Deck 3: Humidity and Aerosol Therapy Equipment

Question 1

Humidity deficit is defined as:

A) the capacity minus the relative humidity
B) he relative humidity minus the capacity
C) the absolute humidity minus the capacity
D) body humidity minus the capacity

Answer 1

D

Question 2

Given the following, solve for the absolute humidity. Relative humidity = 43%
Capacity = 17.3 mg/L

A) 0.40 mg
B) 7.4 mg
C) 40.2 mg
D) 43 mg

Answer 2

C

Question 3

Given the following, calculate the humidity deficit. Capacity = 30.35 mg/L
Relative humidity = 98%

A) 13.55 mg/L
B) 14.16 mg/L
C) 30.35 mg/L
D) 54.1 mg/L

Answer 3

B

Question 4

The ideal particle size for deposition into the pulmonary tract is:

A) > 30 microns
B) between 20 and 30 microns
C) between 5 and 10 microns
D) between 1 and 5 microns

Question 5

An aerosol is defined as:

A) water in vapor or gaseous form
B) particulate matter suspended in a gas
C) liquid water
D) none of the above

Question 6

Given the following, calculate the relative humidity. Capacity = 12.83 mg/L
Absolute humidity = 9.45 mg/L

A) 1.4%
B) 22%
C) 27%
D) 73%

Question 7

If the radius of a liquid particle doubles, its volume increases by a factor of:

A) 2
B) 3
C) 6
D) 8

Question 8

Which of the following best describes how to determine relative humidity?

A) Divide the capacity by the actual humidity.
B) Divide the relative humidity by the capacity.
C) Divide the capacity by the relative humidity.
D) Divide the actual humidity by the capacity.

Question 9

Which of the following best describes how to determine the actual or absolute humidity?

A) Divide the actual humidity by the capacity.
B) Multiply the relative humidity by the capacity.
C) Divide the capacity by the relative humidity.
D) Multiply the actual humidity by the capacity.

Question 10

Given the following, solve for the absolute humidity. Relative humidity = 55%
Capacity = 9.4 mg/L

A) 0.2 mg
B) 5.2 mg
C) 5.6 mg
D) 55 mg

Question 11

A hypertonic solution is characterized by:

A) a saline concentration > 0.9%
B) a saline concentration < 0.9%
C) a saline concentration = 0.9%
D) none of the above

Question 12

Humidity is defined as:

A) water in vapor or gaseous form
B) particulate water suspended in a gas
C) liquid water
D) condensed water as particulates

Question 13

An isotonic solution is characterized by:

A) a saline concentration > 0.9%
B) a saline concentration < 0.9%
C) a saline concentration = 0.9%
D) none of the above

Question 14

Given the following, solve for the absolute humidity. Relative humidity = 21%
Capacity = 23.04 mg/L

A) 0.9 mg
B) 1.1 mg
C) 4.8 mg
D) 21 mg

Question 15

Which of the following are true regarding humidity?
I. Humidity exerts a partial pressure.
II. The capacity of a gas to hold water vapor decreases with the temperature.
III. Humidity must be accounted for when determining partial pressures.
IV. A gas can hold more humidity as the temperature increases.

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

Question 16

Given the following, calculate the relative humidity. Capacity = 20.0 mg/L
Absolute humidity = 10.3 mg/L

A) 1.9%
B) 52%
C) 30.3%
D) 206%

Question 17

Given the following, calculate the humidity deficit. Absolute humidity = 32 mg/L

A) 12 mg/L
B) 32 mg/L
C) 44 mg/L
D) 47 mg/L

Question 18

Given the following, calculate the humidity deficit. Capacity = 23.04 mg/L
Relative humidity = 92%

A) 59.96 mg/L
B) 23.96 mg/L
C) 20.86 mg/L
D) 23.04 mg/L

Question 19

Given the following, calculate the relative humidity. Capacity = 6.8 mg/L
Absolute humidity = 4.5 mg/L

A) 1.5%
B) 66%
C) 30.6%
D) 11.3%

Question 20

A term used to describe a state when a gas is fully saturated with humidity is:

A) relative humidity
B) absolute humidity
C) partial pressure
D) maximum absolute humidity

Question 21

Which of the following are true regarding the ideal breathing pattern for aerosol delivery?
I. rapid fast inspiration
II. slow deep inspiration
III. an end inspiration breath hold
IV. breath hold before inspiration

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

Question 22

The Thera-Mist P35000 humidifier:
I. can provide heated humidity
II. can provide body humidity at minute volumes of up to 20 L/min
III. operates using a wick
IV. uses a diffusion grid

