VA-BC CERTIFICATION / VA-BC EXAMS / VA-BC
STUDY GUIDE ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED A+
What is the French Scale? - ANSWER>>>Measurement of the outside size
(diameter) of a catheter
What is the range of Central venous catheter French sizes? -
ANSWER>>>1.2fr for Neonates up to 15fr for dialysis catheters
As the French size increases, what does the diameter of the catheter do? -
ANSWER>>>It increases
What is the gauge scale? - ANSWER>>>Measurement of the outside
size(diameter) of a catheter
As the gauge number gets larger, what happens to the catheter size? -
ANSWER>>>It gets smaller.
What is the gauge range of IV catheters? - ANSWER>>>24ga to 12 ga
Why are all I.V. devices manufactured in the USA are required to be
radiopaque? - ANSWER>>>To facilitate location of catheter emboli in the
event of shearing or fracture
From what two materials are IV catheters made? - ANSWER>>>Silicone
and Polyurethane
Which catheter material can be affected by alcohol? -
ANSWER>>>Polyurethane
What are the indications for short peripheral catheters? - ANSWER>>>-
Infusions projected for 6 days or less
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
,What are contraindications for short peripheral catheters? - ANSWER>>>-
Placement into an arm with fracture, trauma, infection, or compromised
circulation
-Veins in the arm on the same side of a mastectomy, breast surgery or
lymph node dissection
-Veins in the arm with an A/V fistula or graft
What veins are used for short peripheral catheters? -
ANSWER>>>Metacarpal, cephalic, basilic and accessory veins of the arms
How many short peripheral catheter insertion attempts per healthcare
provider are allowed? - ANSWER>>>2
What additional veins in pediatrics may be used for non-irritating/non-
vesicant infusions? - ANSWER>>>Metacarpal, cephalic or basilic, scalp
veins if <18mo
What are the indications for a midline catheter? - ANSWER>>>-Infusions
projected for 6 days- 4 weeks
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
What are contraindications for a midline? - ANSWER>>>-Arms with: A/V
fistula, infection, fracture, trauma, or compromised circulation
-Chronic Kidney Disease
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
What product should be used for a midline placement? - ANSWER>>>A
product that is specifically designed and labeled as a peripheral midline
catheter
What barrier precautions should be considered for midline placement? -
ANSWER>>>Maximun sterile barrer
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.
What is optimal tip location for a midline catheter? - ANSWER>>>One inch
below the axillary area
For midline placement, what alternative veins can be considered in
pediatric patients? - ANSWER>>>Scalp veins
Popliteal veins
Saphenous veins
What are the indications for non-tunneled catheters? - ANSWER>>>Short
term central vein access
Emergency central vein access
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
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)
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
What type of barrier precautions are required for non-tunneled catheter
placement? - ANSWER>>>Maximun sterile
How should a patient be positioned for non-tunneled catheter placement? -
ANSWER>>>slight Trendelenburg position
, 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
In non-tunneled catheter or PICC placement., what should always be
avoided when accessing veins? - ANSWER>>>Blind-stick attempts.
Prior to any infusion of non-tunneled catheters, how should tip location be
confirmed? - ANSWER>>>ECG technology or radiograph
What must be obtained prior to ANY infusion of a non-tunneled catheter or
a PICC line? - ANSWER>>>A free flowing blood return
What is the optimal tip location for a non-tunneled and PICC catheters? -
ANSWER>>>Cavoatrial juncture (CAJ)
If inserted through the femoral vein, what the optimal tip location for a non-
tunneled and PICC catheters? - ANSWER>>>Inferior vena cava (IVC)
above the level of the diaphragm
Why is the femoral vein is commonly used in pediatric critical care units for
non-tunneled catheter placement? - ANSWER>>>Due to ease of insertion
in young patients
Why may the jugular vein be the preferred point of insertion in very young
children for non-tunneled catheters? - ANSWER>>>To avoid a
pneumothorax
What are the indications for placement of a PICC line? - ANSWER>>>-
Patients who require central venous access when the duration of the
infusions are unknown
-Infusion of irritating medications
-Infusion of vesicant agents
What are the contraindications of PICC line placement? - ANSWER>>>-
Placement into an arm with fracture, trauma, infection, amputations, or
compromised circulation
STUDY GUIDE ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |ALREADY GRADED A+
What is the French Scale? - ANSWER>>>Measurement of the outside size
(diameter) of a catheter
What is the range of Central venous catheter French sizes? -
ANSWER>>>1.2fr for Neonates up to 15fr for dialysis catheters
As the French size increases, what does the diameter of the catheter do? -
ANSWER>>>It increases
What is the gauge scale? - ANSWER>>>Measurement of the outside
size(diameter) of a catheter
As the gauge number gets larger, what happens to the catheter size? -
ANSWER>>>It gets smaller.
