VABC Insertion Techniques & Complications Management 4

Question 1

A patient's implanted port is accessed but the nurse cannot aspirate blood. The patient reports no discomfort. What should the nurse assess FIRST?

Accepted Answer

Have the patient perform positional maneuvers such as raising the arm or coughing

Answer

Positional maneuvers can relieve a fibrin sheath or positional occlusion and are the first-line, non-invasive assessment for inability to aspirate.

Question 2

Pinch-off syndrome is a complication specific to which central venous access approach?

Accepted Answer

Subclavian via infraclavicular approach

Answer

Pinch-off syndrome occurs when the catheter is compressed between the clavicle and first rib, which is unique to the subclavian infraclavicular insertion site.

Question 3

During femoral vein cannulation, the landmark technique uses the mnemonic NAVEL. What does each letter represent in order from lateral to medial?

Accepted Answer

Nerve, Artery, Vein, Empty space, Lymphatics

Answer

NAVEL (Nerve, Artery, Vein, Empty space, Lymphatics) describes the lateral-to-medial arrangement of femoral triangle structures below the inguinal ligament.

Question 4

A PICC patient has a confirmed upper extremity DVT. The catheter is still patent and functional and the patient requires continued IV therapy. What is the recommended approach per current guidelines?

Accepted Answer

Anticoagulate and remove the PICC only if it is no longer needed

Answer

Current guidelines recommend initiating anticoagulation and removing the catheter only when it is no longer needed, balancing thrombosis treatment with ongoing IV access needs.

Question 5

Which of the following steps in aseptic technique is MOST critical for preventing catheter-related bloodstream infections (CRBSI) at the time of insertion?

Accepted Answer

Using a 2% chlorhexidine-based antiseptic with alcohol and allowing it to fully dry

Answer

Maximal sterile barrier precautions including full sterile drape, gown, gloves, mask, and chlorhexidine-alcohol skin prep (allowed to dry) are the most evidence-based insertion practices to prevent CRBSI.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Insertion Techniques & Complications Management 4