Question 1

Why is it necessary to flush peripheral IVs and central venous catheters (CVCs)?

Accepted Answer

It is necessary to flush peripheral IVs and central venous catheters (CVCs) to maintain patency of the catheter and prevent mixing of medications. Flushing also prevents blood clots from forming and reduces the risk of infection. In addition, flushing prevents hemolysis of the sample, which could lead to inaccurate laboratory results. Therefore, both options A and B are correct.

Question 2

Peripheral venous catheters are placed into the:

Accepted Answer

Peripheral venous catheters are placed into peripheral veins, which are veins located outside of the central circulation (e.g. the arms, legs, hands, and feet). The superior vena cava and inferior vena cava are large veins that carry blood directly to the heart and are not accessed with peripheral venous catheters. The radial artery is an artery and not a vein, and is also not accessed with peripheral venous catheters.

Question 3

When a central venous catheter (CVC) is present:

Accepted Answer

Blood is drawn and discarded before the sample is collected to clear the line of any residual fluids or medications that could contaminate the sample.

Question 4

When blood is collected from an IV line:

Accepted Answer

Noting that blood was collected from an IV line on the requisition form is important for accurate interpretation of lab results, as IV fluids can dilute blood samples and affect test outcomes.

Question 5

The central venous catheter (CVC) that is surgically placed by a physician for long-term drug therapies is:

Accepted Answer

The answer of The central venous catheter (CVC) that is...

Question 6

Blood drawn for a blood culture from a central venous catheters (CVC):

Accepted Answer

Blood drawn for a blood culture from a CVC is important and must be collected first to detect any potential infections related to the CVC. It can help detect infection of the catheter tip. It is also often compared with results drawn from a peripheral vein to help determine if the infection is localized to the CVC or if it has spread into the bloodstream. Therefore, all of the above choices are correct.

Question 7

Central venous catheters (CVCs) are inserted into the:

Accepted Answer

Central venous catheters are inserted into the superior vena cava, which is the largest vein in the upper body and is located near the heart. The basilic vein, radial artery, and brachial artery are not appropriate locations for a central venous catheter.

Question 8

20 mL of blood must be discarded or used for other tests before drawing blood for:

Accepted Answer

For coagulation tests, the first 20 mL of blood is often discarded to avoid contamination with tissue thromboplastin, which can affect test results.

Question 9

Sterile gloves are required when:

Accepted Answer

Sterile gloves are required when inserting a peripherally inserted central catheter (PICC) and when inserting a peripheral IV. However, when collecting blood from a central venous catheter (CVC), clean gloves are sufficient unless the CVC is newly placed or the dressing has been recently changed.

Question 10

When collecting a blood culture,complete blood count (CBC),and prothrombin time (PT) from a central venous catheter (CVC),how many syringes must be used?

Accepted Answer

When collecting blood cultures, CBC, and PT from a CVC, it is recommended to use three different syringes to prevent contamination and ensure accurate results. One syringe for blood culture, one for CBC, and one for PT. Using the same syringe can lead to contamination of the specimen, affecting the accuracy of the test results. Therefore, using three separate syringes is the best practice.

Question 11

Which central venous catheter (CVC) is inserted through a peripheral vein into the superior vena cava by specially trained nurses?

Accepted Answer

Peripherally inserted central catheter (PICC) is the only central venous catheter that is inserted through a peripheral vein into the superior vena cava by specially trained nurses. Implanted ports, Hickman catheters, and Groshong catheters are all inserted through surgical or percutaneous insertion.

Question 12

When drawing blood from a central venous catheter (CVC):

Accepted Answer

The first 5 mL of blood is always discarded when drawing blood from a CVC to ensure that the sample being collected is not contaminated with any residual heparin or medications that may be present in the catheter or tubing. A syringe larger than 20 mL or a double- or triple-lumen catheter may or may not be necessary depending on the patient's specific situation, but this is not a universal requirement for drawing blood from a CVC. He-parin may be used to maintain patency of the catheter, but it is not always necessary to inject heparin prior to drawing blood from a CVC.

Question 13

Peripheral access devices include peripheral IV lines and midline peripheral catheters.

Accepted Answer

Peripheral access devices can include both peripheral IV lines and midline peripheral catheters.

Question 14

When inserting a peripheral IV catheter,the line should be flushed after the blood is collected.

Accepted Answer

The answer of When inserting a peripheral IV catheter,the line...

Question 15

Blood sample collection from a peripheral vascular access device:

Accepted Answer

Blood sample collection from a peripheral vascular access device may be required at any time during the patient's treatment, not just at the time of insertion. It is often collected prior to the administration of medications to ensure that the correct dose is given. This process typically involves the use of syringes and a transfer device to ensure proper collection and storage of the sample. Therefore, the correct answer is option D, all of the above.

Question 16

Central venous catheters (CVCs) are threaded into the superior vena cava.

Accepted Answer

Central venous catheters (CVCs) are typically inserted through a vein in the neck or chest and are threaded into the superior vena cava which is a large vein that carries deoxygenated blood from the upper body to the heart.

Question 17

When collecting blood for laboratory tests from a central venous catheter (CVC) that is infusing total parenteral nutrition (TPN) or heparin,it must be flushed with:

Accepted Answer

The answer of When collecting blood for laboratory tests from...

Question 18

A Hickman is a tunneled catheter.

Accepted Answer

A Hickman is a type of tunneled catheter used for long-term intravenous access. It is typically inserted into a large vein in the chest and tunneled under the skin to an exit site on the chest wall. It is commonly used for chemotherapy, total parenteral nutrition (TPN), and other long-term infusion therapies.

Question 19

The most common all-purpose peripheral IV catheter is:

Accepted Answer

The 20-gauge catheter is the most common all-purpose peripheral IV catheter. It is easy to access, has relatively low risk of complications, and can accommodate a variety of medications and fluids. While larger gauges (14 and 16) may be necessary for certain situations, they are more invasive and can cause more discomfort for the patient. A 24-gauge catheter may be too small for certain medications and may be difficult to use in patients with particularly fragile veins.

Question 20

Which of the following is classified as a tunneled catheter?

Accepted Answer

All of the above (Broviac, Hickman, and Groshong) are classified as tunneled catheters.

Quiz 8: Blood Collection From Vascular Access Devices

Why is it necessary to flush peripheral IVs and central venous catheters (CVCs) ?