VA-BC Catheter Types 4 — Questions and Answers
Question 1: Which catheter is MOST appropriate for a patient needing intravenous antibiotics for 3 weeks at home?
- Short peripheral IV catheter
- Non-tunneled subclavian CVC
- Peripherally inserted central catheter (PICC) (Correct answer)
- Implanted venous port
Correct answer: Peripherally inserted central catheter (PICC)
A PICC is appropriate for intermediate-term (1–6 weeks) outpatient IV antibiotic therapy, combining central access with suitability for home care.
Question 2: The French (Fr) scale used to measure catheter size refers to:
- The inner diameter of the catheter lumen in millimeters
- The outer circumference divided by π, approximating outer diameter in mm (Correct answer)
- The gauge equivalent of the catheter wall thickness
- The length of the catheter in centimeters
Correct answer: The outer circumference divided by π, approximating outer diameter in mm
The French scale equals the outer circumference in millimeters divided by π, so 1 Fr ≈ 0.33 mm outer diameter.
Question 3: A patient's implanted port has not been accessed in 4 weeks. Per INS standards, the port should be flushed with:
- Normal saline only, every 4 weeks
- Heparinized saline (10–100 units/mL) every 4 weeks when not in use (Correct answer)
- Tissue plasminogen activator (tPA) monthly to prevent clotting
- Sterile water every 2 weeks
Correct answer: Heparinized saline (10–100 units/mL) every 4 weeks when not in use
INS standards recommend flushing implanted ports every 4 weeks when not in use with heparinized saline to maintain patency.
Question 4: Which insertion site for a non-tunneled CVC carries the HIGHEST risk of catheter-related bloodstream infection (CRBSI)?
- Subclavian vein
- Internal jugular vein
- Femoral vein (Correct answer)
- External jugular vein
Correct answer: Femoral vein
The femoral site has the highest CRBSI risk due to proximity to perineal flora and difficulty maintaining a sterile dressing.
Question 5: What is the clinical significance of a 'reverse taper' design in PICC catheters?
- The catheter widens from hub to tip to improve flow
- The catheter narrows at the tip to reduce vessel trauma on insertion (Correct answer)
- The catheter has reinforced walls at the hub to prevent kinking
- The reverse taper allows use in smaller pediatric veins only
Correct answer: The catheter narrows at the tip to reduce vessel trauma on insertion
A reverse taper PICC narrows at the insertion tip (smaller outer diameter) to minimize vessel trauma while maintaining a larger body for adequate flow.
Question 6: Which catheter feature helps differentiate a double-lumen from a single-lumen CVC during bedside assessment?
- Double-lumen CVCs are always longer than single-lumen
- Double-lumen CVCs have two separate hubs with distinct colored clamps (Correct answer)
- Double-lumen CVCs require chest X-ray confirmation at a different tip location
- Double-lumen CVCs must be placed via the right internal jugular only
Correct answer: Double-lumen CVCs have two separate hubs with distinct colored clamps
Double-lumen CVCs have two separate hubs, typically color-coded (e.g., red and blue or proximal/distal labels) with individual clamps for each lumen.
Question 7: A peripherally inserted central catheter (PICC) inserted via the basilic vein should have its tip confirmed to lie at the:
- Axillary vein
- Subclavian vein junction
- Cavoatrial junction or lower third of the superior vena cava (Correct answer)
- Right atrium, 2 cm below the SVC-RA junction
Correct answer: Cavoatrial junction or lower third of the superior vena cava
PICC tip placement at the cavoatrial junction or lower third of the SVC is recommended by INS to ensure central placement and reduce thrombosis and arrhythmia risk.
VA-BC Catheter Types 4
Which catheter is MOST appropriate for a patient needing intravenous antibiotics for 3 weeks at home?