VA-BC Device Selection & Insertion Techniques 2 — Questions and Answers
Question 1: A patient requires 6 weeks of IV antibiotics but has poor peripheral veins. Which device is most appropriate?
- Peripheral IV catheter
- Midline catheter
- PICC line (Correct answer)
- Implanted port
Correct answer: PICC line
A PICC line is ideal for 6 weeks of IV therapy, providing reliable central access when peripheral veins are poor.
Question 2: Which gauge needle is preferred for a rapid blood transfusion in an emergency adult patient?
- 24 gauge
- 22 gauge
- 20 gauge
- 18 gauge (Correct answer)
Correct answer: 18 gauge
An 18-gauge catheter allows rapid infusion rates needed for emergency transfusions without hemolysis risk.
Question 3: When inserting a PICC, the tip should be confirmed at which anatomical location?
- Superior vena cava/right atrial junction (Correct answer)
- Subclavian vein
- Axillary vein
- Internal jugular vein
Correct answer: Superior vena cava/right atrial junction
PICC tip placement at the cavoatrial junction (SVC/RA junction) is the standard for central venous catheter placement.
Question 4: A midline catheter is contraindicated in which clinical scenario?
- Long-term hydration therapy
- Vesicant chemotherapy administration (Correct answer)
- Intermittent antibiotic therapy
- Blood sampling in outpatients
Correct answer: Vesicant chemotherapy administration
Vesicants must be administered through a central venous access device because extravasation from a midline can cause severe tissue damage.
Question 5: During ultrasound-guided PIV insertion, the probe orientation that shows the vein in cross-section is called:
- Longitudinal view
- Transverse view (Correct answer)
- Oblique view
- Doppler view
Correct answer: Transverse view
The transverse (short-axis) view displays the vein as a circular cross-section, which is commonly used for initial needle entry visualization.
Question 6: Which CVAD is best suited for a patient requiring frequent, long-term chemotherapy with intact body image concerns?
- Non-tunneled central venous catheter
- PICC line
- Tunneled catheter (e.g., Hickman)
- Implanted port (Correct answer)
Correct answer: Implanted port
An implanted port is subcutaneous and nearly invisible, making it ideal for patients with body image concerns who need long-term chemotherapy.
Question 7: What is the primary purpose of using a tourniquet during peripheral IV insertion?
- Prevent infection at the insertion site
- Dilate the vein to improve visibility and access (Correct answer)
- Slow blood flow to prevent air embolism
- Stabilize the catheter during advancement
Correct answer: Dilate the vein to improve visibility and access
A tourniquet causes venous distension by impeding venous return, making veins more prominent and easier to cannulate.
VA-BC Device Selection & Insertion Techniques 2
A patient requires 6 weeks of IV antibiotics but has poor peripheral veins.
Which device is most appropriate?