is dangerous and not accepted by the INS.
D. No; other routes might be appropriate for administration in certain situations and with
selected fluids and medications.
ANS: D
Page: 3
Feedback
A.
B.
7 | P a g e
Infusion Nurses Society (INS) Standards, infusion therapy is provided with
at- tention to safety and quality with individualized care that is
collaborative, cultur- ally sensitive, and age appropriate.
If there are questions about care the nurse (and client) should feel
comfortableenough to ask the healthcare provider and evidence-based criteria should be the basis for practice answers.
C.
This is an acceptable router per INS standards. There are risks, some complica- tions are serious and even life-threatening, and many complications are prevent- able with sound nursing care. The nurse must have a thorough understanding and knowledge of the type of access device being utilized, potential complications of infusion solutions, and safe infusion administration.
D.
The intravenous (I.V.) route is the most commonly used infusion route; however, other infusion routes include intraosseous, subcutaneous, and intraspinal. In this case, the intraosseous route might be appropriate for administration with the se- lected fluids and medications.
5. Which competency assessment method is acceptable for nursing competencies which will occur once per year in the skilled nursing facility? A. Client Evaluation B. Clinical Data C. Sentinel Event Report D. Skills Checklist
ANS: D Page: 4
Feedback A. B. C. D.
Client evaluation is concern that may drive competency validation, but is not a method of competency assessment.
Clinical data is based on outcome criteria that drives competency validation, but is not a method of competency assessment.
Sentinel event reports are another form of competency validation, but they are not methods of competency assessment.
Competency assessment methods include performance measures related to patient care, such as skills, knowledge, ability, and judgement that includes objec- tive, measureable assessment of the actual performance in the form of checklists.
6. One of the primary values of the INS designation of CRNI (certified registered nurse, infusion) is to: A. Protect the public B. Attain competence C. Reflect a measurable goal D. Hold nurses accountable
ANS: A Page: 6 [Show Less]