Download VA-BC Test Practice Questions and Answers: Vascular Access and Infusion Therapy and more Exams Health sciences in PDF only on Docsity!
VA-BC Test Practice Questions and
Answers 2025/
What vessel is the easiest to access for emergency, short term access? EJ Vessels for short PIV Metacarpal, cephalic, basilic, accessory veins in forearm Site selection for port Peripheral: basilic, cephalic Central: subclavian, jugular, femoral What is the name for the non-coring needle for a port? Huber needle How many hours does it take for the site of a central line to be healed? 2 hours Pediatric PIV sites metacarpal, cephalic, basilic, scalp (under 18mo) , saphenous Optimal tip location for Midline catheter One inch below the axillary area Difference between infiltration and extravasation Extravasation is infiltration just with a vesicant or large volume of solution into the tissue Site for PA catheters Right subclavian or IJ When should an arterial line be changed? Only as needed Indications and contraindications for aquapheresis I: Diuretic resistant CHF C: No accessible basilic vein in upper arm Amount of flush for a catheter 2x the length of the catheter Tip placement for dialysis cath Upper right atrium Site and device selection for CKD 3 or higher?
PIV in dorsal veins of dominant hand Safe Medical Device Act of 1990 was passed by who? FDA What size needle do you need for blood? 18 - 24G Site selection for dialysis or apheresis catheters Jugular, subclavian, femoral Outermost layer of vessel & what it's made of Tunica Adventitia Connective tissue Middle layer of vessel and what it's made of Tunica Medica Smooth muscle Inner most layer of vessel and what it's made of Tunica Intima Single layer of endothelial cells Layer of artery/vein that if damaged can form a thrombus Tunica Intima Vessel wall layer that contains nerve fibers for vasoconstriction or dilation Tunica Media Vessel layer that vasoconstricts with pain and anxiety Tunica Media Contraindications for PA catheters Mitral stenosis, right heart mass, tricuspid or pulmonary mechanical valves Evidence based practice that's based on randomized control trials (rct) Level A EBP with consensus viewpoint or expert opinion that obtains a majority agreement from clinical experts Level C Why are implanted VADS used less frequently with peds? Fear of the needle stick, increased risk of dislodgement Tip location for aquapheresis 1 - 2cm below axilla Veins that form axillary vein Basilic and brachial Where does the subclavian vein run? Outer border of 1st rib to the medial border of the anterior scalene muscle
Staphylococcus epidermis G+ Type of organisms that are the leading cause of death from sepsis G- Why are IV devices radiopaque To see catheter emboli in the event of shearing or fracture 2 materials IV catheters can be made out of silicone, polyurethane Scalp veins can be used up to what age <18 months Why is jugular the preferred point of insertion in very young patients for non-tunneled catheters? Avoid causing a pneumo Where might tunneled catheter exit sites be located? Chest, upper back, top of thigh, lower torso How are tunneled catheters secured? Dacron cuff How long does it take the exit site of a tunneled cath to heal? 2 - 3 weeks How is the port secured inside the patient? Port is sutured into a subcutaneous pocket under the skin IO sites Proximal humerus, sternum, iliac crest, femur, or tibia You go to flush a freshly inserted IO and your patient screams in pain. What do you do? Administer analgesic through line. The first flush is often very painful Time frame for umbilical access up to 4days of life What is an antiseptic? Chemical agent that inhibits microorganisms on skin or tissue to limit or prevent infection What factors may affect the activity and effectiveness of an antiseptic solution? Organisms concentration in that area, organisms composition, concentration of the antimicrobial agent, if the antimicrobial agent is combined with any other antiseptic agents, duration of the organisms exposure to the antimicrobial agent What are iodophors? Solutions of iodine in complexes that contain a low amount of free iodine What makes up betadine? Solution that contains up to 10% of an iodine complex, and provides up to 1% free iodine for skin antisepsis What are iodophors effective against?
