RES 220 FINAL (Quizzes)

Choose the number that identifies the pulmonary artery 1)7 2)8 3)9 4)10

1)7

Which of the following can be assessed for tissue perfusion? A)Hair B)eyes C)arterial pulses D)venous blood

C)arterial pulses

Choose the following heart and pulmonary pressure waveforms: A)Right Atrium B)Pulmonary artery C)pulmonary wedge D)Aorta

B)Pulmonary artery

Before insertion, the PA catheter balloon should not be tested for leaks by filling with a fluid A) True B) False

A) True

Capnography can assist a clinician in successful weaning ensuring that the patient is clinically stable and without clinically significant residual effect of any anesthetic agents or sedatives. A) True B) False

A) True

Capnography used for the verification of intubation is the most reliable method of confirming and monitoring correct placement of an endotracheal tube. A) True B) False

A) True

Flushing should not be done in the wedge position A) True B) False

A) True

The "normal" capnogram is a waveform that represents the varying CO2 level throughout the breath cycle over time. A) True B) False

A) True

When aspiration fails to produce a blood return and a blood clot is suspected, the system should not be flushed to attempt to remove the clot. A) True B) False

A) True

Given the following hemodynamic results. The MAP is 130 mmHg BP = 182/104 mmHg A) True B) False

A) True Formula 2(diastolic pressure) + systolic pressure / 3 2(104) + 182 / 3 208 + 182 / 3 390 / 3 MAP= 130

Choose the normal value for the heart rate A)60-100 bpm B)50-60 C)120/80 D)90-120 bpm

A)60-100 bpm

Normal range for MAP A)70-105 mmHg B)less than 60 C)more than 100 mmHg D)60-80 mmHg

A)70-105 mmHg

A patient in the ICU has a chest X-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 3 mm Hg, pulmonary artery pressure (PAP) 21/10 mm Hg, and pulmonary artery occlusion pressure (PAOP) 8 mm Hg. These findings are consistent with which of the following? A)Acute respiratory distress syndrome B)Cardiogenic pulmonary edema C)Pulmonary hypertension D)Right heart failure

A)Acute respiratory distress syndrome

If the patient moves up above the transducer manifold for an indwelling arterial line what will happen to the blood pressure reading A)BP reading will increase B)BP reading will decrease C)BP reading will not change D)BP reading will show an error

A)BP reading will increase

Which of the following can cause an elevated right arterial pressure? A)Cardiac tamponade B)Third-degree heart block C)Decreased ventricular compliance D)Left ventricular failure

A)Cardiac tamponade

Absolute confirmation of placement of a central venous pressure catheter is done with which of the following? A)Chest X-ray B)Checking the centimeter mark C)Ensuring appropriate waveform D)Drawing a blood sample through the catheter

A)Chest X-ray

The capnogram in the figure is indicative of which of the following conditions? A)Chronic obstructive pulmonary disease (COPD) B)Cardiac arrest C)Hyperventilation D)Pulmonary embolism

A)Chronic obstructive pulmonary disease (COPD)

Which of the following can be used to estimate the contractility of the ventricles? A)Ejection fraction B)Systemic vascular resistance C)Pulmonary vascular resistance D)Right and left ventricular end-diastolic pressure

A)Ejection fraction

Which of the following is not a common complication of systemic artery catheterization? A)Phlebitis B)Ischemia C)Hematoma D)Hemorrhage

A)Phlebitis

Which of the following describes the filling pressure of the ventricle at the end of ventricular diastole? A)Preload B)Afterload C)Dicrotic notch D)Ejection fraction

A)Preload

Describe the following waveform A)Rebreathing B)Increasing waveform C)Decreasing waveform D)Muscle Relaxants

A)Rebreathing

Choose what type of symptoms reflects a site infection A)Redness at the site B)nontender at site of insertion C)No redness at the site D)afebrile

A)Redness at the site

Calculate the stroke volume (SV) and the stroke volume index (SI) using the following information: cardiac output = 4.5 L/min, heart rate = 110 beats/min, and body surface area = 1.3 m2. A)SV = 41 mL; SI = 31.5 mL/m2 B)SV = 45 mL; SI = 34.3 mL/m2 C)SV = 46 mL; SI = 36 mL/m2 D)SV = 49.5 mL; SI = 38 mL/m2

