VA-BC CERTIFICATION EXAM QUESTIONS AND CORRECT
ANSWERS|ACCURATE ACTUAL EXAM WITH FREQUENTLY
TESTED QUESTIONS AND STUDY GUIDE| GUARANTEED
PASS|ALREADY GRADED A+|LATEST UPDATE 2024/2025.
What are contraindications for a midline? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER A product that is
specifically designed and labeled as a peripheral midline catheter
What barrier precautions should be considered for midline placement? - CORRECT ANSWER
Maximun sterile barrer
Why should a PICC device NOT be used for midline placement? - CORRECT 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? - CORRECT ANSWER One inch below the
axillary area
For midline placement, what alternative veins can be considered in pediatric patients? -
CORRECT ANSWER Scalp veins
Popliteal veins
Saphenous veins
What are the indications for non-tunneled catheters? - CORRECT ANSWER Short term central
vein access
Emergency central vein access
What are the contraindications for non-tunneled catheters? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER Anti-microbial
catheters
What type of barrier precautions are required for non-tunneled catheter placement? - CORRECT
ANSWER Maximun sterile
How should a patient be positioned for non-tunneled catheter placement? - CORRECT
ANSWER slight Trendelenburg position
Why is a patient placed in slight Trendelenburg position for non-tunneled catheter placement? -
CORRECT 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? - CORRECT ANSWER Blind-stick attempts.
Prior to any infusion of non-tunneled catheters, how should tip location be confirmed? -
CORRECT ANSWER ECG technology or radiograph
What must be obtained prior to ANY infusion of a non-tunneled catheter or a PICC line? -
CORRECT ANSWER A free flowing blood return
What is the optimal tip location for a non-tunneled and PICC catheters? - CORRECT ANSWER
Cavoatrial juncture (CAJ)
If inserted through the femoral vein, what the optimal tip location for a non-tunneled and PICC
catheters? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER To avoid a pneumothorax
What are the indications for placement of a PICC line? - CORRECT 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? - CORRECT ANSWER -Placement
into an arm with fracture, trauma, infection, amputations, or compromised circulation
-Placement into an arm paralyzed as a result of a CVA may increase the risk of catheter-related
thrombosis due to compromised circulation 4
-Chronic kidney disease patients
What vessels are selected for PICC line placement? - CORRECT ANSWER Basilic, brachial or
cephalic vein in the upper arm
What barrier precautions are required for PICC placement? - CORRECT ANSWER Maximum
sterile
What areas of tip location should be avoided in PICC line placement? - CORRECT ANSWER
Avoid catheter tip locations in the upper SVC or midclavicular areas
What Alternative veins for PICC lines may be selected in pediatric pts.? - CORRECT ANSWER
Scalp veins, popliteal veins
In pediatric patients, what, if added ,may decrease catheter occlusion? - CORRECT ANSWER
Heparin (confirm infusatn compatibility)
What are the indications for tunneled catheters? - CORRECT ANSWER -Infusions that are
projected to continue for months or years
-Apheresis
What are the contraindications for tunneled catheter placement? - CORRECT ANSWER -
Presence of a bloodstream infection
-Severe coagulopathy
-Cellulitis (affecting intended insertion site)
which vessels are selected for tunneled catheters? - CORRECT ANSWER a. Subclavian veins
b. Jugular veins
c. Femoral veins
Where might tunneled catheter exits sites be located? - CORRECT ANSWER The chest, upper
back, top of thigh, or lower torso
What attached to the catheter, will be positioned in the tissue track to secure the catheter? -
CORRECT ANSWER A stabilizing Dacron cuff
, After a tunneled catheter placement, how long until the exit site heals? - CORRECT ANSWER
Two to three weeks.
When (upon physician approval) may a tunneled catheter be maintained without a dressing? -
CORRECT ANSWER Once the cuff has developed tissue attachment and the exit site is healed,
In pediatric pts. with tunneled catheters, why do we assess/verify internal catheter tip location as
the child grows? - CORRECT ANSWER To maintain internal tip in the SVC
What are the indications for an implanted port? - CORRECT ANSWER Infusions that are
projected to continue for months to years
What are the contraindications for an implanted port? - CORRECT ANSWER -Severe
coagulopathy
-Severe, uncontrolled sepsis
-Burns or cellulitis (affecting the intended insertion site)
-Patient who is cachectic, below ideal body weight, or lacking subcutaneous tissue for port
implantation
What vessels are selected for a "peripheral" implanted port? - CORRECT ANSWER Basilic or
cephalic vein
What vessels are selected for a "central" implanted port? - CORRECT ANSWER Subclavian
vein
Jugular vein
Femoral vein
Name two things considered when placing an implanted port. - CORRECT ANSWER -Comfort
related to the location of the implanted venous port
-Depth of the implanted port must be shallow enough for the clinician to palpate and insert a
non-coring access needle safely to maintain access into the port septum
Depending on the vein accessed, where might the port implantation site be located? -
CORRECT ANSWER Port implantation site may be upper chest or lower abdominal side area
How is the port secured inside the patient? - CORRECT ANSWER Port is sutured into a
subcutaneous pocket under the skin
ANSWERS|ACCURATE ACTUAL EXAM WITH FREQUENTLY
TESTED QUESTIONS AND STUDY GUIDE| GUARANTEED
PASS|ALREADY GRADED A+|LATEST UPDATE 2024/2025.
