VA-BC Device Selection & Insertion Techniques 3 — Questions and Answers
Question 1: A non-tunneled central venous catheter inserted in an emergency should be replaced within how many days to reduce infection risk?
- 24 hours
- 48 hours (Correct answer)
- 72 hours
- 7 days
Correct answer: 48 hours
CDC guidelines recommend replacing emergency-placed CVCs within 48 hours due to increased infection risk from non-sterile insertion conditions.
Question 2: When selecting a vein for a midline catheter, the preferred insertion site is:
- Dorsal hand veins
- Antecubital fossa veins (basilic, cephalic, or median cubital) (Correct answer)
- External jugular vein
- Femoral vein
Correct answer: Antecubital fossa veins (basilic, cephalic, or median cubital)
Midline catheters are inserted in the antecubital fossa and advance 8–20 cm, terminating below the axilla.
Question 3: The 'Z-track' technique during PIV insertion is used to:
- Prevent catheter kinking
- Anchor the vein and reduce catheter dislodgement (Correct answer)
- Increase blood flashback speed
- Reduce patient pain during insertion
Correct answer: Anchor the vein and reduce catheter dislodgement
The Z-track technique involves applying distal traction on the skin to anchor the vein, preventing rolling and aiding successful cannulation.
Question 4: Which of the following is the LEAST preferred site for peripheral IV placement in an adult?
- Forearm
- Antecubital fossa (Correct answer)
- Hand
- Upper arm
Correct answer: Antecubital fossa
The antecubital fossa is least preferred for routine PIVs because arm flexion restricts flow and increases catheter failure rates.
Question 5: A patient has a known latex allergy. Which CVAD component must the nurse verify before insertion?
- Catheter tip material
- Securement device adhesive
- Port septum and catheter materials for latex-free composition (Correct answer)
- Flush syringe barrel
Correct answer: Port septum and catheter materials for latex-free composition
Port septa and some catheter materials may contain latex; latex-free devices must be confirmed for patients with latex allergy.
Question 6: What technique is used to confirm intravascular placement of a peripheral IV immediately after insertion?
- Checking for a capillary refill at the insertion site
- Observing blood flashback in the catheter hub (Correct answer)
- Measuring blood pressure in the cannulated arm
- Assessing skin temperature distal to the insertion site
Correct answer: Observing blood flashback in the catheter hub
Blood flashback into the catheter hub confirms that the needle tip has entered the vascular lumen.
Question 7: For a pediatric patient under 2 years old requiring IV access, which site is often used when peripheral veins are inaccessible?
- Femoral vein
- Scalp vein (Correct answer)
- Subclavian vein
- Basilic vein at the antecubital fossa
Correct answer: Scalp vein
Scalp veins are commonly used in infants under 2 years when extremity access fails, as scalp veins are prominent and accessible.
VA-BC Device Selection & Insertion Techniques 3
A non-tunneled central venous catheter inserted in an emergency should be replaced within how many days to reduce infection risk?