CLINICAL NURSING SKILLS TECHNIQUES
TENTH EDITION ACTUAL CERTIFICATION
ASSESSMENT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
⩥ The nurse is flushing the implanted port of a client's central venous
access device (CVAD) and meets resistance. What should the nurse do
next?
Ask the client to perform a Valsalva maneuver and place the client's arm
below the heart.
Change the position of the client and lower the head of the bed.
Notify the health care provider immediately.
Check that the clamp is open, gently push down on needle, and attempt
to flush again. Answer: Check that the clamp is open, gently push down
on needle, and attempt to flush again.
Rational: The nurse should first check the clamp to ensure that it is open,
and then gently push down on the needle and attempt to flush again. If
this does not work, the nurse could ask the client to perform a Valsalva
maneuver, change the position, or place the affected arm over the head.
The nurse could also lower or raise the head of the bed. If the port still
does not flush, the needle should be removed and a new needle inserted.
If the port does not flush this time, the health care provider should be
notified.
,⩥ The nurse is accessing the implanted port of a client's central venous
access device (CVAD) to administer medications. After holding the port
stable, the nurse should insert the needle into which location?
right side of the port
left side of the port
top of the port
center of the port Answer: center of the port
Rationale: The nurse should visualize the center of the port and insert
the needle through the skin into the port septum, located in the center of
the port, until the needle hits the back of the port. To function properly,
the needle must be in the middle of the port and inserted to the back wall
of the port.
⩥ The nurse is flushing the implanted port of a client's central venous
access device (CVAD) and meets resistance. The nurse verifies that the
clamp is open, pushes down on the needle, and, after attempting another
flush, meets continued resistance. What should the nurse do next?
Flush the port with heparin.
Notify the health care provider.
Change the access needle.
Ask the client to perform a Valsalva maneuver Answer: Ask the client to
perform a Valsalva maneuver.
,Rationale: If resistance is met when flushing a client's implanted port,
the nurse should first verify the clamp is open, push down on the needle,
and attempt to flush again. If continued resistance is met, the nurse
should ask the client to perform a Valsalva maneuver, change positions,
or place the affected arm over the head. The access needle would not be
changed until other remedies have been attempted. Flushing the port
with heparin may prevent a port from clotting but will not resolve a clot.
The health care provider should be notified after all remedies have been
attempted; the health care provider may give a prescription for a clot-
dissolving agent.
⩥ The nurse is unable to flush the implanted port of a client's central
venous access device (CVAD), despite repeated efforts at repositioning
the client. Which action by the nurse is most appropriate?
Place the client's arm below the level of the heart and attempt to flush
the port.
Re-access the port with a new needle, according to facility policy.
Contact the health care provider for further prescription.
Increase pressure used, gradually, while flushing until the problem
resolves. Answer: Re-access the port with a new needle, according to
facility policy.
Rationale: If resistance is met when flushing the client's implanted port
and the nurse has attempted all remedies including changing client
position, the nurse should re-access the port with a new needle and
attempt to flush again, according to facility policy. After the port has
been re-accessed and the nurse is still unable to flush the port, the nurse
, should contact the health care provider for a further prescription. Placing
the client's arm below the level of the heart will not remedy the problem.
Increasing pressure or "forcing" the flush may result in damage to the
port and should not be attempted.
⩥ A nurse is administering blood products to a client via an implanted
port central venous access device (CVAD). What technique should the
nurse use to locate the site of the port?
Auscultation
Observation
Percussion
palpation Answer: palpation
Rationale: The nurse should put on clean gloves and palpate the location
of the port. Because the port is implanted, observation alone should not
locate the site. Percussion and auscultation would not be effective,
because there are no associated sounds that should enable the nurse to
locate the port.
⩥ After accessing the implanted port of a client's central venous access
device (CVAD), what action does the nurse take to prevent air
embolism?
