Medical Gas Therapy Quiz

You set up an Oxy-Hood with an FiO2 of 0.5 for a newborn infant. What is the maximum time that should pass before assessing this patient's PaO2 or SaO2? A) 1 hr B) 2 hr C) 8 hr D) 12 hr

A) 1 hr

Which of the following equipment(s) could be powered by a small diaphragm or turbine air compressor? 1. Small-volume medication nebulizer 2. All-purpose large-volume jet nebulizer 3. Intermittent positive-pressure breathing device A) 1 only B) 1 and 2 only C) 2 and 3 only D) 1, 2, and 3

A) 1 only Small diaphragm or turbine compressors are ideal for powering devices such as small-volume medication nebulizers.

Primary safety concerns in the application of hyperbaric oxygenation include which of the following? 1. Sudden decompression 2. Electrical fires 3. CO2 accumulation A) 1 and 2 only B) 2 and 3 only C) 1 and 3 only D) 1, 2, and 3

A) 1 and 2 only Box 42.8 Major Complications of HBO Therapy Barotrauma * ear or sinus trauma * Tympanic membrane rupture * Alveolar overdistention * Gas embolism Oxygen Toxicity * CNS toxic reaction * Pulmonary toxic reaction Other * Fire * Sudden decompression * Reversible visual changes * Claustrophobia * Decreased cardia output (CO)

In which of the following clinical situations would you recommend hyperbaric oxygen (HBO) therapy, if available? 1. Carbon monoxide poisoning 2. Respiratory or cardiac arrest 3. Severe trauma 4. Cyanide poisoning A) 1 and 4 only B) 2 and 3 only C) 1, 2, 3, and 4 D) 1, 2, and 4 only

A) 1 and 4 only Carbon monoxide and cyanide poisoning may necessitate HBO therapy.

An infant requires both a precise high FiO2 and maintenance of a neutral thermal environment. Which of the following systems can best achieve these goals? 1. Oxy-Hood or warmed O2 blending system without incubator 2. Heated incubator with automatic O2 controlling system 3. Heated incubator with Oxy-Hood or O2 blending system A) 1 and 2 only B) 2 and 3 only C) 1 and 3 only D) 1, 2, and 3

A) 1, and 2 only Given the highly variable O2 concentration provided by these devices, the best way to control O2 delivery to infants in an incubator is with an Oxy-Hood. The Oxy-Hood is placed over the infant's head inside the incubator. The O2 concentration and gas temperature within the Oxy-Hood, not in the incubator, must be assessed. It is ideal to monitor incubator or Oxy-Hood O2 concentration continuously.

During hyperbaric oxygen (HBO) therapy at 3 ATA, what is the approximate half-life of blood carboxyhemoglobin? A) 23 min B) 80 min C) 5 hr D) 24 hr

A) 23 min The half-life of carboxyhemoglobin under HBO at 3 ATA is only 23 min.

A physician requests that you provide a patient with exactly 40% O2 at a flow of 60 L/min. Lacking a blender, you must manually mix air and O2 to achieve the desired mixture at the prescribed flow. Which of the following air and O2 flows would you select? Air (L/min) O2 (L/min) A) 45 15 B) 15 45 C) 40 20 D) 20 40

A) 45 15 Manually mixing air and oxygen to achieve specified concentration at a given flow. Use Equation 40-3 to compute the O2 flow. (mini clini on p. 924 explains) O2 Flow = Total Flow x (O2% -21) / 79 Airflow = Total Flow - O2 Flow

A true high-flow O2 delivery system should provide at least what flow? A) 60 L/min B) 50 L/min C) 40 L/min D) 30 L/min

A) 60 L/min To qualify as a high-flow device, a system should provide at least 60 L/min total flow.

A patient receiving 3 L/min O2 through a nasal cannula has a measured SpO2 of 93% and no clinical signs of hypoxemia. At this point, what should you recommend? A) Decreasing the flow to 2 L/min and rechecking the SpO2 B) Maintaining the therapy as is and rechecking the SpO2 on the next shift C) Increasing the flow to 4 L/min and rechecking the SpO2 D) Discontinuing the O2 therapy

A) Decreasing the flow to 2 L/min and rechecking the SpO2 The goal is a PaO2 greater than 60 mm Hg or hemoglobin saturation greater than 90%.

