Question 1

After changing the FiO2 of a patient with emphysema, how long should you wait to draw an ABG to monitor the patient's respiratory status?

Accepted Answer

A)  5 to 10 min 
B)  10 to 20 min 
C)  20 to 30 min 
D)  30 to 40 min 
A)  5 to 10 min 
B)  10 to 20 min 
C)  20 to 30 min 
D)  30 to 40 min

Question 2

Capillary puncture should be performed at or through what location?
1) Edematous tissue
2) Areas with new signs of infection
3) The heal of neonates
4) Previous puncture sites

Accepted Answer

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

Question 3

Possible complications of capillary blood gas sampling include which of the following?
1) Infection
2) Hematoma
3) Hemorrhage
4) Hypotension

Accepted Answer

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

Question 4

What is the quality control procedure of analysis and reporting on externally provided control media with unknown values?

Accepted Answer

A)  Automated calibration 
B)  Performance validation 
C)  Proficiency testing 
D)  Preventive maintenance 
A)  Automated calibration 
B)  Performance validation 
C)  Proficiency testing 
D)  Preventive maintenance

Question 5

After obtaining an arterial blood sample, what should you do?
1) Apply pressure to the puncture site until bleeding stops.
2) Place the sample in a transport container with ice slush.
3) Check to see if the patient is getting anticoagulant therapy.
4) Mix the sample by rolling and inverting the syringe.

Accepted Answer

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

Question 6

Precautions and/or possible complications of arterial puncture include which of the following?
1) Arteriospasm
2) Embolization
3) Infection
4) Hemorrhage

Accepted Answer

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

Question 7

What size needle would you recommend to obtain an ABG sample through percutaneous puncture of an infant?

Accepted Answer

A)  18 gauge 
B)  20 gauge 
C)  22 gauge 
D)  25 gauge 
A)  18 gauge 
B)  20 gauge 
C)  22 gauge 
D)  25 gauge

Question 8

How is the accuracy of a blood gas analyzer determined?

Accepted Answer

A)  Examining the repeatability of the analyzer's results 
B)  Comparing the analyzer's measurements to known values 
C)  Adjusting the offset (or balance) of the instrument 
D)  Adjusting the gain (or slope) of the instrument 
A)  Examining the repeatability of the analyzer's results 
B)  Comparing the analyzer's measurements to known values 
C)  Adjusting the offset (or balance) of the instrument 
D)  Adjusting the gain (or slope) of the instrument

Question 9

What chart information should be checked before performing artery puncture?
1) Patient's primary diagnosis and history
2) Presence of bleeding disorders or blood-borne infections
3) Anticoagulant or thrombolytic drug prescriptions
4) Respiratory care orders (e.g., O2 therapy)

Accepted Answer

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

Question 10

An alert outpatient awaiting bronchoscopy has an SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation?

Accepted Answer

A)  Switch sites or replace the sensor probe. 
B)  Immediately start O2 therapy. 
C)  Obtain an ABG. 
D)  Cancel the bronchoscopy procedure. 
A)  Switch sites or replace the sensor probe. 
B)  Immediately start O2 therapy. 
C)  Obtain an ABG. 
D)  Cancel the bronchoscopy procedure.

Question 11

Clinical indications for arterial blood analysis include which of the following?
1) Sudden, unexplained dyspnea
2) Cardiopulmonary resuscitation
3) Changes in ventilator settings
4) Chest pain

Accepted Answer

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

Question 12

Which of the following is false about transcutaneous blood gas monitoring?

Accepted Answer

A)  Transcutaneous blood gas monitoring provides a reasonable estimate of PaO2 and PaCO2. 
B)  Transcutaneous blood gas monitoring is most accurate when used with older adults. 
C)  Accurate estimates of transcutaneous blood gases are difficult in patients with shock. 
D)  Transcutaneous blood gas monitors use heated skin electrodes to arterialize the blood. 
A)  Transcutaneous blood gas monitoring provides a reasonable estimate of PaO2 and PaCO2. 
B)  Transcutaneous blood gas monitoring is most accurate when used with older adults. 
C)  Accurate estimates of transcutaneous blood gases are difficult in patients with shock. 
D)  Transcutaneous blood gas monitors use heated skin electrodes to arterialize the blood.

Question 13

During a single-breath capnogram, what does the occurrence of a plateau indicate?

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

Question 14

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 15

Which of the following are reasons for finding an alternative site for arterial puncture?
1) Failed Allen test
2) History of peripheral vascular disease
3) Anticoagulation therapy
4) Presence of a surgical shunt

Accepted Answer

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

Question 16

When analyzing an ABG sample from a patient with acute respiratory distress syndrome and refractory hypoxemia, you notice a PaO2 of 141 mm Hg and a PaCO2 of 14 mm Hg. Which of the following analytic errors should you suspect?

Accepted Answer

A)  Excessive time since sample collection 
B)  Exposure of the blood sample to air 
C)  Excessive heparin in the sample 
D)  Sample admixture with venous blood 
A)  Excessive time since sample collection 
B)  Exposure of the blood sample to air 
C)  Excessive heparin in the sample 
D)  Sample admixture with venous blood

Question 17

When performing a percutaneous needle puncture of the radial artery, you get only a small spurt of blood. Which of the following is the best action at this time?

