RES 282 Test

Which of the following axis placements represents right-axis deviation?

+120

What is the average total work of breathing for healthy persons?

0.3 to 0.5 J/L

Above what value for VDS/VT is weaning NOT likely?

0.60

What is the normal gradient between PaCO2 and PETCO2?

1 to 5 mm Hg

The equipment necessary for capillary blood sampling includes all of the following except

1-ml syringe

The equipment necessary for capillary blood sampling includes all of the following except.

1-ml syringe

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?

100 to 600 mm Hg

The QRS of an ECG falls on a dark vertical line of the ECG paper. Subsequent QRS complexes fall on every other dark line (10 mm apart). What is the ventricular rate?

150/min

What is a normal level for CaO2?

18 to 20 ml/100 ml

What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor?

2 to 6 hours

Under ideal conditions, electrochemical oxygen (O2) analyzers have approximately what degree of accuracy?

2%

How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FIO2 has just been changed?

20 to 30 minutes

What is the normal approximate value for oxygen consumption?

250 ml/min

What is the normal maximum length of the P wave?

3 mm

Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry?

3% to 5%

What is a normal end-tidal PETCO2 range?

35 to 43 mm Hg

A PaO2 below what value would be considered severe hypoxemia?

40 mm Hg

Which of the following is the Raw of intubated patients receiving ventilatory support?

5 to 10 cm H2O/L/sec

What is the normal range for P(A-a)O2 in a healthy 30-year-old person breathing room air?

5 to 15 mm Hg

What is the normal range for lung compliance?

60 to 100 ml/cm H2O

When is capillary blood gas sampling indicated?

ABG analysis is needed, but arterial access is not available

Temporary variation in pulmonary artery pressure readings due to movement of the hemodynamic monitoring line is an example of what type of variability?

Artifact

After obtaining an arterial blood sample from an arterial line, you would do all of the following except.

Aspirate at least 5 ml of fluid or blood (dead space or waste)

All of the following are indications for capnography except.

Assessing a patient's readiness for weaning from ventilatory support.

How often should blood gas calibration verification by control media take place?

At least two levels of control media should be analyzed every 8 hours

On inspection of an ECG rhythm strip from an adult patient, you notice the following: regular sawtooth-like waves occurring at a rate of 280/min and a regular ventricular rhythm occurring at a rate of about 140/min. What is the most likely interpretation?

Atrial flutter

What is a possible serious complication associated with atrial fibrillation?

Atrial thrombi

What is implied by an abnormally prolonged PR interval?

Atrioventricular block

Which of the following medications is used to treat sinus bradycardia?

Atropine

What term is used to define the ability of certain cardiac cells to depolarize without stimulation?

Automaticity

What is the value of determining the lower inflection point during measurement of the pressure-volume curve?

Best PEEP level

Patient parameters that should be assessed as part of arterial blood sampling include all of the following except.

Blood pressure

What is the measurement of CO2 in respiratory gases called?

Capnometry

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?

Change the sensor or electrode.

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

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

How is the accuracy of a blood gas analyzer determined?

Comparing the analyzer's measurements to known values

Factors contributing to imprecision (random) errors during blood gas analysis include all of the following except.

Contaminated buffers

What condition is often associated with right-axis deviation?

Cor pulmonale

All of the following will tend to cause false low readings when using a pulse oximeter except.

Dark nail polish

Which of the following would you expect to occur if too much heparin was used in gathering an ABG sample from a patient breathing room air?

Decrease in PCO2

You determine that a blood gas sample that requires analysis has been sitting in an ice slush for 90 minutes. What should you do?

Discard the sample and notify the appropriate clinician.

Which of the following ECG abnormalities is most life threatening?

Elevated ST segment

Which of the following conditions is associated with an increased lung compliance measurement?

Emphysema

Which of the following does NOT lead to an increased end-tidal PCO2?

Exercise

When analyzing an ABG sample from a patient with acute respiratory distress syndrome and refractory hypoxemia, you notice a PaO2 of 141 mm Hg and a PaCO2 of 14 mm Hg. Which of the following analytic errors should you suspect?

Exposure of the blood sample to air

Atrial flutter is considered to be a life-threatening arrhythmi

False

Valvular defects in the heart can be detected with a 12-lead ECG.

False

In low-perfusion patients, what site would be best for monitoring SpO2?

Finger

The ECG you are looking at has one P wave for every QRS complex and the PR interval is 0.30 second. What is your interpretation?

First-degree heart block

What is considered normal for the PaO2/FIO2 ratio?

Greater than 400

A blood gas analyzer measures all of the following except.

HCO3-

In which of the following disorders would an increased VDS/VT ratio not be likely?

Hypothalamus tumor

Which of the following clinical conditions is not associated with tachycardia?

Hypothermia

After obtaining an arterial blood sample, what should you do?

I. Apply pressure to the puncture site until bleeding stops. II. Place the sample in a transport container with ice slush. IV. Mix the sample by rolling and inverting the syringe.

Which of the following are the reasons monitors are needed?

I. Continuous assessment III. Measurement of values that caregivers cannot detect

Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble?

I. Decreased PCO2 III. Increased PO2

What method(s) is/are used to measure oxygen consumption?

I. Fick method II. Analysis of inspired and expired gases

Capillary puncture should NOT be performed at or through what location?

