Question 1

During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicates what?

Accepted Answer

A) exhalation of mainly dead space gas 
B) inspiration of fresh respiratory gas 
C) exhalation of mixed alveolar and dead space gas 
D) exhalation of mainly alveolar gas 
A) exhalation of mainly dead space gas 
B) inspiration of fresh respiratory gas 
C) exhalation of mixed alveolar and dead space gas 
D) exhalation of mainly alveolar gas B

Question 2

A physician requests that you obtain and set up an arterial line system for invasive monitoring of blood pressure. Which of the following equipment would you gather?
I.pressurized intravenous bag
II.continuous flush device
III.arterial catheter
IV.pressure transducer
V.amplifier or monitor

Accepted Answer

A) I, III, and IV 
B) II, III, IV, and V 
C) III, IV, and V 
D) I, II, III, IV, and V 
A) I, III, and IV 
B) II, III, IV, and V 
C) III, IV, and V 
D) I, II, III, IV, and V D

Question 3

If patient pain or anxiety occurs during arterial puncture, which of the following will probably occur?

Accepted Answer

A) hypoventilation 
B) hyperventilation 
C) respiratory acidosis 
D) hypoxemia 
A) hypoventilation 
B) hyperventilation 
C) respiratory acidosis 
D) hypoxemia B

Question 4

Which of the following should be monitored during the sampling of arterial blood?
I.blood pressure proximal to puncture site
II.presence of pulsatile blood return
III.presence of air bubbles or clots in sample
IV.appearance of puncture site

Accepted Answer

A) I, II, and III 
B) II, III, and IV 
C) I, II, III, and IV 
D) II and III 
A) I, II, and III 
B) II, III, and IV 
C) I, II, III, and IV 
D) II and III

Question 5

Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except:

Accepted Answer

A) mode of ventilatory support and settings 
B) time of last incentive breathing exercise 
C) FIO2 (analyzed) or prescribed flow 
D) proper application of the O2 device 
A) mode of ventilatory support and settings 
B) time of last incentive breathing exercise 
C) FIO2 (analyzed) or prescribed flow 
D) proper application of the O2 device

Question 6

A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period?
I.PCO2
II.pH
III.PO2

Accepted Answer

A) I only 
B) I and II 
C) II and III 
D) I, II, and III 
A) I only 
B) I and II 
C) II and III 
D) I, II, and III

Question 7

Before performing puncture or cannulation of the radial artery, what should you do?

Accepted Answer

A) Fix and tighten a tourniquet above the antecubital fossa. 
B) Perform the Allen test to ensure collateral circulation. 
C) Inject heparin into the adjoining subcutaneous tissues. 
D) Apply firm pressure to the arterial site for 5 minutes. 
A) Fix and tighten a tourniquet above the antecubital fossa. 
B) Perform the Allen test to ensure collateral circulation. 
C) Inject heparin into the adjoining subcutaneous tissues. 
D) Apply firm pressure to the arterial site for 5 minutes.

Question 8

All of the following will tend to cause false low readings when using a pulse oximeter except:

Accepted Answer

A) vascular dyes 
B) anemia 
C) high metHb 
D) dark nail polish 
A) vascular dyes 
B) anemia 
C) high metHb 
D) dark nail polish

Question 9

Oximetry is the measurement of blood hemoglobin saturations using what technique?

Accepted Answer

A) electrochemical dissociation 
B) photoplethysmography 
C) photochemical reactions 
D) spectrophotometry 
A) electrochemical dissociation 
B) photoplethysmography 
C) photochemical reactions 
D) spectrophotometry

Question 10

The shape of the expired CO2 tracing of a patient is normal but instead of being zero, the baseline is elevated to about 12 mm Hg. Which of the following is the most likely problem?

Accepted Answer

A) patient disconnected from the system 
B) obstruction of the sampling tube 
C) rebreathing 
D) presence of N2O 
A) patient disconnected from the system 
B) obstruction of the sampling tube 
C) rebreathing 
D) presence of N2O

Question 11

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FIO2 has just been changed?

Accepted Answer

A) 5 to 10 minutes 
B) 10 to 15 minutes 
C) 15 to 20 minutes 
D) 20 to 30 minutes 
A) 5 to 10 minutes 
B) 10 to 15 minutes 
C) 15 to 20 minutes 
D) 20 to 30 minutes

Question 12

Components of a laboratory blood gas analyzer include which of the following?
I.three-electrode measuring chamber
II.reagent containers
III.calibrating gas tanks
IV.waste container

Accepted Answer

A) I, II, and IV 
B) II and III 
C) II and IV 
D) I, II, III, and IV 
A) I, II, and IV 
B) II and III 
C) II and IV 
D) I, II, III, and IV

Question 13

A mechanically ventilated patient exhibits a sudden decrease in end-tidal CO2 levels. All of the following are possible causes of this change except:

Accepted Answer

A) massive pulmonary embolism 
B) disconnection of the ventilator 
C) increase in CO2 production 
D) sudden drop in cardiac output 
A) massive pulmonary embolism 
B) disconnection of the ventilator 
C) increase in CO2 production 
D) sudden drop in cardiac output

Question 14

The equipment necessary for capillary blood sampling includes all of the following except:

Accepted Answer

A) lancet 
B) capillary tubes 
C) 1-ml syringe 
D) warming pad 
A) lancet 
B) capillary tubes 
C) 1-ml syringe 
D) warming pad

Question 15

Which of the following can cause false high readings when using a pulse oximeter?