Accepted Answer

A)  Slowly withdraw the needle until a pulsatile flow fills the syringe. 
B)  Pull out entirely, use a different angle and then reinsert it. 
C)  Slowly advance the needle until a pulsatile flow fills the syringe. 
D)  Repeat the procedure with a fresh blood gas kit. 
A)  Slowly withdraw the needle until a pulsatile flow fills the syringe. 
B)  Pull out entirely, use a different angle and then reinsert it. 
C)  Slowly advance the needle until a pulsatile flow fills the syringe. 
D)  Repeat the procedure with a fresh blood gas kit.

Question 18

You must immediately begin monitoring the oxygenation status of an infant admitted to the emergency department in severe respiratory distress. Which of the following approaches would you select?

Accepted Answer

A)  Pulse oximetry (SpO2) 
B)  Transcutaneous monitoring (PtcO2) 
C)  Arterial puncture (PaO2) 
D)  Intraarterial optode monitoring 
A)  Pulse oximetry (SpO2) 
B)  Transcutaneous monitoring (PtcO2) 
C)  Arterial puncture (PaO2) 
D)  Intraarterial optode monitoring

Question 19

A patient suffering from traumatic brain injury in the ICU has a PtO2 (tissue oxygen) value of 10 to 15 mm Hg, what does this indicate?

Accepted Answer

A)  Normal intracranial pressure 
B)  Ischemic brain damage 
C)  Normal cerebral perfusion 
D)  Cerebral hyperperfusion 
A)  Normal intracranial pressure 
B)  Ischemic brain damage 
C)  Normal cerebral perfusion 
D)  Cerebral hyperperfusion

Question 20

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

Exam 19: Analysis and Monitoring of Gas Exchange

After changing the FiO2 of a patient with emphysema, how long should you wait to draw an ABG to monitor the patient's respiratory status?

Capillary puncture should be performed at or through what location? 1) Edematous tissue 2) Areas with new signs of infection 3) The heal of neonates 4) Previous puncture sites

Possible complications of capillary blood gas sampling include which of the following? 1) Infection 2) Hematoma 3) Hemorrhage 4) Hypotension

What is the quality control procedure of analysis and reporting on externally provided control media with unknown values?

Precautions and/or possible complications of arterial puncture include which of the following? 1) Arteriospasm 2) Embolization 3) Infection 4) Hemorrhage

What size needle would you recommend to obtain an ABG sample through percutaneous puncture of an infant?

How is the accuracy of a blood gas analyzer determined?

What chart information should be checked before performing artery puncture? 1) Patient's primary diagnosis and history 2) Presence of bleeding disorders or blood-borne infections 3) Anticoagulant or thrombolytic drug prescriptions 4) Respiratory care orders (e.g., O2 therapy)

An alert outpatient awaiting bronchoscopy has an SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation?

Clinical indications for arterial blood analysis include which of the following? 1) Sudden, unexplained dyspnea 2) Cardiopulmonary resuscitation 3) Changes in ventilator settings 4) Chest pain

Which of the following is false about transcutaneous blood gas monitoring?

During a single-breath capnogram, what does the occurrence of a plateau indicate?

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

Which of the following are reasons for finding an alternative site for arterial puncture? 1) Failed Allen test 2) History of peripheral vascular disease 3) Anticoagulation therapy 4) Presence of a surgical shunt

When analyzing an ABG sample from a patient with acute respiratory distress syndrome and refractory hypoxemia, you notice a PaO2 of 141 mm Hg and a PaCO2 of 14 mm Hg. Which of the following analytic errors should you suspect?

When performing a percutaneous needle puncture of the radial artery, you get only a small spurt of blood. Which of the following is the best action at this time?

You must immediately begin monitoring the oxygenation status of an infant admitted to the emergency department in severe respiratory distress. Which of the following approaches would you select?

A patient suffering from traumatic brain injury in the ICU has a PtO2 (tissue oxygen) value of 10 to 15 mm Hg, what does this indicate?

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

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

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

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Pulmonary Function Testing

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Respiratory Distress Syndrome

Trauma, Burns and Near Drowning

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

Airway Clearance Therapy Act

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring 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

After changing the FiO₂ of a patient with emphysema, how long should you wait to draw an ABG to monitor the patient's respiratory status?

What chart information should be checked before performing artery puncture? 1) Patient's primary diagnosis and history 2) Presence of bleeding disorders or blood-borne infections 3) Anticoagulant or thrombolytic drug prescriptions 4) Respiratory care orders (e.g., O₂ therapy)

An alert outpatient awaiting bronchoscopy has an SpO₂ reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation?

When analyzing an ABG sample from a patient with acute respiratory distress syndrome and refractory hypoxemia, you notice a PaO₂ of 141 mm Hg and a PaCO₂ of 14 mm Hg. Which of the following analytic errors should you suspect?

A patient suffering from traumatic brain injury in the ICU has a PtO₂ (tissue oxygen) value of 10 to 15 mm Hg, what does this indicate?