VACC test Format | Course Contents | Course Outline | test Syllabus | test Objectives
DOMAIN CATEGORY I: Clinical Knowledge and Application
A. Device Assessment and Selection
1. Central venous access devices
2. Peripheral intravenous devices
3. Dialysis, apheresis and aquapheresis catheters
4. Intraosseous devices
5. Arterial catheters
6. Pulmonary artery catheters
7. Device characteristics (e.g., single versus multi-lumen devices, optimal insertion and tip location)
B. Patient Assessment
1. Vascular pathology (e.g., impact of disease processes on vascular access)
2. Device selection (e.g., infusion therapy, alternative to IV placement, vesicants and osmolality)
3. Patient specific characteristics (e.g., compromised skin integrity, product reaction) and resources to maintain vascular access devices
4. Imaging technology (e.g., ultrasound, transillumination, fluoroscopy / venogram, chest x-ray)
C. Preparation
1. Infection prevention procedures, concepts and principles (e.g., sterile field, aseptic non-touch technique [ANTT], common pathogens)
2. Anatomy and physiology
3. Growth and development implications
DOMAIN CATEGORY I (continued): Clinical Knowledge and Application
D. Insertion
1. Vascular access device and insertion components
2. Insertion techniques (e.g., Modified Seldinger)
3. Flushing and locking solutions / procedures
4. Imaging technology (e.g., ultrasound, infra-red, transillumination)
5. Laboratory values relevant to device placement and maintenance
6. Tip location and confirmation systems
7. Engineered securement devices
8. Complications and emergency interventions (e.g., inadvertent arterial puncture, pneumothorax, catheter tip malposition, nerve injury)
E. Care and Maintenance of Vascular Access
1. Insertion / exit site assessment
2. Lumen patency and catheter clearance (e.g., flushing protocol, occlusion therapy)
3. Infusion equipment and add-on supplies (e.g., needleless connector)
4. Dressing change procedure
5. Patient / caregiver education
6. Care plan throughout the healthcare continuum (e.g., catheter insertion information, care and maintenance instructions, patient restrictions)
7. Vascular access device removal (e.g., removal length of PICC, removal complications, patient tolerance of removal procedure)
F. Troubleshooting, Complications, and Interventions
1. Post-insertion risks and complications (e.g., extravasation, thrombosis, infection, catheter tip migration, occlusion, nerve damage, phlebitis)
2. Pharmacologic interventions (e.g., catheter clearance, antibiotic lock, ethanol lock, extravasation treatment)
3. Catheter repair / exchange
4. Other complications (e.g., central vein occlusion, internal fracture, compromised skin integrity)
DOMAIN CATEGORY II: Interpersonal and Communication Skills
A. Interpersonal Communication
1. Communication with patient / caregiver (e.g., risks, benefits and alternatives; device care; infection prevention)
2. Communication with patient / caregiver with additional needs (e.g., developmental/ cognitive deficit, psychosocial concerns)
3. Cultural competency (e.g., cultural and religious differences, family involvement, language barrier)
4. Collaboration with patient's care team
B. Mentoring and education
1. Educational / staff development opportunities (e.g., quality improvement, hospital committees, early assessment for vessel preservation)
2. Infection control measures and techniques
DOMAIN CATEGORY III: Professional Development
A. Evidence-based Practice and Continuing Education
1. Evidence-based practice guidelines (e.g., AVA, INS, MAGIC, KDOQI, ACCP, SHEA)
2. Process improvement initiatives and outcome evaluation (e.g., implementation of new techniques and / or products)
3. Professional practice and development (e.g., seminars, webinars, conferences, certification)
4. Critical analysis of published research (e.g., research methodologies)
DOMAIN CATEGORY IV: Legal and Ethical Considerations
A. Legal Considerations
1. Professional codes of conduct, professional guidelines, scope of practice and standards of care
2. Legal principles in the practice of vascular access (e.g., consent, liability, HIPAA)
3. Documentation requirements
4. Manufacturer's guidelines for product use (e.g., Instructions for Use [IFUs], expiration dates, off-label use)
B. Ethical Considerations
1. Patient advocacy (e.g., patient preferences, end of life care)
2. Reporting requirements (e.g., MAUDE database, Joint Commission [JC], state health department)
3. Fiscal responsibility (e.g., accurate recording of charges, use of supplies and equipment, use of time)
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Question: 734
In the context of vascular access, "thrombosis" refers to .
