VABC Complication Management 4

Question 1

Which of the following dressing changes is recommended by the CDC for central venous catheters to reduce CRBSI risk?

Accepted Answer

Gauze dressing changed every 48 hours or transparent semi-permeable dressing changed every 7 days

Answer

CDC guidelines recommend gauze dressings every 48 hours or transparent semi-permeable dressings every 7 days (or sooner if soiled, loosened, or visibly contaminated).

Question 2

A patient's implanted port cannot be de-accessed because the needle is stuck in the septum. What is the most appropriate initial step?

Accepted Answer

Rotate the needle 90 degrees while applying gentle outward pressure

Answer

A gentle rotational motion while applying steady outward traction can release a huber needle stuck in the port septum without damaging the septum or surrounding tissue.

Question 3

In the setting of CRBSI with Staphylococcus aureus, what is the minimum recommended duration of systemic antibiotic therapy when the catheter is removed?

Accepted Answer

14 days

Answer

S. aureus CRBSI requires at least 14 days of systemic antibiotics after catheter removal to reduce the risk of endocarditis and metastatic infection.

Question 4

A patient with a dialysis catheter develops recurrent CRBSI despite appropriate antibiotic therapy. Which preventive strategy is recommended to preserve catheter salvage?

Accepted Answer

Antibiotic lock therapy between dialysis sessions

Answer

Antibiotic lock therapy, instilling high-concentration antibiotics into the catheter lumen between sessions, is evidence-based for preventing recurrent CRBSI in dialysis catheters.

Question 5

What is the first step when a vascular access nurse suspects a catheter-associated deep vein thrombosis (CA-DVT)?

Accepted Answer

Order compression ultrasound of the affected extremity

Answer

Compression ultrasound is the diagnostic gold standard for upper or lower extremity DVT and should be obtained before treatment decisions are made.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Complication Management 4