NURS 5355 FINAL EXAM QUESTIONS & ANSWERS
Seldinger technique - Answers -A medical procedure performed during central line
placement to obtain access to blood vessels and other hollow organs. Example for
inserting a catheter: a needle is used to puncture the structure and a guide wire is
threaded through the needle; when the needle is withdrawn, a catheter is threaded over
the wire; the wire is then withdrawn, leaving the catheter in place.
Modified Seldinger Technique - Answers -sheath over the needle technique
Allen's Test performed? - Answers -prior to radial arterial line placement; Doppler eval in
high risk patients
right IJ central line placement? - Answers -shorter in length- 16cm versus 20cm
central lines sit in? - Answers -SVC, except femoral is in IVC
triple lumen size? - Answers -7Fr, 15-20cm length
resuscitation or dialysis catheter size? - Answers -11.5Fr, 20cm length
jugular vein ? to common carotid artery? - Answers -lateral
femoral vein ? to femoral artery? - Answers -medial (venous penis)
carotid sheath? - Answers -IJ vein, carotid artery, and vagus nerve
NAVEL? - Answers -nerve, artery, vein, empty space, and lymphatics
apply constant negative pressure when? - Answers -inserting needle for CVC
placement
cover open port during CVC placement to prevent? - Answers -air embolization
CI to CVC placement? - Answers -No absolutes; Relative:coagulopathy &
thrombocytopenia- plt <50, INR >1.5, PTT >50
preferred subclavian vein approach? - Answers -infraclavicular
IJ risk? - Answers -arterial cannulation
SC risk? - Answers -pneumo/hemo
Femoral risk? - Answers -infection/thrombosis
site for emergent lines? - Answers -Femoral artery and vein
, common and less severe complications of ALine placement? - Answers -temporary
occlusion due to arterial spasm, hematoma, and bleeding
RICE or pressure to treat
zero ALine to? - Answers -midaxillary line, 4th intercostal space, Phlebostatic axis
Most common PAL placement complication? - Answers -Thrombosis
lung disease determine by ? A-a gradient? - Answers -increased; difficulty getting O2
from alveoli to the blood
A-a gradient normal? - Answers -reduced alveolar ventilation/hypoventilation
measurement of O2 dissolved in the blood? - Answers -PaO2
O2 attached to hemoglobin molecules? - Answers -oximeter- O2
elevated carboxyhemoglobin? - Answers -CO poisoning
<pO2 60 & <O280%, oxyhemoglobin saturation curve? - Answers -steep, large changes
in oximetry mean small changes in oxygenation
Increased PaCO2? - Answers -reduced alveolar ventilation
vein blood flow? - Answers -dark nonpulsatile flow- unless hemodynamic compromise
pleura insensitive to pain? - Answers -visceral pleura
neurovascular bundle (intercostal vein, artery, and nerve) runs? - Answers -along
inferior borders of the ribs; anterior supplied by internal thoracic artery from subclavian
artery & posterior supplied by aorta
pleural effusion causes dyspnea due to? - Answers -lung being unable to fully expand
criteria to distinguish transudate from exudate? - Answers -Light's criteria- 1 or more are
met
position for thoracentesis in stable patient? - Answers -Upright, leaning over table; 5-
10cm lateral to spine at midscapular line
posterior thoracentesis should not be below? rib due to diaphragm or abdominal injury?
- Answers -9th rib
needle gauges for thoracentesis:
SQ anesthesia?
Seldinger technique - Answers -A medical procedure performed during central line
placement to obtain access to blood vessels and other hollow organs. Example for
inserting a catheter: a needle is used to puncture the structure and a guide wire is
threaded through the needle; when the needle is withdrawn, a catheter is threaded over
the wire; the wire is then withdrawn, leaving the catheter in place.
Modified Seldinger Technique - Answers -sheath over the needle technique
Allen's Test performed? - Answers -prior to radial arterial line placement; Doppler eval in
high risk patients
right IJ central line placement? - Answers -shorter in length- 16cm versus 20cm
central lines sit in? - Answers -SVC, except femoral is in IVC
triple lumen size? - Answers -7Fr, 15-20cm length
resuscitation or dialysis catheter size? - Answers -11.5Fr, 20cm length
jugular vein ? to common carotid artery? - Answers -lateral
femoral vein ? to femoral artery? - Answers -medial (venous penis)
carotid sheath? - Answers -IJ vein, carotid artery, and vagus nerve
NAVEL? - Answers -nerve, artery, vein, empty space, and lymphatics
apply constant negative pressure when? - Answers -inserting needle for CVC
placement
cover open port during CVC placement to prevent? - Answers -air embolization
CI to CVC placement? - Answers -No absolutes; Relative:coagulopathy &
thrombocytopenia- plt <50, INR >1.5, PTT >50
preferred subclavian vein approach? - Answers -infraclavicular
IJ risk? - Answers -arterial cannulation
SC risk? - Answers -pneumo/hemo
Femoral risk? - Answers -infection/thrombosis
site for emergent lines? - Answers -Femoral artery and vein
, common and less severe complications of ALine placement? - Answers -temporary
occlusion due to arterial spasm, hematoma, and bleeding
RICE or pressure to treat
zero ALine to? - Answers -midaxillary line, 4th intercostal space, Phlebostatic axis
Most common PAL placement complication? - Answers -Thrombosis
lung disease determine by ? A-a gradient? - Answers -increased; difficulty getting O2
from alveoli to the blood
A-a gradient normal? - Answers -reduced alveolar ventilation/hypoventilation
measurement of O2 dissolved in the blood? - Answers -PaO2
O2 attached to hemoglobin molecules? - Answers -oximeter- O2
elevated carboxyhemoglobin? - Answers -CO poisoning
<pO2 60 & <O280%, oxyhemoglobin saturation curve? - Answers -steep, large changes
in oximetry mean small changes in oxygenation
Increased PaCO2? - Answers -reduced alveolar ventilation
vein blood flow? - Answers -dark nonpulsatile flow- unless hemodynamic compromise
pleura insensitive to pain? - Answers -visceral pleura
neurovascular bundle (intercostal vein, artery, and nerve) runs? - Answers -along
inferior borders of the ribs; anterior supplied by internal thoracic artery from subclavian
artery & posterior supplied by aorta
pleural effusion causes dyspnea due to? - Answers -lung being unable to fully expand
criteria to distinguish transudate from exudate? - Answers -Light's criteria- 1 or more are
met
position for thoracentesis in stable patient? - Answers -Upright, leaning over table; 5-
10cm lateral to spine at midscapular line
posterior thoracentesis should not be below? rib due to diaphragm or abdominal injury?
- Answers -9th rib
needle gauges for thoracentesis:
SQ anesthesia?
