PICC PICC Equipment & Device Selection 3

Question 1

What is the gold standard method for confirming PICC tip placement after insertion?

Accepted Answer

Post-insertion chest X-ray

Answer

Post-insertion chest X-ray remains the gold standard for verifying correct PICC tip position at the cavoatrial junction or lower SVC.

Question 2

The optimal PICC tip position in an adult patient is at:

Accepted Answer

The cavoatrial junction (CAJ) or lower third of the SVC

Answer

Tip placement at the CAJ or lower third of the SVC maximizes hemodilution of infused medications and reduces thrombosis risk while avoiding cardiac arrhythmias.

Question 3

During EKG-guided PICC tip confirmation, which waveform change indicates the tip has reached the cavoatrial junction?

Accepted Answer

The P-wave increases in amplitude, then becomes biphasic as the tip enters the right atrium, signaling slight withdrawal is needed

Answer

EKG guidance relies on P-wave changes: amplitude increases as the tip nears the SVC/atrial junction and becomes biphasic upon entering the right atrium, guiding the clinician to withdraw slightly to the CAJ.

Question 4

Which external measurement is used to estimate insertion length before placing a PICC?

Accepted Answer

Measured length from the intended insertion site, along the arm, across the shoulder to approximately the sternal notch or third intercostal space

Answer

The external body surface measurement (insertion site → up the arm → across the shoulder → to the sternal notch/third ICS) estimates the catheter length required to reach the CAJ.

Question 5

Before using a PICC with a power injector for a contrast CT scan, the nurse must verify which of the following?

Accepted Answer

The catheter or hub is labeled 'CT Injectable' or 'Power Injectable' by the manufacturer

Answer

Only PICCs with manufacturer labeling confirming power-injectable status ('CT Injectable' or 'Power Injectable') may be used with power injectors, as unlabeled PICCs risk rupture at high pressures.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC PICC Equipment & Device Selection 3