VA-BC Infection Prevention & Complication Management 4

Question 1

A nurse is unable to flush a PICC line and notes resistance. Which action should be performed FIRST?

Accepted Answer

Reposition the patient's arm and ask them to cough or breathe deeply

Answer

Positional occlusion (catheter tip against vessel wall) is common; repositioning the arm, changing patient position, or having the patient cough often restores patency before further intervention.

Question 2

When administering alteplase (tPA) for a thrombotic catheter occlusion, what is the standard dwell time recommended before attempting aspiration?

Accepted Answer

30–120 minutes

Answer

Standard protocols recommend a dwell time of 30–120 minutes (commonly 30 minutes with a repeat dwell if needed) to allow alteplase to dissolve the fibrin clot.

Question 3

A patient with an implanted port is noted to have difficulty withdrawing blood but infusion flows freely. This is MOST likely due to:

Accepted Answer

Fibrin tail or fibrin sheath formation

Answer

A fibrin tail or sheath acts as a one-way valve allowing infusion but obstructing aspiration, which is a hallmark presentation distinguishing it from complete thrombotic occlusion.

Question 4

Which of the following is considered an ABSOLUTE indication for immediate central venous catheter removal?

Accepted Answer

Positive blood culture for Candida species

Answer

Fungal CRBSI (e.g., Candida) mandates immediate catheter removal because the risk of biofilm-protected yeast causing persistent or metastatic infection is extremely high.

Question 5

A patient receiving vesicant chemotherapy via a peripheral IV reports burning pain and the nurse observes blanching at the site. What is the IMMEDIATE priority action?

Accepted Answer

Stop the infusion, disconnect the IV tubing, and attempt aspiration before removing the catheter

Answer

For vesicant extravasation, stop infusion immediately, leave the catheter in place, disconnect tubing, and aspirate as much residual drug as possible before removal to minimize tissue damage.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Infection Prevention & Complication Management 4