Question 1

The total instrument error (inaccuracy) of a blood gas analyzer equals which of the following?

Accepted Answer

A)  Bias + imprecision 
B)  Imprecision + random error 
C)  Bias + systematic error 
D)  Trend error + bias 
A)  Bias + imprecision 
B)  Imprecision + random error 
C)  Bias + systematic error 
D)  Trend error + bias A

Question 2

Which of the following are true about invasive versus noninvasive monitoring?
1. Invasive procedures require insertion of a device into the body.
2. Laboratory analysis of gas exchange is usually noninvasive in nature.
3. Physiologic monitoring can be either invasive or noninvasive.
4. Invasive procedures provide more accurate data but carry greater risks.

Accepted Answer

A) 2 and 4 only 
B) 1, 3, and 4 only 
C) 2 only 
D) 1, 2, 3, and 4 
A) 2 and 4 only 
B) 1, 3, and 4 only 
C) 2 only 
D) 1, 2, 3, and 4 B

Question 3

A PaO2 below what value would be considered moderate hypoxemia?

Accepted Answer

A)  75 mm Hg 
B)  65 mm Hg 
C)  55 mm Hg 
D)  Depends on the FiO2 
A)  75 mm Hg 
B)  65 mm Hg 
C)  55 mm Hg 
D)  Depends on the FiO2 C

Question 4

What is the best site for capillary puncture in an infant?

Accepted Answer

A)  Lateral aspect of the heel's plantar surface 
B)  Anterior curvature of the heel 
C)  Medial aspect of the heel's plantar surface 
D)  Posterior curvature of the heel 
A)  Lateral aspect of the heel's plantar surface 
B)  Anterior curvature of the heel 
C)  Medial aspect of the heel's plantar surface 
D)  Posterior curvature of the heel

Question 5

What is a normal end-tidal PETCO2 range?

Accepted Answer

A)  30 to 38 mm Hg 
B)  35 to 43 mm Hg 
C)  38 to 46 mm Hg 
D)  42 to 50 mm Hg 
A)  30 to 38 mm Hg 
B)  35 to 43 mm Hg 
C)  38 to 46 mm Hg 
D)  42 to 50 mm Hg

Question 6

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

Question 7

In which of the following patients would transcutaneous blood gas monitoring most likely provide inaccurate or erroneous results?

Accepted Answer

A)  Newborn infant with respiratory distress syndrome (RDS) 
B)  Patient with hypoxemia 
C)  Patient with a hyperpyrexia 
D)  Patient in hypovolemic shock 
A)  Newborn infant with respiratory distress syndrome (RDS) 
B)  Patient with hypoxemia 
C)  Patient with a hyperpyrexia 
D)  Patient in hypovolemic shock

Question 8

What is the most common technique used to measure CO2 in respiratory gases?

Accepted Answer

A)  Infrared absorption 
B)  Mass spectroscopy 
C)  Photoacoustics 
D)  Raman scattering 
A)  Infrared absorption 
B)  Mass spectroscopy 
C)  Photoacoustics 
D)  Raman scattering

Question 9

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 min. 
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 min.

Question 10

What is the most common source of error and false alarms with pulse oximetry?

Accepted Answer

A)  Presence of HbCO 
B)  Patient motion artifact 
C)  Presence of vascular dyes 
D)  Ambient light detection 
A)  Presence of HbCO 
B)  Patient motion artifact 
C)  Presence of vascular dyes 
D)  Ambient light detection

Question 11

Purposes of a needle-capping device include which of the following?
1) To isolate the sample from air exposure
2) To help prevent needlestick injuries
3) To hold the excess anticoagulant

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 12

When is capillary blood gas sampling indicated?

Accepted Answer

A)  There is a need for direct analysis of blood oxygenation. 
B)  Normal noninvasive monitor readings need to be checked. 
C)  ABG analysis is needed, but arterial access is not available. 
D)  Continuous data on patient ventilation status are needed. 
A)  There is a need for direct analysis of blood oxygenation. 
B)  Normal noninvasive monitor readings need to be checked. 
C)  ABG analysis is needed, but arterial access is not available. 
D)  Continuous data on patient ventilation status are needed.

Question 13

You are monitoring a nurse acquiring a capillary blood sample from an infant. The nurse immediately punctures the infant's heel with a lancet and then squeezes the puncture site to increase the flow of blood. What mistakes has the nurse made while obtaining the capillary blood sample?
1) Inadequate warming of the capillary bed
2) Squeezing of the puncture site
3) Puncture of the infant's heel
4) Use of a lancet.

Accepted Answer

A) 1 and 2 only 
B) 3 and 4 only 
C) 1, 2, and 3 only 
D) 1, 3, and 4 only 
A) 1 and 2 only 
B) 3 and 4 only 
C) 1, 2, and 3 only 
D) 1, 3, and 4 only

Question 14

Components of a laboratory blood gas analyzer include which of the following?
1) Two-electrode measuring chamber
2) Reagent containers
3) Calibrating gas tanks
4) Waste container

Accepted Answer

A) 1, 2, and 3 only 
B) 1 and 4 only 
C) 2 and 4 only 
D) 2, 3, and 4 only 
A) 1, 2, and 3 only 
B) 1 and 4 only 
C) 2 and 4 only 
D) 2, 3, and 4 only

Question 15

Through which pulmonary artery catheter port would you obtain a mixed venous blood sample?

