VA-BC Certification Exam 2023/ 2024
Updated Review| Questions and Verified
Answers
Q: What are contraindications for a midline?
Answer:
-Arms with: A/V fistula, infection, fracture, trauma, or compromised circulation
-Chronic Kidney Disease
Q: What are the sites and vessel selection for midline catheters?
Answer:
Basilic or cephalic vein in the antecubital fossa or lower part of the upper arm
Q: What product should be used for a midline placement?
Answer:
A product that is specifically designed and labeled as a peripheral midline catheter
Q: What barrier precautions should be considered for midline placement?
Answer:
Maximun sterile barrer
Q: Why should a PICC device NOT be used for midline placement?
Answer:
Using a PICC device for midline placement will risk confusion related to the type of access
device a patient has; places the catheter tip outside the SVC, which is contrary to the
manufacturers’ DFU related to the intention of the product and risks potential liability for the
nurse.
Q: What is optimal tip location for a midline catheter?
Answer:
One inch below the axillary area
Q: For midline placement, what alternative veins can be considered in pediatric patients?
Answer:
Scalp veins
Popliteal veins
Saphenous veins
Q: What are the indications for non-tunneled catheters?
Answer:
Short term central vein access
Emergency central vein access
Q: What are the contraindications for non-tunneled catheters?
Answer:
Neck or chest sites may be excluded for patients with tracheostomies, radical neck dissection,
and cervical fracture instability, or unstable airway
Inability to position patient, insert or stabilize catheter
Avoid insertion on same side as a PICC that passes through the subclavian vein
Q: What are the potential vessels for non-tunneled catheters?
Answer:
A. Jugular veins, external and/or internal
B. Subclavian veins
C. Femoral veins (least preferred)
Q: In patients at greater risk for catheter associated bloodstream infections (CABSI) what typed
of PICC or non-tunneled catheters should be considered?
Answer:
Anti-microbial catheters
Q: What type of barrier precautions are required for non-tunneled catheter placement?
Answer:
Maximun sterile
Q: How should a patient be positioned for non-tunneled catheter placement?
Answer:
slight Trendelenburg position
Q: Why is a patient placed in slight Trendelenburg position for non-tunneled catheter
placement?
Answer:
to avoid the possibility of air emboli during the placement procedure
Q: In non-tunneled catheter or PICC placement., what should always be avoided when
accessing veins?
VA-BC Exam Quiz Bank | 150+ Questions
and Verified Answers (2023/ 2024 Updated)
Qs:
- Device selection may be limited in pediatric patients due to small size of vessel or patient
activity. T or F - Do pediatric patients have more or less venous options to choose from?
- What type of devices preserve vessels and avoid unnecessary anxiety and pain related to
venipuncture attempts? - Patients may have a preference for or where a line is placed. Give examples of why?
Answers: - T
- Less, related to their size
- VADs
- School, work, bra, seatbelt
Qs: - Give examples of what to assess when considering demographics.
- Why should an IVAD be placed as shallow as possible?
- With co-morbidities, insertion of VADs can be complicated. List some co-morbidities to
consider. - Meaning the side that you would NOT choose to use for VAD placement. I.E. same side as
cardiac device.
Answers: - Age, sex, homelessness, disability
- Easier palpation, increased success of access
- ESRD, fistulas, venous thrombosis or stenosis, breast cancer, pacemakers, previous or future
port placement - Ipsilateral
Qs: - Relating to the side you would choose to place a VAD. I.E. opposite side of a cardiac device.
- How long is recommended to wait to use a side with a recent cardiac device implanted before
using for VAD?
a. 6 months
b. 1 year
c. 6 weeks
d. Never - CVAD insertion in the presence of an IVC filter can inadvertently trap wires in the filter. T
or F - Why is important to avoid CVAD or PVAD devices in the lower extremities of infants and
toddlers? - PIV devices are recommended for use with what type of infusion therapy?
- Power injectable catheters are made of?
Answers: - Contralateral
- A
- T
- Interferes with crawling and ambulating
- Non-vesicants, >900 mOsm/L
- Polyurethane
Qs: - How much pressure are power injectable ports rated to withstand?
- Patients with known septicemia, neutropenia or thrombocytopenia may benefit from what
specific type of VAD? - IVAD is indicated for complex chemo or infusion therapy > than?
- What type of CVAD is recommended for patients with acute leukemia and other cancers and
blood and bone marrow transplants? - Who are tunneled CVADs used more frequently with?
Answers: - >300 pounds per square inch (PSI)
- PICC with antimicrobial properties
- 3 months
- Tunneled CVAD
- Infants and younger children
Qs:
- IVADs are used less frequently with pediatric population. Why?