1. Infection at the catheter site
amage to the vein during insertion atheter dislodgement
wer: B
anation: Thrombosis refers to the formation of a blood clot within the eter, which can obstruct blood flow and lead to complications.
stion: 735
ording to the INS guidelines, the maximum duration for using a periph atheter without replacement is ________.
hours hours
The formation of a blood clot within the catheter
2. D
3. C
Ans Expl
cath
Que
Acc eral
IV c
1. 24
2. 48
3. 72 to 96 hours
4. 1 week Answer: C
Explanation: The INS recommends that peripheral IV catheters can remain in place for 72 to 96 hours, provided there are no complications.
Question: 736
Which of the following devices is specifically designed for use in emergency situations?
unneled catheter eripheral IV catheter traosseous device ICC line
wer: C
anation: Intraosseous devices are primarily used in emergencies when venous access is difficult or impossible, providing rapid access to the ular system.
stion: 737
is the appropriate action if a central venous catheter becomes occlud ttempt to flush the catheter
T
P
In
P
Ans Expl
intra vasc
Que
What ed?
1. A
2. Remove the catheter immediately
3. Administer thrombolytics
4. Use a larger syringe for flushing Answer: A
Question: 738
The use of a hemostatic dressing post-insertion is primarily to .
rovide warmth bsorb drainage
romote clotting and reduce bleeding revent infection
wer: C
anation: Hemostatic dressings are designed to promote clotting and mize bleeding at the catheter insertion site.
stion: 739
is the significance of tracking catheter dwell times in vascular access agement?
indicates staffing needs
P
A
P
P
Ans Expl
mini
Que
What man
1. It
2. It helps identify trends in complications
3. It is unnecessary for patient care
4. It simplifies documentation processes Answer: B
Question: 740
uration of catheter placement
atient's request to remove the catheter gns of infection or complications atient's favorite activities
wer: A, C
anation: The duration of catheter placement and the presence of signs tion or complications are critical factors in determining the need for eter removal.
stion: 741
ch of the following is a potential complication of catheter tip malpositi
Which two factors are essential in the decision-making process for catheter removal?
1. D
2. P
3. Si
4. P
Ans
Expl of
infec cath
Que
Whi on?
1. Phlebitis
2. Cardiac arrhythmias
3. Hematoma
4. Thrombosis Answer: B
Explanation: Catheter tip malposition can irritate the heart or major vessels, potentially leading to cardiac arrhythmias.
Question: 742
ular access practitioners?
etworking opportunities creased administrative duties andatory attendance
imited educational content wer: A
anation: Professional conferences provide valuable networking rtunities, allowing practitioners to share knowledge and learn from ea
stion: 743
nt education regarding catheter care should emphasize which two poi
Which of the following is a critical aspect of professional conferences for vasc
1. N
2. In
3. M
4. L
Ans Expl
oppo ch
other.
Que
Patie nts?
1. Signs of infection to monitor
2. The ability to shower with the catheter
3. How to secure the catheter
4. Avoiding all physical activity
Explanation: Educating patients on signs of infection and how to secure the catheter is crucial for preventing complications and ensuring proper care.
Question: 744
does the term "asepsis" refer to in the context of medical procedures
he presence of pathogens
he absence of pathogenic microorganisms he use of antibiotics
he placement of catheters wer: B
anation: Asepsis refers to the absence of pathogenic microorganisms, h is essential in preventing infections during medical procedures.
stion: 745
ch vascular access device is least likely to be associated with infection
What ?
