VABC Exam UPDATED ACTUAL Exam
Questions and CORRECT Answers
Patient Education - CORRECT ANSWER - - Provide education to patient and caregiver
related to the vascular access device, medication or infusate, plan of care, potential complications
and how to address problems during therapy
-Includes hands on training for use, care, maintenance tops, print outs, flipcharts and device
models
-Should be at the appropriate level for the learner and involve teach back comprehension
Organizations related to patient safety are - CORRECT ANSWER - ▪ National patient
safety goals and speak up campaign from the joint commission
▪ Oley foundation-patient advocacy group specific to enteral and parenteral nutrition
▪ CDC patient education online materials
▪ Safe care campaign
▪ AHRQ PS net
▪ Institute for healthcare improvement
Cognitively impaired - CORRECT ANSWER - - The decision making ability of a person
under the influence of drugs, alcohol or anesthetic is determined by the persons ability to
understand information, decisional capacity and voluntarism.
- These individuals cannot consent for a procedure
- Verify patient, caregiver and family health care literacy.
Mental illness - CORRECT ANSWER - - The decision making ability of a person with a
____ is determined by the persons ability to understand information, decisional capacity and
voluntarism
- Made on case by case basis
,- Formal psych eval or consult may be needed as part of the consent process
Limited language proficiency - CORRECT ANSWER - - Language barriers can create
disparities in the informed consent process
- Professional interpreters are necessary
- Could be a phone or video remote technology
- Patients friends or family should not be used
Religious and cultural differences - CORRECT ANSWER - - Individuals sometimes
decline medical care for themselves based on religious beliefs
- Clinicians need to be sensitive to patients culture and should attempt to make collaborative
decisions including the patient whenever possible
Vulnerable populations - CORRECT ANSWER - ▪ Leave people at risk for skewed power
dynamics in interpersonal relationships creating an environment prone to coercion
● Pediatric patients, aging population, prison population, behavioral/mentally challenged
● Assess for medical power of attorney, advanced directives or living will prior to making any
medical decisions on behalf of a mentally incompetent or vulnerable person
Children population - CORRECT ANSWER - - parents or legal guardian provide informed
consent
- use developmentally and age appropriate teaching
- Ethical review and legal intervention may be required in instances in which parents or legal
guardian refuse treatment in life threatening situations
Informed consent prior to CVAD placement - CORRECT ANSWER - ▪ May be limited in
emergent situation possible involving a legally authorized representative
▪ Selection of the most appropriate vascular access device occurs as a collaborative process
among the team
▪ Patient preference must also be considered but has not been considered a high priority when
selecting
,patient education to CVAD placement - CORRECT ANSWER - ● Patients and caregivers
must possess basic knowledge about their catheter, how to check for complications, what to do
and whom to contact when problems arise and how to protect the line during ADLS
● Teach CVAD flushing and locking, site care and dressing changes depending on type of CVAD
● PICC site care and dressing changes consider the risks of outward catheter migration and
dislodgement when the dressing and stabilization device are removed or replaced. Routine site
care may be provided in an outpatient setting or by home care nurse
Recommendations for informed consent include - CORRECT ANSWER - ● Provide
educational materials and a consent form at an educational level between the 4th and 6th grade
● Use medical interpreter for non English speaking patients
● Use appropriate resources for those with visual or hearing deficits
● Allow adequate time and opportunity for questions and answers
● Use most appropriate method to deliver the information such as verbal, information, written
handouts, video and online sources
● Validate understanding by teach back and clarify information as needed
● Collaborate with provider who is inserting catheter if confusion
consent - CORRECT ANSWER - - freely given, pt is capable of comprehending and
understanding treatment/procedure, education includes risks, benefits and alternatives
- represented by patients signature and documented
What size syringe to use for flushing central line - CORRECT ANSWER - 10ml or larger
to minimize pressure on a catheter while checking for blood return and initial flush
- after patency has been verified the use of smaller syringe sizes for medication delivery is
acceptable
how often to change securement devices - CORRECT ANSWER - with dressing change
unless sutured in (every 7 days)
, how often to change Transparent semipermeable membrane (TSM) polyurethane dressing -
CORRECT ANSWER - every 7 days or when clinically indicated
how often to change gauze dressings - CORRECT ANSWER - every 2 days or when
clinically indicated
how often to change needleless connectors - CORRECT ANSWER - changed with every
dressing change or with IV tubing if continuously connected by no more often than 96 hours
cardiac arrhythmia causes - CORRECT ANSWER - - catheter or wire annoying cardiac
conduction
- post insertion due to migration of catheter
cardiac arrhythmia prevention - CORRECT ANSWER - ● Ensure optimal tip position
using tip location technology or CXR
● Careful measurement and documentation of external anatomic landmarks
● Adequate stabilization and proper dressing management
● Daily assessment of VAD and pt condition regularly comparing current external catheter length
to the time of insertion
● Pts with cardiac conditions or post MI are sensitive to wire and catheters. If arrhythmia occurs
consider left sided insertion where there is a bit more length to insert wire before reaching
sensitive areas of the heart
cardiac arrhythmia symptoms - CORRECT ANSWER - - palpitations
- rapid heart pounding
- irregular heart rhythm (tachy, PVCs, ventricular tachy)
cardiac arrhythmia treatment - CORRECT ANSWER - - if catheter is tunneled or
implanted refer to IR
- retract any catheter CXR has indicated is in the right atrium if arrhythmias are being
experienced
Questions and CORRECT Answers
Patient Education - CORRECT ANSWER - - Provide education to patient and caregiver
related to the vascular access device, medication or infusate, plan of care, potential complications
and how to address problems during therapy
-Includes hands on training for use, care, maintenance tops, print outs, flipcharts and device
models
-Should be at the appropriate level for the learner and involve teach back comprehension
Organizations related to patient safety are - CORRECT ANSWER - ▪ National patient
safety goals and speak up campaign from the joint commission
▪ Oley foundation-patient advocacy group specific to enteral and parenteral nutrition
▪ CDC patient education online materials
▪ Safe care campaign
▪ AHRQ PS net
▪ Institute for healthcare improvement
Cognitively impaired - CORRECT ANSWER - - The decision making ability of a person
under the influence of drugs, alcohol or anesthetic is determined by the persons ability to
understand information, decisional capacity and voluntarism.