A)SV = 41 mL; SI = 31.5 mL/m2

Choose the best definition for Colorimetric Method Sampling for CO2 monitoring A)are disposable devices that provide a qualitative measurement of ETCO2. Its use is based on a chemical reaction of litmus paper rather than an actual measurement. B)requires a gas sample to be aspirated from the patient's airway and transported to the sensor inside a monitor by means of a pump. This type of system can be used on non-intubated patients while utilizing a variety of sampling cannulas. C)utilizes a sensor or infrared measuring device placed directly in-line between the ventilator breathing circuit and the ET tube. Mainstream generally provides a fast response time and the elimination for the need of water traps.

A)are disposable devices that provide a qualitative measurement of ETCO2. Its use is based on a chemical reaction of litmus paper rather than an actual measurement.

Choose from the following why tachycardia may lead to a decrease in Cardiac Output? A)less time for ventricular filling B)more time more for ventricular filling C)less time for atrial filling D)more time for atrial filling

A)less time for ventricular filling

When does a cleft appear on the plateau portion of the capnogram? A)when spontaneously ventilation returns or muscle relaxants wear off B)when sedation and muscle relaxants are given and spontaneous ventilation stops C)during disconnection of circuit D)when the ETCO2 is initially connected

A)when spontaneously ventilation returns or muscle relaxants wear off

A patient is thought to have hypertension when the blood pressure is significantly less than 140/90. A) True B) False

B) False

Drug administration and fluid maintenance can be given using an arterial line. A) True B) False

B) False

Possible causes for a decreasing ETCO2 level is indicative of an decrease in RR, decrease in VT, and increase metabolic rate. A) True B) False

B) False

The PASP is 4-12 mmHg A) True B) False

B) False

The PAWP is 8 -15 mmHg A) True B) False

B) False

The reason for an increasing ETCO2 level could be caused by a decrease in RR, decrease in CO, and a decrease in tidal volume A) True B) False

B) False

Which of the following statements is true concerning the insertion of a radial arterial line? 1. The catheter tip must face upstream. 2. The catheter tip must face downstream. 3. The transducer must be higher than the catheter tip. 4. The transducer must be level with the catheter tip. A)1 and 3 only B)1 and 4 only C)2 and 3 only D)2 and 4 only

B)1 and 4 only

Calculate cardiac output using the Fick principle for the following values: Oxygen consumption 280 mL/min Arterial oxygen content 19.5 vol% Mixed venous oxygen content 12 vol% A)2.1 L/min B)3.7 L/min C)7.5 L/min D)20.5 L/min

B)3.7 L/min Formula O2 consumption / Venous O2 content - Arterial O2 content 280 / 12 - 19.5= 3.8

Calculate the cardiac index using the following data: Cardiac output = 4.6 L/min Body surface area = 1.2 m2 A)0.26 m2/L/min B)3.8 L/min/m2 C)5.5 L/min-m2 D)5.8 m2/L/min

B)3.8 L/min/m2

Which of the following describes the total force opposing ventricular ejection? A)Preload B)Afterload C)Dicrotic notch D)Ejection fraction

B)Afterload

A high cardiac output can cause which of the following complications with a pulmonary artery catheter? A)Pneumothorax B)Catheter whip C)Pulmonary infarction D)Catheter knotting

B)Catheter whip

Which of the following is the hemodynamic measurement that is indicative of a patient with right heart failure? A)Pulmonary artery occlusion pressure (PAOP) = 12 mm Hg B)Central venous pressure (CVP) = 16 mm Hg C)Pulmonary artery pressure (PAP) = 35/15 mm Hg D)Mean arterial pressure (MAP) = 80 mm Hg

B)Central venous pressure (CVP) = 16 mm Hg

Which of the following is the function of the transducer in the invasive vascular monitoring system? A)Measure the flow of fluid in the catheter. B)Convert the fluid pressure to an electrical signal. C)Connect to the thermistor to measure cardiac output. D)Amplify the electrical signal so it may be seen on the monitor.

B)Convert the fluid pressure to an electrical signal.

An intubated patient with no known history of congestive heart failure is in the ICU. The patient is comatose and currently receiving mechanical ventilation via volume-controlled continuous mandatory ventilation (VC-CMV), set rate 12 breaths/min, set tidal volume (VT) 400 mL, positive end-expiratory pressure (PEEP) 18 cm H2O, fractional inspired oxygen (FIO2) 0.35, and the patient is not assisting. Hemodynamic measurements show the following: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 33/20 mm Hg, and pulmonary artery occlusion pressure (PAOP) 16 mm Hg. Arterial blood gas (ABG) results are: pH 7.43, arterial partial pressure of carbon dioxide (PaCO2) 38 mm Hg, arterial partial pressure of oxygen (PaO2) 90 mm Hg. The physician asks for recommendations to improve this patient's hemodynamics. The most appropriate recommendation for this patient is which of the following? A)Initiate pressure support ventilation (PSV) 10 cm H2O with CPAP 10 cm H2O, and check cardiac output. B)Decrease the PEEP incrementally and recheck hemodynamic measurements. C)Change to volume-controlled synchronized intermittent mandatory ventilation (VC-SIMV) with the same settings, and recheck hemodynamic measurements. D)Change to pressure-controlled continuous mandatory ventilation (PC-CMV), peak inspiratory pressure (PIP) 25 cm H2O, PEEP 18 cm H2O, FIO2 0.35, and check PAP.

B)Decrease the PEEP incrementally and recheck hemodynamic measurements.

Ventricular contractility can be estimated by which of the following? A)Systemic vascular resistance B)Ejection fraction C)Pulmonary vascular resistance D)Left ventricular stroke work

B)Ejection fraction

If the transducer manifold position is moved down what will happen to the blood pressure reading A)No change in the blood pressure reading B)False high C)False low

B)False high

Which of the following disorders can cause an increase in systemic vascular resistance? A)Lung collapse B)Hypervolemia C)Chronic bronchitis D)Cardiogenic pulmonary edema

B)Hypervolemia

Which of the following is not a complication that may occur during the insertion of a central venous pressure line? A)Bleeding B)Infection C)Pneumothorax D)Vessel damage

B)Infection

Once placed, central vein catheter position may be confirmed by all of the following except A)catheter length B)Measurement of PaO2 C)Pressure waveform D)X-ray

B)Measurement of PaO2

A patient who has undergone CABG surgery is receiving VC, A/C ventilation. Radial arterial and pulmonary artery catheters are in place for monitoring. Which of the following should a respiratory therapist use to evaluate tissue oxygenation in this patient? A)ABG analysis B)Mixed venous analysis C)serum lactate level D)cardiac output

B)Mixed venous analysis

While attempting to draw blood from an indwelling arterial catheter, the respiratory therapist notices a dampened waveform and has difficulty withdrawing blood for sampling. What should the respiratory therapist's immediate action be? A)Flush the catheter. B)Remove the catheter. C)Reposition the catheter. D)Recalibrate the transducer.

B)Remove the catheter.

Choose the following heart and pulmonary pressure waveforms Mean 0-6 mmHg A)Right ventricle B)Right Atrium C)Pulmonary artery D)Aorta

B)Right Atrium

A pulse oximeter differentiates oxyhemoglobin from deoxygenated hemoglobin by which of the following methods? A)Relating cyclical changes in light transmission through the sampling site. B)Shining and comparing two wavelengths of light through the sampling site. C)Direct measurement by a heated polarographic electrode applied to the skin. D)Using a color sensing device that absorbs one wavelength of light through the skin.

B)Shining and comparing two wavelengths of light through the sampling site.

A 50-year-old patient would be said to have hypotension when her: A)blood pressure is 130/90 mm Hg. B)blood pressure is 85/55 mm Hg. C)heart rate is 55 bpm. D)pulse pressure is 40 mm Hg.

B)blood pressure is 85/55 mm Hg.

Rapid assessment of the oxygenation status of a new patient is best achieved by A)CBG analysis B)pulse oximetry C)abg analysis D)transcutaneous monitoring

B)pulse oximetry

Select the appropriate device for obtaining a blood pressure. A)Pulse Oximeter B)sphygmomanometer C)Thermometer D)Capnometer

B)sphygmomanometer

What is the main purpose for the cardiopulmonary system? A)To supply oxygen only to the heart B)to maintain adequate perfusion to the tissues C)To supply oxygen only to the brain D)to supply oxygen to the lungs

B)to maintain adequate perfusion to the tissues

Choose which of the following is/are the most common technique to measure ETCO2 1.Infrared Absorption 2.pulse oximetry 3.Side stream configuration 4.mainstream configuration A)1 and 2 only B)1, 2, and 3 only C)1, 3, and 4 only D)All the above

C)1, 3, and 4 only

Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 9 g%, arterial oxygen saturation (SaO2) = 96%, arterial partial pressure of oxygen (PaO2) = 97 mm Hg. A)8.6 vol% B)11.0 vol% C)11.9 vol% D)12.1 vol%

C)11.9 vol% CaO2 = (SaO2 x Hgb x 1.36) + (PaO2 x 0.003) (.96 x 9 x 1.36) + (97 x 0.003) (11.57) + (0.291) 11.861= 11.9

Which of the following are vessels that often require a surgical cut down when used for pulmonary artery catheter access? 1. Femoral vein 2. Subclavian vein 3. Internal jugular vein 4. Antecubital vein A)1 and 2 only B)1 and 4 only C)2 and 4 only D)2 and 3 only

C)2 and 4 only

Which of the following will be found in a patient with asystole? 1. Increased ventricular activity 2. Absence of electrical activity 3. No blood pressure 4. Highly variable heart rate A)2 B)1, 4 C)2, 3 D)1, 3, 4

C)2, 3

While trying to use a finger probe to assess a patient's oxygenation status, the respiratory therapist finds that the pulse rate and the ECG monitor heart rate are not consistent and the oxygen saturation measured by pulse oximeter (SpO2) reading is blank. The patient is awake, alert, and in no obvious respiratory distress. The respiratory therapist should first take which of the following actions? 1. Change the probe site. 2. Draw an arterial blood gas. 3. Adjust the probe position on the finger. 4. Remove the probe, and perform a capillary refill test. A)1 and 2 only B)2 and 3 only C)3 and 4 only D)1 and 4 only

C)3 and 4 only

The body's response to supply and demand to compensate for increased oxygen demands includes anaerobic metabolism. Which response is anaerobic metabolism classified as? A)1st B)2nd C)3rd D)Anaerobic metabolism is not part of oxygen tissue compensation

C)3rd

BPdia normal value is: A)10-15mmhg B)100-140mmhg C)60-80mmhg D)70-105mmhg

C)60-80mmhg

An arterial blood gas should be done to confirm pulse oximetry findings less than a minimum of _____________. A)60% B)70% C)80% D)90%

C)80%

While checking an indwelling central venous pressure (CVP) catheter the respiratory therapist observes that the transducer is at the epistatic line. The respiratory therapist should do which of the following at this time? A)Zero the pressure transducer. B)Raise the pressure transducer. C)Accept the CVP reading obtained. D)Recalibrate the pressure transducer.

C)Accept the CVP reading obtained.

O2 supply is a function of: A)Arterial O2 tension - PvO2 B)Arterial O2 content - CvO2 C)Arterial O2 content x CO D)Arterial O2 content / CO

C)Arterial O2 content x CO

Fill in the Blank: BP = SVR x ________ A)PVR B)HR C)CO D)sysBP

C)CO

Which of the following hemodynamic parameter that is not within normal limits? A)Cardiac index (CI) = 4 L/min/m2 B)Mixed venous oxygen content (CO2) = 10 vol% C)Mean arterial pressure (MAP) = 18 mm Hg D)Pulmonary vascular resistance (PVR) = 200 dyne ´ sec ´ cm-5

C)Mean arterial pressure (MAP) = 18 mm Hg

The respiratory therapist preparing to insert an arterial line in the right radial artery performs an Allen test. The result of the Allen test is 20 seconds. The respiratory therapist should do which of the following? A)Insert the cannula into the right radial artery. B)Repeat the Allen test on the right hand. C)Perform an Allen test on the left hand. D)Recommend a surgical cut down at the right radial site.

C)Perform an Allen test on the left hand.

Advancing a pulmonary artery catheter into a smaller artery may cause which of the following complications? A)Pneumothorax B)Air embolism C)Pulmonary infarction D)Ventricular fibrillation

C)Pulmonary infarction

Choose the following heart and pulmonary pressure waveforms Mean 4-12 mmHg. A)Aorta B)Right atrium C)Pulmonary wedge D)Left Ventricle

C)Pulmonary wedge

During the inspiratory phase of spontaneous breathing, what happens to the pulmonary artery (PA) waveform? A)There is no change in the waveform. B)The PA waveform trend increases. C)The PA waveform trend decreases. D)The PA diastolic pressure increases.

C)The PA waveform trend decreases.

Complete loss of waveform indicates which of the following causes A)adequate placement of ET tube B)a patent ET tube C)an obstructed ET tube D)spontaneous breathing

C)an obstructed ET tube

Choose the appropriate description that explains why the radial artery is considered to be a better insertion site than either a femoral or brachial site A)Difficult to access B)High injury at insertion site C)easy to access D)difficult to control and/or observe bleeding

C)easy to access

Choose the most appropriate cause for rebreathing or elevation of the baseline value of the capnogram A)sufficient expiratory time B)adequate inspiratory flow C)malfunction of system D)none of the above

C)malfunction of system

A central venous pressure (CVP) catheter is used to: A)measure left atrial pressure. B)measure left ventricular work. C)monitor right ventricular function. D)monitor left ventricular function.

C)monitor right ventricular function.

Choose the best definition for Mainstream Method Sampling for CO2 monitoring A)are disposable devices that provide a qualitative measurement of ETCO2. Its use is based on a chemical reaction of litmus paper rather than an actual measurement. B)requires a gas sample to be aspirated from the patient's airway and transported to the sensor inside a monitor by means of a pump. This type of system can be used on non-intubated patients while utilizing a variety of sampling cannulas. C)utilizes a sensor or infrared measuring device placed directly in-line between the ventilator breathing circuit and the ET tube. Mainstream generally provides a fast response time and the elimination for the need of water traps.

C)utilizes a sensor or infrared measuring device placed directly in-line between the ventilator breathing circuit and the ET tube. Mainstream generally provides a fast response time and the elimination for the need of water traps.

If the heart rate is 80 beats per minute, how long is one beat? A)0.75 second B)0.9 second C)1 second D)1.3 second

D)1.3 second

Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 17 g%, arterial oxygen saturation (SaO2) = 93%, arterial partial pressure of oxygen (PaO2) = 64 mm Hg. A)10.6 vol% B)14.6 vol% C)16.2 vol% D)21.4 vol%

D)21.4 vol%

The quantity of Oxygen pumped by the heart to the body tissues per unit time is: A)O2 supply B)O2 delivery C)O2 transport D)All of the above

D)All of the above

A patient arrives in the emergency department via ambulance following rescue from a house fire. The instrument that would be most appropriate to assist the respiratory therapist in assessing this patient's oxygenation status is which of the following? A)Capnograph B)Pulse oximeter C)Calorimeter D)CO-oximeter

D)CO-oximeter

A patient in the ICU has a chest X-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 24/13 mm Hg, and pulmonary artery occlusion pressure (PAOP) 21 mm Hg. These findings are consistent with which of the following? A)Pulmonary hypertension B)Right ventricular failure C)Noncardiogenic pulmonary edema D)Cardiogenic pulmonary edema

D)Cardiogenic pulmonary edema

If a positive inotropic agent is given what effect should you expect this to have on the heart and on Cardiac Output? A)Decrease HR and increase CO B)Increase HR and decrease CO C)Decrease HR and CO D)Increase HR and CO

D)Increase HR and CO

A 50-year-old patient has a heart rate by palpation of 120 bpm. How should this be interpreted? A)Within the normal range for an adult B)An error since a stethoscope was not used C)Bradycardia D)Tachycardia

D)Tachycardia

Mixed venous blood is present in the RA, RV, and pulmonary arteries. True False

False

Place the terms in the correct order for the flow of blood through the heart

_5__Right Ventricle __1__Superior Vena Cava _9__Left Atrium _12__Aorta __8__Pulmonary Vein __3__Right Atrium __6__Pulmonary Artery __7__Lung Capillaries __11__Left ventricle _4__Tricuspid valve __10__Mitral Valve _2__Inferior Vena Cava