VABC Complication Management 3

Question 1

When treating catheter-related thrombosis in an upper extremity PICC, what is the preferred initial anticoagulation agent according to current guidelines?

Accepted Answer

Low molecular weight heparin (LMWH) or direct oral anticoagulant (DOAC)

Answer

Current guidelines recommend LMWH or DOACs as first-line anticoagulation for upper extremity DVT related to vascular access catheters.

Question 2

A nurse notes that a PICC line appears to have advanced several centimeters since the last documented length. What is the priority action?

Accepted Answer

Obtain a chest X-ray to verify tip position before use

Answer

Any change in catheter external length requires radiographic tip position confirmation before the line is used, as migration into the heart is dangerous.

Question 3

Which clinical sign most strongly suggests superior vena cava (SVC) syndrome as a complication of a long-term central venous catheter?

Accepted Answer

Bilateral facial and upper extremity edema with venous distension

Answer

SVC syndrome causes bilateral facial and upper extremity edema plus prominent neck and chest wall venous collaterals due to obstruction of the superior vena cava.

Question 4

A patient develops chylothorax following left-sided central venous catheter insertion. Which structure was most likely injured?

Accepted Answer

Thoracic duct

Answer

The thoracic duct runs near the left subclavian-jugular venous junction, and injury during left-sided CVC insertion can cause lymphatic leakage (chylothorax).

Question 5

A patient receiving vesicant chemotherapy through a peripheral IV develops swelling and burning pain at the infusion site. What is the immediate action?

Accepted Answer

Stop the infusion, aspirate residual drug, and remove the IV without flushing

Answer

With vesicant extravasation, the infusion must stop immediately, any residual drug should be aspirated through the existing catheter, and the IV removed without flushing to avoid spreading the vesicant.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Complication Management 3