A variant of a common low-flow, nasal O2 delivery device that is capable of providing both high humidity and a high FiO2 is known as which of the following? A) High-flow nasal cannula B) Transtracheal catheter C) Nasal catheter D) Demand-flow oxygen

A) High-Flow Nasal Cannula A variation of the standard nasal cannula which can provide both a high FiO2 and high humidity is known as a high-flow nasal cannula.

You must deliver the highest possible FiO2 to a 67-year-old man with pulmonary edema breathing at a rate of 35/min. Which of the following O2 delivery systems would be most appropriate? A) Nonrebreathing mask at 12 to 15 L/min B) Simple mask at 12 to 15 L/min C) Partial rebreathing mask at 12 to 15 L/min D) Aerosol mask with nebulizer set to 100%

A) Non-Rebreathing Mask at 12 to 15 L/min Table 42-3 lists the FiO2 range, FiO2 stability, advantages, disadvantages, and best use of each of these devices.

Which of the following is false about multiplace hyperbaric oxygenation chambers? A) The chamber normally is filled with 100% O2. B) Air locks allow entry and egress of caregivers. C) Pressures of 6 ATA or more can be applied. D) Care is provided directly within the chamber.

A) The chamber is normally filled with 100% O2 The multiplace chamber is filled with air.

A well-fitted nonrebreathing mask, adjusted so that the patient's inhalation does not deflate the bag (flows approximately 10 L/min), should provide inspired O2 concentrations in what range? A) 55% to 70% B) 45% to 60% C) 75% to 90% D) 70% to 85%

As indicated in Table 42-3, however, modern disposable nonrebreathing masks normally do not provide much more than approximately 70% O2. Table 42-3 Overview of Oxygen Therapy Systems * Partial Rebreathing Mask Flow: Minimum of 10 L/min (prevent bag collapse on inspiration) FiO2 Range: 40%-70% * Nonrebreathing Mask Flow: Minimum of 10 L/min (prevent bag collapse on inspiration) FiO2 Range: 60%-80%

Toxic side effects of inhaled NO include which of the following? 1. Acute pulmonary edema 2. Direct cellular damage 3. Impaired surfactant production 4. Sulfahemoglobinemia A) 1 and 3 only B) 1, 2, and 3 only C) 3 and 4 only D) 2, 3, and 4 only

B) 1, 2, and 3 Levels greater than 10 ppm can cause cell damage, hemorrhage, pulmonary edema, and death.

Which of the following are true about ASSS standards? 1. They provide specifications for more than 60 gases and mixtures. 2. They apply only to cylinders sizes F through H/K. 3. They apply to high-pressure connections. 4. They provide a separate connector for all gases. A) 1 and 3 only B) 1, 2, and 3 only C) 3 and 4 only D) 2, 3, and 4 only

B) 1, 2, and 3 only Because there are only 26 connections for the 62 listed gases and mixtures, each gas may not have a unique connection. This means that some gases have identical connections.

Which of the following alternatives may increase the FiO2 capabilities of air-entrainment nebulizers? 1. Add open reservoir to expiratory side of T tube. 2. Connect together two or more nebulizers. 3. Use a commercial dual-flow system. 4. Add open reservoir to inspiratory side of T tube. A) 1 and 2 only B) 1, 2, and 3 only C) 1 and 4 only D) 1, 2, 3, and 4

B) 1, 2, and 3 only Rule of Thumb Box 42.2 Increasing FiO2 Capabilities of Air-Entrainment Nebulizer: * Add open reservoir to expiratory side of T-tube * Provide inspiratory reservoir with one-way expiratory valve * Connect two or more nebulizers together in parallel * Set nebulizer to low concentration; bleed-in O2; analyze and adjust * Use a commercial dual-flow system

Low-flow O2 delivery systems used in respiratory care include which of the following? 1. Nasal O2 cannula 2. Nasal O2 catheter 3. Air-entrainment mask 4. Transtracheal catheter A) 1 and 3 only B) 1, 2, and 4 only C) 3 and 4 only D) 2, 3, and 4 only

B) 1, 2, and 4 Low-flow O2 delivery systems include the nasal cannula, the nasal catheter, and the transtracheal catheter.

