A nurse is caring for a client who has a prescription for parenteral therapy. Which of the following actions should the nurse take when initiating IV therapy?

Insert the IV catheter using the Z-track technique.

Insert the IV catheter with the bevel down.

Remove the roller clamp from the tubing prior to IV insertion.

Apply the tourniquet 5 to 10 cm (about 2 to 4 in) above the IV insertion site.

Answer and Explanation

The Correct Answer is D

A. "Insert the IV catheter using the Z-track technique." The Z-track technique is used for intramuscular (IM) injections, not IV therapy.
B. "Insert the IV catheter with the bevel down." The bevel should be up to facilitate smooth vein entry.
C. "Remove the roller clamp from the tubing prior to IV insertion." The roller clamp should remain in place to control fluid flow and prevent air from entering the tubing.
D. "Apply the tourniquet 5 to 10 cm (about 2 to 4 in) above the IV insertion site." This placement helps distend the vein for easier cannulation without restricting arterial blood flow.

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Correct Answer is A

Explanation

A. Suctioning a client's tracheostomy tube A face shield or goggles with a mask should be worn when performing procedures that generate aerosols or splashes, such as suctioning a tracheostomy. This helps protect the nurse from exposure to respiratory secretions.
B. Emptying an indwelling urinary catheter bag This task carries a low risk of splashing, so gloves are typically sufficient. If splashing is anticipated, wearing a gown and goggles may be appropriate.
C. Inserting an IV catheter for a client who has peritonitis IV insertion does not pose a high risk of splashes or sprays, so standard precautions (gloves) are usually adequate.
D. Changing the brief of an older adult client who has a Clostridium difficile infection While contact precautions (gown and gloves) are required for C. difficile, a face shield is not necessary unless significant splashing of fecal matter is expected. Hand hygiene with soap and water (not alcohol-based hand sanitizer) is essential.

A. "I can discuss client information in the hallway outside a client's room." B. "I will need permission from a client to share health information with a relative." C. "I can share a client's diagnosis with any member of the health care team." D. "I will need written permission from the provider to allow a client to access their electronic medical record."

Correct Answer is B

Explanation

A. "I can discuss client information in the hallway outside a client's room." Discussing client information in a public or semi-public area is a violation of HIPAA (Health Insurance Portability and Accountability Act).
B. "I will need permission from a client to share health information with a relative." Under HIPAA, health information cannot be shared with family members unless the client gives explicit permission.
C. "I can share a client's diagnosis with any member of the health care team." Information should only be shared with team members directly involved in the client's care. Not all healthcare workers need access to all client information.
D. "I will need written permission from the provider to allow a client to access their electronic medical record." Clients have the right to access their medical records without needing provider permission. The facility may have specific procedures, but a provider cannot block access unless there is a legal or safety concern.

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A nurse is caring for a client who has a prescription for parenteral therapy. Which of the following actions should the nurse take when initiating IV therapy?

Nursing Test Bank

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