PICC Anatomy & Vascular Access Evaluation 3

Question 1

The superior vena cava (SVC) is formed by the union of which two vessels?

Accepted Answer

Right and left brachiocephalic (innominate) veins

Answer

The SVC is formed by the union of the right and left brachiocephalic (innominate) veins behind the right first costal cartilage.

Question 2

Which nerve runs in close proximity to the basilic vein in the upper arm and can be inadvertently injured during PICC insertion?

Accepted Answer

Medial cutaneous nerve of the forearm (medial antebrachial cutaneous nerve)

Answer

The medial cutaneous nerve of the forearm (MACN) runs adjacent to the basilic vein in the upper arm and is at risk of injury during insertion.

Question 3

Using the PICC-CIRC formula for catheter length estimation, from which surface landmark is measurement typically initiated?

Accepted Answer

Proposed insertion site on the upper arm

Answer

Measurement begins at the proposed insertion site, then extends to the right sternal border at the third intercostal space to estimate required catheter length.

Question 4

Which vessel serves as the venous drainage pathway from the upper extremity to the heart in the order: basilic → axillary → subclavian → ?

Accepted Answer

Brachiocephalic (innominate) vein, then SVC

Answer

After the subclavian vein, blood flows into the brachiocephalic vein, which then joins the contralateral brachiocephalic vein to form the SVC.

Question 5

A PICC nurse notes that a patient has a large, easily visible cephalic vein but a deep, non-visible basilic vein. Using best practice, which vessel should be selected and why?

Accepted Answer

Basilic vein, because it is larger, has fewer valves, and a more direct central course

Answer

Despite being deeper and requiring ultrasound guidance, the basilic vein is preferred because of its larger caliber, fewer venous valves, and more direct path to the SVC.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC Anatomy & Vascular Access Evaluation 3