Which of the following conditions can be treated with hyperbaric oxygen (HBO) therapy? 1. Carbon monoxide poisoning 2. Septic shock 3. Air embolism 4. Clostridial gangrene A) 1 and 2 only B) 1, 3, and 4 only C) 3 and 4 only D) 1, 2, 3, and 4

B) 1, 3, and 4 only

Features of an ideal delivery system for NO for use with mechanical ventilation include which of the following? 1. Provides precise and stable NO dose delivery. 2. Premixes NO and O2 in a holding reservoir. 3. Provides accurate NO and NO2 monitoring. 4. Maintains proper ventilator function. A) 1 and 3 only B) 1, 3, and 4 only C) 2 and 4 only D) 1, 2, 3, and 4

B) 1, 3, and 4 only Box 42-11 Features of Ideal Nitric Oxide Delivery System * Dependability and Safety * Delivery of a precise and stable dose of NO * Limited production of Nitrogen Oxide * Accurate monitoring of NO and NO2 levels * Maintenance of adequate patient ventilation

Benefits of properly applied O2 therapy in patients with chronic hypoxemia include which of the following? 1. Reversal of pulmonary vasoconstriction 2. Relief of pulmonary hypertension 3. Decreased right ventricular workload 4. Improved pulmonary vital capacity A) 1 and 3 only B) 1, 2, and 3 only C) 3 and 4 only D) 2, 3, and 4 only

B) 1,2, and 3 only Oxygen therapy can reverse pulmonary vasoconstriction and decrease right ventricular workload.

A physician orders 40% O2 through an air-entrainment nebulizer for a patient with a minute volume of 12 L/min. What is the minimum nebulizer input flow required to ensure the prescribed FiO2? A) 8 L/min B) 10 L/min C) 12 L/min D) 14 L/min

B) 10 L/min For example, the total output flow of an air-entrainment nebulizer set to deliver 40% O2 ranges from 48 to 60 L/min.

Which of the following would indicate adequate oxygenation for adult patients with chronic lung disease and an accompanying acute-on-chronic hypoxemia? 1. SaO2 of 90% or higher 2. PaO2 of 50 to 60 mm Hg 3. SaO2 of 85% to 90% A) 1 and 2 only B) 2 and 3 only C) 1 and 3 only D) 1, 2, and 3

B) 2 and 3 only Adequate oxygenation of these patients generally means an SaO2 of 85% to 90% with a PaO2 of 50 to 60 mm Hg.

What is the minimum flow setting for a simple mask applied to an adult? A) 3 L/min B) 5 L/min C) 8 L/min D) 10 L/min

B) 5 L/min At a flow less than 5 L/min, the mask volume acts as dead space and causes CO2 rebreathing. Table 42-3 Overview of Oxygen Therapy Systems * Simple Mask Flow: 5-10 L/min FiO2: 35%-50%

Delivery systems that provide only a portion of a patient's inspired gas are referred to as what? A) Fixed-performance systems B) Variable-performance systems C) High-flow O2 systems D) Air-entrainment systems

B) Variable-performance systems A system that supplies only a portion of the inspired gas always provides a variable FiO2. An example of a variable-performance system is a nasal cannula.

According to AARC clinical practice guidelines, what is the minimum frequency for checking the functioning of an O2 delivery system? A) Every 4 hr B) Every 8 hr C) Every 24 hr D) Every 48 hr

C) Every 24 hr Excerpts from the AARC guideline on O2 therapy in acute care hospitals appear in CPG 41-1.

Properly applied O2 therapy can decrease which of the following? 1. Ventilatory demand 2. Work of breathing 3. Cardiac output A) 2 and 3 only B) 1 and 2 only C) 1, 2, and 3 D) 1 and 3 only

C) 1, 2, and 3 In cases of acute hypoxemia, supplemental O2 can decrease demands on both the heart and the lungs.

Which of the following signs and symptoms are associated with the presence of hypoxemia? 1. Tachypnea 2. Tachycardia 3. Cyanosis 4. Bradycardia A) 2 and 3 only B) 1 and 2 only C) 1, 2, and 3 only D) 1 and 4 only

C) 1, 2, and 3 Last, hypoxemia has many manifestations, such as tachypnea, tachycardia, cyanosis, and distressed overall appearance.

