Deck 13: Monitoring and Life Support Equipment

Question 1

During the process of taking a patient's blood pressure,the Korotkoff sound that increases in intensity with a distinct tapping is associated with which of the following clinical interpretations?

A)Systolic pressure
B)Blood flow increasing as artery compression is decreasing
C)Diastolic pressure in <13 years of age
D)Diastolic pressure in adults

Answer 1

B
The first sound heard (faint tapping sound with increasing intensity)is systolic whereas the sounds increasing in intensity with a distinct tapping indicate blood flow increasing as the artery compression is decreasing.When the sounds become muffled or disappear,it indicates diastolic in children <13 years and in adults,respectively.

Question 2

Which of the following bispectral index monitor (BIS)reading value ranges indicates light to moderate sedation?

A)90 to 100
B)70 to 85
C)60 to 70
D)40 to 55

Answer 2

C
The manufacturer of BIS guidelines indicates a 60 to 70 BIS value as being light to moderate sedation.A value is produced every 15 seconds that ranges from 0 (no cortical electrical activity)to 100 (awake,aware,no suppression).

Question 3

Which of the following arteries is the arterial line for hemodynamic monitoring MOST commonly inserted?

A)Femoral artery
B)Radial artery
C)Brachial artery
D)Axillary artery

Answer 3

B
An arterial line is most commonly inserted through the radial artery,but can also be inserted through the femoral artery.Less commonly it can be inserted into the brachial,axillary,ulnar,or dorsalis pedis arteries.

Question 4

Which of the following values BEST reflects normal adult systolic blood pressure at rest?

A)150 to 165 mm Hg
B)140 to 150 mm Hg
C)90 to 135 mm Hg
D)75 to 90 mm Hg

Question 5

A patient in the ICU who is posttraumatic brain injury has an intracranial pressure monitoring device that reads 55 mm Hg at rest when the physical therapist enters the room to begin a treatment session.Based on the intracranial pressure reading,what should the physical therapist do next?

A)Start passive range of motion and allow frequent periods of rest.
B)Continue with assisting the patient out of bed into a recliner with a mechanical lift.
C)Hold any activity interventions and attempt to see patient next scheduled visit.
D)Perform passive stretching and reposition the patient.

Question 6

Which of the following factors associated with a patient is NOT considered a cause of inaccurate pulse oximetry readings?

A)Presence of perspiration or sweat
B)Presence of dark nail polish
C)Anemia
D)Low perfusion states (low cardiac output)

Question 7

The continuous positive airway pressure (CPAP)ventilation system is the treatment of choice for which of the following pulmonary abnormalities?

A)Obstructive sleep apnea
B)Chronic ventilator failure
C)Acute respiratory failure
D)Pulmonary edema

Question 8

Which of the following masks is typically used in conjunction with a nebulizer to humidify the gas being administered?

A)Nasal cannula
B)Simple mask
C)Aerosol mask
D)Venturi mask

Question 9

The pulmonary artery end-diastolic pressure measured by a Swan-Ganz catheter is essentially equal to which of the following cardiac pressures?

A)Left ventricular end-diastolic pressure
B)Left atrial pressure
C)Right atrial pressure
D)Systolic pressure

Question 10

A central line or central venous pressure (CVP)provides which of the following functions?

A)Continuous monitoring of cardiac function and intravascular fluid status.
B)Route for medication administration.
C)Emergency placement of temporary pacemaker.
D)All of the above functions can be completed through a central line.

Question 11

Which of the following statements is TRUE about mean arterial pressure (MAP)readings?

A)The MAP reading does not vary significantly with motion artifact or movement.
B)The MAP is useful clinically as it relates to cardiac output and systemic vascular resistance.
C)An MAP value of <60 mm Hg may indicate inadequate tissue perfusion.
D)All of the above are true statements.

Question 12

Which of the following oxygen delivery devices is generally intended for lower flow rates of oxygen between 1 and 6 L/min?

A)Nasal cannula
B)Simple mask
C)Aerosol mask
D)Venturi mask

Question 13

Which of the following clinical signs is MOST indicative of respiratory distress?

A)Patient is wincing.
B)Color in patient's face is flushed red.
C)Paradoxical breathing.
D)Patient is shivering.

Question 14

A physical therapist is working with a patient bedside in ICU assisting with bed mobility and repositioning.An irregular rhythm was noted on the single-channel ECG monitor and an alarm sounded.What should the physical therapist do next?

A)The physical therapist should silence the alarm and continue with care.
B)The physical therapist should temporarily stop treatment and determine the cause of the alarm.
C)The physical therapist should temporarily stop the treatment and defer to the nurse about the reason for the alarm.
D)The physical therapist should end the treatment session and notify the nurse an alarm was sounding.

Question 15

The term cardiac index is BEST defined by which of the following statements?

A)The amount of blood pumped by the heart per unit of time
B)The amount of blood pumped by the heart per unit of time per square meter of body surface area
C)The amount of blood ejected with each contraction of the heart
D)The primary indicator of left ventricular performance reflecting pulmonary vascular resistance

Question 16

Which of the following reasons is given for a reduced infection rate with tunneled catheters for long-term use as compared to peripherally inserted central catheter (PICC)lines?

