Advanced Central Vascular Access Devices
(CVAD) questions and correct answers
updated 2026
A patient is to begin chemotherapy and there is discussion regarding placement of a CVAD.
Which statement requires correction? - --CORRECT ANSWER----An implanted venous port and a
percutaneous CVAD require surgical placement.
In caring for the patient with a central vascular access device, the nurse must continuously
assess for complications. - --CORRECT ANSWER----1. Air embolism: Dyspnea, chest pain
2. Thrombosis: Pain in neck, shoulder, or ear of affected side
3. Catheter migration: Complaints of gurgling sounds
4. Occlusion: Absent blood return, inability to infuse IV solution
Midline catheter. - --CORRECT ANSWER----Usually shorter than a PICC line.
Percutaneous central vascular access device. - --CORRECT ANSWER----Inserted directly through
the skin into a large vein.
PICC line. - --CORRECT ANSWER----Usually located in the antecubital fossa.
Rationale & Interventions - --CORRECT ANSWER----The nurse should wear a mask; follow
agency protocol regarding whether the patient is masked. If patient is not masked, have patient
turn head in opposite direction of catheter insertion site. This prevents spread of airborne
microorganisms over the vascular access site.The placement or exit site is cleaned with CHG
solution by using friction in a back-and-forth motion for 30 seconds. Performing skin antisepsis
reduces the incidence of catheter-related infections. Chlorhexidine must be dry to be effective
in reducing microbial count. The upper-arm circumference of a peripherally inserted central
catheter (PICC) line or midline catheter will provide information regarding potential thrombus
formation. An arm measurement with a 3-cm increase can indicate thrombosis. The dressing
should be labeled with the date, time, and initials of the person performing the procedure. This
provides a means to determine when the next dressing change is due.
, The nurse is changing the dressing over a triple-lumen CVAD and assesses the exit site. Which
observation would be cause for concern and should be reported to the health care provider? - -
-CORRECT ANSWER----Patient afebrile; redness and tenderness at exit site
The nurse is going to change the dressing on a patient's peripherally inserted central catheter
(PICC) line when the nurse notices that the patient's arm appears swollen and is cool to the
touch. The patient has been receiving IV parenteral nutrition through the PICC line. The patient
states that the IV infusion pump has been "beeping" a lot, so he kept pushing the "silence"
button on the pump. The nurse suspects extravasation. What actions should the nurse take?
Select all that apply. - --CORRECT ANSWER-----Stop the IV infusion.
-Notify the health care provider.
-Administer appropriate antidote per protocol.
The nurse is going to start a continuous infusion on a patient who has a central vascular access
device. The nurse is unable to flush the catheter. What actions should the nurse take? Select all
that apply. - --CORRECT ANSWER-----Have the patient cough and deep breathe.
-Reposition the patient.
-Attempt to aspirate and flush again; if unsuccessful, notify health care provider.
-Make sure the tubing is kink free or unclamped.
The nurse is performing a dressing change for a central vascular access device (CVAD). The
nurse performs hand hygiene and applies clean gloves and a mask. The nurse removes the old
dressing with the nondominant hand pulling in an upward direction, noting drainage and
appearance of insertion site. The nurse inspects the catheter and hub for intactness, removes
clean gloves, and performs hand hygiene. The nurse opens the dressing kit and applies clean
gloves. The nurse cleans the exit site with chlorhexidine gluconate (CHG) swabs using friction in
a back-and-forth motion and applies a transparent dressing. The nurse labels the dressing with
date, time of dressing change, and initials. The nurse disposes of soiled supplies, removes
gloves, performs hand hygiene, and documents the procedure. Which of the following actions
made by the nurse require correction? Select all that apply. - --CORRECT ANSWER-----The type
of gloves worn to apply the new dressing.
-The method the nurse used to remove the old dressing.
-The time between swabbing the site and application of dressing.
(CVAD) questions and correct answers
updated 2026
A patient is to begin chemotherapy and there is discussion regarding placement of a CVAD.
Which statement requires correction? - --CORRECT ANSWER----An implanted venous port and a
percutaneous CVAD require surgical placement.
In caring for the patient with a central vascular access device, the nurse must continuously
assess for complications. - --CORRECT ANSWER----1. Air embolism: Dyspnea, chest pain
2. Thrombosis: Pain in neck, shoulder, or ear of affected side
3. Catheter migration: Complaints of gurgling sounds
4. Occlusion: Absent blood return, inability to infuse IV solution
Midline catheter. - --CORRECT ANSWER----Usually shorter than a PICC line.
Percutaneous central vascular access device. - --CORRECT ANSWER----Inserted directly through
the skin into a large vein.
PICC line. - --CORRECT ANSWER----Usually located in the antecubital fossa.
Rationale & Interventions - --CORRECT ANSWER----The nurse should wear a mask; follow
agency protocol regarding whether the patient is masked. If patient is not masked, have patient
turn head in opposite direction of catheter insertion site. This prevents spread of airborne
microorganisms over the vascular access site.The placement or exit site is cleaned with CHG
solution by using friction in a back-and-forth motion for 30 seconds. Performing skin antisepsis
reduces the incidence of catheter-related infections. Chlorhexidine must be dry to be effective
in reducing microbial count. The upper-arm circumference of a peripherally inserted central
catheter (PICC) line or midline catheter will provide information regarding potential thrombus
formation. An arm measurement with a 3-cm increase can indicate thrombosis. The dressing
should be labeled with the date, time, and initials of the person performing the procedure. This
provides a means to determine when the next dressing change is due.
, The nurse is changing the dressing over a triple-lumen CVAD and assesses the exit site. Which
observation would be cause for concern and should be reported to the health care provider? - -
-CORRECT ANSWER----Patient afebrile; redness and tenderness at exit site
The nurse is going to change the dressing on a patient's peripherally inserted central catheter
(PICC) line when the nurse notices that the patient's arm appears swollen and is cool to the
touch. The patient has been receiving IV parenteral nutrition through the PICC line. The patient
states that the IV infusion pump has been "beeping" a lot, so he kept pushing the "silence"
button on the pump. The nurse suspects extravasation. What actions should the nurse take?
Select all that apply. - --CORRECT ANSWER-----Stop the IV infusion.
-Notify the health care provider.
-Administer appropriate antidote per protocol.
The nurse is going to start a continuous infusion on a patient who has a central vascular access
device. The nurse is unable to flush the catheter. What actions should the nurse take? Select all
that apply. - --CORRECT ANSWER-----Have the patient cough and deep breathe.
-Reposition the patient.
-Attempt to aspirate and flush again; if unsuccessful, notify health care provider.
-Make sure the tubing is kink free or unclamped.
The nurse is performing a dressing change for a central vascular access device (CVAD). The
nurse performs hand hygiene and applies clean gloves and a mask. The nurse removes the old
dressing with the nondominant hand pulling in an upward direction, noting drainage and
appearance of insertion site. The nurse inspects the catheter and hub for intactness, removes
clean gloves, and performs hand hygiene. The nurse opens the dressing kit and applies clean
gloves. The nurse cleans the exit site with chlorhexidine gluconate (CHG) swabs using friction in
a back-and-forth motion and applies a transparent dressing. The nurse labels the dressing with
date, time of dressing change, and initials. The nurse disposes of soiled supplies, removes
gloves, performs hand hygiene, and documents the procedure. Which of the following actions
made by the nurse require correction? Select all that apply. - --CORRECT ANSWER-----The type
of gloves worn to apply the new dressing.
-The method the nurse used to remove the old dressing.
-The time between swabbing the site and application of dressing.
