VA Patient & Caregiver Education — Questions and Answers
Question 1: Which technique best confirms that a patient understands how to care for their PICC at home?
- Asking "Do you have any questions?"
- Giving the patient a printed brochure
- The teach-back method, where the patient explains or demonstrates the care in their own words (Correct answer)
- Having the patient sign an education form
Correct answer: The teach-back method, where the patient explains or demonstrates the care in their own words
Teach-back checks understanding directly: the patient restates or demonstrates what they learned, which shows the clinician any gaps to clarify. A yes/no question or a signed form does not show comprehension.
Question 2: A patient going home with a PICC should be taught to report which finding right away?
- Mild itching under a dry, intact dressing
- Swelling of the arm, neck or face on the PICC side (Correct answer)
- Seeing the external catheter length markings
- A flush that feels cool
Correct answer: Swelling of the arm, neck or face on the PICC side
Swelling of the arm, neck or face on the catheter side can mean catheter-related deep vein thrombosis or SVC obstruction. It needs prompt evaluation.
Question 3: Which instruction is appropriate for a patient who has a PICC in their arm?
- Swimming is fine once the site has healed
- Avoid blood pressure measurements and heavy lifting with the PICC arm (Correct answer)
- Take off the dressing to shower and replace it afterward
- Clamping is never needed for any PICC
Correct answer: Avoid blood pressure measurements and heavy lifting with the PICC arm
Taking blood pressure on the PICC arm, or lifting heavy weights with it, can damage the catheter or vein and raise the risk of thrombosis or dislodgement. Patients should cover the dressing to shower and should not submerge the site.
Question 4: Before teaching a patient to manage their own home infusion, what should the nurse assess first?
- The patient's insurance carrier
- The patient's health literacy, readiness to learn and physical or cognitive ability (Correct answer)
- The patient's favorite TV programs
- The brand of infusion pump only
Correct answer: The patient's health literacy, readiness to learn and physical or cognitive ability
Assessing health literacy, readiness to learn, language needs, dexterity and cognition lets the nurse tailor the teaching and decide whether a caregiver should be included.
Question 5: What should a patient with chronic kidney disease be taught about vein preservation?
- PICCs are the preferred access device in CKD
- Arm veins should be protected from unnecessary venipuncture and PICCs avoided, to preserve future dialysis access (Correct answer)
- Any arm vein may be used for IV starts without restriction
- Vein preservation applies only after dialysis begins
Correct answer: Arm veins should be protected from unnecessary venipuncture and PICCs avoided, to preserve future dialysis access
Arm veins in CKD patients may be needed for a future arteriovenous fistula. Patients should learn to speak up for vein preservation: avoid PICCs and unnecessary sticks, and ask that the nephrology team be consulted before any device placement.
Question 6: Which instruction about infection prevention is most important to teach a patient or caregiver who will access an implanted port or CVAD at home?
- Wipe the needleless connector briefly with dry gauze
- Perform hand hygiene and scrub the needleless connector with an antiseptic, letting it dry, before every access (Correct answer)
- Reuse syringes to reduce waste
- Leave the connector cap off between uses
Correct answer: Perform hand hygiene and scrub the needleless connector with an antiseptic, letting it dry, before every access
Hand hygiene plus a vigorous antiseptic scrub of the needleless connector, followed by full drying, before every access is a key way to prevent intraluminal contamination and CLABSI at home.