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

Question 23

When placing a thermometer or thermistor probe to monitor a heated humidifier's temperature output, the probe:

A) should be placed at the outlet of the humidifier
B) should be placed in the middle of the circuit
C) should be placed proximal to the patient
D) none of the above

Question 24

According to the American Association for Respiratory Care Clinical Practice Guideline: Humidification During Invasive and Non-Invasive Mechanical Ventilation, which of the following are contraindications for the use of a heat moisture exchanger (HME)?
I. thick copious secretions
II. body temperature less than 30 degrees Celsius
III. spontaneous minute volumes > 10 L/min

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

Question 25

According to the AARC Clinical Practice Guideline: Oxygen Therapy for Adults in the Acute Care Setting, use of humidification with flows < 4 L/min:

A) is recommended.
B) is not recommended.
C) should be provided with a heated humidifier.
D) none of the above

Question 26

A baffle or a wall distal to the jet of an aerosol generator:
I. stabilizes size of particles
II. removes larger particles from suspension
III. works by inertial impaction
IV. allows smaller particles to pass

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

Question 27

An advantage of the Thera-Mist P35000 humidifier is:

A) isolation of gas and water in the heating element
B) prevention of cross-contamination
C) high gas flow delivery
D) all of the above

Question 28

The Fisher and Paykel MR 850 humidifier operates using:

A) the Babington principle
B) pass-over technology
C) a heated wick
D) a diffusion grid

Question 29

According to the American Association for Respiratory Care Clinical Practice Guideline: Humidification During Mechanical Ventilation, a humidifier chosen should:
I. provide at least 30 mg/L water vapor
II. provide body humidity
III. provide a temperature of at least 30 degrees Celsius
IV. provide a temperature of at least 37 degrees Celsius

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

Question 30

Factors that can be applied to increase the efficiency of a humidifier are:
I. increased temperature
II. increased surface area
III. increased time for contact
IV. added baffle

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

Question 31

Many bubble humidifiers incorporate which of the following safety features?
I. Diameter Index Safety System (DISS) inlet fitting
II. 2 psi pop-off valve
III. sealed prefilled reservoir

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

Question 32

When humidifying an artificial airway using a heated humidifier, equipment you need includes:
I. large bore tubing (22-mm diameter)
II. drainage bag or trap
III. thermometer or temperature probe
IV. sterile water

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

Question 33

According to the AARC Clinical Practice Guideline: Oxygen Therapy for Adults in the Acute Care Setting, use of humidification when flow exceeds 4 L/min:

A) is recommended.
B) is not recommended.
C) should be provided with a heated humidifier.
D) none of the above

Question 34

According to the American Association for Respiratory Care Clinical Practice Guideline: Humidification During Invasive and Non-Invasive Mechanical Ventilation, a heat moisture exchanger (HME) should:

A) not be used for more than 12 hours
B) not be used for more than 24 hours
C) not be used for more than 48 hours
D) not be used for more than 96 hours

Question 35

Most aerosol generators that are pneumatically powered operate using:

A) Bernoulli's theorem
B) Poiseuille's law
C) the venturi principle
D) choked flow and vorticity

Question 36

Relative humidity output from most disposable bubble humidifiers range from:

A) 10-20% relative humidity
B) 23-33% relative humidity
C) 33-40% relative humidity
D) > 50% relative humidity

Question 37

The difference between an atomizer and a nebulizer is:

A) the difference in operating pressure
B) the difference in the output's particle size
C) the size of the device
D) the presence of a baffle

Question 38

In a pneumatically powered small-volume nebulizer, fluid moves up the capillary tube because:

A) of gas flow that pushes it
B) of capillary action alone
C) of a pressure differential
D) none of the above

Question 39

Heat and moisture exchangers (HMEs):
I. provide 70% to 90% relative humidity
II. provide temperatures between 30 and 31 degrees Celsius
III. are intended for short-term use
IV. may be used without an artificial airway

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

Question 40

The Fisher and Paykel MR 850 humidifier:
I. is servo controlled
II. uses pass-over humidification
III. can use heated wire circuits
IV. can deliver temperatures between 29 and 40 degrees Celsius

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

Question 41

Dry powder inhalers (DPIs):

A) use fluorocarbon propellants
B) deliver liquid aerosol medication
C) require a pressurized-gas source
D) none of the above

Question 42

Bland aerosol therapy may include the following hazards and complications according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Bland Aerosol Administration?
I. wheezing and bronchospasm
II. infection
III. overhydration
IV. edema of the airway wall

