CRNI Central Venous Access Devices Practice Test

Question 1

Which central venous access device is most appropriate for a patient requiring intermittent IV chemotherapy over 12 months?

Accepted Answer

Implanted venous access port

Answer

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.

Question 2

What is the primary advantage of a tunneled central venous catheter over a non-tunneled catheter?

Accepted Answer

Reduced catheter-related bloodstream infection due to the subcutaneous cuff

Answer

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.

Question 3

A nurse is preparing to access an implanted venous access port. What is the correct needle type to use?

Accepted Answer

Non-coring (Huber) needle

Answer

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.

Question 4

What is the recommended tip position for a central venous catheter?

Accepted Answer

Cavoatrial junction or lower third of the SVC

Answer

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.

Question 5

Which complication is most likely to occur during subclavian vein central line insertion?

Accepted Answer

Pneumothorax

Answer

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.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Central Venous Access Devices Practice Test