CRNI Vascular Access Device Management Questions and Answers

Question 1

A patient with a peripherally inserted central catheter (PICC) in the right basilic vein reports sudden, sharp pain at the insertion site during a bolus infusion of a vesicant medication.
The nurse notes swelling and coolness to the touch proximal to the site.
Which of the following is the MOST appropriate initial nursing action?

Accepted Answer

Stop the infusion immediately and disconnect the tubing.

Answer

Slow the infusion rate and apply a warm compress.

Answer

Administer an analgesic and continue to monitor the site.

Answer

Flush the line with normal saline to check for patency.

Question 2

When selecting a vein for peripheral intravenous catheter insertion in an adult patient, which principle is most critical for preserving future vascular access?

Accepted Answer

Starting with the most distal, appropriate site in the non-dominant arm.

Answer

Choosing the most visible and easily palpable vein.

Answer

Using the patient's dominant arm for convenience.

Answer

Selecting a site in the antecubital fossa for stability.

Question 3

A nurse is unable to aspirate a blood return from a non-tunneled central venous catheter that has been infusing total parenteral nutrition (TPN) without issue. What is the most likely cause of this finding?

Accepted Answer

A fibrin sheath has formed around the catheter tip.

Answer

The catheter has migrated into the extravascular space.

Answer

The patient is severely dehydrated.

Answer

The TPN solution has clotted the entire catheter lumen.

Question 4

Which of the following is a key maintenance step for reducing the risk of a central line-associated bloodstream infection (CLABSI)?

Accepted Answer

Scrubbing the access hub vigorously for at least 5-15 seconds prior to each use.

Answer

Performing routine dressing changes every 24 hours.

Answer

Flushing all lumens with heparinized saline daily.

Answer

Administering prophylactic antibiotics before accessing the line.

Question 5

A patient with an implanted port is scheduled for a monthly infusion. Upon accessing the port with a non-coring needle, the nurse meets resistance and is unable to flush the device. Which of the following complications should the nurse suspect?

Accepted Answer

Thrombotic occlusion.

Answer

Catheter-related bloodstream infection.

Answer

Catheter migration.

Answer

Pinch-off syndrome.

Question 6

A nurse is assessing a short peripheral catheter site and notes blanching, edema, and skin that is cool to the touch around the insertion point. The IV pump is not alarming. The nurse should identify these findings as signs of what complication?

Accepted Answer

Infiltration

Answer

Phlebitis

Answer

Infection

Answer

Hematoma