Accepted Answer

A) fetal hemoglobin 
B) intravascular dyes 
C) carboxyhemoglobin 
D) presence of metHb 
A) fetal hemoglobin 
B) intravascular dyes 
C) carboxyhemoglobin 
D) presence of metHb

Question 16

During calibration of a Clark polarographic O2 analyzer, you cannot get the sensor to read 100% when exposed to 100% O2, even after adjusting its calibration control. The unit has new batteries. Which of the following actions would be correct?

Accepted Answer

A) Use it only with low Fio2 values. 
B) Send the device out for repair. 
C) Replace the unit's batteries. 
D) Change the sensor or electrode. 
A) Use it only with low Fio2 values. 
B) Send the device out for repair. 
C) Replace the unit's batteries. 
D) Change the sensor or electrode.

Question 17

To validate patient readings obtained from a transcutaneous blood gas monitor, what should you do?

Accepted Answer

A) Measure and compare the PtcO2 and PtcCO2 at three or more different sites. 
B) Compare the monitor's readings to a concurrent pulse oximetry reading. 
C) Compare the monitor's readings to those obtained with a concurrent ABG sample. 
D) Compare the patient reading to those obtained when calibrating the sensor. 
A) Measure and compare the PtcO2 and PtcCO2 at three or more different sites. 
B) Compare the monitor's readings to a concurrent pulse oximetry reading. 
C) Compare the monitor's readings to those obtained with a concurrent ABG sample. 
D) Compare the patient reading to those obtained when calibrating the sensor.

Question 18

What is the normal gradient between PaCO2 and PETCO2?

Accepted Answer

A) 1 to 5 mm Hg 
B) 5 to 10 mm Hg 
C) 10 to 15 mm Hg 
D) 15 to 20 mm Hg 
A) 1 to 5 mm Hg 
B) 5 to 10 mm Hg 
C) 10 to 15 mm Hg 
D) 15 to 20 mm Hg

Question 19

You are asked to perform a radial artery puncture on an unconscious patient. How can you confirm the presence of collateral circulation?
I.Use a Doppler transducer to assess thumb blood flow with radial obstruction.
II.Use a pulse oximeter to assess thumb blood flow with ulnar obstruction.
III.Use a pulse oximeter to assess thumb blood flow with radial obstruction.

Accepted Answer

A) I and II 
B) I and III 
C) II and III 
D) I, II, and III 
A) I and II 
B) I and III 
C) II and III 
D) I, II, and III

Question 20

Required equipment and supplies for percutaneous arterial blood sampling of an adult include all of the following except:

Accepted Answer

A) antiseptic (alcohol or Betadine) 
B) patient or sample label 
C) 20- to 22-gauge needle 
D) local anesthetic 
A) antiseptic (alcohol or Betadine) 
B) patient or sample label 
C) 20- to 22-gauge needle 
D) local anesthetic

Exam 18: Analysis and Monitoring of Gas Exchange

During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicates what?

A physician requests that you obtain and set up an arterial line system for invasive monitoring of blood pressure. Which of the following equipment would you gather? I.pressurized intravenous bag II.continuous flush device III.arterial catheter IV.pressure transducer V.amplifier or monitor

If patient pain or anxiety occurs during arterial puncture, which of the following will probably occur?

Which of the following should be monitored during the sampling of arterial blood? I.blood pressure proximal to puncture site II.presence of pulsatile blood return III.presence of air bubbles or clots in sample IV.appearance of puncture site

Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except:

A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period? I.PCO2 II.pH III.PO2

Before performing puncture or cannulation of the radial artery, what should you do?

All of the following will tend to cause false low readings when using a pulse oximeter except:

Oximetry is the measurement of blood hemoglobin saturations using what technique?

The shape of the expired CO2 tracing of a patient is normal but instead of being zero, the baseline is elevated to about 12 mm Hg. Which of the following is the most likely problem?

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FIO2 has just been changed?

Components of a laboratory blood gas analyzer include which of the following? I.three-electrode measuring chamber II.reagent containers III.calibrating gas tanks IV.waste container

A mechanically ventilated patient exhibits a sudden decrease in end-tidal CO2 levels. All of the following are possible causes of this change except:

The equipment necessary for capillary blood sampling includes all of the following except:

Which of the following can cause false high readings when using a pulse oximeter?

During calibration of a Clark polarographic O2 analyzer, you cannot get the sensor to read 100% when exposed to 100% O2, even after adjusting its calibration control. The unit has new batteries. Which of the following actions would be correct?

To validate patient readings obtained from a transcutaneous blood gas monitor, what should you do?

What is the normal gradient between PaCO2 and PETCO2?

Required equipment and supplies for percutaneous arterial blood sampling of an adult include all of the following except:

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period? I.PCO₂ II.pH III.PO₂

The shape of the expired CO₂tracing of a patient is normal but instead of being zero, the baseline is elevated to about 12 mm Hg. Which of the following is the most likely problem?

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FIO₂ has just been changed?

A mechanically ventilated patient exhibits a sudden decrease in end-tidal CO₂ levels. All of the following are possible causes of this change except:

During calibration of a Clark polarographic O₂ analyzer, you cannot get the sensor to read 100% when exposed to 100% O₂, even after adjusting its calibration control. The unit has new batteries. Which of the following actions would be correct?

What is the normal gradient between PaCO₂ and PETCO₂?