VA-BC Patient Assessment 4

Question 1

A patient presents with a port-a-cath that has not been accessed in 8 months. Prior to drawing blood from the port, the nurse should FIRST:

Accepted Answer

Assess port patency by injecting 10 mL normal saline and feeling for resistance

Answer

Assessing for patency by evaluating resistance to flush with normal saline determines whether the port and catheter are functional before blood withdrawal.

Question 2

When assessing a patient for appropriateness of a midline catheter, which therapy would be a contraindication for midline use?

Accepted Answer

Continuous vesicant chemotherapy infusion

Answer

Vesicant chemotherapy must be administered through a central venous catheter because extravasation from a midline can cause severe tissue necrosis.

Question 3

A nurse assesses a patient's arm after peripheral IV insertion and notes the infusion is flowing by gravity but the site is cool, pale, and slightly swollen. This presentation is MOST consistent with:

Accepted Answer

Infiltration

Answer

Coolness, pallor, and swelling at the IV site indicate infiltration, where fluid is leaking into the surrounding subcutaneous tissue rather than the vein.

Question 4

Which assessment finding in a patient with a femoral central venous catheter would prompt the nurse to immediately notify the physician?

Accepted Answer

Hematoma formation and expanding bruising at the groin insertion site

Answer

Expanding hematoma at a femoral CVC site suggests vascular injury or inadequate hemostasis and requires urgent physician notification.

Question 5

When assessing a patient's PICC for a blood draw, the nurse aspirates and obtains no blood return. Which intervention should be attempted FIRST?

Accepted Answer

Reposition the patient's arm and have them take a deep breath, then reattempt

Answer

Repositioning the arm and changing intrathoracic pressure can relieve tip malposition against the vessel wall, restoring blood return.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Patient Assessment 4