VABC Vascular Access Devices & Technologies 3 — Questions and Answers
Question 1: A midline catheter is appropriately placed when its tip terminates in which anatomical location?
- Superior vena cava
- Subclavian vein
- Basilic or cephalic vein between the antecubital fossa and the axilla (Correct answer)
- Internal jugular vein
Correct answer: Basilic or cephalic vein between the antecubital fossa and the axilla
Midline catheters are defined by tip placement in the peripheral venous system, typically in the upper arm veins, not reaching central circulation.
Question 2: Which type of implanted port requires a non-coring (Huber) needle because:
- Standard needles cannot penetrate the port septum
- Standard needles core out the silicone septum, causing leakage over time (Correct answer)
- Huber needles have a smaller gauge to reduce patient discomfort
- Huber needles have anti-microbial coatings
Correct answer: Standard needles core out the silicone septum, causing leakage over time
Huber needles have an angled bevel that deflects through the septum without removing a core of silicone, preserving septum integrity for thousands of punctures.
Question 3: Which dressing type is recommended by the INS as the standard for securing a PICC insertion site?
- Dry gauze changed daily
- Sterile transparent semipermeable membrane (TSM) dressing (Correct answer)
- Non-sterile gauze secured with tape
- Hydrocolloid wound dressing
Correct answer: Sterile transparent semipermeable membrane (TSM) dressing
INS standards recommend a sterile TSM dressing because it allows visual inspection of the site while maintaining a sterile barrier; it is changed every 5-7 days or when soiled.
Question 4: An umbilical venous catheter (UVC) tip should ideally be positioned at which location?
- Right atrium
- Junction of the inferior vena cava and right atrium (Correct answer)
- Portal vein
- Hepatic vein
Correct answer: Junction of the inferior vena cava and right atrium
Optimal UVC tip position is at the IVC-right atrium junction to ensure central placement while avoiding cardiac arrhythmias and hepatic complications from portal/hepatic vein placement.
Question 5: Which characteristic distinguishes a tunneled CVC from a non-tunneled CVC?
- Tunneled CVCs use a smaller gauge needle for insertion
- The catheter travels subcutaneously from the exit site to the venous entry site (Correct answer)
- Tunneled CVCs are placed exclusively in the jugular vein
- Tunneled CVCs do not require flushing between uses
Correct answer: The catheter travels subcutaneously from the exit site to the venous entry site
Tunneled catheters (e.g., Hickman, Broviac) have a subcutaneous tunnel that reduces infection risk and provides stability, making them appropriate for long-term use.
Question 6: The Dacron cuff on a tunneled catheter serves what primary function?
- Acts as an antimicrobial barrier impregnated with chlorhexidine
- Anchors the catheter by promoting tissue ingrowth to prevent migration and reduce infection (Correct answer)
- Marks the insertion depth for proper tip placement
- Allows the catheter to be repositioned without removal
Correct answer: Anchors the catheter by promoting tissue ingrowth to prevent migration and reduce infection
Fibrous tissue grows into the Dacron cuff within 2-3 weeks, securing the catheter in place and creating a mechanical barrier against microorganism migration along the catheter tract.
Question 7: Which vascular access device is CONTRAINDICATED for vesicant chemotherapy administration?
- Implanted port with confirmed central tip position
- PICC with confirmed SVC tip position
- Midline catheter (Correct answer)
- Tunneled CVC with confirmed SVC tip position
Correct answer: Midline catheter
Midline catheters terminate in peripheral veins and are contraindicated for vesicant administration due to the risk of extravasation injury in non-central vessels.
VABC Vascular Access Devices & Technologies 3
A midline catheter is appropriately placed when its tip terminates in which anatomical location?