Clamp the extension tubing
Start the intravenous infusion
Flush the extension tubing with normal saline
TENTH EDITION ACTUAL CERTIFICATION
ASSESSMENT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
⩥ The nurse is flushing the implanted port of a client's central venous
access device (CVAD) and meets resistance. What should the nurse do
next?
Ask the client to perform a Valsalva maneuver and place the client's arm
below the heart.
Change the position of the client and lower the head of the bed.
Notify the health care provider immediately.
Check that the clamp is open, gently push down on needle, and attempt
to flush again. Answer: Check that the clamp is open, gently push down
on needle, and attempt to flush again.
Rational: The nurse should first check the clamp to ensure that it is open,
and then gently push down on the needle and attempt to flush again. If
this does not work, the nurse could ask the client to perform a Valsalva
maneuver, change the position, or place the affected arm over the head.
The nurse could also lower or raise the head of the bed. If the port still
does not flush, the needle should be removed and a new needle inserted.
If the port does not flush this time, the health care provider should be
notified.
,⩥ The nurse is accessing the implanted port of a client's central venous
access device (CVAD) to administer medications. After holding the port
stable, the nurse should insert the needle into which location?
right side of the port
left side of the port
top of the port
center of the port Answer: center of the port
Rationale: The nurse should visualize the center of the port and insert
the needle through the skin into the port septum, located in the center of
the port, until the needle hits the back of the port. To function properly,
the needle must be in the middle of the port and inserted to the back wall
of the port.
⩥ The nurse is flushing the implanted port of a client's central venous
access device (CVAD) and meets resistance. The nurse verifies that the
clamp is open, pushes down on the needle, and, after attempting another
flush, meets continued resistance. What should the nurse do next?
Flush the port with heparin.
Notify the health care provider.
Change the access needle.
Ask the client to perform a Valsalva maneuver Answer: Ask the client to
perform a Valsalva maneuver.
,Rationale: If resistance is met when flushing a client's implanted port,
the nurse should first verify the clamp is open, push down on the needle,
and attempt to flush again. If continued resistance is met, the nurse
should ask the client to perform a Valsalva maneuver, change positions,
or place the affected arm over the head. The access needle would not be
changed until other remedies have been attempted. Flushing the port
with heparin may prevent a port from clotting but will not resolve a clot.
The health care provider should be notified after all remedies have been
attempted; the health care provider may give a prescription for a clot-
dissolving agent.
⩥ The nurse is unable to flush the implanted port of a client's central
venous access device (CVAD), despite repeated efforts at repositioning
the client. Which action by the nurse is most appropriate?
Place the client's arm below the level of the heart and attempt to flush
the port.
Re-access the port with a new needle, according to facility policy.
Contact the health care provider for further prescription.
Increase pressure used, gradually, while flushing until the problem
resolves. Answer: Re-access the port with a new needle, according to
facility policy.
Rationale: If resistance is met when flushing the client's implanted port
and the nurse has attempted all remedies including changing client
position, the nurse should re-access the port with a new needle and
attempt to flush again, according to facility policy. After the port has
been re-accessed and the nurse is still unable to flush the port, the nurse
, should contact the health care provider for a further prescription. Placing
the client's arm below the level of the heart will not remedy the problem.
Increasing pressure or "forcing" the flush may result in damage to the
port and should not be attempted.
⩥ A nurse is administering blood products to a client via an implanted
port central venous access device (CVAD). What technique should the
nurse use to locate the site of the port?
Auscultation
Observation
Percussion
palpation Answer: palpation
Rationale: The nurse should put on clean gloves and palpate the location
of the port. Because the port is implanted, observation alone should not
locate the site. Percussion and auscultation would not be effective,
because there are no associated sounds that should enable the nurse to
locate the port.
⩥ After accessing the implanted port of a client's central venous access
device (CVAD), what action does the nurse take to prevent air
embolism?
Clamp the extension tubing
Start the intravenous infusion
Flush the extension tubing with normal saline