What are contraindications for a midline? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER A product that is
specifically designed and labeled as a peripheral midline catheter
What barrier precautions should be considered for midline placement? - CORRECT ANSWER
Maximun sterile barrer
Why should a PICC device NOT be used for midline placement? - CORRECT 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? - CORRECT ANSWER One inch below the
axillary area
For midline placement, what alternative veins can be considered in pediatric patients? -
CORRECT ANSWER Scalp veins
Popliteal veins
Saphenous veins
What are the indications for non-tunneled catheters? - CORRECT ANSWER Short term central
vein access
Emergency central vein access
What are the contraindications for non-tunneled catheters? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER Anti-microbial
catheters
What type of barrier precautions are required for non-tunneled catheter placement? - CORRECT
ANSWER Maximun sterile
How should a patient be positioned for non-tunneled catheter placement? - CORRECT
ANSWER slight Trendelenburg position
Why is a patient placed in slight Trendelenburg position for non-tunneled catheter placement? -
CORRECT 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? - CORRECT ANSWER Blind-stick attempts.
Prior to any infusion of non-tunneled catheters, how should tip location be confirmed? -
CORRECT ANSWER ECG technology or radiograph
What must be obtained prior to ANY infusion of a non-tunneled catheter or a PICC line? -
CORRECT ANSWER A free flowing blood return
What is the optimal tip location for a non-tunneled and PICC catheters? - CORRECT ANSWER
Cavoatrial juncture (CAJ)
If inserted through the femoral vein, what the optimal tip location for a non-tunneled and PICC
catheters? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER To avoid a pneumothorax
What are the indications for placement of a PICC line? - CORRECT 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? - CORRECT ANSWER -Placement
into an arm with fracture, trauma, infection, amputations, or compromised circulation
-Placement into an arm paralyzed as a result of a CVA may increase the risk of catheter-related
thrombosis due to compromised circulation 4
-Chronic kidney disease patients
What vessels are selected for PICC line placement? - CORRECT ANSWER Basilic, brachial or
cephalic vein in the upper arm
What barrier precautions are required for PICC placement? - CORRECT ANSWER Maximum
sterile
What areas of tip location should be avoided in PICC line placement? - CORRECT ANSWER
Avoid catheter tip locations in the upper SVC or midclavicular areas
What Alternative veins for PICC lines may be selected in pediatric pts.? - CORRECT ANSWER
Scalp veins, popliteal veins
In pediatric patients, what, if added ,may decrease catheter occlusion? - CORRECT ANSWER
Heparin (confirm infusatn compatibility)
What are the indications for tunneled catheters? - CORRECT ANSWER -Infusions that are
projected to continue for months or years
-Apheresis
What are the contraindications for tunneled catheter placement? - CORRECT ANSWER -
Presence of a bloodstream infection
-Severe coagulopathy
-Cellulitis (affecting intended insertion site)
which vessels are selected for tunneled catheters? - CORRECT ANSWER a. Subclavian veins
b. Jugular veins
c. Femoral veins
Where might tunneled catheter exits sites be located? - CORRECT ANSWER The chest, upper
back, top of thigh, or lower torso
What attached to the catheter, will be positioned in the tissue track to secure the catheter? -
CORRECT ANSWER A stabilizing Dacron cuff
, After a tunneled catheter placement, how long until the exit site heals? - CORRECT ANSWER
Two to three weeks.
When (upon physician approval) may a tunneled catheter be maintained without a dressing? -
CORRECT ANSWER Once the cuff has developed tissue attachment and the exit site is healed,
In pediatric pts. with tunneled catheters, why do we assess/verify internal catheter tip location as
the child grows? - CORRECT ANSWER To maintain internal tip in the SVC
What are the indications for an implanted port? - CORRECT ANSWER Infusions that are
projected to continue for months to years
What are the contraindications for an implanted port? - CORRECT ANSWER -Severe
coagulopathy
-Severe, uncontrolled sepsis
-Burns or cellulitis (affecting the intended insertion site)
-Patient who is cachectic, below ideal body weight, or lacking subcutaneous tissue for port
implantation
What vessels are selected for a "peripheral" implanted port? - CORRECT ANSWER Basilic or
cephalic vein
What vessels are selected for a "central" implanted port? - CORRECT ANSWER Subclavian
vein
Jugular vein
Femoral vein
Name two things considered when placing an implanted port. - CORRECT ANSWER -Comfort
related to the location of the implanted venous port
-Depth of the implanted port must be shallow enough for the clinician to palpate and insert a
non-coring access needle safely to maintain access into the port septum
Depending on the vein accessed, where might the port implantation site be located? -
CORRECT ANSWER Port implantation site may be upper chest or lower abdominal side area
How is the port secured inside the patient? - CORRECT ANSWER Port is sutured into a
subcutaneous pocket under the skin
