CRNI CRNI Central Venous Access Devices Practice Test 4

Question 1

A patient with a newly placed PICC line develops upper extremity swelling and pain 48 hours post-insertion. Which complication should the nurse suspect first?

Accepted Answer

Catheter-associated deep vein thrombosis

Answer

Upper extremity swelling and pain after PICC insertion are classic signs of catheter-associated deep vein thrombosis (CADVT), which is a known complication of PICC lines.

Question 2

When performing a blood draw from a central venous access device, how much blood should be discarded before obtaining the sample?

Accepted Answer

3–5 mL

Answer

Current INS standards recommend discarding 3–5 mL of blood (or the dead-space volume plus 1 mL) before obtaining a blood sample from a CVAD to avoid dilution or contamination.

Question 3

A nurse is assessing a tunneled CVC and notes the cuff is visible outside the skin. What is the most appropriate action?

Accepted Answer

Notify the provider, as the catheter may be migrating out

Answer

An externalized cuff indicates the tunneled catheter is migrating out of its tunnel, which requires provider notification and evaluation for possible replacement.

Question 4

Which gauge needle is recommended for accessing an implanted port to minimize damage to the port septum?

Accepted Answer

Non-coring (Huber) needle

Answer

A non-coring (Huber) needle must be used to access an implanted port because its angled bevel cuts through the septum without removing a core of silicone material.

Question 5

A patient receiving TPN through a CVAD develops sudden fever, chills, and hypotension. Blood cultures are drawn. While waiting for results, which intervention is the highest priority?

Accepted Answer

Administer empiric broad-spectrum antibiotics per protocol

Answer

Suspected CLABSI with hemodynamic instability requires prompt empiric antibiotic therapy while awaiting culture results, as delayed treatment increases mortality.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI CRNI Central Venous Access Devices Practice Test 4