Question 1

Which of the following should be monitored during the sampling of arterial blood?
1) Blood pressure proximal to puncture site
2) Presence of pulsatile blood return
3) Presence of air bubbles or clots in sample
4) Appearance of puncture site

Accepted Answer

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

Question 2

Warming a capillary bed to 42° C has which of the following effects?
1) It constricts the underlying blood vessels.
2) It increases blood flow well above tissue needs.
3) It "arterializes" the capillary blood.

Accepted Answer

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

Question 3

To avoid thermal injury with transcutaneous blood gas monitor sensors, what should you do?
1) Carefully monitor the sensor temperature.
2) Apply hydrocortisone cream under the sensor.
3) Regularly rotate the sensor site.

Accepted Answer

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

Question 4

Which of the following is false about the galvanic fuel cell O2 analyzer?

Accepted Answer

A)  It actually measures the PO2 and not the O2 concentration. 
B)  It requires an external power source (alternating current line or batteries). 
C)  It has a slower response time than the Clark electrode. 
D)  Its fuel cells deplete and must be periodically replaced.

Question 5

What is the normal gradient between PaCO2 and PETCO2?

Accepted Answer

A)  3 to 5 mm Hg 
B)  5 to 10 mm Hg 
C)  10 to 15 mm Hg 
D)  15 to 20 mm Hg

Question 6

Which of the following are indications for capnography?
1) Evaluating the response to therapies affecting ventilation/perfusion ratio (  ) relationships
2) Determining the position of an artificial airway (trachea vs. esophagus)
3) Assessing a patient's readiness for weaning from ventilatory support
4) Monitoring the integrity of the ventilatory circuit and artificial airway

Accepted Answer

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

Question 7

Transcutaneous blood gas monitoring is indicated when what need exists?
1) To continuously analyze gas exchange in infants or children
2) To quantify the real-time responses to bedside interventions
3) To continuously monitor for hyperoxia in newborn infants
4) To monitor CO levels following hyperbaric oxygen treatment

Accepted Answer

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

Question 8

Statistically derived limits for internal quality control of blood gas samples are usually set at what appropriate level?

Accepted Answer

A)  1 standard deviation from the mean 
B)  2 standard deviations from the mean 
C)  3 standard deviations from the mean 
D)  5 standard deviations from the mean

Question 9

Which of the following indicates venous admixture during arterial puncture?
1) Need to use syringe suction.
2) Dark-colored blood.
3) Small sample volumes.

Accepted Answer

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

Question 10

Which of the following describes the correct procedure for an Allen test?

Accepted Answer

A)  Compress both the radial and ulnar arteries, and then release the radial artery. 
B)  Compress both the radial and ulnar arteries, and then release the ulnar artery. 
C)  Compress both the radial and ulnar arteries, and then release both arteries at once. 
D)  Compress the brachial artery only and observe circulation to the hand.

Question 11

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.

Question 12

When analyzing a blood gas control sample, you notice that the result falls outside the 2 SD range. How could you verify that this was a random error (error of imprecision)?
1) Repeat the analysis on a different analyzer.
2) Compare the control to an actual patient sample.
3) Rerun the control sample a second time.

Accepted Answer

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

Question 13

You obtain an SpO2 reading of 90% using an oximeter with an approximate accuracy of 5%. This could indicate a PO2 as low as what level?

Accepted Answer

A)  55 mm Hg 
B)  60 mm Hg 
C)  65 mm Hg 
D)  70 mm Hg

Question 14

While checking a polarographic (Clark) electrode, you determine that the device fails to read 100% when exposed to pure O2. Which of the following actions would be the proper first step?

Accepted Answer

A)  Check the silica crystals. 
B)  Send the device out for repair. 
C)  Replace the analyzer's batteries. 
D)  Change the analyzer's fuel cell.

Question 15

For continuous monitoring of adults and children, you should set a pulse oximeter's low alarm in what range?

Accepted Answer

A)  80% to 85% 
B)  85% to 88% 
C)  88% to 92% 
D)  93% to 97%

Question 16

During capnography monitoring of a mechanically ventilated patient, you note that the PETCO2 has dropped to 0 mm Hg. Which of the following is the most likely problem?

Accepted Answer

A)  Ventilator disconnection 
B)  Tracheal intubation 
C)  Increased cardiac output 
D)  Hypoventilation

Question 17

You obtain an SpO2 reading of 100% on a patient receiving O2 through a nonrebreathing mask. What range of PaO2 levels is possible in this patient?

Accepted Answer

A)  60 to 90 mm Hg 
B)  90 to 100 mm Hg 
C)  100 to 200 mm Hg 
D)  100 to 600 mm Hg

Question 18

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble?
1) Decreased PCO2
2) Decreased pH
3) Increased PO2

Accepted Answer

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

Question 19

After obtaining an arterial blood sample through percutaneous puncture using a syringe that does not have a capping safety device, what should you do?

Accepted Answer

A)  Remove the needle with a Kelly clamp, then plug the syringe. 
B)  "Scoop" the needle cap up with one hand, then plug the syringe. 
C)  Force the needle into a rubber cork or plastic stopper. 
D)  Manually remove and bend the needle, then plug the syringe.

