VABC Maintenance & Troubleshooting of Vascular Access Devices 3

Question 1

A precipitate occlusion caused by calcium-phosphate incompatibility in a PICC is best treated with which agent?

Accepted Answer

0.1N hydrochloric acid (HCl)

Answer

Calcium-phosphate precipitates are alkaline and dissolve in acidic solutions; 0.1N hydrochloric acid is the standard treatment for this type of non-thrombotic occlusion.

Question 2

How long should alteplase (1 mg/mL) dwell in a catheter when treating a thrombotic occlusion, per standard protocol?

Accepted Answer

30–60 minutes with reassessment up to 2 hours

Answer

Standard alteplase protocol calls for a 30–60 minute dwell time, with reassessment; if patency is not restored, a second dwell of up to 2 hours total may be used.

Question 3

Which dressing type is preferred for CVAD insertion sites in adults without excessive perspiration or bleeding?

Accepted Answer

Transparent semipermeable membrane (TSM) dressing

Answer

TSM dressings allow continuous visualization of the insertion site, reduce infection risk, and require less frequent changes than gauze dressings.

Question 4

A chlorhexidine-impregnated sponge dressing is indicated for which patient population according to CDC guidelines?

Accepted Answer

Adults with CVADs when the catheter-related bloodstream infection (CRBSI) rate is not decreasing despite standard precautions

Answer

CDC guidelines recommend chlorhexidine-impregnated dressings as an adjunct measure for adults when CRBSI rates remain elevated despite standard prevention bundles.

Question 5

When changing a CVAD dressing, the nurse should cleanse the site with chlorhexidine gluconate (CHG) using which technique?

Accepted Answer

Friction scrub from insertion site outward with 30-second contact time

Answer

CHG requires a friction scrub moving from the insertion site outward, with at least 30 seconds of contact and full dry time to maximize antimicrobial effectiveness.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Maintenance & Troubleshooting of Vascular Access Devices 3