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

Question 43

You are using a small-volume nebulizer and note that aerosol output stops even though medication remains in the reservoir. Which of the following should you check?
I. the oxygen flowmeter for the correct setting
II. the oxygen supply tubing and its connections
III. the nebulizer jet
IV. the nebulizer top or lid

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

Question 44

Bland aerosol therapy is indicated for which of the following conditions according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Bland Aerosol Administration?
I. upper airway edema
II. presence of a bypassed upper airway
III. need for sputum induction
IV. need to mobilize secretions

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

Question 45

A breath-activated nebulizer:
I. delivers aerosol only during inspiration
II. delivers aerosol continuously
III. takes longer to administer a given dose
IV. reduces medication waste

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

Question 46

The use of heated aerosol therapy is indicated for:

A) upper airway edema
B) acute bronchospasm
C) induction of a sputum sample
D) use with an artificial airway

Question 47

An example of the breath-enhanced nebulizer is the:

A) Respigard II
B) Updraft nebulizer
C) NebuTech^TM HDN
D) AeroEclipseII

Question 48

When instructing a patient to use a metered-dose inhaler (MDI) without a holding chamber, you should tell the patient:

A) "Place this in your mouth and close your lips around the mouthpiece."
B) "Squeeze the MDI when you exhale."
C) "Open your mouth and place the MDI a few centimeters away."
D) "Inhale as deeply and rapidly as you can when you squeeze the MDI."

Question 49

Updraft small-volume nebulizers used to deliver medications operate using:

A) choked flow and vorticity
B) Bernoulli's theorem
C) the venturi principle
D) the Babington principle

Question 50

When using a holding chamber with a metered-dose inhaler (MDI), you should tell the patient:

A) "Inhale as deeply and rapidly as you can when you squeeze the MDI."
B) "Squeeze the MDI when you exhale."
C) "Open your mouth and place the mouthpiece a few centimeters away."
D) "Place the mouthpiece in your mouth and inhale slowly when you squeeze."

Question 51

You assemble a metered-dose inhaler (MDI), and when the patient squeezes it the MDI doesn't activate. What could cause this?
I. It is empty.
II. It is assembled incorrectly.
III. The patient isn't squeezing hard enough.
IV. The valve has malfunctioned.

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

Question 52

When using a heat and moisture exchanger (HME) on a ventilated patient, the external disconnect alarm should ideally be placed:

A) proximal to the ventilator
B) proximal to the HME
C) between the HME and the airway
D) at the ventilator's outlet

Question 53

An example of a breath-activated nebulizer is the:

A) Respigard II
B) Updraft nebulizer
C) NebuTech HDN
D) AeroEclipseII

Question 54

A common type of small-volume nebulizer used to administer pentamidine is:

A) the disposable updraft nebulizer
B) the Nebutech^TM HDN nebulizer
C) the large volume nebulizer
D) a small volume nebulizer with an expiratory filter

Question 55

Contraindications of bland aerosol administration may include the following according to the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Bland Aerosol Administration?
I. bronchoconstriction
II. airway hyperresponsiveness
III. upper airway edema
IV. placement of an artificial airway

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

Question 56

Advantages of using aerosol to administer medications to the lower airway include:
I. rapid onset of action
II. few systemic side effects
III. smaller doses used compared to other routes
IV. application of the medication to the lung directly

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

Question 57

A heat and moisture exchanger (HME):

A) is placed at the outlet of the ventilator
B) is placed proximal to the exhalation valve
C) is placed between the patient's airway and the circuit
D) is placed at the outlet of the humidifier

Question 58

How do you instruct your patient to check how many doses are left on their pMDI inhaler?

A) it should be full
B) it is partially full
C) check the dosage counter
D) replace it after two weeks of use

Question 59

Which of the following devices may enhance medication delivery with a metered-dose inhaler (MDI)?

A) a holding chamber
B) a propellant reservoir
C) a cardboard tube
D) none of the above

Question 60

Which of the following is the most important regarding the use of a metered dose inhaler (MDI)?

