VA-BC Patient Assessment 2

Question 1

When assessing a patient's arm for peripheral IV placement, which finding would be MOST concerning and warrant selecting an alternate site?

Accepted Answer

Edematous extremity on the affected side post-mastectomy

Answer

An edematous extremity on the post-mastectomy side is contraindicated for IV placement due to impaired lymphatic drainage and risk of lymphedema exacerbation.

Question 2

A patient reports a history of 'difficult veins' and multiple failed IV attempts. Which assessment technique is BEST to perform first?

Accepted Answer

Review prior access documentation and ask about past successful sites

Answer

Reviewing prior documentation and asking the patient about previously successful sites guides site selection and reduces unnecessary attempts.

Question 3

Which lab value should be reviewed BEFORE placing a central venous catheter to assess bleeding risk?

Accepted Answer

International Normalized Ratio (INR)

Answer

INR reflects coagulation status; elevated INR indicates coagulopathy and increases procedural bleeding risk.

Question 4

During a pre-procedure assessment for PICC placement, the nurse notes the patient's dominant arm has an arteriovenous fistula for dialysis. What is the correct action?

Accepted Answer

Select the contralateral arm for PICC placement

Answer

The contralateral (opposite) arm must be used to protect the AV fistula from damage or thrombosis that could compromise dialysis access.

Question 5

A nurse is assessing a patient for a peripherally inserted central catheter. The patient's BMI is 42. Which assessment finding is MOST relevant to site selection?

Accepted Answer

Presence of subcutaneous tissue obscuring veins

Answer

Obesity increases subcutaneous tissue depth, making veins difficult to palpate and visualize, often necessitating ultrasound guidance.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Patient Assessment 2