A nurse is caring for a client who has just had a central venous access line inserted. What action will the nurse take next?

Begin the prescribed infusion via the new access.

Ensure that an x-ray is completed to confirm placement.

Check medication calculations with a second RN.

Make sure that the solution is appropriate for a central line.

Answer and Explanation

The Correct Answer is B

Choice A reason: Beginning the infusion before confirming placement risks complications, as the catheter may be misplaced in an artery or tissue, causing emboli or tissue damage. X-ray confirmation ensures safe administration through the central line.
Choice B reason: An x-ray confirms the central venous catheter’s tip is correctly positioned in the superior vena cava, preventing complications like pneumothorax, arterial puncture, or infusion into tissues, which could lead to serious adverse effects.
Choice C reason: Checking medication calculations is unrelated to catheter placement. Ensuring proper placement via x-ray is critical to prevent infusion errors, such as delivering medication into an incorrect vessel or tissue space.
Choice D reason: Verifying solution compatibility is important but secondary to confirming catheter placement. Incorrect placement can cause infusion into non-vascular spaces, leading to tissue damage or ineffective therapy, making x-ray confirmation the priority.

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Correct Answer is C

Explanation

Choice A reason: Scrubbing the spike with alcohol may not fully sterilize it after contact with a non-sterile surface. Contaminated tubing risks introducing bacteria into the bloodstream, leading to catheter-related infections or sepsis.
Choice B reason: Replacing the IV bag is unnecessary, as the bag was not contaminated. The spike, which contacts the bag’s sterile port, is the compromised component, requiring new tubing to ensure sterility.
Choice C reason: New IV tubing ensures sterility after the spike contacts a non-sterile surface. Contaminated tubing could introduce pathogens into the IV system, causing bloodstream infections. Replacing it maintains the sterile field for safe infusion.
Choice D reason: Wiping with Betadine may not adequately sterilize the spike after contamination. Betadine requires contact time and may leave residue. New tubing is the safest option to prevent infection during IV administration.

A. Bevel up B. Bevel down or up C. Bevel center D. Bevel down

Correct Answer is A

Explanation

Choice A reason: Positioning the needle bevel up during IV insertion aligns the sharp edge upward, facilitating smooth vein entry and reducing vessel trauma. This orientation ensures better visualization of the needle tip and minimizes the risk of piercing the vein’s back wall.
Choice B reason: Bevel down or up is not a standard practice, as it lacks specificity. Bevel up is preferred to ensure controlled entry and minimize vein damage. Inconsistent bevel positioning can increase the risk of failed cannulation or hematoma formation.
Choice C reason: Bevel center is not a recognized term in IV insertion. The bevel must be up to optimize vein entry and reduce trauma. Incorrect positioning can lead to vessel perforation or difficulty advancing the catheter, compromising the procedure.
Choice D reason: Bevel down increases the risk of piercing the vein’s back wall, causing hematoma or failed cannulation. Bevel up is the standard to ensure smooth entry, reduce tissue trauma, and facilitate catheter advancement into the vein.

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A nurse is caring for a client who has just had a central venous access line inserted. What action will the nurse take next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing a continuous intravenous (IV) infusion at the medication cart. As the nurse goes to insert the spike end of the IV tubing into the IV bag, the tubing drops and the spike end hits the top of the medication cart. The nurse should take which action?

Correct Answer is C

Explanation

When entering the skin and cannulating a vein, the usual needle position is:

Correct Answer is A

Explanation

The most common dressing used to cover an IV site is a transparent dressing. This dressing:

Which methods will the nurse use to administer an intravenous (IV) medication that is incompatible with the patient’s IV fluid? (Select all that apply)

When performing an IV insertion on an adult, which actions will the nurse take? (Select all that apply)

A nurse is assessing clients who have intravenous therapy prescribed. Which assessment finding for a client with a peripherally inserted central catheter (PICC) requires immediate attention?

When performing an IV insertion on an infant, the nurse can select which needle size?

The student nurse is aware that IV fluids should hang for no longer than:

Which interventions should the nurse include to prevent a catheter-related bloodstream infection? (Select all that apply)

Microdrop tubing has which of the following drop factors?