VABC Pediatric Access 5

Question 1

What is the primary reason chlorhexidine gluconate (CHG) skin antisepsis is used with caution in neonates under 2 months of age?

Accepted Answer

Immature neonatal skin allows significant percutaneous absorption causing systemic toxicity

Answer

The thin, permeable skin of neonates, especially preterm infants, allows CHG to be absorbed systemically, potentially causing chemical burns and systemic toxicity.

Question 2

Which veins should be avoided for PICC insertion in a pediatric patient with chronic kidney disease who may require future hemodialysis?

Accepted Answer

Basilic and cephalic veins of the non-dominant arm

Answer

Preserving the basilic and cephalic veins of the non-dominant arm is essential for potential future AV fistula creation in patients with chronic kidney disease.

Question 3

A 5-year-old child has a midline catheter placed in the right basilic vein with the tip confirmed at the mid-upper arm. Which infusate is appropriate for this device?

Accepted Answer

Vancomycin at standard concentration

Answer

Midline catheters are appropriate for isotonic or near-isotonic infusates such as standard-concentration antibiotics, but are not indicated for vesicants, hyperosmolar solutions, or vasopressors.

Question 4

When performing ultrasound-guided peripheral IV placement in a child, the short-axis (transverse) view is used to:

Accepted Answer

Identify vessel location, depth, and surrounding structures during needle approach

Answer

The short-axis view provides a cross-sectional image that allows the clinician to identify vessel location, assess surrounding structures, and guide needle placement.

Question 5

A neonate requires umbilical venous catheter (UVC) placement. The correct tip position is:

Accepted Answer

At the junction of the inferior vena cava and right atrium

Answer

The UVC tip should be positioned at the IVC–right atrial junction to avoid hepatic complications such as portal hypertension or hepatic necrosis.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Pediatric Access 5