PICC Cheat Sheet 2026

The 30 highest-yield PICC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. During pre-insertion vascular assessment, which finding would most likely cause the PICC nurse to abandon the basilic vein and select an alternative site? → Non-compressible vein with absence of flow on Doppler
2. How is phlebitis managed? → Remove catheter and apply warm compress
3. When conducting a risk assessment for PICC operations, which factor should receive the HIGHEST priority? → Probability and severity of potential harm
4. Which regulatory requirement is UNIVERSAL across all Peripherally Inserted Central Catheter Certified Nurse practice settings? → Maintaining current certification and continuing education
5. A PICC nurse is preparing to change a dressing over a newly inserted PICC. Which agent is the preferred antiseptic for skin antisepsis per INS standards? → Chlorhexidine gluconate ≥0.5% in alcohol
6. On chest radiograph, a PICC tip seen at the level of the carina is considered to be in which location? → Too high — in the proximal SVC
7. A nurse attempts to flush a PICC line and encounters resistance. What is the FIRST action the nurse should take? → Assess for catheter kinking or positional changes
8. Why use ultrasound during insertion? → Visualize and guide vein access
9. What anatomical landmark is used for measuring catheter length? → From insertion site to SVC
10. Which factor MOST significantly affects the quality of technical outcomes in PICC practice? → The practitioner's training, preparation, and attention to detail
11. What tool helps monitor line complications? → Nursing checklists
12. Which patient factor most significantly increases the risk of PICC-associated CLABSI in critically ill patients? → Total parenteral nutrition administration
13. Which vein is least ideal for PICC? → Cephalic vein
14. A PICC dressing change reveals the catheter has advanced 2 cm further into the insertion site. What action is required? → Do not advance the catheter back — notify the provider and verify tip position
15. A nurse is administering vancomycin via PICC and the patient develops flushing, erythema of the neck, and hypotension. This presentation is consistent with: → Red man syndrome due to rapid infusion rate
16. After successful PICC placement, the ideal catheter tip position is: → Superior vena cava–right atrial junction
17. When troubleshooting a sluggish PICC infusion, the nurse elevates the patient's arm and the flow improves. This suggests what cause? → Positional occlusion due to catheter tip location
18. What document tracks line performance? → PICC care records
19. A nurse accidentally cuts a PICC catheter during a dressing change. What is the priority intervention? → Clamp the catheter above the cut immediately and notify the provider
20. What must be documented after insertion? → Insertion date and method
21. What to do if catheter dislodges? → Stop infusion and notify provider
22. During troubleshooting of a non-functional PICC, a chest X-ray reveals the catheter tip has migrated to the internal jugular vein. What is the correct response? → Stop using the catheter and notify the provider for repositioning
23. What is the PRIMARY reason for regulatory compliance in the Peripherally Inserted Central Catheter Certified Nurse profession? → To protect public safety, ensure quality, and maintain professional integrity
24. What is the primary purpose of documenting external catheter length at each assessment? → To detect catheter migration by comparing to the insertion baseline measurement
25. The cephalic vein is less preferred for PICC placement primarily because of which anatomical feature? → It makes a sharp turn at the deltopectoral groove before joining the axillary vein
26. Intravascular catheter-related thrombosis associated with a PICC is most commonly located in the: → Upper extremity vein (basilic, brachial, or axillary vein)
27. A nurse notes blood backflow into the PICC extension tubing that is not resolving with repositioning. This finding most likely suggests: → Elevated central venous pressure or a valve issue in the connector
28. Which concentration of heparin is recommended by ISMP for PICC flush solutions in adult patients to reduce the risk of medication errors? → 10 units/mL
29. The azygos vein, into which a PICC can malposition, enters the SVC at approximately which vertebral level? → T4
30. Which assessment method provides the MOST reliable data for PICC professionals making critical decisions? → Standardized tools combined with professional observation