Central Venous Catheter Insertion: Assisting - CE/NCPD

The practitioner has just placed a catheter into the patient's internal jugular vein. Which order should the nurse anticipate to confirm catheter placement? A) Obtain a portable chest radiograph B) Evaluate the tip of the catheter using ultrasonography C) Review the CVP waveforms D) Assess the catheter for a blood return

A) Obtain a portable chest radiograph

As the CVC is inserted, the nurse observes a decrease in the patient's respiratory status, hypotension, and jugular venous distention. The nurse suspects that the patient has developed which complication? A) Tension pneumothorax B) An arterial puncture C) A hematoma D) A hemothorax

A) Tension pneumothorax

A nurse is teaching a new nurse what the CVP waveforms mean. Which statement indicates that the new nurse understands what the a, c, or v waves indicate? A) The a wave reflects right atrial contraction B) The c wave reflects right atrial filling during ventricular systole C) The v wave reflects closure of the tricuspid valve D) The c wave reflects right atrial contraction

A) The a wave reflects right atrial contraction

The patient reports dizziness and has a blood pressure of 85/68 mm Hg. A CVC is inserted and the patient's initial CVP is 2 mm Hg. Which order should the nurse anticipate receiving from the practitioner to correct this situation? A) Administer a diuretic B) Start an inotropic infusion C) Administer IV fluids D) Keep the patient on bed rest

C) Administer IV fluids

Which position decreases the risk of an air embolism during CVC insertion into the internal jugular vein? A) Left lateral position B) Semi-Fowler position C) Slight Trendelenburg position D) High Fowler position

C) Slight Trendelenburg position

While assisting with CVC placement, the nurse observes arrhythmias on the monitor but they resolve after the procedure. Which situation is the most probable cause of the arrhythmias? A) The patient's potassium is high B) The patient's potassium is low C) The guidewire was advanced too far into the right atrium D) The guidewire was not advanced far enough into the right atrium

C) The guidewire was advanced too far into the right atrium

When preparing a patient before a CVC insertion, the nurse should perform which intervention? A) Place the patient in a high Fowler position B) Withhold sedatives and analgesics for 12 hours before the procedure C) Allow the patient nothing by mouth for 6 hours before the procedure D) Gently cleanse the skin around the insertion site with an appropriate antiseptic

D) Gently cleanse the skin around the insertion site with an appropriate antiseptic

After CVC placement, the patient reports chest pain. Signs and symptoms of respiratory distress are evident, including decreased breath sounds upon auscultation and resonance to percussion. A chest x-ray is performed. Which condition is the most likely complication? A) Hydrothorax B) Hemothorax C) Catheter embolism D) Pneumothorax

D) Pneumothorax

A patient with acute heart failure has a CVC placed to obtain which information? A) Cardiac output B) Cardiac index C) Pulmonary artery occlusion pressure D) Right ventricular preload

D) Right ventricular preload

Which statement by the patient indicates the need for further education about the CVC insertion procedure? A) I must lie still during the procedure B) I should let the nurse know if I feel wetness around the insertion site C) During the procedure, the sterile drape may cover my face D) The catheter will be removed and reinserted in a new site every 2 days

D) The catheter will be removed and reinserted in a new site every 2 days