CRNI Vascular Access Device Management 2

Question 1

What is the recommended method for securing a peripheral IV catheter to prevent dislodgement?

Accepted Answer

Manufactured catheter stabilization device (engineered stabilization device)

Answer

INS standards recommend manufactured engineered stabilization devices (ESDs) over tape to reduce catheter movement, decrease phlebitis, and prevent unplanned dislodgement.

Question 2

When performing PICC tip confirmation, what landmark indicates proper placement on a chest X-ray?

Accepted Answer

Lower third of the SVC at or near the caval-atrial junction

Answer

The ideal PICC tip position is in the lower third of the SVC at or near the caval-atrial junction, confirmed by chest X-ray before initiating infusion therapy.

Question 3

What is the correct procedure for accessing an implanted port?

Accepted Answer

Palpate the port, cleanse with CHG, access with a non-coring (Huber) needle using sterile technique

Answer

Port access requires aseptic technique, CHG skin antisepsis, and a non-coring Huber needle to prevent damage to the port septum.

Question 4

How should the CRNI manage a central venous catheter with a suspected partial occlusion?

Accepted Answer

Use a gentle push-pull technique with a 10 mL syringe; if unsuccessful, instill alteplase per protocol

Answer

Partial CVC occlusion should be managed with gentle flushing technique using an appropriate syringe size, followed by thrombolytic instillation if mechanical methods fail.

Question 5

What is the rationale for using ultrasound guidance during PICC insertion?

Accepted Answer

It improves vein visualization, increases first-attempt success, reduces complications, and aids in vein-to-catheter ratio assessment

Answer

Ultrasound guidance provides real-time vein visualization, enabling optimal vein selection, improved first-attempt success, and reduced mechanical complications during PICC insertion.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Vascular Access Device Management 2