VA-BC Pediatric Access 3

Question 1

A child with a PICC line develops fever, chills, and hypotension 48 hours after insertion. The FIRST priority nursing action is:

Accepted Answer

Obtain blood cultures from the PICC and a peripheral site before antibiotics

Answer

Blood cultures should be drawn from both the PICC and a peripheral site before starting antibiotics to properly identify a catheter-related bloodstream infection (CRBSI).

Question 2

Which pH range is considered SAFE for peripheral IV administration in pediatric patients to minimize risk of phlebitis?

Accepted Answer

5.0–9.0

Answer

Solutions with a pH of 5.0–9.0 are considered safe for peripheral infusion, as extremes of pH cause chemical irritation and phlebitis of the vessel wall.

Question 3

When using a transilluminator device to locate veins in a premature infant, the nurse should be aware of which RISK?

Accepted Answer

Thermal injury to fragile neonatal skin from prolonged light exposure

Answer

Prolonged transilluminator contact with fragile premature skin can cause thermal burns, so the device must be moved continuously and contact time minimized.

Question 4

A 10-year-old child has a tunneled central venous catheter for long-term chemotherapy. The nurse notes the catheter has migrated 2 cm externally. The BEST action is:

Accepted Answer

Do not reposition; notify the provider and obtain a chest X-ray to verify tip position

Answer

A migrated catheter should never be advanced back in; the provider must be notified and tip position verified radiologically before resuming use.

Question 5

In pediatric patients, which condition MOST increases the risk of catheter-associated thrombosis in a central venous catheter?

Accepted Answer

Congenital heart disease with polycythemia

Answer

Polycythemia in congenital heart disease increases blood viscosity, significantly raising the risk of thrombosis around central venous catheters.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Pediatric Access 3