VABC Ultrasound Guidance 5

Question 1

According to evidence-based guidelines, routine ultrasound confirmation of tip position via intracavitary ECG during PICC insertion detects tip malposition better than:

Accepted Answer

Post-procedure chest X-ray alone

Answer

Intracavitary ECG guidance provides real-time tip localization and has been shown to be equivalent to or better than chest X-ray for detecting malposition at time of insertion.

Question 2

Posterior wall puncture during ultrasound-guided venipuncture most often occurs because:

Accepted Answer

The needle is advanced too quickly through the near wall without pausing to confirm intraluminal entry

Answer

Advancing the needle past the near wall without confirming flashback or intraluminal position on ultrasound commonly results in posterior wall puncture.

Question 3

When assessing for pneumothorax after subclavian/axillary vein cannulation using lung ultrasound, the absence of which sign confirms no pneumothorax?

Accepted Answer

Lung sliding

Answer

Lung sliding (the shimmer of visceral over parietal pleura with respiration) is absent in pneumothorax; its presence confirms the lung is apposed to the chest wall.

Question 4

Which patient population most benefits from routine ultrasound guidance for peripheral IV access compared to standard landmark technique?

Accepted Answer

Adult patients with difficult venous access (DIVA)

Answer

Patients classified as difficult intravenous access (DIVA) — those with prior IV failure, obesity, history of IV drug use, or sickle cell disease — derive the greatest benefit from ultrasound guidance.

Question 5

During ultrasound-guided IJ cannulation, the probe is rotated 90 degrees from short-axis to long-axis view primarily to:

Accepted Answer

Visualize the needle advancing in-plane toward the vessel

Answer

Rotating to long-axis allows the needle to be seen in-plane, enabling continuous visualization of the needle tip and shaft as it advances toward and enters the vessel.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Ultrasound Guidance 5