Which of the following are advantages of the nasal cannula as a low-flow O2 delivery system? 1. Stability 2. Low cost 3. Easy application 4. Disposability A) 2 and 4 only B) 1, 2, and 4 only C) 2, 3, and 4 only D) 1, 2, 3, and 4

C) 2, 3, and 4 Table 42-3 lists the FiO2 range, FiO2 stability, advantages, disadvantages, and best use of the nasal cannula.

What temperature is required to maintain a neutral thermal environment (NTE) in an Oxy-Hood for infants weighing 2500 g or more? A) 25° C B) 30° C C) 35° C D) 40° C

C) 35° C For example, the NTE temperature for newborns weighing less than 1200 g is 35° C.

What is the upper limit of O2 concentrations available through tents? A) 60% to 70% B) 50% to 60% C) 40% to 50% D) 30% to 40%

C) 40% to 50% For example, in large tents O2 input flow of 12 to 15 L/min can provide only 40% to 50% O2 levels.

To minimize the risk of retinopathy of prematurity (ROP), the American Academy of Pediatrics recommends keeping the PaO2 below what level? A) 60 mm Hg B) 70 mm Hg C) 80 mm Hg D) 90 mm Hg

C) 80 mm Hg The American Academy of Pediatrics recommends keeping an infant's arterial PO2 below 80 mm Hg as the best way of minimizing the risk of ROP.

What is the level of SpO2 typically associated with discontinuation of O2 therapy? A) 88% B) 90% C) 92% D) 94%

C) 92% Once the SpO2 is 92% or higher on room air, therapy is often discontinued.

Before administering a helium-O2 mixture to a patient with large airway obstruction, what should you do? A) Analyze the helium concentration of the mixture. B) Heat the cylinder to ensure complete mixing of contents. C) Analyze the O2 concentration of the mixture. D) Roll the cylinder to ensure complete mixing of contents.

C) Analyze the O2 concentration of the mixture In addition to special flow considerations, the respiratory therapist should use an O2 analyzer to continuously monitor heliox (actually O2) concentrations between the source of the mixture and the patient.

A patient is receiving O2 through a nonrebreathing mask set at 8 L/min. You notice that the mask's reservoir bag collapses completely before the end of each inspiration. Which of the following actions is appropriate in this case? A) Change to a partial rebreather. B) Decrease the liter flow. C) Increase the liter flow. D) Change to a simple mask.

C) Increase the liter flow Refer to Table 42.6 Troubleshooting Common Problems with Reservoir Masks (p. 917)

Which of the following is considered an advantage of the transtracheal catheter? A) It does not provide any economic benefit compared with the nasal cannula. B) It decreases the anatomic reservoir. C) It requires 40% to 60% less O2 flow than the nasal cannula. D) It requires higher flows than the nasal cannula.

C) It requires 40% to 60% less O2 flow than the nasal cannula Compared with a nasal cannula, a transtracheal catheter needs 40% to 60% less O2 flow to achieve a given arterial partial pressure of O2 (PaO2).

A cooperative and alert postoperative patient who is able to eat requires a continuous but low FiO2. Precise FiO2 concentrations are not needed. Which of the following devices would best achieve this end? A) Simple O2 mask B) Air-entrainment mask C) Nasal cannula D) Nonrebreathing mask

C) Nasal Cannula Table 42-3 lists the FiO2 range, FiO2 stability, advantages, disadvantages, and best use of each of these devices.

A patient with chronic hypercapnia placed on an FiO2 of 0.6 starts hypoventilating. What is a possible cause of this phenomenon? A) Decreased cardiac output B) O2 toxicity C) O2-induced hypoventilation D) Absorption atelectasis

C) O2-induced hypoventilation When breathing moderate to high O2 concentrations, COPD patients with chronic hypercapnia may tend to ventilate less.

Compared to air, the density of an 80% He and 20% O2 mixture is about which of the following? A) Two-thirds as much B) One-half as much C) One-third as much D) One-fifth as much

C) One-third as much

A physician orders 2 L/min O2 through a simple mask to a 33-year-old postoperative woman with moderate hypoxemia breathing room air (PaO2 = 52 mm Hg). What would be the correct action at this time? A) Carry out the physician's prescription exactly as written. B) Recommend that the mask be changed to a cannula at 2 L/min. C) Recommend a flow of at least 5 L/min to washout carbon dioxide (CO2). D) Do not apply the O2 until the medical director has been contacted.

