VA-BC Catheter Types 3 — Questions and Answers
Question 1: What is the primary advantage of a valved PICC (e.g., PASV or Groshong-type) over an open-ended PICC?
- It allows higher infusion flow rates
- It reduces the need for heparin flushing by preventing blood reflux (Correct answer)
- It is easier to insert under ultrasound guidance
- It has a longer recommended dwell time
Correct answer: It reduces the need for heparin flushing by preventing blood reflux
Valved PICCs prevent blood from refluxing into the catheter lumen, reducing clot formation and often eliminating the need for heparin flushes.
Question 2: Which of the following best describes a 'power-injectable' PICC?
- A PICC rated to withstand contrast injection at up to 300 psi (Correct answer)
- A PICC with a larger outer diameter than standard PICCs
- A PICC that delivers medication via a pressure-driven pump only
- A PICC approved for arterial blood pressure monitoring
Correct answer: A PICC rated to withstand contrast injection at up to 300 psi
Power-injectable PICCs are constructed to tolerate high-pressure contrast media injection (typically up to 300 psi) required for CT imaging.
Question 3: A patient has a tunneled catheter with a Dacron cuff. Where is the cuff ideally positioned after placement?
- At the venipuncture site on the skin surface
- 1–2 cm inside the subcutaneous tunnel from the exit site (Correct answer)
- Immediately above the catheter tip in the SVC
- At the bifurcation of the internal and external jugular veins
Correct answer: 1–2 cm inside the subcutaneous tunnel from the exit site
The Dacron cuff is positioned 1–2 cm inside the subcutaneous tunnel from the exit site so fibrous tissue ingrowth anchors the catheter and forms a barrier against infection.
Question 4: Which catheter material is most resistant to thrombotic occlusion due to its surface characteristics?
- Polyvinyl chloride (PVC)
- Teflon (PTFE)
- Silicone (Correct answer)
- Nylon
Correct answer: Silicone
Silicone has a smooth, hydrophobic surface with low thrombogenicity, making it more resistant to thrombus formation compared to stiffer materials like PVC or Teflon.
Question 5: A midline catheter tip should terminate in which anatomical location?
- Superior vena cava
- Axillary vein
- Subclavian vein
- Proximal basilic or cephalic vein below the axilla (Correct answer)
Correct answer: Proximal basilic or cephalic vein below the axilla
Midline catheter tips terminate in the proximal basilic, cephalic, or brachial vein below the axilla, not reaching central circulation.
Question 6: Which of the following is a defining feature of an implanted venous port compared to a tunneled CVC?
- It exits the skin at a visible site for daily care
- Its reservoir is completely beneath the skin with no external component (Correct answer)
- It requires daily flushing with heparin
- It cannot be used for blood sampling
Correct answer: Its reservoir is completely beneath the skin with no external component
An implanted port is entirely subcutaneous—the reservoir and catheter are under the skin, requiring access only with a non-coring (Huber) needle.
Question 7: A patient receiving parenteral nutrition requires a multi-lumen CVC. Why is a dedicated lumen for PN important?
- PN is incompatible with saline flushes used in other lumens
- Dedicating one lumen reduces contamination risk and prevents drug incompatibilities (Correct answer)
- Multi-lumen catheters cannot handle PN in shared lumens legally
- PN must flow through the distal lumen only for osmolarity reasons
Correct answer: Dedicating one lumen reduces contamination risk and prevents drug incompatibilities
A dedicated PN lumen reduces infection risk and prevents chemical incompatibilities between PN and other infusates or medications.
VA-BC Catheter Types 3
What is the primary advantage of a valved PICC (e.g., PASV or Groshong-type) over an open-ended PICC?