VA-BC Ultrasound Guidance 4

Question 1

A nurse notices that the ultrasound image shows a 'dirty shadow' artifact below a hyperechoic structure during vessel scanning. This artifact most likely indicates:

Accepted Answer

A calcified vessel wall or foreign body

Answer

A clean acoustic shadow behind a hyperechoic structure suggests calcification or a dense foreign body, while a 'dirty shadow' is more associated with gas/air.

Question 2

The catheter-to-vein ratio for PICC placement, assessed via ultrasound, should ideally not exceed:

Accepted Answer

33%

Answer

A catheter-to-vein ratio of ≤33% is recommended to minimize thrombosis risk by allowing adequate blood flow around the catheter.

Question 3

Which technique uses ultrasound to inject saline around a nerve or vessel to create a tissue plane before catheter insertion?

Accepted Answer

Hydrodissection

Answer

Hydrodissection uses saline injected under ultrasound guidance to separate tissue planes, potentially displacing nerves or other structures before needle advancement.

Question 4

When using M-mode ultrasound to assess vessel pulsatility during vascular access assessment, what does a flat, non-pulsatile waveform most likely represent?

Accepted Answer

A patent peripheral vein

Answer

Veins display flat, non-pulsatile waveforms on M-mode, while arteries show cyclical pulsatile waveforms corresponding to cardiac contractions.

Question 5

A patient has a history of multiple previous PIVs and difficult access. Ultrasound reveals the cephalic vein is patent but located 2.8 cm deep. The best catheter choice is:

Accepted Answer

Ultrasound-guided long peripheral catheter (LPC)

Answer

A long peripheral catheter (LPC/extended dwell catheter) is appropriate for deep peripheral veins too superficial for PICC criteria but inaccessible with standard PIV length.

(VA-BC) Vascular Access Nurse Certification Practice Test

(VA-BC) Vascular Access Nurse Certification Practice Test

VA-BC Ultrasound Guidance 4