VA-BC Catheter Types 2 — Questions and Answers
Question 1: Which catheter type is specifically designed for long-term hemodialysis access when arteriovenous fistula creation is not possible?
- Peripherally inserted central catheter (PICC)
- Tunneled cuffed hemodialysis catheter (Correct answer)
- Non-tunneled central venous catheter
- Midline catheter
Correct answer: Tunneled cuffed hemodialysis catheter
Tunneled cuffed hemodialysis catheters are designed for long-term dialysis access, with a Dacron cuff that anchors the catheter subcutaneously and reduces infection risk.
Question 2: A patient requires vesicant chemotherapy infusion over 6 months. Which vascular access device is most appropriate?
- Peripheral IV catheter
- Midline catheter
- Implanted port (Correct answer)
- Non-tunneled CVC
Correct answer: Implanted port
An implanted port is the preferred device for long-term vesicant chemotherapy due to its low infection risk, patient comfort, and ability to withstand repeated access.
Question 3: What distinguishes a polyurethane PICC from a silicone PICC in clinical practice?
- Polyurethane PICCs are softer and more flexible
- Polyurethane PICCs have higher flow rates due to thinner walls (Correct answer)
- Silicone PICCs can tolerate power injection
- Polyurethane PICCs require more frequent flushing
Correct answer: Polyurethane PICCs have higher flow rates due to thinner walls
Polyurethane catheters have thinner walls than silicone, allowing larger inner lumens relative to outer diameter, which supports higher flow rates.
Question 4: Which statement about non-tunneled central venous catheters (CVCs) is correct regarding intended duration of use?
- They are designed for use up to 1 year
- They are intended for short-term use, typically less than 14 days (Correct answer)
- They can remain in place indefinitely with proper care
- They are recommended for outpatient long-term therapy
Correct answer: They are intended for short-term use, typically less than 14 days
Non-tunneled CVCs are intended for short-term use (typically fewer than 14 days) due to higher infection risk without subcutaneous tunneling.
Question 5: A Groshong catheter differs from a standard tunneled catheter because it features:
- A Dacron cuff placed at the skin exit site
- A three-position slit valve at the tip (Correct answer)
- A bifurcated hub for dual-lumen access
- A valved tip that eliminates the need for flushing
Correct answer: A three-position slit valve at the tip
The Groshong catheter has a three-position slit valve at its tip that prevents backflow of blood and air entry, reducing clotting risk.
Question 6: Which catheter gauge is correctly matched to its primary intended use in vascular access?
- 24-gauge peripheral IV for rapid blood transfusion
- 16-gauge peripheral IV for routine saline infusion in adults
- 20-gauge peripheral IV for most routine adult IV therapy (Correct answer)
- 18-gauge peripheral IV for pediatric routine access
Correct answer: 20-gauge peripheral IV for most routine adult IV therapy
A 20-gauge peripheral IV catheter is appropriate for most routine adult IV therapy, balancing adequate flow with patient comfort.
Question 7: An antimicrobial-impregnated CVC is indicated primarily to reduce which complication?
- Catheter-related thrombosis
- Central line-associated bloodstream infection (CLABSI) (Correct answer)
- Catheter occlusion from lipid precipitation
- Air embolism during insertion
Correct answer: Central line-associated bloodstream infection (CLABSI)
Antimicrobial-impregnated CVCs (e.g., chlorhexidine/silver sulfadiazine or minocycline/rifampin) are used specifically to reduce CLABSI rates.
VA-BC Catheter Types 2
Which catheter type is specifically designed for long-term hemodialysis access when arteriovenous fistula creation is not possible?