1066 Non-Invasive Exam Reading Quiz

At the very beginning of exhalation, the PETCO2 normally should be at what level? Question options: A. 0 mm Hg B. 15 mm Hg C. 25 mm Hg D. 40 mm Hg

A. 0 mm Hg

What is the normal gradient between PaCO2 and PETCO2? Question options: A. 3 to 5 mm Hg B. 5 to 10 mm Hg C. 10 to 15 mm Hg D. 15 to 20 mm Hg

A. 3 to 5 mm Hg

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? Question options: A. 55 mm Hg B. 60 mm Hg C. 65 mm Hg D. 70 mm Hg

A. 55 mm Hg

Which of the following patient parameters does not need to be assessed as part of arterial blood sampling? Question options: A. Blood pressure B. Temperature C. Position or activity level D. Clinical appearance

A. Blood pressure

What is the greatest hazard of pulse oximetry? Question options: A. False results leading to incorrect decisions B. Pressure sores at the measuring site C. Skin burns due to using incompatible probes D. Electrical shock at the measuring site

A. False results leading to incorrect decisions

What is the most common technique used to measure CO2 in respiratory gases? Question options: A. Infrared absorption B. Mass spectroscopy C. Photoacoustics D. Raman scattering

A. Infrared absorption

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

You are asked to provide continuous monitoring of the FiO2 provided by a humidified O2 delivery system using a galvanic cell analyzer. Where would you install the analyzer's sensor? Question options: A. Proximal to the heated humidifier B. On the expiratory side of the circuit C. Distal to the heated humidifier D. As close to the patient as possible

A. Proximal to the heated humidifier

To assess gas exchange at the tissues, you would obtain a blood sample from which of the following? Question options: A. Pulmonary artery (balloon-deflated) B. Peripheral artery (radial, brachial) C. Central vein (superior or inferior vena cava) D. Pulmonary artery (balloon-inflated)

A. Pulmonary artery (balloon-deflated)

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? Question options: A. Pulse oximetry (SpO2) B. Transcutaneous monitoring (PtcO2) C. Arterial puncture (PaO2) D. Intraarterial optode monitoring

A. Pulse oximetry (SpO2)

To measure PCO2, blood gas analyzers use what electrode? Question options: A. Severinghaus B. Clark C. Sahn D. White

A. Severinghaus

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? Question options: A. Ventilator disconnection B. Tracheal intubation C. Increased cardiac output D. Hypoventilation

A. Ventilator disconnection

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. Question options: A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 3 only

You are asked to calibrate an O2 analyzer. Which of the following gases would you use for this procedure? 1. 100% oxygen 2. 50% oxygen 3. 21% oxygen (room air) Question options: A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

B. 1 and 3 only

A patient being monitored by capnography exhibits a sudden rise in end-tidal CO2 levels. Which of the following are possible causes? 1. Sudden release of a tourniquet 2. Massive pulmonary embolism 3. Sudden increase in cardiac output 4. Injection of NaHCO3 Question options: A. 2 and 3 only B. 1, 3, and 4 only C. 2, 3, and 4 only D. 1, 2, 3, and 4

B. 1, 3, and 4 only

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. 3. Physiologic monitoring can be either invasive or noninvasive. 4. Invasive procedures provide more accurate data but carry greater risks. Question options: A. 2 and 4 only B. 1, 3, and 4 only C. 2 only D. 1, 2, 3, and 4

B. 1, 3, and 4 only

What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor? Question options: A. 1 to 2 hr B. 2 to 12 hr C. 6 to 8 hr D. 8 to 12 hr

B. 2 to 12 hr

Under ideal conditions, electrochemical oxygen (O2) analyzers have approximately what degree of accuracy? Question options: A. 1% B. 2% C. 3% D. 4%

B. 2%

What is a normal end-tidal PETCO2 range? Question options: A. 30 to 38 mm Hg B. 35 to 43 mm Hg C. 38 to 46 mm Hg D. 42 to 50 mm Hg

B. 35 to 43 mm Hg

What is the normal variation for end-tidal CO2 as measured by capnography compared to PaCO2? Question options: A. 0% to 5% B. 5% to 6% C. 6% to 8% D. 35% to 45%

B. 5% to 6%

Pulse oximeter readings are generally unreliable at saturations below what level? Question options: A. 70% B. 80% C. 90% D. 95%

B. 80%

What is the measurement of CO2 in respiratory gases called? Question options: A. Oximetry B. Capnometry C. Optometry D. Barometry

B. Capnometry

Which of the following is not a common tissue injury to be on guard for at the site of transcutaneous blood gas electrode placement? Question options: A. Erythema B. Hematomas C. Burns or blisters D. Skin tears

B. Hematomas

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

B. Inspiration of fresh respiratory gas

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? Question options: A. Normal intracranial pressure B. Ischemic brain damage C. Normal cerebral perfusion D. Cerebral hyperperfusion

B. Ischemic brain damage

Which of the following is false about the galvanic fuel cell O2 analyzer? Question options: 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.

B. It requires an external power source (alternating current line or batteries).

What is the most common source of error and false alarms with pulse oximetry? Question options: A. Presence of HbCO B. Patient motion artifact C. Presence of vascular dyes D. Ambient light detection

B. Patient motion artifact

Which of the following is false about transcutaneous blood gas monitoring? Question options: 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.

