CRNI Central Venous Access Devices Practice Test Flashcards
6 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CRNI Central Venous Access Devices Practice Test flashcards as text
Which central venous access device is most appropriate for a patient requiring intermittent IV chemotherapy over 12 months?
Answer: Implanted venous access port
An implanted venous access port is most appropriate for long-term intermittent therapy such as chemotherapy over 12 months. Ports are fully implanted beneath the skin, reducing infection risk and allowing patients to swim and bathe normally between treatments. They require only monthly flushing when not in use.
What is the primary advantage of a tunneled central venous catheter over a non-tunneled catheter?
Answer: Reduced catheter-related bloodstream infection due to the subcutaneous cuff
Tunneled catheters have a subcutaneous Dacron cuff that promotes tissue ingrowth, creating a mechanical barrier against bacterial migration along the external catheter surface. This significantly reduces the risk of catheter-related bloodstream infection compared to non-tunneled catheters, making them suitable for longer-term use.
A nurse is preparing to access an implanted venous access port. What is the correct needle type to use?
Answer: Non-coring (Huber) needle
A non-coring (Huber) needle must be used to access an implanted port. This needle has a deflected point that parts the septum rather than coring out a piece of it. Using standard needles would remove small cores of the silicone septum with each access, eventually causing the port to leak and requiring replacement.
What is the recommended tip position for a central venous catheter?
Answer: Cavoatrial junction or lower third of the SVC
The recommended tip position is at the cavoatrial junction (CAJ) or in the lower third of the superior vena cava. This position provides optimal blood flow around the catheter tip, reducing thrombosis risk, and ensures the tip is in a large vessel where hyperosmolar solutions are rapidly diluted. The tip should be parallel to the vessel wall.
Which complication is most likely to occur during subclavian vein central line insertion?
Answer: Pneumothorax
Pneumothorax is the most significant complication of subclavian vein catheterization due to the proximity of the lung apex to the insertion site. The risk is approximately 1-3% and is higher on the left side. A post-insertion chest X-ray is mandatory to confirm tip position and rule out pneumothorax.
A patient with a PICC line develops arm swelling, pain, and discoloration. The nurse suspects upper extremity deep vein thrombosis. What is the priority action?
Answer: Notify the provider for diagnostic ultrasound and anticoagulation evaluation
Suspected upper extremity DVT requires confirmation with Doppler ultrasound and evaluation for anticoagulation therapy. The PICC should not be immediately removed unless there is clinical deterioration, as removal can dislodge thrombus. The catheter may be preserved if the patient responds to anticoagulation, avoiding the need for new venous access.