C) Recommend a flow of at least 5 L/min to washout CO2 At a flow less than 5 L/min, the mask volume acts as dead space and causes CO2 rebreathing.

A physician orders supplemental O2 for a patient through a nasal cannula at a flow of 12 L/min. When you ask what the goal is, the physician states that the patient should receive approximately 60% O2. Which of the following should you recommend? A) The O2 should be given through a reservoir mask at 10 L/min. B) The cannula flow should be set to 15 instead of 12 L/min. C) The O2 should be given through a simple mask set at 5 to 12 L/min. D) The O2 should be given through a simple mask set at 12 to 15 L/min.

C) The O2 should be given through a simple mask set at 5 to 12 L/min Table 42-3 lists the FiO2 range, FiO2 stability, advantages, disadvantages, and best use of each of these devices.

When full, a gas cylinder registers a pressure of 2200 psig. After a few hours of use, the pressure gauge reads 550 psig. The cylinder is now how full? A) One-half B) One-third C) One-fourth D) Two-thirds

C) one-fourth For gas-filled cylinders, the volume of gas in the cylinder is directly proportional to its pressure at a constant temperature. If a cylinder is full at 2200 psig, it will be half full when the pressure decreases to 1100 psig.

Which of the following would indicate a need for O2 therapy for an adult or a child? 1. SaO2 less than 90% 2. PaCO2 greater than 45 mm Hg 3. PaO2 less than 60 mm Hg A) 2 and 3 only B) 1 and 2 only C) 1, 2, and 3 D) 1 and 3 only

D) 1 and 3 only

Which of the following factors should be used in properly selecting an O2 delivery device? 1. Knowledge of general performance of the device 2. Physician's preference 3. Individual capabilities of the equipment A)2 and 3 only B)1 and 2 only C)1, 2, and 3 D)1 and 3 only

D) 1 and 3 only Proper device selection requires in-depth knowledge of both the general performance characteristics of these systems and the individual capabilities.

In giving O2 to an infant through a hood, which of the following are correct? 1. A neutral thermal environment should be maintained. 2. Gases should be directed away from the infant's face. 3. High input flow (>10 to 15 L/min) should be avoided. 4. A minimum flow of 7 L/min must be maintained. A) 1, 2, and 3 only B) 2 and 4 only C) 2, 3, and 4 only D) 1, 2, 3, and 4

D) 1, 2, 3, and 4 In the care of premature infants, it is especially important to ensure that the gas mixture is properly warmed and humidified and not directed toward the patient's face or head.

A patient breathing 100% O2 for 24 hr or longer would most likely exhibit which of the following? 1. Decreased DLCO 2. Decreased CL 3. Increased PAO2 - PaO2 4. Decreased VC A) 2 and 4 only B) 1, 2, and 3 only C) 3 and 4 only D) 1, 2, 3, and 4

D) 1, 2, 3, and 4 Table 42-2 summarizes the physiological response to breathing 100% O2 at sea level.

What are some key patient considerations in selecting O2 therapy equipment? 1. Type of airway (natural or artificial) 2. Severity and cause of the hypoxemia 3. Age group (infant, child, adult) 4. Stability of the minute ventilation A) 2 and 4 only B) 1, 2, and 3 only C) 3 and 4 only D) 1, 2, 3, and 4

D) 1, 2, 3, and 4 Table 42-9 lists guidelines for selecting an O2 delivery system on the basis of the level and stability of the FiO2 needed. p. 925

Which of the following factors will decrease the FiO2 delivered by a low-flow O2 system? 1. Short inspiratory time 2. Fast rate of breathing 3. Lower O2 input 4. Large minute ventilation A) 2 and 4 only B) 1, 2, and 3 only C) 3 and 4 only D) 1, 2, 3, and 4

D) 1, 2, 3, and 4 The amount of air dilution depends on several patient and equipment variables. Table 42-4 summarizes these key variables and how they affect the FiO2 provided by low-flow systems

A well-designed oxygen protocol will ensure which of the following? 1. The patient undergoes initial assessment. 2. The patient is evaluated for protocol criteria. 3. The patient receives a treatment plan that is modified according to need. 4. The patient stops receiving therapy as soon as it is no longer needed. A) 1, 2, and 4 only B) 2 and 3 only C) 1 and 3 only D) 1, 2, 3, and 4

D) 1, 2, 3, and 4 An order for "O2 therapy via protocol" permits O2 therapy to be initiated, modified, or discontinued by the RT, provided that an assessment reveals that the patient meets previously approved clinical criteria. A well-designed O2 protocol ensures the patient (1) undergoes initial assessment (2) is evaluated for protocol criteria (3) receives a treatment plan that is modified according to need (4) stops receiving therapy as soon as it is no longer needed.

