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 separate lumens (or 'pigtails'), which is the defining characteristic of a triple-lumen catheter.
- It is a type of non-tunneled percutaneous central venous catheter, used for short-term access (less than 14 days).
- The presence of suture wings for stabilization and the absence of a Dacron cuff confirm its identity as a non-tunneled CVC.
- These catheters are inserted into large central veins like the internal jugular, subclavian, or femoral vein.
- The multiple lumens allow for simultaneous infusion of incompatible medications, fluid resuscitation, and hemodynamic monitoring.
Why Other Options Were Wrong
- Option A: A Hickman catheter is a tunneled catheter, meaning it is surgically placed under the skin and has a Dacron cuff to promote tissue ingrowth and prevent infection. The device in the image lacks this cuff.
- Option C: A Peripherally Inserted Central Catheter (PICC) is inserted into a vein in the arm (e.g., basilic or cephalic vein) and threaded to the superior vena cava. The catheter shown is designed for direct insertion into a central vein in the neck or chest.
- Option D: This is a broad category. While the device is a central venous catheter, the term 'Tunnelled' is incorrect. Tunneled catheters are placed in a subcutaneous tunnel and have a cuff for long-term use. The device shown is a non-tunneled catheter.
Related Visual
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 as background academic context rather than a clinical decision trigger.
- Nurses must know the specific uses for each lumen (distal, medial, proximal) to prevent medication incompatibilities and ensure accurate CVP readings. The distal port is typically used for CVP monitoring as it has the largest gauge and is furthest inside the vein.
- Strict aseptic technique is critical during insertion, dressing changes, and accessing the ports to prevent Central Line-Associated Bloodstream Infections (CLABSIs), a major complication.
- Patient safety requires confirming catheter tip placement via X-ray before initiating any infusions.
How to Approach the Question
- First, carefully examine the image for key identifying features of the medical device.
- Note the number of lumens (three), the presence of suture wings, and the absence of a fabric cuff.
- Consider the term 'Triple lumen catheter'. This directly describes the most obvious feature of the device.
- Evaluate the other options. 'Hickman' and 'Tunnelled' catheters both imply a long-term device with a cuff, which is not seen here.
- 'Peripherally inserted' refers to the insertion site (the arm), which is inconsistent with the design of this central line hub.
- Conclude that 'Triple lumen catheter' is the most accurate and specific identification based on the visual evidence.
Concept Tested & Keywords
- Concept Tested: Identification of central venous access devices.
- Stem keywords: Identify, image
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Clinical cues: Image of a catheter with three distinct lumens and color-coded ports.
Question ID
Q2xB9TwefIAF5QJyMuW0VV
Reference Book
E6 Nursing Fundamentals Taylor p. 796-798
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 105-107
Practise the full NORCET 8 Prelims-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Fluid and Electrolytes: Balance and Distribution Questions
- All are crystalloid solution; except:
- ECG of the patient is showing ST depression, Prominent U wave and inverted T wave. Which of the electrolyte imbalance present?
- A patient reports calcium loss. What is the nursing intervention?
- The principle of hemodialysis in which the water is moving under high pressure to an area of lower pressure is:
- Measurement of arterial blood gas shows pH: 7.2, PaCO2 : 70 mm Hg, HCO3: 27 mmol/L and PaO2: 59 mm Hg. Interpret this:
- Fluid volume deficit or hypovolemia describes the loss of
- 100 mL fluid is given to patient and patient's CVP is 3 mm Hg, then what is the next intervention?
- A patient presents to the emergency department with a serum pH of 7.25, pCO2 of 40 mmHg, HCO3 of 22 mEq/L, sodium of 150 mEq/L, and chloride of 100 m…
- A 65-year-old patient is admitted to the hospital with a serum sodium level of 132 mmol/L. Despite being asymptomatic at admission, the patient begin…
- How would you most accurately assess fluid volume status in a patient with 20% total body surface area (TBSA) burns?
More NORCET 8 Prelims-2025 Questions
- What is the most common reaction to blood transfusion?
- A 9-year-old child with nephrotic syndrome is on corticosteroid therapy. What should be the first priority in the assessment?
- A male adult patient diagnosed with COPD shows signs of hypoxia without hypercapnia and shortness of breath. This condition is best classified as?
- A nurse is preparing to administer digoxin to an adult patient. The apical pulse is 54/min. What should the nurse do?
- Which abnormal ECG wave is seen in a patient with hypothermia?
- While teaching a nursing officer to a patient about slow deep breathing. Which of the following indicates that the technique is being performed corre…
- A 3-week-old infant presents with persistent vomiting and a palpable olive-shaped mass in the upper abdomen. Which electrolyte imbalances may be seen…
- In a 72 kg patient, lorazepam is prescribed at 40 mcg/kg/min to be administered within 15 minutes. The available concentration is 2 mg/mL. How many m…
- Choose the correctly spelt word.
- Fill in the blank with the appropriate preposition: She was annoyed \ \ \ \ \ \ his rude nature.