B. Transcutaneous blood gas monitoring is most accurate when used with older adults.

Which of the following will result in falsely low HbO2 readings with a pulse oximeter? Question options: A. Presence of HbCO B. Vascular dyes C. Dark skin pigmentation D. Presence of fetal hemoglobin

B. Vascular dyes

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 Question options: A. 1 and 3 only B. 2, 3, and 4 only C. 1, 2, and 4 only D. 1, 2, 3, and 4

C. 1, 2, and 4 only

Indications for pulse oximetry include which of the following? 1. To assess changes in HbO2 during certain procedures 2. To measure abnormal Hb 3. To comply with external regulations or recommendations 4. To monitor the adequacy of HbO2 saturation Question options: A. 1 and 4 only B. 1, 2, and 4 only C. 1, 3, and 4 only D. 1, 2, 3, and 4

C. 1, 3, and 4 only

What is a normal level for CaO2? Question options: A. 12 to 15 ml/100 ml B. 14 to 16 ml/100 ml C. 18 to 20 ml/100 ml D. 16 to 22 ml/100 ml

C. 18 to 20 ml/100 ml

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. Question options: A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

C. 2 and 3 only

Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry? Question options: A. 1% to 2% B. 2% to 3% C. 3% to 5% D. 5% to 7%

C. 3% to 5%

A PaO2 below what value would be considered moderate hypoxemia? Question options: A. 75 mm Hg B. 65 mm Hg C. 55 mm Hg D. Depends on the FiO2

C. 55 mm Hg

For continuous monitoring of adults and children, you should set a pulse oximeter's low alarm in what range? Question options: A. 80% to 85% B. 85% to 88% C. 88% to 92% D. 93% to 97%

C. 88% to 92%

Which of the following can cause false high readings when using a pulse oximeter? Question options: A. Fetal hemoglobin B. Intravascular dyes C. Carboxyhemoglobin D. Presence of metHb

C. Carboxyhemoglobin

While monitoring an active infant through a transcutaneous blood gas system, you notice a rapid rise in PtcO2 from 63 to 145 mm Hg. At that same time, the (PtcCO2) drops from 35 to 7 mm Hg. What is the most appropriate action in this case? Question options: A. Perform a quick assessment of the infant's airway. B. Stabilize the infant and call for emergency assistance. C. Check the sensor for air leaks or dislodgment. D. Remove the sensor and recalibrate the instrument.

C. Check the sensor for air leaks or dislodgment.

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

C. Compare the monitor's readings to those obtained with a concurrent ABG sample.

How does the Clark polarographic O2 electrode function? Question options: A. It measures the magnetic properties of O2 versus N2. B. It measures the electrical potential across a Wheatstone bridge. C. It uses O2 to produce a reduction-oxidation reaction. D. It measures the comparative cooling effect on a heated wire.

C. It uses O2 to produce a reduction-oxidation reaction.

The shape of the expired CO2 tracing of a patient is normal but instead of being zero, the baseline is elevated to approximately 12 mm Hg. Which of the following is the most likely problem? Question options: A. Patient disconnected from the system B. Obstruction of the sampling tube C. Rebreathing D. Presence of N2O

C. Rebreathing

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? Question options: 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.

C. Replace the analyzer's batteries.

Before attaching a transcutaneous blood gas monitor sensor to a patient, what should you do? 1. Provide a specified warm-up time and set the probe temperature. 2. Check the membrane and prepare a sensor with an adhesive ring and gel. 3. Prepare the monitoring site (remove excess hair and clean the skin). Question options: A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3

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. Question options: A. 1 and 2 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3

D. 1, 2, and 3

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 Question options: A. 3 and 4 only B. 1 and 3 only C. 2 and 4 only D. 1, 2, and 3 only

D. 1, 2, and 3 only

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? Question options: A. 60 to 90 mm Hg B. 90 to 100 mm Hg C. 100 to 200 mm Hg D. 100 to 600 mm Hg

D. 100 to 600 mm Hg

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 Question options: A. 1, 2, and 3 only B. 1 and 4 only C. 2 and 4 only D. 2, 3, and 4 only

D. 2, 3, and 4 only

Which of the following guidelines should you adhere to when performing pulse oximetry? 1. Mix different sensors among different devices to ensure accuracy. 2. Make sure that the sensors are the correct size and are properly applied. 3. Avoid using pulse oximetry to monitor hyperoxia in neonates. 4. Whenever possible, validate the initial SpO2 against the actual SaO2. Question options: A. 1 and 3 only B. 1, 2, and 3 only C. 3 and 4 only D. 2, 3, and 4 only

D. 2, 3, and 4 only

During calibration of a Clark polarographic O2 analyzer, you cannot get the sensor to read 100% when exposed to 100% O2, even after adjusting its calibration control. The unit has new batteries. Which of the following actions would be correct? Question options: A. Use it only with low FiO2 values. B. Send the device out for repair. C. Replace the unit's batteries. D. Change the sensor or electrode.

D. Change the sensor or electrode.

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

D. Exhalation of mainly alveolar gas

In which of the following patients would transcutaneous blood gas monitoring most likely provide inaccurate or erroneous results? Question options: A. Newborn infant with respiratory distress syndrome (RDS) B. Patient with hypoxemia C. Patient with a hyperpyrexia D. Patient in hypovolemic shock

D. Patient in hypovolemic shock

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? Question options: 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.

D. Relocate the sensor to a more stable location.

Oximetry is the measurement of blood hemoglobin saturations using what technique? Question options: A. Electrochemical dissociation B. Photoplethysmography C. Photochemical reactions D. Spectrophotometry

D. Spectrophotometry

The transcutaneous blood gas electrode should not be placed on the: Question options: A. chest. B. abdomen. C. lower back. D. thigh.

D. thigh.