To prevent an adverse rebound effect when withdrawing NO therapy, what should you do? 1. Reduce the NO to the lowest effective dose (ideally, less than 5 ppm). 2. Hyperoxygenate the patient just before discontinuing NO. 3. Ensure that the patient is hemodynamically stable. A) 1 and 2 only B) 2 and 3 only C) 1 and 3 only D) 1, 2, and 3

D) 1, 2, and 3 First, the NO level should be reduced to the lowest effective dose (ideally =5 ppm). Second, the patient's condition should be hemodynamically stable, and the patient should be able to maintain adequate oxygenation while breathing a moderate FiO2 (0.4 or less) on low levels of positive end expiratory pressure. Third, the patient should be hyperoxygenated (FiO2, 0.60 to 0.70) just before discontinuation of NO inhalation.

Directing a cool O2 mixture to an infant in an Oxy-Hood can result in which of the following? 1. Increased O2 consumption 2. Increased convective heat loss 3. Apnea (cessation of breathing) A) 1 and 2 only B) 2 and 3 only C) 1 and 3 only D) 1, 2, and 3

D) 1, 2, and 3 In premature infants, cold stress can increase O2 consumption and even cause apnea.

Specific clinical objectives of oxygen (O2) therapy include which of the following? 1. Decrease the symptoms caused by chronic hypoxemia. 2. Decrease the workload hypoxemia imposes on the heart and lungs. 3. Correct documented arterial hypoxemia. 4. Correct documented respiratory acidosis. A) 2 and 4 only B) 3 and 4 only C) 1 and 3 only D) 1, 2, and 3 only

D) 1, 2, and 3 only Specific clinical objectives of O2 therapy are to (1) correct documented or suspected acute hypoxemia, (2) decrease the symptoms associated with chronic hypoxemia (3) decrease the workload hypoxemia imposes on the cardiopulmonary system.

Physiologic effects of inhaled nitric oxide (NO) include which of the following? 1. Recruitment of collapsed alveoli 2. Improved blood flow to ventilated alveoli 3. Decreased pulmonary vascular resistance 4. Reduced intrapulmonary shunting 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 The result is a reduction in intrapulmonary shunting, an improvement in arterial oxygenation, and a decrease in pulmonary vascular resistance and pulmonary arterial pressure.

Which of the following statements are true about low-flow O2 delivery systems? 1. The greater the patient's inspiratory flow, the greater is the FiO2. 2. All low-flow devices provide variable O2 concentrations. 3. The O2 provided by a low-flow device is diluted with air. 4. The patient's flow usually exceeds that from a low-flow device. 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 In this case, the more the patient breathes, the more air dilutes the delivered O2, and the lower is the FiO2. Hence, there is an inverse or opposite relationship between FiO2 and inspiratory flow with such O2 devices.

Disadvantages of standard O2 masks include which of the following? 1. Being difficult to apply to patients. 2. Patient discomfort (straps and heat). 3. Increasing the risk of aspiration. 4. Must be removed for eating. 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 Table 42-3 lists the FiO2 range, FiO2 stability, advantages, disadvantages, and best use of each of these devices.

Which of the following are true about air-entrainment systems? 1. Their FiO2 values are directly proportional to their total flow. 2. They can provide variable FiO2 values under some clinical conditions. 3. They always deliver O2 concentrations less than 100%. 4. They yield a set FiO2 only if their flow exceeds the patient's. 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 The typical AEM is designed to deliver a range of low to moderate FiO2 (0.24 - 0.40). The more air they entrain, the higher is the total output flow, but the lower is the delivered FiO2.