A)The tunneled catheter is coated with an antibiotic before insertion.
B)The tunneled catheter is protected by the natural barrier of the skin.
C)Both types of long-term central access have the same level of infection rate.
D)During insertion of a tunneled cathartic surgically,the site is washed with antibiotic.

Question 17

Low central venous pressure (CVP)indicates which of the following clinical abnormalities?

A)Fluid overload
B)Right ventricular failure
C)Dehydration
D)Tricuspid insufficiency

Question 18

Which of the following oxygen delivery devices would potentially provide the HIGHEST fraction of inspired oxygen (FiO₂)?

A)Simple mask
B)Venturi mask
C)Partial rebreather mask
D)Nonrebreather mask

Question 19

Which of the following ventilation systems is MOST likely used when there is a need to disconnect the patient from mechanical ventilation for a prolonged period of time for ambulation training?

A)Continuous positive airway pressure
B)Bilevel positive airway pressure
C)Manual resuscitator
D)Venturi mask

Question 20

Which of the following oxygen fraction percentages is the MINIMAL percentage in which humidification is desired to avoid nasal and oral mucosa dryness and irritation?

A)24%
B)32%
C)45%
D)55%

Question 21

A patient's inability to clear secretions from the lower airways along with a need for positive-pressure mechanical ventilator assistance is an indication for which of the following airway devices?

A)Oral pharyngeal airway
B)Nasal pharyngeal airway
C)Endotracheal tube
D)Tracheostomy

Question 22

Patients with intra-aortic balloon pump can tolerate early activity such as mobilization out of bed and ambulation.

Question 23

The physical therapist is scheduled to see a patient mid-afternoon who completed hemodialysis that morning.Which of the following monitoring and intervention pairings would be MOST appropriate?

A)Monitor patient fatigue,complete bedside active range of motion exercise with patient in supine position.
B)Monitor patient symptoms,perform one set of active range of motion extremity exercises in bed and then progress patient to sitting on the edge of the bed.
C)Monitor vital signs and patient symptoms before,during,and after mobility to edge of bed,active exercise in sitting,and low-intensity ambulation.
D)Monitor vital signs and patient symptoms at rest.If stable,assist the patient with mobility out of bed and hall ambulation as tolerated.

Question 24

Which of the following ventilator modes allows a patient to take spontaneous breaths between minimum minute ventilation provided mechanically?

A)Assist control
B)Synchronized intermittent mandatory ventilation (SIMV)
C)Pressure support ventilation
D)Continuous positive airway pressure

Question 25

Which of the following statements provides the MOST appropriate rationale for inserting a tracheostomy as opposed to an endotracheal tube?

A)It is used with a patient who has upper airway obstruction.
B)It is used with a patient who demonstrates an inability to clear secretions from the lower airways.
C)It is used with a patient who needs positive-pressure mechanical ventilator assistance.
D)It is used with a patient who needs prolonged intubation along with protection of trachea and vocal cords.

Question 26

Using a simple mask and an oxygen flow rate of 9 L/min,the patient is inspiring close to a 100% of oxygen fraction.

Question 27

Mechanical ventilation that possibly leads to respiratory alkalosis or hyperinflation in a patient with airway obstruction is MOST likely which of the following types of ventilator modes?

A)Assist control
B)Synchronized intermittent mandatory ventilation
C)Pressure support ventilation
D)Continuous positive airway pressure

Question 28

Which of the following invasive ventilator devices provides an airway and is LESS likely to stimulate a gag reflex in the semiconscious or alert patient?

A)Oral pharyngeal airway
B)Nasal pharyngeal airway
C)Endotracheal tube
D)Tracheostomy

Question 29

Which of the following statements BEST describes how the intra-aortic balloon pump (IABP)facilitates an increase in cardiac output?

A)The inflated balloon creates a pressure forcing the blood to circulate into the coronary arteries.
B)The deflated balloon creates a pressure gradient enhancing the flow of blood through the aorta during left ventricular systole.
C)The inflated balloon creates a pressure enhancing the blood flow into the chambers of the heart.
D)The deflated balloon enhances relaxation of the heart muscle.

Question 30

Which of the following modes of mechanical ventilation would provide an augmentation to a spontaneously breathing patient with weakened respiratory musculature such as in Guillain-Barré syndrome?

A)Negative-pressure ventilator
B)Positive-pressure ventilator
C)High-frequency oscillatory ventilation
D)Bilevel positive airway pressure ventilation

Question 31

Electrocardiogram electrodes are used in continuous monitoring of a patient and provide information on heart rate,heart rhythm,and respiratory rate.

Question 32

Which of the following is an indicator for mechanical ventilation?

A)Protection of the airway and lung parenchyma.
B)Relief of upper airway obstruction.
C)Improvement of pulmonary toilet in patients with excessive secretions.
D)All of the above are appropriate indicators.