Caringfor CVAD Exam

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Sample questions from Caringfor CVAD Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client on a medical unit has a tunneled central venous access device (CVAD) for chemotherapy. The nurse notes a temperature of 38.6 C (101.5 F), chills, heart rate 112/min, and blood pressure 96/58 mm Hg during an infusion. What is the nurse's priority action?

   • A.Stop the infusion and notify the provider while maintaining access for evaluation
   • B.Flush the CVAD with saline to determine whether it is patent
   • C.Remove the CVAD immediately and send the tip for culture
   • D.Give acetaminophen and reassess the temperature in 1 hour

   Rationale: The client may have a catheter-related bloodstream infection with early hemodynamic instability, so stop the infusion and promptly escalate care while preserving the line for assessment and cultures as ordered. Flushing may worsen a problem and does not evaluate infection; the nurse should not independently remove the device. Acetaminophen and delayed reassessment could mask symptoms and postpone treatment.

2. 2.A 54-year-old client on a surgical unit has a newly inserted PICC for prolonged antibiotics. The client reports sudden shortness of breath and chest pain; oxygen saturation is 88%, heart rate is 124/min, and the PICC dressing is intact. What should the nurse do first?

   • A.Stop the infusion, apply oxygen, and activate the rapid response system
   • B.Flush the PICC briskly with saline
   • C.Place the client flat and ask the client to cough
   • D.Remove the PICC and apply pressure to the site

   Rationale: Sudden dyspnea, chest pain, tachycardia, and hypoxemia may indicate a serious embolic or cardiopulmonary event; stopping the infusion and supporting oxygenation while activating urgent help is the priority. Flushing could worsen an obstruction or dislodge material, and coughing or positioning alone is inadequate. Removing a PICC without assessment and an order is not the first response.

3. 3.A 72-year-old client on a medical unit has a non-tunneled CVAD with a transparent dressing that is damp at one edge. The client is afebrile, with a heart rate of 82/min and blood pressure of 128/74 mm Hg. What should the nurse do?

   • A.Replace the dressing using sterile technique
   • B.Reinforce the damp edge with additional tape
   • C.Wait until the scheduled dressing change tomorrow
   • D.Clean the exposed edge with alcohol and leave the dressing in place

   Rationale: A damp, loose, or soiled CVAD dressing compromises the sterile barrier and should be replaced promptly using the organization's aseptic procedure. Reinforcing it or waiting leaves the insertion site inadequately protected. Cleaning only the visible edge does not restore the integrity of the dressing.

4. 4.A 46-year-old client with a PICC is receiving an intermittent medication on an oncology unit. The nurse notices that the needleless connector is disconnected from the extension tubing; the client is stable with oxygen saturation 98% and blood pressure 122/76 mm Hg. What is the best immediate action?

   • A.Clamp the catheter promptly, then replace the connector using aseptic technique
   • B.Reconnect the existing connector after wiping it with an alcohol pad
   • C.Flush the open catheter with saline to clear air
   • D.Leave the catheter unclamped and call the provider before taking action

   Answer and rationale are in the full material.

5. 5.A 63-year-old client with a multilumen CVAD is receiving a continuous vasopressor through one lumen in the intensive care unit. A second lumen is available for a prescribed blood draw; blood pressure is 104/62 mm Hg on the infusion. Which action is best?

   • A.Use the available lumen according to policy without interrupting the vasopressor
   • B.Stop the vasopressor and draw blood from its lumen
   • C.Draw blood from the vasopressor lumen while the infusion continues
   • D.Ask unlicensed assistive personnel to draw blood from the available lumen

   Answer and rationale are in the full material.