VABC Vascular Access Devices & Technologies 5

Question 1

A patient with an implanted port reports inability to withdraw blood but medications infuse freely. The FIRST intervention should be:

Accepted Answer

Reposition the patient and attempt aspiration with a 10 mL syringe using gentle pressure

Answer

Positional fibrin flap or tip malposition can cause withdrawal occlusion; repositioning (raising arms, Valsalva, changing position) often resolves the issue before pharmacological intervention.

Question 2

Which statement about the basilic vein is TRUE regarding PICC insertion?

Accepted Answer

It runs medially in the upper arm and is the preferred vein for PICC insertion due to its larger diameter and more direct path

Answer

The basilic vein is the largest and most direct upper extremity vein for PICC insertion, with fewer valves and a more favorable anatomy compared to the cephalic vein.

Question 3

The primary reason to avoid placing a PICC in the antecubital fossa (versus the upper arm) is:

Accepted Answer

Arm flexion at the elbow increases catheter complications including occlusion, phlebitis, and dislodgement

Answer

Antecubital placement creates a flexion point that increases mechanical stress on the catheter, leading to higher rates of occlusion, phlebitis, and catheter damage.

Question 4

Which catheter-to-vein ratio is recommended to minimize PICC-related thrombosis?

Accepted Answer

Catheter occupying no more than 33-45% of the vein lumen

Answer

Evidence supports that a catheter-to-vein ratio ≤33-45% reduces turbulent blood flow around the catheter and lowers the risk of deep vein thrombosis.

Question 5

A split-tip (bifurcated tip) CVC design, such as the Ash Split Cath used in dialysis, offers the advantage of:

Accepted Answer

Allowing higher flow rates in a smaller outer diameter catheter by separating arterial and venous ports

Answer

Split-tip designs separate the inflow and outflow lumens at the tip to reduce recirculation and improve flow efficiency, enabling high-flow dialysis through a catheter with smaller outer diameter.

(VABC) Vascular Access Board Certification Practice Test

(VABC) Vascular Access Board Certification Practice Test

VABC Vascular Access Devices & Technologies 5