- Chemotherapy/biotherapy: CVAD required for tx > how long, for vesicant tx > how long, or
continuous tx > than how long? - Chemo/biotherapy: A blood return is not needed prior to infusion therapy. T or F
- Why should chemotherapy lines and infusions not be interrupted if at all possible?
- What are the recommended devices for chemotherapy?
- When administering TPN, any CVAD is acceptable to use. T or F
- For infants and toddlers receiving TPN, what access devices is recommended?
Answers: - Size of patient, fear of needle, increased risk of dislodgement
- 3 months, 1 hour, 24-96 hours
- F
- Increased patient risk of infection, increased exposure risk to clinician
- Tunneled CVAD or PICC
- T
- Tunneled CVAD
Qs: - Intravenous infusion of multiple and/or simultaneous medication sand solutions may require
a multi-lumen catheter. Is if best to check for compatibilities prior to choosing the number of
lumens? - For medications such as Remodulin, or Prostacylin, what type of access device is best?
- For Stem Cell Apheresis and Plasmapheresis a large bore catheter is required for flow rates
of? - Hemodialysis devices are temporary or long term. What flow rates are required for HD?
- Aquapheresis is designated to do what?
- What devices is recommended for Aquaphoresis?
- There are multiple contraindications for placement of VAD on Ipsilateral side. Name some
potential contraindications.
Answers: - Yes
- Tunneled single lumen CVAD; PICC OK of bridge, but meds are in use for years
- 90-120 ml/min
- 350-400 ml/min
- Remove excess salt and water from body safely
- Dual lumen large bore catheter or CVAD
- AVF, CKD stage 3 or higher, axillary lymph node dissection, stenosis, burns, opening of scar
tissue
VA-BC Exam 2023/ 2024 Updated Review|
Questions and Verified Answers
Q: Which part of the vessel has the most smooth muscle?
Abian family wants everything done even though patients outcome is death what do you do?
Answer:
media
respect there cultural beliefs on death.
Q: What should you consider for Device Selection in adults?
What are the pediatric considerations?
Answer:
Patient assessment like: preference, lifestyle, willingness to preform maintenance, history,
complications, review of variables to determine correct VAD, high risk factors, advantages and
disadvantages.
limited selection, fewer veins, VAD’s preserve vessels, caregiver education, avoid scalp vad’s in
infants rolling, avoid lower extremity Vad’s for crawling patients.
Q: What are the Indications for short peripheral catheters?
Answer:
infusion for 6 days or less.
non-irritating and non-vesicant medications and solutions.
Q: What are the contraindications for short peripheral catheters?
Answer:
Placement into arm with fracture,trauma, infection, or compromised circulation.
Veins in the arm on the side of a mastectomy, breast surgery, lymph node dissection, av fistula or
graft.
Q: What are the preferred vessels for Short peripheral catheters?
Answer:
metacarpal, cephalic, basilic, accessory veins in arm.
Q: What are the insertion procedures for short peripheral catheters?
Answer:
follow guidelines, aseptic technique, 2 attempts per provider, limit of 2 providers, smallest
gauge possible to deliver therapy.
Q: What are pediatric considerations for short peripheral catheters?
Answer:
Metacarpal, cephalic, basic, scalp and saphenous veins may be used. Use imaging devices to
minimize iv attempts and secure with approved devices.
Q: What are the indications for MIDLINE catheters?
Answer:
infusion for 6 days to 4 weeks.
Non-irritating and Non-vesicant medications or solutions.
Q: What are the contraindications for a MIDLINE?
Answer:
Placement in arm with fracture, trauma, infection, AV fistula, or compromised circulation.
Chronic kidney disease patients.
Q: What is the vessel selection for Midline?
Answer:
Basilic or cephalic vein in antecubital fossa
Q: What is the insertion procedures for MIDLINE?
Answer:
Follow guidelines, sterile technique, max sterile barrier precautions, 2 attempts per provider,
PICC for midline risks liability as its against midline DFU.
Q: What are the supplies and the optimal tip location for MIDLINE?
Answer:
Midline device, sterile insertion tray, ultrasound, normal saline flush, dressing supplies.
One inch below the axillary area.
Q: What are the Pediatric considerations for MIDLINE?
Answer:
alternative vein selection like the scalp, popliteal, and saphenous veins.
Q: What are the indications and Contraindications for Non-Tunneled Catheters?
Answer:
Short term and emergency central vein access.
neck and chest sites excluded for trach patients, neck dissection, cervical fracture, or unstable
airway. unable to position, insert, or stabilize catheter. Avoid same side as PICC.
Q: What is the vessel selection for Non-tunneled catheters?
Answer:
Jugular, Subclavian, or femoral veins