A) equipment assembly
B) use of a holding chamber
C) infection control
D) patient instruction and education

Question 61

Most large-volume nebulizers operate using:

A) choked flow and vorticity
B) Bernoulli's theorem
C) the venturi principle
D) the Babington principle

Question 62

The Airlife large-volume nebulizer may be:
I. used continuously
II. used for cool aerosol therapy
III. used for heated aerosol therapy
IV. used for medication delivery

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

Question 63

You are troubleshooting the Vital Signs, Inc., Gas Injection Nebulizer (GIN). You note the delivered F_IO₂ is not correct. You should check:
I. the air flowmeter setting
II. the oxygen flowmeter setting
III. the tubing for obstruction
IV. the entrainment setting

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

Question 64

Use of a Diskhaler dry powder inhaler (DPI) requires:

A) grasping the mouthpiece, holding it stationary, and rotating the base of the DPI
B) opening a cover and cocking a lever prior to use
C) inserting a medication disk on a tray
D) dropping a capsule containing the powder into a chamber

Question 65

When a Vital Signs, Inc., Hi-Fi large-volume nebulizer with the oxygen flowmeter on the "flush" (maximum setting) is used, flow through the jet is:

A) 15 L/min
B) 30 L/min
C) 40 L/min
D) 43 L/min

Question 66

The Vital Signs, Inc., Gas Injection Nebulizer (GIN) may use:
I. oxygen as a primary gas source
II. air as a primary gas source
III. oxygen as an injected gas source
IV. air as an injected gas source

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

Question 67

The Vital Signs Hi-Fi nebulizer's reservoir connection is designed to use:

A) only the manufacturer's prefilled sterile water
B) standard 38-mm diameter disposable water containers
C) isotonic solutions
D) an immersion heater

Question 68

Use of a Diskus dry powder inhaler (DPI) requires:

A) grasping the mouthpiece, holding it stationary, and rotating the base of the DPI
B) opening a cover and cocking a lever prior to use
C) inserting a medication disk on a tray
D) dropping a capsule containing the powder into a chamber

Question 69

The Vital Signs, Inc., Misty Ox Hi-Fi nebulizer may provide:
I. F_IO₂ levels from 0.28 to 0.65
II. F_IO₂ levels from 0.60 to 0.96
III. flow rates from 12 to 42 L/min
IV. flow rate from 42 to 77 L/min

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

Question 70

The reservoir connection of the Vital Signs, Inc., Gas Injection Nebulizer (GIN) is designed to use:

A) only the manufacturer's prefilled sterile water
B) standard 38-mm diameter disposable water containers
C) isotonic solutions
D) an immersion heater

Question 71

The Vital Signs, Inc., Gas Injection Nebulizer (GIN) may be used to provide:
I. cool aerosol
II. heated aerosol
III. high flow rates (up to 100 L/min)
IV. high oxygen concentrations

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

Question 72

The Airlife large-volume nebulizer's reservoir fitting may use:

A) only the manufacturer's prefilled sterile water
B) standard 38-mm diameter disposable water containers
C) isotonic solutions
D) the Babington principle in its operation

Question 73

You are troubleshooting a large-volume nebulizer, and the aerosol output has stopped. Which of the following should you check?
I. the oxygen flowmeter setting
II. the reservoir for liquid
III. the capillary tube
IV. the tubing for obstructions

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

Question 74

You are troubleshooting the Vital Signs, Inc., Gas Injection Nebulizer (GIN). You note that aerosol output is low or absent. You should check:
I. the flowmeter settings
II. the reservoir for liquid
III. the capillary tube
IV. the tubing for obstructions

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

Question 75

When troubleshooting a Vital Signs, Inc., Hi-Fi large-volume nebulizer, you note the oxygen concentration to be too high. You should check:
I. the entrainment setting
II. the oxygen flowmeter setting
III. the tubing for obstructions
IV. the fittings and connections for tightness

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

Question 76

Large-volume nebulizers typically must be filled every:

A) 12-24 hours
B) 10-2 hours
C) 8-10 hours
D) 4-8 hours

Question 77

Prior to instructing a patient to use a dry powder inhaler (DPI), you should:
I. learn to assemble it
II. practice with a placebo DPI
III. read the package insert on its use
IV. use a holding chamber with the DPI

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

Question 78

The Vortan HEART nebulizer is intended for administration of:

A) heated aerosol
B) heated humidity
C) continuous medication
D) medication in the home care environment

Question 79

Use of a Turbuhaler dry powder inhaler (DPI) requires:

A) grasping the mouthpiece, holding it stationary, and rotating the base of the DPI
B) opening a cover and cocking a lever prior to use
C) inserting a medication disk on a tray
D) dropping a capsule containing the powder into a chamber

Question 80

Large-volume nebulizers are best used for:

A) medication delivery
B) intermittent application of aerosol therapy
C) continuous use
D) delivery of heated humidity to an artificial airway