PICC PICC Troubleshooting & Problem Resolution

Question 1

A nurse attempts to flush a PICC line and encounters resistance. What is the FIRST action the nurse should take?

Accepted Answer

Assess for catheter kinking or positional changes

Answer

Before any intervention, the nurse should assess for mechanical causes such as catheter kinking, patient position, or external clamping that may be causing the resistance.

Question 2

Which syringe size is recommended when flushing a PICC line to avoid generating excessive pressure that could damage the catheter?

Accepted Answer

10 mL syringe

Answer

A 10 mL syringe generates lower pressure per psi than smaller syringes and is the minimum recommended size for flushing PICCs to prevent catheter damage.

Question 3

A patient's PICC line is infusing but blood cannot be aspirated. What is the most likely cause?

Accepted Answer

Fibrin tail or fibrin sheath formation

Answer

A fibrin tail or sheath acts as a one-way valve, allowing infusion but preventing blood aspiration from the catheter.

Question 4

Alteplase (tPA) is ordered to restore patency in an occluded PICC. What is the standard dwell time before attempting aspiration?

Accepted Answer

30–60 minutes

Answer

The standard protocol for alteplase instillation in a PICC is a 30–60 minute dwell time before attempting to aspirate and restore patency.

Question 5

A nurse notices that the external length of a patient's PICC has increased by 3 cm since insertion. What does this indicate?

Accepted Answer

The PICC has migrated outward and tip position must be verified

Answer

An increase in external catheter length indicates outward migration, which may mean the tip is no longer in the superior vena cava and requires radiographic confirmation.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC PICC Troubleshooting & Problem Resolution