N4-Test Successful IV Starts

This article has a lot of good advice and pictures for starting IV's and perfecting techniques.
http://www.nursingcenter.com/library/journalarticle.asp?article_id=582116
Answers are in the comments.

1.
To become truly proficient in venipuncture techniques, you must
a. attend instructional classes.
b. perform many procedures on real patients.
c. practice on anatomic training arms.
d. work with clinical preceptors.

2.
You should perform venipunctures initially on patients who
a. have chronic diseases.
b. are well hydrated.
c. have a history of many courses of infusion therapy.
d. are dehydrated.

3.
The maximum number of unsuccessful venipuncture attempts before calling a more skilled practitioner for help is
a. two.
b. three.
c. four.
d. five.

4.
Assess a patient for an MLC or PICC if I.V. therapy is likely to continue beyond
a. 3 days.
b. 4 days.
c. 5 days.
d. 6 days.

5.
Short peripheral catheters are indicated when
a. therapy lasts more than 7 days.
b. fluids have a pH between 5 and 9.
c. fluids have an osmolarity of more than 500 mOsm/liter.
d. medications have a pH of less than 5.

6.
For venipuncture in most adults, start with veins in the
a. wrist.
b. forearm.
c. hand.
d. upper arm.

7.
When initiating peripheral I.V. access,
a. start with the most proximal site available.
b. avoid rotating from one extremity to the other.
c. start with the dominant arm.
d. avoid routine use of veins in and above the antecubital fossa.

8.
The best option for emergent I.V. access in the lower extremity is the
a. calf.
b. thigh.
c. dorsum of the foot.
d. popliteal space.

9.
Which site should you avoid for venipuncture?
a. veins above a previous I.V. infiltration
b. an extremity with an arteriovenous fistula
c. veins in the forearm
d. veins above a phlebitic area

10.
A suitable vein for venipuncture feels soft, elastic, and
a. hard.
b. engorged.
c. bumpy.
d. flat.

11.
To avoid inadvertent arterial puncture, remember that
a. veins are located deeper than arteries.
b. arterial pulsation disappears after proper tourniquet application.
c. arteries and veins lie close together in the antecubital fossa.
d. arteries are frequently damaged during venipuncture.

12.
Which intervention helps to prevent nerve damage during venipuncture?
a. Use a plunging or jabbing technique to insert the catheter.
b. Avoid venipuncture on the dorsal aspect of the wrist.
c. Immediately remove the cannula if you suspect nerve damage.
d. Perform venipuncture 1 inch above the level of the wrist.

13.
If your patient complains of tingling or numbness during venipuncture, you may have damaged a
a. nerve.
b. tendon.
c. ligament.
d. artery.

14.
Which statement about over-the-needle catheters is correct?
a. They shouldn't be used to administer vesicants.
b. Use them only for one-time bolus injections.
c. They greatly increase the risk of vein injury.
d. They're an ideal choice for hand or forearm veins.

15.
Which statement about a PICC is correct?
a. It's indicated for therapies that will last 1 to 12 months.
b. Its tip resides in the proximal portion of the upper arm.
c. It's used only for therapies with osmolarities less than 500 mOsm/liter.
d. It's used only for therapies with a pH range of 5 to 9.

16.
Which catheter size is indicated for trauma patients and those requiring large, rapid fluid volumes?
a. 22-gauge
b. 20-gauge
c. 18-gauge
d. 16-gauge

17.
Placing the patient's arm across his chest and standing on the opposite side of the bed can help you cannulate the
a. basilic vein.
b. metacarpal vein.
c. cubital vein.
d. dorsal hand veins.

18.
Which is correct about the large upper cephalic vein?
a. It's easy to visualize.
b. It can accommodate only 24- to 20-gauge catheters.
c. It should be reserved for an MLC or PICC.
d. It's easy to stabilize.

19.
Which statement is correct about cannulating a vein in the upper extremity?
a. The veins in the fingers and thumbs can support a catheter for long periods.
b. Veins in the hands require a handboard.
c. After you apply a handboard, finger mobility should be restricted.
d. The veins in the fingers allow for increased blood flow around the catheter.

20.
If you see and feel the vessel pulsating after you apply the tourniquet, you're over
a. a vein.
b. a nerve.
c. an artery.
d. a venule.