Question 20

How often should blood gas calibration verification by control media take place?

Accepted Answer

A)  At least one level of control media should be analyzed every 8 hr. 
B)  At least two levels of control media should be analyzed every day. 
C)  At least two levels of control media should be analyzed every 8 hr. 
D)  At least two levels of control media should be analyzed every hour.

Exam 19: Analysis and Monitoring of Gas Exchange

Which of the following should be monitored during the sampling of arterial blood? 1) Blood pressure proximal to puncture site 2) Presence of pulsatile blood return 3) Presence of air bubbles or clots in sample 4) Appearance of puncture site

Warming a capillary bed to 42° C has which of the following effects? 1) It constricts the underlying blood vessels. 2) It increases blood flow well above tissue needs. 3) It "arterializes" the capillary blood.

To avoid thermal injury with transcutaneous blood gas monitor sensors, what should you do? 1) Carefully monitor the sensor temperature. 2) Apply hydrocortisone cream under the sensor. 3) Regularly rotate the sensor site.

Which of the following is false about the galvanic fuel cell O₂ analyzer?

What is the normal gradient between PaCO₂ and PETCO₂?

Statistically derived limits for internal quality control of blood gas samples are usually set at what appropriate level?

Which of the following indicates venous admixture during arterial puncture? 1) Need to use syringe suction. 2) Dark-colored blood. 3) Small sample volumes.

Which of the following describes the correct procedure for an Allen test?

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

You obtain an SpO₂ reading of 90% using an oximeter with an approximate accuracy of 5%. This could indicate a PO₂ as low as what level?

While checking a polarographic (Clark) electrode, you determine that the device fails to read 100% when exposed to pure O₂. Which of the following actions would be the proper first step?

For continuous monitoring of adults and children, you should set a pulse oximeter's low alarm in what range?

During capnography monitoring of a mechanically ventilated patient, you note that the PETCO₂ has dropped to 0 mm Hg. Which of the following is the most likely problem?

You obtain an SpO₂ reading of 100% on a patient receiving O₂ through a nonrebreathing mask. What range of PaO₂ levels is possible in this patient?

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble? 1) Decreased PCO₂ 2) Decreased pH 3) Increased PO₂

After obtaining an arterial blood sample through percutaneous puncture using a syringe that does not have a capping safety device, what should you do?

How often should blood gas calibration verification by control media take place?

Exam 19: Analysis and Monitoring of Gas Exchange

Which of the following should be monitored during the sampling of arterial blood? 1) Blood pressure proximal to puncture site 2) Presence of pulsatile blood return 3) Presence of air bubbles or clots in sample 4) Appearance of puncture site

Warming a capillary bed to 42° C has which of the following effects? 1) It constricts the underlying blood vessels. 2) It increases blood flow well above tissue needs. 3) It "arterializes" the capillary blood.

To avoid thermal injury with transcutaneous blood gas monitor sensors, what should you do? 1) Carefully monitor the sensor temperature. 2) Apply hydrocortisone cream under the sensor. 3) Regularly rotate the sensor site.

Which of the following is false about the galvanic fuel cell O2 analyzer?

What is the normal gradient between PaCO2 and PETCO2?

Statistically derived limits for internal quality control of blood gas samples are usually set at what appropriate level?

Which of the following indicates venous admixture during arterial puncture? 1) Need to use syringe suction. 2) Dark-colored blood. 3) Small sample volumes.

Which of the following describes the correct procedure for an Allen test?

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

You obtain an SpO2 reading of 90% using an oximeter with an approximate accuracy of 5%. This could indicate a PO2 as low as what level?

While checking a polarographic (Clark) electrode, you determine that the device fails to read 100% when exposed to pure O2. Which of the following actions would be the proper first step?

For continuous monitoring of adults and children, you should set a pulse oximeter's low alarm in what range?

During capnography monitoring of a mechanically ventilated patient, you note that the PETCO2 has dropped to 0 mm Hg. Which of the following is the most likely problem?

You obtain an SpO2 reading of 100% on a patient receiving O2 through a nonrebreathing mask. What range of PaO2 levels is possible in this patient?

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble? 1) Decreased PCO2 2) Decreased pH 3) Increased PO2

After obtaining an arterial blood sample through percutaneous puncture using a syringe that does not have a capping safety device, what should you do?

How often should blood gas calibration verification by control media take place?

Which of the following is false about the galvanic fuel cell O₂ analyzer?

What is the normal gradient between PaCO₂ and PETCO₂?

You obtain an SpO₂ reading of 90% using an oximeter with an approximate accuracy of 5%. This could indicate a PO₂ as low as what level?

While checking a polarographic (Clark) electrode, you determine that the device fails to read 100% when exposed to pure O₂. Which of the following actions would be the proper first step?

During capnography monitoring of a mechanically ventilated patient, you note that the PETCO₂ has dropped to 0 mm Hg. Which of the following is the most likely problem?

You obtain an SpO₂ reading of 100% on a patient receiving O₂ through a nonrebreathing mask. What range of PaO₂ levels is possible in this patient?

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble? 1) Decreased PCO₂ 2) Decreased pH 3) Increased PO₂