- These individuals cannot consent for a procedure
- Verify patient, caregiver and family health care literacy.
Mental illness - CORRECT ANSWER - - The decision making ability of a person with a
____ is determined by the persons ability to understand information, decisional capacity and
voluntarism
- Made on case by case basis
,- Formal psych eval or consult may be needed as part of the consent process
Limited language proficiency - CORRECT ANSWER - - Language barriers can create
disparities in the informed consent process
- Professional interpreters are necessary
- Could be a phone or video remote technology
- Patients friends or family should not be used
Religious and cultural differences - CORRECT ANSWER - - Individuals sometimes
decline medical care for themselves based on religious beliefs
- Clinicians need to be sensitive to patients culture and should attempt to make collaborative
decisions including the patient whenever possible
Vulnerable populations - CORRECT ANSWER - ▪ Leave people at risk for skewed power
dynamics in interpersonal relationships creating an environment prone to coercion
● Pediatric patients, aging population, prison population, behavioral/mentally challenged
● Assess for medical power of attorney, advanced directives or living will prior to making any
medical decisions on behalf of a mentally incompetent or vulnerable person
Children population - CORRECT ANSWER - - parents or legal guardian provide informed
consent
- use developmentally and age appropriate teaching
- Ethical review and legal intervention may be required in instances in which parents or legal
guardian refuse treatment in life threatening situations
Informed consent prior to CVAD placement - CORRECT ANSWER - ▪ May be limited in
emergent situation possible involving a legally authorized representative
▪ Selection of the most appropriate vascular access device occurs as a collaborative process
among the team
▪ Patient preference must also be considered but has not been considered a high priority when
selecting
,patient education to CVAD placement - CORRECT ANSWER - ● Patients and caregivers
must possess basic knowledge about their catheter, how to check for complications, what to do
and whom to contact when problems arise and how to protect the line during ADLS
● Teach CVAD flushing and locking, site care and dressing changes depending on type of CVAD
● PICC site care and dressing changes consider the risks of outward catheter migration and
dislodgement when the dressing and stabilization device are removed or replaced. Routine site
care may be provided in an outpatient setting or by home care nurse
Recommendations for informed consent include - CORRECT ANSWER - ● Provide
educational materials and a consent form at an educational level between the 4th and 6th grade
● Use medical interpreter for non English speaking patients
● Use appropriate resources for those with visual or hearing deficits
● Allow adequate time and opportunity for questions and answers
● Use most appropriate method to deliver the information such as verbal, information, written
handouts, video and online sources
● Validate understanding by teach back and clarify information as needed
● Collaborate with provider who is inserting catheter if confusion
consent - CORRECT ANSWER - - freely given, pt is capable of comprehending and
understanding treatment/procedure, education includes risks, benefits and alternatives
- represented by patients signature and documented
What size syringe to use for flushing central line - CORRECT ANSWER - 10ml or larger
to minimize pressure on a catheter while checking for blood return and initial flush
- after patency has been verified the use of smaller syringe sizes for medication delivery is
acceptable
how often to change securement devices - CORRECT ANSWER - with dressing change
unless sutured in (every 7 days)
, how often to change Transparent semipermeable membrane (TSM) polyurethane dressing -
CORRECT ANSWER - every 7 days or when clinically indicated
how often to change gauze dressings - CORRECT ANSWER - every 2 days or when
clinically indicated
how often to change needleless connectors - CORRECT ANSWER - changed with every
dressing change or with IV tubing if continuously connected by no more often than 96 hours
cardiac arrhythmia causes - CORRECT ANSWER - - catheter or wire annoying cardiac
conduction
- post insertion due to migration of catheter
cardiac arrhythmia prevention - CORRECT ANSWER - ● Ensure optimal tip position
using tip location technology or CXR
● Careful measurement and documentation of external anatomic landmarks
● Adequate stabilization and proper dressing management
● Daily assessment of VAD and pt condition regularly comparing current external catheter length
to the time of insertion
● Pts with cardiac conditions or post MI are sensitive to wire and catheters. If arrhythmia occurs
consider left sided insertion where there is a bit more length to insert wire before reaching
sensitive areas of the heart
cardiac arrhythmia symptoms - CORRECT ANSWER - - palpitations
- rapid heart pounding
- irregular heart rhythm (tachy, PVCs, ventricular tachy)
cardiac arrhythmia treatment - CORRECT ANSWER - - if catheter is tunneled or
implanted refer to IR
- retract any catheter CXR has indicated is in the right atrium if arrhythmias are being
experienced