Accepted Answer

A)  Proximal (right atrium) port 
B)  Catheter thermistor connector 
C)  Distal (catheter tip) port 
D)  Balloon inflation port 
A)  Proximal (right atrium) port 
B)  Catheter thermistor connector 
C)  Distal (catheter tip) port 
D)  Balloon inflation port

Question 16

Which of the following are true about a blood gas analyzer's waste fluids?
1) A strong disinfectant should be added to waste fluid containers.
2) Waste fluids should be handled as if they were blood samples.
3) Waste fluids should be treated as potentially infectious.

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 17

At the very beginning of exhalation, the PETCO2 normally should be at what level?

Accepted Answer

A)  0 mm Hg 
B)  15 mm Hg 
C)  25 mm Hg 
D)  40 mm Hg 
A)  0 mm Hg 
B)  15 mm Hg 
C)  25 mm Hg 
D)  40 mm Hg

Question 18

The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing:

Accepted Answer

A)  reduces turnaround time. 
B)  utilizes equipment that is less expensive. 
C)  does not require trained personnel to run the tests. 
D)  is more accurate than traditional laboratory testing. 
A)  reduces turnaround time. 
B)  utilizes equipment that is less expensive. 
C)  does not require trained personnel to run the tests. 
D)  is more accurate than traditional laboratory testing.

Question 19

When inspecting an internal quality-control plot for a blood gas analyzer, you notice several data points sporadically appearing outside the 2 standard deviation (SD) range. This represents what type of analytic error?
1) Random error
2) Bias
3) Imprecision
4) Systematic error

Accepted Answer

A) 1 and 3 only 
B) 2 and 4 only 
C) 1, 2, and 4 only 
D) 1, 2, 3, and 4 
A) 1 and 3 only 
B) 2 and 4 only 
C) 1, 2, and 4 only 
D) 1, 2, 3, and 4

Question 20

During continuous monitoring of an active 5-year-old patient with a finger pulse oximetry probe, you obtain frequent and repeated false low HbO2 alarms (<90%). Which of the following would be the best action to take in this situation?

Accepted Answer

A)  Sedate the patient and restrain the arms. 
B)  Reset the low alarm limit to the 80% to 85% range. 
C)  Use a spot check instead of continuous monitoring. 
D)  Relocate the sensor to a more stable location. 
A)  Sedate the patient and restrain the arms. 
B)  Reset the low alarm limit to the 80% to 85% range. 
C)  Use a spot check instead of continuous monitoring. 
D)  Relocate the sensor to a more stable location.

Exam 19: Analysis and Monitoring of Gas Exchange

The total instrument error (inaccuracy) of a blood gas analyzer equals which of the following?

A PaO2 below what value would be considered moderate hypoxemia?

What is the best site for capillary puncture in an infant?

What is a normal end-tidal PETCO2 range?

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FiO2 has just been changed?

In which of the following patients would transcutaneous blood gas monitoring most likely provide inaccurate or erroneous results?

What is the most common technique used to measure CO2 in respiratory gases?

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

What is the most common source of error and false alarms with pulse oximetry?

Purposes of a needle-capping device include which of the following? 1) To isolate the sample from air exposure 2) To help prevent needlestick injuries 3) To hold the excess anticoagulant

When is capillary blood gas sampling indicated?

Components of a laboratory blood gas analyzer include which of the following? 1) Two-electrode measuring chamber 2) Reagent containers 3) Calibrating gas tanks 4) Waste container

Through which pulmonary artery catheter port would you obtain a mixed venous blood sample?

Which of the following are true about a blood gas analyzer's waste fluids? 1) A strong disinfectant should be added to waste fluid containers. 2) Waste fluids should be handled as if they were blood samples. 3) Waste fluids should be treated as potentially infectious.

At the very beginning of exhalation, the PETCO2 normally should be at what level?

The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing:

When inspecting an internal quality-control plot for a blood gas analyzer, you notice several data points sporadically appearing outside the 2 standard deviation (SD) range. This represents what type of analytic error? 1) Random error 2) Bias 3) Imprecision 4) Systematic error

During continuous monitoring of an active 5-year-old patient with a finger pulse oximetry probe, you obtain frequent and repeated false low HbO2 alarms (<90%). Which of the following would be the best action to take in this situation?

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Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

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Filters

A PaO₂ below what value would be considered moderate hypoxemia?

What is a normal end-tidal PETCO₂ range?

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FiO₂ has just been changed?

What is the most common technique used to measure CO₂ in respiratory gases?

At the very beginning of exhalation, the PETCO₂ normally should be at what level?

During continuous monitoring of an active 5-year-old patient with a finger pulse oximetry probe, you obtain frequent and repeated false low HbO₂ alarms (<90%). Which of the following would be the best action to take in this situation?