OCC OCC Vascular Access & Infusion Techniques 1 — Questions and Answers
Question 1: Before administering chemotherapy through a port-a-cath, the nurse aspirates and gets no blood return. What is the MOST appropriate next step?
- Administer the chemotherapy slowly and monitor the site
- Flush with 20 mL normal saline to clear the port
- Hold the chemotherapy and notify the provider to assess catheter function (Correct answer)
- Reposition the patient and try aspiration again, then administer if still no return
Correct answer: Hold the chemotherapy and notify the provider to assess catheter function
Lack of blood return from a port-a-cath before chemotherapy administration requires provider notification and catheter assessment to prevent extravasation of vesicant drugs.
Question 2: Which type of central venous access device is MOST appropriate for a patient requiring 6 months of intermittent chemotherapy infusions?
- Peripheral IV catheter
- Non-tunneled central venous catheter
- Implanted port (port-a-cath) (Correct answer)
- Midline catheter
Correct answer: Implanted port (port-a-cath)
An implanted port is the preferred long-term vascular access device for intermittent chemotherapy due to its durability, low infection risk, and patient comfort.
Question 3: A patient with a PICC line develops pain, erythema, and a palpable cord along the arm. What complication does the nurse suspect?
- Catheter occlusion
- Thrombophlebitis (Correct answer)
- Air embolism
- Catheter migration
Correct answer: Thrombophlebitis
Pain, redness, and a palpable cord along the vessel indicate thrombophlebitis, a known complication of PICC lines requiring immediate evaluation.
Question 4: What is the correct flushing sequence for a positive pressure implanted port after chemotherapy administration?
- Heparin → saline → clamp
- Saline → heparin → clamp while maintaining positive pressure (Correct answer)
- Saline → clamp → heparin
- Heparin only → clamp
Correct answer: Saline → heparin → clamp while maintaining positive pressure
The correct sequence is saline flush followed by heparin lock while maintaining positive pressure to prevent blood backflow and clot formation in the port.
Question 5: Which chemotherapy agent requires extra caution with peripheral IV administration due to its extreme vesicant properties?
- Fluorouracil (5-FU)
- Vincristine (Correct answer)
- Cyclophosphamide
- Carboplatin
Correct answer: Vincristine
Vincristine is a potent vesicant that causes severe tissue necrosis on extravasation, requiring central venous access and vigilant infusion monitoring.
Question 6: A nurse is preparing to access an implanted port. Which action is ESSENTIAL to prevent infection?
- Use a non-coring Huber needle with strict aseptic technique (Correct answer)
- Use the smallest gauge needle available
- Clean the site with povidone-iodine and allow it to dry for 30 seconds
- Palpate the port without gloves to locate the septum accurately
Correct answer: Use a non-coring Huber needle with strict aseptic technique
A non-coring Huber needle is required to access implanted ports without coring the silicone septum, and strict aseptic technique prevents catheter-related bloodstream infections.
OCC OCC Vascular Access & Infusion Techniques 1
Before administering chemotherapy through a port-a-cath, the nurse aspirates and gets no blood return.
What is the MOST appropriate next step?