PICC Line Insertion & Maintenance 5

Question 1

Which catheter gauge is most appropriate for power injection of IV contrast through a PICC?

Accepted Answer

18 Fr or larger (power-injectable rated)

Answer

Power injection requires a power-injectable PICC rated for the flow rates and pressures used in CT contrast administration, typically 4–5 mL/sec.

Question 2

A PICC placed in the right arm has migrated into the right internal jugular vein as confirmed on X-ray. The most appropriate next action is:

Accepted Answer

Have the patient turn their head toward the insertion side and reposition under fluoroscopy

Answer

Repositioning maneuvers (head turn, arm repositioning, fluoroscopic guidance) can redirect a malpositioned PICC from the IJ back into the SVC.

Question 3

When obtaining blood cultures through a PICC, the nurse should:

Accepted Answer

Collect one set from the catheter and one from a peripheral site to differentiate CRBSI from bacteremia

Answer

Paired blood cultures (catheter vs. peripheral) allow differential time-to-positivity analysis to determine whether the catheter is the infection source.

Question 4

Needle-free connectors (NFC) on PICC lines should be changed:

Accepted Answer

Every 72–96 hours per INS guidelines or per manufacturer instructions

Answer

INS standards recommend changing NFCs at least every 72–96 hours, concurrent with tubing changes, to minimize infection risk.

Question 5

To confirm PICC tip placement, the gold standard imaging modality is:

Accepted Answer

Chest X-ray (posteroanterior or anteroposterior projection)

Answer

Chest X-ray remains the standard method for verifying PICC tip position before initiating infusion therapy.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC Line Insertion & Maintenance 5