1. T
2. T
3. T
4. T
Ans Expl
whic
Que
Whi risk?
1. Peripheral IV
2. Tunneled central catheter
3. PICC line
4. Non-tunneled central catheter
Explanation: Tunneled central catheters have a lower infection risk due to their design, which reduces skin flora exposure compared to other devices.
Question: 746
effec
1. To
2. To
3. To
4. To
Ans
When collaborating with a patient’s care team, what is the primary goa tive communication?
assign blame for complications
ensure all team members are informed and aligned expedite the discharge process
prioritize the physician’s directives wer: B
anation: Effective communication fosters teamwork and ensures that a bers are informed and aligned in patient care.
stion: 747
is the recommended dwell time for a peripheral intravenous catheter
l of
Expl ll
mem
Que
What in an
adult patient?
1. 24 hours
2. 72-96 hours
3. 1 week
4. 2 weeks
Explanation: The recommended dwell time for a peripheral IV catheter in adults is typically 72-96 hours, depending on the site and condition of the catheter.
stion: 748
ch of the following is a sign of potential nerve injury during catheter tion?
ocalized swelling
ersistent pain or tingling in the extremities ever
edness around the insertion site wer: B
anation: Persistent pain or tingling in the extremities indicates potenti injury during catheter insertion.
stion: 749
Que
Whi inser
1. L
2. P
3. F
4. R
Ans
Expl al
nerve
Que
What is the primary goal of infection control measures during central line insertion?
1. To minimize costs
2. To enhance patient comfort
3. To prevent catheter-related bloodstream infections
Answer: C
Explanation: The primary goal is to prevent catheter-related bloodstream infections through strict adherence to aseptic techniques during insertion.
stion: 750
is the most appropriate method for confirming the placement of a ce us catheter?
uscultation of breath sounds hest X-ray
isual inspection of insertion site hecking for blood return
wer: B
anation: A chest X-ray is the gold standard for confirming the correct ement of a central venous catheter to ensure it is not in the lungs.
Que
What ntral
veno
1. A
2. C
3. V
4. C
Ans Expl
plac
Question: 751
The "5 Moments of Hand Hygiene" concept highlights the importance of
.
1. Wearing gloves
2. Using hand sanitizers
3. Specific times for hand hygiene to prevent infection
4. Relying on non-touch techniques only Answer: C
stion: 752
atient with a known allergy to chlorhexidine, which antiseptic should ded for vascular access site preparation?
ovidone-iodine lcohol
ydrogen peroxide aline
wer: A
anation: Povidone-iodine can cause allergic reactions in patients with e allergies, making it unsuitable for skin preparation.
Explanation: The "5 Moments of Hand Hygiene" emphasizes critical moments when hand hygiene is necessary to prevent infection.
Que
In a p be
avoi
1. P
2. A
3. H
4. S
Ans Expl
iodin
Question: 753
What is the most appropriate way to handle a patient who experiences discomfort during the catheter removal process?
1. Ignore the discomfort
2. Explain the procedure and reassure the patient
3. Rush the removal process
4. Discontinue the removal immediately Answer: B
stion: 754
ch pathogen is commonly associated with infections in patients with anted devices?
treptococcus pneumoniae nterobacter cloacae aphylococcus epidermidis scherichia coli
wer: C
anation: Staphylococcus epidermidis is a coagulase-negative hylococcus that frequently causes infections in patients with implanted ces due to its ability to adhere and form biofilms.
Explanation: Providing reassurance and explanation helps alleviate patient anxiety and discomfort during the procedure.
Que
Whi impl
1. S
2. E
3. St
4. E
Ans Expl
stap devi
Question: 755
What is the primary concern when managing a patient with a pulmonary artery catheter?
1. Insertion site infection
2. Cardiac arrhythmias
3. Fluid overload
anation: Monitoring for cardiac arrhythmias is critical when managin nt with a pulmonary artery catheter due to the risk of complications d eter placement.
Catheter occlusion Answer: B
Expl g a
patie uring
cath
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