A 45-year-old patient with congestive heart failure is receiving O2 through a 35% air-entrainment mask. With an O2 input of 6 L/min, what is the total output gas flow? A) 16 L/min B) 24 L/min C) 28 L/min D) 36 L/min

D) 36 L/min Table 42-7 lists the approximate air-to-O2 ratios for several common O2 percentages.

During hyperbaric oxygen therapy at 3 ATA, plasma contains about how much dissolved O2? A) 1 ml/dl B) 3 ml/dl C) 5 ml/dl D) 7 ml/dl

D) 7 mL/dl When a patient is breathing room air, only a small amount of O2 dissolves in the plasma (approximately 0.3 mL/dl). At 3 ATA, plasma contains nearly 7 ml/dl dissolved O2, a level exceeding average resting tissue uptake.

You design an air-entrainment system that mixes air with O2 at a fixed ratio of 1:7. Approximately what O2 concentration will this device provide? A) 33% B) 40% C) 80% D) 90%

D) 90% Table 42-7 lists the approximate air-to-O2 ratios for several common O2 percentages.

Which of the following devices would you select if the goal was to accurately meter the flow through a jet nebulizer? A) Bourdon gauge B) Flow restrictor C) Uncompensated Thorpe tube D) Compensated Thorpe tube

D) Compensated Thorpe Tube Mini Clini (p. 904) A Compensated Thorpe Tube is required for metering flow through high-resistance equipment such as jet nebulizers

Which of the following is true about reservoir cannulas? A) They reduce O2 use as much as 200%. B) During exercise, they do not reduce O2 use. C) Humidification is absolutely necessary. D) Nasal anatomy and breathing pattern can affect performance of the device.

D) Nasal anatomy and breathing pattern can affect performance of the device. Although flow savings are fairly predictable, factors such as nasal anatomy and breathing pattern can affect the performance of the device.

What is the fire-risk classification of both N and CO2? A) Flammable B) Supports combustion C) Inflammable D) Nonflammable

D) Non-Flammable Table 41.1 Physical Characteristics of Medical Gases Laboratory Gases Flammability Nitrogen (N) Nonflammable Helium (He) Nonflammable Carbon Dioxiode (CO2) Nonflammable

According to the National Institute of Standards and Technology of the U.S. Department of Commerce, a gas cylinder that is color-coded brown and green should contain which of the following? A) O2-N2 mixture B) O2-CO2 mixture C) CO2 D) O2-He mixture

D) O2-He mixture Table 41.2 lists the color codes for medical gases as adopted by the Bureau of Standards of the U.S. Department of Commerce. Color Codes for Medical Gas Cylinders O2 = Green CO2 = Gray N2O = Blue Cyclopropane = Orange He = Brown C2H4 = Red CO2-O2 = Gray/Green He-O2 = Brown/Green N2 = Black Air = Yellow N2-O2 = Black/Green

You connect an intubated patient to an air-entrainment nebulizer system through a T tube set at 60% with an input flow of 15 L/min. Toward the middle of inspiration, you observe that mist stops exiting from the open end of the T tube. What does this indicate? A) Flow is adequate to meet patient needs. B) Patient has a low inspiratory flow rate. C) Flowmeter must be calibrated. D) Patient is not receiving 60% O2.

D) Patient is NOT receiving 60% O2 As long as mist can be seen escaping throughout inspiration, flow is adequate to meet the patient's needs, and the delivered FiO2 is ensured.

Physiologic effects of hyperbaric oxygen (HBO) therapy include all of the following except: A) neovascularization. B) bubble reduction. C) enhanced immune function. D) systemic vasodilation.

D) Systemic Vasodilation Box 42.5 Physiologic Effects of Hyperbaric Oxygen Therapy * Bubble reduction (Boyle's Law) * Hyperoxygenation of blood & tissue (Henry's Law) * Vasoconstriction * Enhanced host immune function * Neovascularization

Which of the following factors determine the actual O2 provided by an air-entrainment system? 1. O2 input flow to the jet 2. Air-to-O2 ratio of the device 3. Resistance downstream from the jet A) 2 and 3 only B) 1 and 2 only C) 1, 2, and 3 D) 1 and 3 only

The FiO2 provided by air-entrainment devices depends on two key variables: 1) the air-to-O2 ratio 2) the amount of flow resistance downstream from the mixing site.