VABC Pediatric Access 4

Question 1

A pediatric patient with sickle cell disease requires frequent blood transfusions. Which vascular access device best balances repeated access needs with infection risk?

Accepted Answer

Implanted port

Answer

An implanted port offers the lowest infection risk for frequent but intermittent access needs, with no external components when not in use.

Question 2

Which intraosseous insertion site is preferred in children over 6 years of age when tibial access is unavailable?

Accepted Answer

Distal femur

Answer

The distal femur is an alternative IO insertion site in older children and adults when the proximal tibia is not accessible.

Question 3

When securing a peripheral IV in a toddler, which method is most appropriate to prevent accidental dislodgement while allowing ongoing assessment?

Accepted Answer

Sterile transparent dressing with site visible, and a splint as needed

Answer

A transparent semipermeable membrane dressing keeps the site visible for ongoing assessment while securing the catheter, with a splint added for joint sites if needed.

Question 4

Which clinical sign BEST indicates infiltration of a peripheral IV in a preverbal child who cannot report symptoms?

Accepted Answer

Localized swelling, firmness, or skin blanching around the insertion site

Answer

Localized swelling, induration, or blanching at the IV site are objective signs of infiltration, especially important in preverbal patients who cannot verbalize pain.

Question 5

A 2-year-old receiving vesicant chemotherapy via peripheral IV develops swelling at the site. What is the FIRST action?

Accepted Answer

Stop the infusion immediately and aspirate residual drug before removing the catheter

Answer

When vesicant extravasation is suspected, the infusion must be stopped immediately and residual drug aspirated before catheter removal to limit tissue damage.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Pediatric Access 4