VA-BC Patient Evaluation & Care Coordination 5

Question 1

A multidisciplinary team is discussing vascular access for a patient admitted with septic shock who needs vasopressors, fluids, and blood draws simultaneously. Which device is most appropriate?

Accepted Answer

Multi-lumen central venous catheter

Answer

A multi-lumen CVC provides simultaneous administration of incompatible medications (vasopressors), fluids, and blood sampling without the limitations of peripheral or single-lumen access in critical illness.

Question 2

A vascular access nurse is called to evaluate a patient who has had three failed peripheral IV attempts by floor nurses. On assessment, the nurse finds no suitable peripheral veins but the patient needs only a 3-day course of IV antibiotics. What is the most appropriate recommendation?

Accepted Answer

Attempt ultrasound-guided peripheral IV insertion before escalating to a PICC

Answer

For a short-term need, ultrasound-guided peripheral IV insertion should be attempted before escalating to a PICC, following the Infusion Nurses Society's vascular access device selection algorithm.

Question 3

While reviewing a patient's chart before PICC insertion, the nurse notes the patient has an AV fistula in the left arm and a history of right-sided breast cancer with axillary lymph node dissection. Where should the PICC be placed?

Accepted Answer

Femoral approach, avoiding both arms

Answer

Both arms are contraindicated (left: AV fistula, right: lymph node dissection with lymphedema risk), so an alternative approach such as femoral or jugular access with provider collaboration is required.

Question 4

A vascular access nurse completes a PICC insertion and obtains a post-insertion chest X-ray. The radiologist reports the tip is in the right atrium. What is the correct next action?

Accepted Answer

Withdraw the catheter by the estimated number of centimeters to reposition the tip at the cavoatrial junction

Answer

A tip in the right atrium must be withdrawn to the cavoatrial junction per standards, as right atrial placement increases the risk of arrhythmias and cardiac perforation.

Question 5

In the context of vascular access care coordination, which action best demonstrates the nurse's role as a patient advocate?

Accepted Answer

Educating the patient about the risks and benefits of different access options and incorporating their preferences into the care plan

Answer

Patient advocacy in vascular access includes ensuring informed decision-making by educating patients about their options, risks, and benefits, and incorporating their preferences into the care plan.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Patient Evaluation & Care Coordination 5