21.
The most deadly hospital-acquired infection is
a. urinary tract infection.
b. pneumonia.
c. surgical site infection.
d. bloodstream infection associated with I.V. devices.

22.
To decrease infections associated with I.V. catheters,
a. use an over-the-catheter system without an extension set.
b. use a closed catheter system.
c. use alcohol to disinfect the patient's skin.
d. use multidose vials.

23.
If your patient's vein fills poorly after tourniquet application, try
a. positioning his arm above heart level.
b. gently rubbing his arm to warm the skin.
c. having him make a tight fist during venipuncture.
d. covering his entire arm with cool compresses for 5 to 10 minutes.

24.
Which statement about tourniquet application is correct?
a. Apply the tourniquet 1 to 2 inches above the intended venipuncture site.
b. Venous distension may take longer in elderly patients.
c. Reusable multiple-patient-use tourniquets are preferred.
d. Peripheral veins in a well-hydrated patient should distend in about 2 minutes.

25.
According to the CDC, the preferred agent for preparing the venipuncture site is
a. tincture of iodine 2%.
b. chlorhexidine gluconate solution.
c. 10% povidone-iodine.
d. 70% isopropyl alcohol.

26.
Always clean visibly dirty skin with
a. soap and water.
b. an aqueous benzalkonium-like compound.
c. hexachlorophene.
d. an alcohol-based hand rub.

27.
Which statement about venipuncture site preparation is correct?
a. Shave the site if it's excessively hairy.
b. Apply 70% isopropyl alcohol after a 10% povidone-iodine prep.
c. Apply chlorhexidine solution in a back-and-forth motion.
d. Blot excess antimicrobial solution at the insertion site.

28.
Which statement about upper extremity veins is correct?
a. Keeping the vein in a taut, distended, stable position will prevent rolling.
b. Arm veins are easier to immobilize than hand veins.
c. There's less risk of nerve injury in the hand and wrist areas.
d. Arm veins are easier to cannulate because they're surrounded with less fatty tissue.

29.
Which statement about using local anesthetics in venipuncture is correct?
a. The anesthetic of choice is 1% lidocaine with epinephrine.
b. Topical anesthetic creams must be applied 15 minutes before venipuncture.
c. The intradermal anesthetic should be administered beside or below the vein.
d. The intradermal anesthetic should be administered before tourniquet application.

30.
Which insertion technique is preferred if you've injected a local anesthetic?
a. tunneling
b. approaching the vein from the top
c. inserting the cannula distal to a valve
d. approaching the vein from the side

31.
When inserting the cannula,
a. use a 50-degree angle.
b. look for blood backflow in the cannula tubing or hub.
c. insert the cannula bevel down.
d. always expect to feel a popping or giving-way sensation.

32.
If the initial insertion isn't successful,
a. remove the cannula tip from the skin and reposition it.
b. remove the cannula and insert a new one in another site.
c. reinsert the stylet into the catheter and try again.
d. reuse the catheter for a second venipuncture.

33.
When approaching a vein that's visible for a short segment,
a. insert the cannula directly over the segment.
b. avoid tunneling to reduce trauma on insertion.
c. aim for bifurcations and valves.
d. insert 1 to 2 cm below the visible segment.

34.
To cannulate a deep vein that's palpable but hard to see,
a. palpate the site again after applying the skin antiseptic.
b. use a tentative "stop and start" technique.
c. ask the patient to clench her fist as tightly as possible.
d. use anatomic landmarks to mentally locate the vein.

35.
To properly secure the catheter,
a. use clean tape, preferably from your pocket.
b. place a 1-inch-wide tape strip across the hub, making sure it covers the puncture site.
c. place a 1-inch-wide tape strip over the tubing directly on top of the tape under the hub.
d. make sure a short segment of tubing extends beyond the hand.

36.
Which statement about a transparent dressing is correct?
a. It lets you observe the insertion site.
b. It needs to be replaced routinely because it's not waterproof.
c. You apply it directly to the site while stretching it.
d. It should cover the catheter and the entire hub.

37.
When preparing to remove the I.V. cannula, first
a. turn off the I.V. infusion.
b. remove all tape.
c. put on gloves.
d. moisten the transparent dressing with alcohol.

38.
To decrease excessive blood spillage,
a. leave the tourniquet on when removing the stylet.
b. release the tourniquet before removing the stylet.
c. remove the stylet before cannulating the vein.
d. use a 50-degree approach when cannulating the vein.