Certified Registered Nurse Infusion (CRNI) Test Review

The Certified Registered Nurse Infusion certification indicates the nurse has achieved a specialized level of practice in providing infusion therapy to patients. Infusion Nurses work in collaboration with many specialists to appropriately and safely administer intravenous medications to patients suffering from a broad spectrum of illnesses.

In order to take the Certified Registered Nurse Infusion exam, the applicant must be a licensed Registered Nurse. This specialized certification is available to both Bachelor's Degree and 2-year degree RNs. At least 1,600 hours of employment should be completed in the field of Infusion Nursing within the past 2 years.

The Certified Registered Nurse Infusion exam is offered throughout the year at specified testing centers throughout the United States. The fee to take the exam is $285 for members of the Infusion Nurse Society (INS) and $410 for nonmembers. The fee to join the INS and take the exam is $375.

The exam consists of 150 multiple-choice questions that test the RN's knowledge on all aspects of Infusion Nursing. Approximately one-fifth of the exam consists of questions pertaining to the technical aspects of infusion therapy. The remainder of the exam is divided between considerations with administering specific medications, fluid and electrolyte imbalances, infection control, and pharmacology.

The Certified Registered Nurse Infusion certification is valid for 3 years. At the end of that time period, the licensed Registered Nurse has the option of recertifying. At least 1,000 hours of employment in Infusion Nursing is required or the RN can retake the exam to maintain certification. The fee for recertifying is $150 if the minimum hours of employment are acquired. If the RN wishes to retake the exam to recertify, the cost is $435 for INS members and $585 for nonmembers. To join INS and take the recertification exam, the cost is $525.

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CRNI Practice Questions

1. According to the phlebitis scale, when a streak and/or palpable venous cord begins to form, the phlebitis is classified as which of the following?

a. Grade 1.
b. Grade 2.
c. Grade 3.
d. Grade 4.

2. Which of the following is a normal serum osmolality for an adult patient?

a. 285 mOsm/kg.
b. 270mOsm/kg.
c. 300 mOsm/kg.
d. 265 mOsm/kg.

3. A palliative care patient requires intravenous therapy for about 6 to 8 weeks. Which of the following central venous access devices is most commonly used for this duration?

a. Non-tunneled central catheter.
b. Peripherally-inserted central catheter (PICC).
c. Tunneled central catheter.
d. Implantable port.

4. In a patient receiving total parenteral nutrition, which of the following is an indication of essential fatty acid deficiency?

a. Thrombocytosis.
b. Pernicious anemia.
c. Hemolytic anemia.
d. Iron deficiency anemia.

5. A patient develops sudden fever and chills, nausea, diarrhea, vomiting, hypotension, and tachycardia within 6 hours of receiving parenteral fluids. Which of the following is recommended to rule out septicemia related to the central catheter?

a. Culture of parenteral fluids.
b. Cultures of peripheral blood and blood per catheter.
c. Culture of blood per catheter.
d. Culture of IV administration set and fluid container.

Answers

1. C: Grade 3. Phlebitis may occur because of irritating medications or IV fluids, injury to the lining of the vein, or infection. The phlebitis scale: Grade 0: Asymptomatic. Grade 1: Redness about site and may complain of pain. Grade 2: Pain as well as redness and/or swelling. Grade 3: Pain and redness as well as streak and/or palpable venous cord. Grade 4: Pain and redness as well as streak and palpable venous cord more than one inch long and/or purulent discharge.

2. A: A normal serum osmolality for an adult patient is 285 mOsm/kg (normal range 275 to 295 mOsm/kg). Hypo-osmolality occurs with values <275 mOsm/kg (critical value 265 mOsm/g) and hyper-osmolality with values above 295 mOsm/kg (critical value 320 mOsm/kg). When sodium levels increase or fluid levels decrease, osmolality increases. Corticosteroid and mannitol may increase serum osmolality while carbamazepine, hydrochlorothiazide, and chlorpromazine may decrease levels. Respiratory arrest may result from levels of 360 mOsm/kg. Death may occur with levels >420 mOsm/g.

3. B: Peripherally-inserted central catheters (PICCs) are frequently used for intravenous infusions over several days or months (intermediate-term). PICC lines are used for chemotherapy and are inserted in one of the arms, usually below the elbow. Non-tunneled central catheters are used for short-term therapy, usually under 6 weeks. Tunneled central catheters are inserted when patients require long-term intravenous therapy as they may stay in place for many years. Implantable ports are also used primarily for long-term IV therapy. Once implanted, the ports require little care and are easily accessed.

4. C: Hemolytic anemia, thrombocytopenia and liver dysfunction are indications of essential fatty acid deficiency. Other indications may include dermatitis and slowed healing. Patients should receive a minimum fatty acid intake of 2 to 4% of daily calories, but most patients receive 10 to 40%. Fatty acids should not exceed 60% of daily calories. Increased fatty acids (9 kcal/g) allow a decrease in glucose (3.4 kcal/g) and decrease incidence of hyperglycemia.

5. B: While cultures should be done of the parenteral fluid as well as the administration set and fluid container, the method to determine if the infection is catheter-related is to culture both peripheral blood and blood drawn per the catheter to determine if the concentration of organisms is higher from blood drawn from the catheter. If catheter-related, concentration of organisms is usually five to ten times higher from the catheter-related sample than the peripheral sample.

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