Practice Test Geeks(VABC) Vascular Access Board Certification Practice Test
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Pediatric Access Flashcards

7 cards from real VABC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. In a pediatric patient requiring PICC placement, the tip should be positioned at which anatomical location?

    Answer: Superior vena cava–right atrial junction

    The ideal PICC tip position is at the cavoatrial junction (SVC–right atrial junction) to ensure adequate hemodilution of infusates and reduce thrombosis risk.

  2. Which of the following fluids requires a central venous access device rather than a peripheral IV in pediatric patients?

    Answer: Total parenteral nutrition with >10% dextrose

    Solutions with osmolarity >900 mOsm/L, such as TPN with high dextrose concentrations, must be administered via central venous access to prevent severe phlebitis.

  3. A 10-year-old child with cancer requires long-term intermittent IV chemotherapy over the next 12 months. Which vascular access device is most appropriate?

    Answer: Implanted port

    An implanted port is ideal for long-term intermittent access, offering reduced infection risk, preserved body image, and minimal maintenance between cycles.

  4. When using the basilic vein for PICC insertion in a pediatric patient, which position of the arm optimizes vessel diameter?

    Answer: Arm abducted 45–90 degrees from the body

    Abducting the arm 45–90 degrees increases basilic vein diameter and straightens the venous pathway, improving cannulation success.

  5. Which complication is MOST commonly associated with PICC lines in neonates compared to older pediatric patients?

    Answer: Cardiac tamponade from tip migration

    Cardiac tamponade from catheter tip migration into the pericardial space is a rare but disproportionately reported complication in neonates due to their small size and catheter mobility.

  6. Which topical anesthetic agent is contraindicated in infants under 3 months of age due to the risk of methemoglobinemia?

    Answer: EMLA cream (prilocaine/lidocaine)

    EMLA cream contains prilocaine, which can cause methemoglobinemia in infants under 3 months due to immature enzyme systems for reducing methemoglobin.

  7. What is the recommended flushing volume for a central venous catheter in a 4 kg neonate?

    Answer: 2× the internal volume of the catheter plus dead space (typically 1–2 mL)

    In neonates, flush volume should be proportional to catheter dead space (2× internal volume), typically 1–2 mL, to avoid fluid overload.