What is the gauge range of IV catheters? - ANSWER>>>24ga to 12 ga
Why are all I.V. devices manufactured in the USA are required to be
radiopaque? - ANSWER>>>To facilitate location of catheter emboli in the
event of shearing or fracture
From what two materials are IV catheters made? - ANSWER>>>Silicone
and Polyurethane
Which catheter material can be affected by alcohol? -
ANSWER>>>Polyurethane
What are the indications for short peripheral catheters? - ANSWER>>>-
Infusions projected for 6 days or less
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
,What are contraindications for short peripheral catheters? - ANSWER>>>-
Placement into an arm with fracture, trauma, infection, or compromised
circulation
-Veins in the arm on the same side of a mastectomy, breast surgery or
lymph node dissection
-Veins in the arm with an A/V fistula or graft
What veins are used for short peripheral catheters? -
ANSWER>>>Metacarpal, cephalic, basilic and accessory veins of the arms
How many short peripheral catheter insertion attempts per healthcare
provider are allowed? - ANSWER>>>2
What additional veins in pediatrics may be used for non-irritating/non-
vesicant infusions? - ANSWER>>>Metacarpal, cephalic or basilic, scalp
veins if <18mo
What are the indications for a midline catheter? - ANSWER>>>-Infusions
projected for 6 days- 4 weeks
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
What are contraindications for a midline? - ANSWER>>>-Arms with: A/V
fistula, infection, fracture, trauma, or compromised circulation
-Chronic Kidney Disease
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
What product should be used for a midline placement? - ANSWER>>>A
product that is specifically designed and labeled as a peripheral midline
catheter
What barrier precautions should be considered for midline placement? -
ANSWER>>>Maximun sterile barrer
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.
What is optimal tip location for a midline catheter? - ANSWER>>>One inch
below the axillary area
For midline placement, what alternative veins can be considered in
pediatric patients? - ANSWER>>>Scalp veins
Popliteal veins
Saphenous veins
What are the indications for non-tunneled catheters? - ANSWER>>>Short
term central vein access
Emergency central vein access
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
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)
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
What type of barrier precautions are required for non-tunneled catheter
placement? - ANSWER>>>Maximun sterile
How should a patient be positioned for non-tunneled catheter placement? -
ANSWER>>>slight Trendelenburg position
, 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
In non-tunneled catheter or PICC placement., what should always be
avoided when accessing veins? - ANSWER>>>Blind-stick attempts.
Prior to any infusion of non-tunneled catheters, how should tip location be
confirmed? - ANSWER>>>ECG technology or radiograph
What must be obtained prior to ANY infusion of a non-tunneled catheter or
a PICC line? - ANSWER>>>A free flowing blood return
What is the optimal tip location for a non-tunneled and PICC catheters? -
ANSWER>>>Cavoatrial juncture (CAJ)
If inserted through the femoral vein, what the optimal tip location for a non-
tunneled and PICC catheters? - ANSWER>>>Inferior vena cava (IVC)
above the level of the diaphragm
Why is the femoral vein is commonly used in pediatric critical care units for
non-tunneled catheter placement? - ANSWER>>>Due to ease of insertion
in young patients
Why may the jugular vein be the preferred point of insertion in very young
children for non-tunneled catheters? - ANSWER>>>To avoid a
pneumothorax
What are the indications for placement of a PICC line? - ANSWER>>>-
Patients who require central venous access when the duration of the
infusions are unknown
-Infusion of irritating medications
-Infusion of vesicant agents
What are the contraindications of PICC line placement? - ANSWER>>>-
Placement into an arm with fracture, trauma, infection, amputations, or
compromised circulation
