VA-BC Pediatric Access 4

Question 1

Which catheter-to-vein ratio is recommended to minimize thrombotic risk when selecting a PICC for a pediatric patient?

Accepted Answer

Catheter should occupy no more than 33% of the vein lumen

Answer

INS and AVA guidelines recommend the catheter occupy no more than 33% of the vein lumen to maintain adequate blood flow and reduce thrombosis risk.

Question 2

A neonate receiving parenteral nutrition (PN) through a peripheral IV develops erythema, blistering, and skin breakdown at the site. This is MOST consistent with:

Accepted Answer

Extravasation with tissue necrosis risk

Answer

Blistering and skin breakdown following PN infusion indicate extravasation, which is a medical emergency in neonates due to high osmolarity causing tissue necrosis.

Question 3

When teaching a parent to care for their child's peripherally inserted central catheter (PICC) at home, the nurse should instruct them to report which symptom IMMEDIATELY?

Accepted Answer

Fever greater than 38°C (100.4°F)

Answer

Fever greater than 38°C in a child with a PICC may indicate catheter-related bloodstream infection and requires immediate medical evaluation.

Question 4

In premature neonates, which anatomical factor makes scalp veins an acceptable but secondary peripheral IV site?

Accepted Answer

Scalp veins are well-visualized and relatively immobile, aiding cannulation

Answer

Scalp veins are visible and relatively fixed against the skull, making them easier to cannulate in premature neonates when extremity veins are inaccessible.

Question 5

Which osmolarity threshold for IV solutions generally requires central venous access rather than peripheral access in pediatric patients?

Accepted Answer

Greater than 900 mOsm/L

Answer

Solutions with osmolarity greater than 900 mOsm/L are typically required to be administered through central venous access to prevent peripheral vein damage.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Pediatric Access 4