G+, G-, fungi, and viruses. But minimal against bacterial spores What must happen for an iodophor to be effective? Contact with the skin for at least 2 minutes to release the free iodine How long are the residual effects of iodine? 2hrs What contains 1-2% iodine in an alcohol base? Tincture of iodine What population shouldn't have an iodine prep? Neonates and infants due to percutaneous absorption that can cause hypothyroidism in newborns How does alcohol work as an antimicrobial? Denatures the cell proteins and dissolves the cell lipids Type of organisms that alcohol has a good effect on G+, G-, fungus, virus Disinfectant works against what G+, G-, virus, and fungi on hard, non-porous surfaces What type of CVAD is recommended for patients with acute leukemia and other cancers? Tunneled CVL or Port What VAD is recommended for infants and toddlers receiving TPN? Tunneled CVL Apheresis flow rates Dialysis flow rates 90 - 120mL/min 350 - 400mL/min Device selection for aquapheresis Dual lumen, large bore catheter Congenital heart diseases that increase the risk for occluded vessels Glenn or Fontan anastomoses What is the best VAD in cases of sepsis or bacteremia? PIV Landmark based measurements have what % failure rate? 30% How do you measure for a PICC in the scalp? Insertion site, along the jugular, right clavicular head, 3rd intercostal space How do you measure for PICC in the lower extremities? insertion site, up leg to umbilicus, up to Xyphoid process Veins transport _____ from tissues to the right side of the heart deoxygenated
Include in discussions Offer honest/open explanations Equipment used for infusion therapy is regulated by who? FDA and Center for Devices and Radiologic Health (CDRA) Minimal catheter size for apheresis in adults 11.5Fr PICCs not appropriate due to small catheter size Name of technique we use for PIVs Modified Seldinger Technique Slides catheter over the needle and into the vessel 40% of patients who exhibit signs of pinch-off syndrome will experience ... catheter embolization (line fracture) Pinch off syndrome rare complication of tunneled central venous catheters that occurs when the catheter is compressed between the first rib and the clavicle, causing an intermittent mechanical occlusion for both infusion and aspiration Multi use vials of 0.9% NS that have benzol alcohol preservative do what to bacteria? Bacteriostatic. Prevent growth of bacteria You have a PICC that has been infusing lipids and has become occluded. What do you use to unclog the line? Ethyl alcohol PICC is occluded by low pH solution like Vancomycin. What do you use to dissolve it? Hydrochloric acid PICC occluded by high pH solution like phenytoin. What do you use to dissolve it? Sodium bicarb Positive needleless connector Flush, disconnect, clamp. Reflux greatest at connection. Negative needleless connector Flush, clamp, disconnect. Greatest amount of reflux at disconnect. Neutral needleless connector No sequence of clamping and no reflux 1mL of air infused over 15min could be fatal to a patient with what? SVC syndrome SVC syndrome Partial or complete obstruction of blood through the SVC Could be due to tumor or thrombus formation Circulatory system that contains the most blood
Venous circulating system. Contains 70% of circulating blood at once More force had to be used on a central line and now patient is having problems. What probably happened? Catheter embolization Continuous IV tubing is changed how often? 96 hours Fowlers position a semi-sitting position; the head of the bed is raised between 45 and 60 degrees Trendelenburg position A position in which the patient's feet and legs are higher than the head Dynamic ultrasound technique Visualizing the needle in real time throughout insertion Static ultrasound technique Finding the vein using ultrasound, marking the site, then inserting as a "blind stick" without watching on the ultrasound What is the primary rationale for avoiding cannulation of veins in the palmar aspect of the wrist? Nerve injury CVAD for a patient with a platelet count <50, PICC Least invasive option for a patient requiring short term apheresis access 18G PIV in the AC Which PIV gauge has the greatest risk for causing phlebitis? A. 18G B. 20G C. 16G D. 24G C. 16G A patient with an implanted venous port presents with periorbital, facial and neck edema, skin ruddiness, and distended neck veins. Upper chest examination reveals distended peripheral vessels. The catheter has no blood return. A chest x-ray shows the tip of the catheter to be in the optimal position. Which of the following is the cause of these symptoms? A. pneumonia B. extravasation C. Allergic reaction D. SVC syndrome d. SVC syndrome
A, B
A nurse is assessing a patient with a PICC. Which complications should the nurse assess for? A. Phlebitis B. Pneumo C. Excessive bleeding D. Throbophlebitis A, D Before administering IVF, it's most important for the nurse to obtain what information from the provider? A. IV catheter size B. Osmolarity of the solution C. Vein to be used for therapy D. Type of IV fluid D. Order must contain type of fluid, rate of administration, and drugs added to the solution. Osmolarity is incorporated into the type of fluid. Which publication can you find resources that have written standards for IV therapy? A. IV Therapy Nursing Society B. Infusion Nurses Society C. Nurses State BON D. Hospitals IV solutions vendor B They publish guidelines & standards related to IV therapy, BON publishes legal info r/t nursing practice. Answer A doesn't exist. D would just be related to a specific product only Osmolarity Number of solute particles per 1L of solvent Osmolality Number of solute particles in 1kg of solvent Patient is admitted for nausea, vomiting, and has a BP of 90/50. Which gauge catheter would be best for this patient? A. 24 B. 18 C. 20 D. Midline C. 20G can give large amounts of fluid and can be used for all fluids. 22 & 24 would run at a slower rate. 18 is good for rapid infusions but more prone to vein irritation
Groshong catheter type of midline that needs to be flushed after intermittent use Which of these 4 patients would you assess first? A. Patient with a new PICC waiting for an xray B. Patient with PIV for intermittent infusions C. Older adult with a nonaccessed port D. Older adult with continuous NS D. Older adults are at a much higher risk for fluid overload A patient just had an IV started in the cephalic vein and is now complaining of pins and needles feelings in their wrist and hand. Which action is best? A. Document findings and continue to monitor the site B. Check for blood return with aspiration C. Discontinue the IV and start a new one somewhere else D. Elevate the extremity above the level of the heart. C. Indicates nerve damage whether the IV is good or not. IV should be immediately removed and replaced elsewhere Hypodermoclysis Subcutaneous therapy involving slow infusion of isotonic fluids. Often for hospice pain management. Most common complication of an IO Compartment syndrome due to needle dislodgement into tissue Nurse is preparing to administer a med IV push. What does she need to know before administering? (select all that apply) A. Any dilution required B. Rate of administration C. Compatibility with infusions D. Other routes of administration E. Specific monitoring needed A, B, C, E
