VA-BC Infection Prevention & Complication Management 5 — Questions and Answers
Question 1: According to INS standards, how frequently should administration sets used for continuous non-lipid infusions be routinely changed?
- Every 24 hours
- Every 48 hours
- Every 96 hours or longer unless clinically indicated (Correct answer)
- Every 72 hours
Correct answer: Every 96 hours or longer unless clinically indicated
INS and CDC guidelines recommend changing continuous non-lipid, non-blood administration sets no more frequently than every 96 hours (and up to 7 days) to reduce infection risk and cost.
Question 2: A vascular access nurse is reviewing a patient's central line for daily necessity. Which of the following is the PRIMARY criterion for determining if the line should be removed?
- The line has been in place for more than 10 days
- The patient no longer has a clinical indication for central venous access (Correct answer)
- The patient has a positive blood culture from a peripheral site
- The dressing was last changed more than 7 days ago
Correct answer: The patient no longer has a clinical indication for central venous access
Daily line necessity review is a core CLABSI bundle element; a line with no current clinical indication should be removed promptly to eliminate infection risk.
Question 3: Which of the following correctly describes catheter pinch-off syndrome?
- Compression of the catheter between the clavicle and first rib causing intermittent occlusion (Correct answer)
- Catheter tip migration against the superior vena cava wall
- Fibrin deposition around the catheter tip preventing aspiration
- Kinking of the catheter within the subcutaneous tunnel
Correct answer: Compression of the catheter between the clavicle and first rib causing intermittent occlusion
Pinch-off syndrome occurs when a subclavian catheter is compressed between the clavicle and first rib, causing intermittent or positional occlusion and risk of catheter fracture.
Question 4: A patient with a tunneled hemodialysis catheter is found to have CRBSI caused by S. aureus. After catheter removal, what is the MINIMUM recommended duration of systemic antibiotic therapy?
- 7 days
- 10 days
- 14 days
- 4–6 weeks (Correct answer)
Correct answer: 4–6 weeks
S. aureus CRBSIs carry a high risk of endovascular complications (endocarditis, septic emboli) requiring 4–6 weeks of systemic antibiotics after catheter removal per IDSA guidelines.
Question 5: Which of the following is the MOST appropriate action when a needleless connector has visible blood residue or debris?
- Scrub vigorously with CHG/alcohol wipe and access after drying
- Change the connector immediately before accessing the line (Correct answer)
- Flush 10 mL normal saline through the connector to clear debris
- Document and continue with routine scrub protocol
Correct answer: Change the connector immediately before accessing the line
Visible contamination of a needleless connector warrants immediate replacement; scrubbing alone is insufficient to eliminate debris or blood that harbors microorganisms.
Question 6: A patient with a PICC in the basilic vein develops unilateral arm swelling, warmth, and a positive compression ultrasound for DVT. The catheter is functioning and still required. Which statement BEST reflects current management guidelines?
- Remove the catheter immediately regardless of clinical need
- Initiate anticoagulation and reassess catheter necessity; retain if still needed and functional (Correct answer)
- Elevate the arm and apply warm compresses without anticoagulation
- Replace the PICC in the opposite arm and anticoagulate
Correct answer: Initiate anticoagulation and reassess catheter necessity; retain if still needed and functional
Guidelines support anticoagulation with catheter retention when the device remains clinically necessary and functional, with catheter removal if symptoms worsen or anticoagulation is contraindicated.
Question 7: What is the purpose of using a chlorhexidine-impregnated dressing (e.g., Biopatch) at the central line insertion site?
- To absorb drainage and prevent moisture accumulation
- To provide a sustained antimicrobial barrier that reduces microbial colonization at the exit site (Correct answer)
- To anchor the catheter and reduce dislodgement risk
- To replace the need for routine antiseptic skin prep during dressing changes
Correct answer: To provide a sustained antimicrobial barrier that reduces microbial colonization at the exit site
CHG-impregnated dressings release chlorhexidine continuously at the exit site, reducing skin colonization and demonstrated reduction in CLABSI rates in multiple clinical trials.
VA-BC Infection Prevention & Complication Management 5
According to INS standards, how frequently should administration sets used for continuous non-lipid infusions be routinely changed?