IV Venous Access Devices 3 — Questions and Answers
Question 1: When a totally implantable venous access port is not in use, the recommended flushing interval to maintain patency is:
- Every 24 hours
- Every week
- Every 4 weeks (monthly) (Correct answer)
- Every 3 months
Correct answer: Every 4 weeks (monthly)
Implanted ports not in active use are typically flushed monthly with heparinized saline to maintain patency per INS guidelines.
Question 2: A patient with a triple-lumen central venous catheter (CVC) asks why three separate lumens are used. The BEST explanation is:
- It reduces the risk of air embolism
- It allows simultaneous administration of incompatible medications through separate channels (Correct answer)
- It increases catheter longevity
- It eliminates the need for flushing
Correct answer: It allows simultaneous administration of incompatible medications through separate channels
Multiple lumens allow incompatible drugs to be infused simultaneously without mixing, and permit blood draws without interrupting infusions.
Question 3: The MOST common insertion site for a peripherally inserted central catheter (PICC) in adults is:
- Femoral vein
- External jugular vein
- Basilic vein (Correct answer)
- Cephalic vein
Correct answer: Basilic vein
The basilic vein is the preferred PICC insertion site due to its larger diameter and straighter path to the central circulation.
Question 4: Which complication is UNIQUE to subclavian central venous catheter insertion compared to internal jugular or femoral approaches?
- Catheter-associated bloodstream infection
- Deep vein thrombosis
- Pneumothorax (Correct answer)
- Air embolism
Correct answer: Pneumothorax
Pneumothorax is a specific risk of subclavian insertion due to the proximity of the apex of the lung to the insertion site.
Question 5: A nurse is preparing to access an implanted port. After palpating the septum, the correct needle insertion technique is:
- Insert at a 45-degree angle toward the edge of the port
- Insert perpendicular (90 degrees) through the skin into the center of the septum (Correct answer)
- Insert at a 15-degree angle parallel to the skin surface
- Insert at a 30-degree angle like a standard venipuncture
Correct answer: Insert perpendicular (90 degrees) through the skin into the center of the septum
The non-coring Huber needle must be inserted at a 90-degree angle directly into the center of the port septum to avoid damaging the septum.
Question 6: An umbilical venous catheter (UVC) is placed in neonates. The correct tip position for a UVC should be confirmed at:
- The right atrium
- The junction of the inferior vena cava and right atrium (Correct answer)
- The umbilical vein at the liver level
- The superior vena cava
Correct answer: The junction of the inferior vena cava and right atrium
The UVC tip should be positioned at the IVC/right atrial junction to avoid hepatic complications from infusion into hepatic vessels.
Question 7: Which vascular access device is specifically designed with a pressure-activated safety valve (PASV) to reduce the risk of air embolism and blood reflux?
- Standard non-valved PICC
- Groshong catheter (Correct answer)
- Peripheral short catheter
- Arterial line catheter
Correct answer: Groshong catheter
The Groshong catheter has a three-position pressure-sensitive valve at the tip that opens for infusion or aspiration and remains closed at rest.
IV Venous Access Devices 3
When a totally implantable venous access port is not in use, the recommended flushing interval to maintain patency is: