Final
An RCP forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following will increase? 1. PCO2 2.pH 3. PO2 A.1 B. 1 and 2 C. 2 and 3 D. 1, 2 and 3
A. 1
Which of the following are types of manual resuscitators? 1.Self inflating 2. Flow inflating 3.Duck bill 4. Diaphragm
A. 1,2,4 B.1,2 (TRUE) C.1,2,3 D.1,2,3,4
Pulse oximetry readings are generally unreliable at saturations below what level? A. 70% B. 80% C. 90% D. 95%
A. 70%
When using capnometry of colorimetry to differentiate esophageal from tracheal placement of an ET tube, which of the following can result in a false-negative (no CO2 present even when the tube is in the trachea)? A. Cardiac arrest B. Gastric CO2 diffusion C. Right mainstem intubation D. Delivery of a high Fio2
A. Cardiac arrest
A surgical resident has asked that you assist in an elective tracheotomy on an orally intubated patient. Which of the following would be an appropriate action? A. Remove the oral tube just before tracheostomy tube insertion B. Remove the oral tube before the tracheotomy is performed C. Pull the oral tube only after the tracheostomy tube in placed D. Withdraw the oral tube 2-3 inches while the incision is made
A. Remove the oral tube just before tracheostomy tube insertion
To measure PCO2, blood gas analyzers use which electrode? A. Severinghaus B. Clark C. Sanz D. White
A. Severinghaus
Which of the following barrier precautions would you use when obtaining an ABG via percutaneous puncture? 1. Gloves 2. Protective eyewear 3. Gown or apron A.1 and 2 B.1 and 3 C. 2 and 3 D. 1,2 and 3
A.1 and 2
Which of the following types of artificial airways are inserted through the larynx? 1. Combitube 2. tracheostomy 3. nasotracheal tubes 4. Orotracheal tubes A.1,3,4 B.1,4 C.3,4 D.1,2,3,4
A.1,3,4
After obtaining an ABG sample, what should you do? 1. Apply pressure to the puncture site until bleeding stops 2. Place the sample in a container with ice slush 3. Check to see if the patient is getting anticoagulation therapy 4. Mix the sample by rolling the syringe A. 1 and 2 B. 1,2 and 4 C. 3 and 4 D. All
B. 1,2 and 4
What is the standard size for endotracheal or tracheostomy tube adapters? A. 22 mm external diameter B. 15 mm external diameter C. 15 mm internal diameter D. 22 mm internal diameter
B. 15 mm external diameter
Indications for arterial blood sampling by percutaneous needle puncture include all the following except the need to A. Monitor the severity of the disease process B. Assess the adequacy of tissue oxygenation C.Evaluate ventilation and acid-base status D. Evaluate a patient's response to therapy
B. Assess the adequacy of tissue oxygenation (FALSE)
What is the measurement of CO2 in respiratory gases called? A.Oximetry B. Capnometry C. Capnography D. Barometry
B. Capnometry
When checking a Miller and Macintosh blade on an intubation tray during an emergency intubation, you find that the miller blade "lights" but the Macintosh blade does not. What should you do first? A. Swap the defective Macintosh for the good Miller blade B. Check and replace the bulb in the Macintosh blade C. Replace the batteries in the laryngoscope handle D. Check and clean the laryngoscope handle electrical contact
B. Check and replace the bulb in the Macintosh blade
If pain or anxiety occurs during arterial puncture, which of the following will probably occur? A. Hypoventilation B. Hyperventilation C.Respiratory Acidosis D. Hypoxemia
B. Hyperventilation
Which of the following is false about invasive versus noninvasive monitoring? A. Invasive procedures require insertion of a device into the body B. Laboratory analysis of gas exchange is usually noninvasive in nature C. Physiologic monitoring can be either invasive or noninvasive D. Invasive procedures provide more accurate data but carry greater risks
B. Laboratory analysis of gas exchange is usually noninvasive in nature
What is the primary indication for a tracheotomy? A. When a patient loses pharyngeal or laryngeal reflexes B. When a patient has long term need for an artificial airway C. When a patient has been orally intubated for more than 24 hours D. When a patient has upper airway obstruction due to secretion
B. When a patient has long term need for an artificial airway
When are oropharyngeal airways contraindicated? 1. when foreign body obstruction already exists 2.in patients who are unconscious or comatose 3.in cases of oromaxillary or mandibular trauma A. 1,2,3 B. 1,2 C. 1,3 D.4
C. 1,3
All of the following are grounds for finding an alternative site for arterial puncture except: A. Negative modified Allen's test B. History of peripheral vascular disease C. Anticoagulation therapy D. Presence of a surgical shunt
C. Anticoagulation therapy
All of the following are types of nonrebreathing valves found in manual resiscitators except? A. Duckbill B. Diaphragm C.Bi-directional D. Spring and disk
C. Bi- directional
Because of an extremely low PO2, you suspect venous admixture when puncturing the brachial artery.Which of following could help you confirm your suspicion? A. Call the lab to get the latest chemistry report B. Inspect the sample for color and consistency C. Cross-check the sample with an SpO2 reading D. Measure the sample's actually hemoglobin sample
C. Cross-check the sample with an SpO2 reading
A patient has been receiving PPV through a tracheostomy tube for 4 days. In the past 2 days, there is evidence of both recurrent aspiration and abdominal distention but minimal air leakage around the tube cuff. What is the most likely cause of the problem? A. Paralysis of the vocal cords B. Under inflated tube cuff C. Tracheoesophageal fistula D. Tracheoinnominate fistula
C. Tracheoesophageal fistula
How does the polarographic analyzer function? A. Measures the magnetic properties of O2 versus N2 B. Measures the electrical potential across a Wheatstone bridge C. Uses O2 to produce a reduction-oxidation reaction D. Measures the comparative cooling effect on a heated wire
C. Uses O2 to produce a reduction-oxidation reaction
Which of the following best describes the position of a correctly sized and properly inserted oropharyngeal airway? A. distal tip at the base of tongue, flange inside anterior teeth B. distal at the level of uvula, flange extending outside the teeth C. distal tip at the base of tongue, flange outside the teeth D. distal below the epiglottis,flange extending outside the teeth
C. distal tip at the base of tongue, flange outside the teeth
While checking a crash cart for intubation equipment, you find the following: suction equipment, oxygen apparatus, two laryngoscopes and assorted blades,five tubes, Magill forceps, tape,lubricating gel, and local anesthetic. What is missing? 1. Obturator 2. Syringe (s) 3.Resuscitator bag and mask 4. Tube stylet A.1,2,3 B.2,4 C.2,3,4 D1,2,3,4
C.2,3,4
A patient is hypothermic. Which of the following would you expect to increase in- vivo? 1.PCO2 2.PO2 3.pH A.1 B. 1 and 2 C. 3 D 1,2 and 3
C.3
Which of the following injuries are NOT seen with tracheostomy tubes? 1. Tracheomalacia 2. Tracheal stenosis 3. Glottic edema 4. Vocal cord granulomas A. 1,4 B. 2,4 C.3,4 D. 1,2,3
C.3,4
A patient in the emergency department exhibits signs of acute upper airway obstruction and is concurrently having severe seizures that make it impossible to open the mouth. In this case, what would be the adjunct airway of choice? A.Oropharyngeal airway B. Oral endotracheal tube C.Nasopharyngeal airway D. Tracheostomy tube
C.Nasopharyngeal airway
Why is the radial artery the preferred site for arterial sampling? 1. Near surface; easy to palpate and stabilize 2. Ulnar artery normal provide collateral circulation 3. The radial artery is not near any large vein A.1 and 2 B. 1 and 3 C. 2 and 3 D. 1,2 and 3
D. 1,2 and 3
In order to deliver as high of a concentration of oxygen as possible, what must one do? 1.Use a high input flow 2.Use the longest possible refill time 3.Connect an oxygen reservoir A. 1,2 B. 2,3 C. 1,3 D. 1,2,3
D. 1,2,3 (TRUE)
How long should you wait before drawing an ABG on a COPD patient whose FiO2 has been changed? A. 5-10 mins B. 10-15 mins C. 15-20 mins D. 20-30 mins
D. 20-30 mins (TRUE)
What is the purpose of the additional side port (Murphy eye) on most modern endotracheal tubes? A.Protect the airway against aspiration B.Help ascertain proper tube position C. Minimize mucosal trauma during insertion D. Ensure gas flow if the main port is blocked
D. Ensure gas flow if the main port is blocked
Which is the most common sign associated with transient glottis edema or vocal cord inflammation that follows extubation? A. Difficult in swallowing B. Wheezing C. Orthopnea D. Hoarseness
D. Hoarseness
Which of the following is FALSE about methods used to displace the epiglottis during oral intubation? A. Regardless of the blade used, the laryngoscope is lifted up and forward B. The Macintosh blade lifts the epiglottis indirectly C. The Miller blade lifts the epiglottis directly D. Levering the laryngoscope against the teeth can aid displacement
D. Levering the laryngoscope against the teeth can aid displacement
How would you estimate the appropriate length for a nasopharyngeal airway? A. Subtract twice the diameter of the tube from its length B. Measure the distance from the earlobe to the Adams apple C. Apply the estimating formula : length (cm) = 15 + (age / 2) D. Measure the distance from the earlobe to the tip of the nose
D. Measure the distance from the earlobe to the tip of the nose
Serious complications of Oral intubation include all the following except: A. Cardiac arrest B. Acute hypoxemia C. Bradycardia D. Tongue lacerations
D. Tongue lacerations
When performing blind nasotracheal intubation, approach AND successful tube passage is indicated by which of the following? 1.Louder breath sounds 2.Harsh cough 3.Vocal silence A.1,2 B.1,3 C.2,3 D.1,2,3
D.1,2,3
Which of the following factors should be considered when deciding to change from an endotracheal tube to a tracheostomy tube? 1.Patient's tolerance of the endotracheal tube 2. Risks on continued intubation versus tracheotomy 3.Patient's severity of illness and overall condition 4. Length of time the patient will need an artificial airway 5. Patient's ability to tolerate a surgical procedure A. 1,2,4 B.3,4,5 C.1,2,3,4 D.1,2,3,4,5
D.1,2,3,4,5
Which of the following bedside methods can ABSOLUTELY confirm proper ET tube position in the trachea? A.Auscultation B. Observation of chest movement C. Tube length (cm to teeth) D.Fiberoptic laryngoscopy
D.Fiberoptic laryngoscopy
You are assisting a physician in the emergency care of a patient with maxillofacial injury who will require short term ventilator support. Which of the following would you recommend? A. Intubate via the oral route B.Insert an oropharyngeal airway C.Perform an emergency tracheotomy D.Intubate via the nasal route
D.Intubate via the nasal route
