NORCET 8 Prelims-2025
Medical & Surgical Nursing
Easy
Identify the following image.
Appeared in: NORCET 8 Prelims-2025
Explanation
- The image clearly shows a catheter with three distinct ports, or lumens, which is the defining characteristic of a triple-lumen catheter.
- This design allows for the simultaneous administration of multiple, often incompatible, medications or fluids through separate channels into a large central vein.
- It is a type of non-tunneled central venous catheter, typically used for short-term (less than 14 days) intravenous therapy in critically ill patients.
Why Other Options Were Wrong
- Option A: A Hickman catheter is a tunneled catheter, meaning it has a Dacron cuff that is placed under the skin to anchor it and reduce infection risk. The device in the image lacks this cuff and is a non-tunneled catheter.
- Option C: A Peripherally Inserted Central Catheter (PICC) is inserted into a vein in the arm (like the basilic or cephalic vein), not a central vein in the neck or chest. PICC lines are also significantly longer.
- Option D: This is a broad category. While a triple-lumen catheter is a central venous catheter, the device in the image is specifically a non-tunneled type. It lacks the subcutaneous tunnel and cuff that are characteristic of tunneled catheters.
Related Visual
- Visual 1: Diagram - A comparative chart showing a non-tunneled (Triple Lumen), tunneled (Hickman), peripherally inserted (PICC), and implanted port (Port-a-Cath). The diagram should highlight the different insertion sites, presence/absence of a cuff, and whether the device is internal or external.
- Visual 2: Infographic - An infographic detailing the three lumens of a triple-lumen catheter, with color-coding (Brown/Distal, Blue/Medial, White/Proximal) and arrows pointing to their common uses (CVP, TPN, Meds, Blood draws).
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of central venous access devices (CVADs) as background academic context rather than a clinical decision trigger.
- Correctly identifying the type of central line and the function of each lumen is a critical nursing responsibility to ensure patient safety and prevent medication errors or line complications.
- Nurses must follow strict aseptic technique during insertion, care, and maintenance to prevent Central Line-Associated Bloodstream Infections (CLABSIs), a serious and potentially fatal complication.
- The distal (brown) port is the largest and exits at the tip of the catheter, making it the only port suitable for measuring Central Venous Pressure (CVP).
How to Approach the Question
- This is an image-based identification question. The primary task is to match visual evidence to medical knowledge.
- First, carefully observe the key features of the device in the image. Ask yourself: How many access points (lumens) are visible? Is there a cuff? What is its likely insertion site based on its design?
- The most obvious feature is the three distinct 'pigtails' or lumens. This immediately points towards 'Triple lumen catheter'.
- Next, evaluate the other options. A 'Hickman' or 'tunneled' catheter would have a cuff. A 'PICC' would be inserted in the arm. The device in the image has none of these features.
- By systematically analyzing the visual evidence and eliminating incorrect options based on their defining characteristics, you can confidently arrive at the correct answer.
Concept Tested & Keywords
- Concept Tested: Identification of central venous access devices (CVADs)
- Stem keywords: Identify, image
- Lead-in keywords: Identify
- Negative lead-in flag: false
Question ID
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Attempt every question from this paper in a timed mock, then review the full solution for each one.
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