PICC Anatomy & Vascular Access Evaluation 4

Question 1

What minimum internal diameter of the target vein is generally recommended to accommodate a PICC catheter without causing significant flow restriction?

Accepted Answer

Greater than 3 mm

Answer

A minimum vein diameter of at least 3 mm (ideally larger) is recommended to maintain adequate blood flow around the catheter and reduce thrombosis risk.

Question 2

Which anatomical structure at the mid-upper arm can be identified by ultrasound as a hyperechoic, pulsatile structure lying medial to the basilic vein?

Accepted Answer

Brachial artery

Answer

The brachial artery lies medial to the basilic vein in the mid-upper arm and is identifiable by its thick, pulsatile walls on ultrasound.

Question 3

A PICC nurse is assessing a patient with a history of multiple prior PICCs in the right arm. Ultrasound reveals a patent right basilic vein but echogenic material within the right brachial vein. What is the correct course of action?

Accepted Answer

Use the right basilic vein only if it is patent and adequate in size

Answer

Thrombosis in the brachial vein does not preclude use of the patent basilic vein; however, the patent vessel must be assessed for adequate diameter and compressibility.

Question 4

The 'Zone B' insertion site for PICC placement refers to which region of the arm?

Accepted Answer

Upper arm between the antecubital fossa and the axilla

Answer

Zone B (the upper arm) is the preferred PICC insertion zone because it allows for larger vein selection and reduces complication rates compared to antecubital (Zone A) insertion.

Question 5

Which of the following conditions is an absolute contraindication to PICC placement in a specific extremity?

Accepted Answer

End-stage renal disease with an arteriovenous fistula in that arm

Answer

An arteriovenous fistula or graft is an absolute contraindication for ipsilateral PICC placement because instrumentation risks fistula damage, infection, and thrombosis.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC Anatomy & Vascular Access Evaluation 4