I. Inflamed or edematous tissue II. Localized areas of infection III. The fingers of neonates IV. Previous puncture sites

Which of the following guidelines should you adhere to when performing pulse oximetry?

I. Never mix different sensors among different devices. II. Make sure that the sensors are the correct size and are properly applied. III. Avoid using pulse oximetry to monitor hyperoxia in neonates. IV. Whenever possible, validate the initial SpO2 against the actual SaO2.

A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period?

I. PCO2

Most preanalytical ABG errors can be avoided by ensuring that the sample is which of the following?

I. Properly anticoagulated II. Obtained anaerobically III. Analyzed within 15 minutes

Before attaching a transcutaneous blood gas monitor sensor to a patient, what should you do?

I. Provide a specified warm-up time and set the probe temperature. II. Check the membrane and prepare a sensor with an adhesive ring and gel. III. Prepare the monitoring site (remove excess hair and clean the skin).

When analyzing a blood gas control sample, you notice that the result falls outside the 2 SD range. How could you verify that this was a random error (error of imprecision)?

I. Repeat the analysis on a different analyzer. III. Rerun the control sample a second time.

A mixed venous blood sample obtained from a pulmonary artery catheter sample has a PO2 of 85 mm Hg and a hemoglobin saturation of 95%. Which of the following is likely?

I. The pulmonary artery catheter balloon was not deflated. III. The blood sample was withdrawn too quickly.

Transcutaneous blood gas monitoring is indicated when what need exists?

I. To continuously analyze gas exchange in infants or children. II. To quantify the real-time responses to bedside interventions. III. To continuously monitor for hyperoxia in newborn infants.

Which of the following should be monitored during the sampling of arterial blood?

II. Presence of pulsatile blood return. III. Presence of air bubbles or clots in sample. IV. Appearance of puncture site

Which of the following is NOT associated with a decreased end-tidal PCO2?

Increase in lung perfusion

During capnography monitoring of a mechanically ventilated patient, you note that the PETCO2 has dropped to 0 mm Hg. All of the following are possible causes of this finding except

Increased cardiac output

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

Inspiration of fresh respiratory gas.

Which of the following is FALSE about the galvanic fuel cell O2 analyzer?

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

Which of the following is false about invasive versus noninvasive monitoring?

Laboratory analysis of gas exchange is usually noninvasive in nature.

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

Lateral aspect of the heel's plantar surface

What is the upper limit for plateau airway pressure that is recommended during mechanical ventilation?

Less than 30 cm H2O

What medication is most useful for the treatment of premature ventricular contractions?

Lidocaine

Required equipment and supplies for percutaneous arterial blood sampling of an adult include all of the following except.

Local anesthetic

What is the best parameter to measure when trying to assess respiratory muscle endurance?

Maximum voluntary ventilation (MVV)

All of the following can help avoid the problem of arterial blood sample contamination with air except.

Mixing before expelling air

What is suggested by inverted T waves on the ECG?

Myocardial ischemia

Which of the following is NOT a common characteristic of a premature ventricular complex (PVC)?

Narrow QRS

All of the following are advantages of mainstream capnometry except.

No bulky sensor

Your patient has a normal ECG reading. What does this finding tell you about the patient's likelihood of having a myocardial infarction in the immediate future?

No predictive value

What is the normal period of time for the PR interval?

Not longer than 0.20 second

What is the width of the normal QRS complex?

Not wider than 3 mm

What is the best single measure of effective ventilation in the intensive care unit patient?

PaCO2

Before performing puncture or cannulation of the radial artery, what should you do?

Perform the Allen test to ensure collateral circulation.

Which of the following is NOT a common cause of ventricular tachycardia?

Pericarditis

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?

Proximal to the heated humidifier.

Which of the following factors is not associated with an increased risk for auto-PEEP?

Pulmonary fibrosis

At what part of the cardiac conduction system does the electrical impulse travel most rapidly?

Purkinje fibers

Which of the following waves represents depolarization of the ventricles?

QRS wave

Which of the following parameters is NOT a major factor in determining tissue oxygenation?

R/Q ratio

The shape of the expired CO2 tracing of a patient is normal but instead of being zero, the baseline is elevated to about 12 mm Hg. Which of the following is the most likely problem?

Rebreathing

While checking a Clark O2 analyzer, 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?

Replace the analyzer's batteries

While checking a galvanic fuel cell O2 analyzer, 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?

Replace the analyzer's batteries.

Which of the following is NOT likely to cause errors in SpO2 readings?

Significant tachycardia

What structure normally paces the healthy heart?

Sinoatrial (SA) node

When performing a percutaneous needle puncture of the radial artery, you get only a small spurt of blood. Which of the following is the best action at this time?

Slowly withdraw the needle until a pulsatile flow fills the syringe.

Which of the following is NOT a cause of increased airway resistance?

Suctioning

An alert outpatient awaiting bronchoscopy has an SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation?

Switch sites or replace the sensor probe.

Which of the following waves represents repolarization of the ventricles?

T

Which of the following criteria applies to third-degree block?

There is no relationship between the P waves and the QRS complexes.

For which of the following arrhythmias would an electronic pacemaker be indicated?

Third-degree block

Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except.

Time of last incentive breathing exercise

Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except

Time of last incentive breathing exercise.

Why is the electrical impulse temporarily delayed at the atrioventricular (AV) node?

To allow better filling of the ventricles.

Which of the following is NOT a common purpose of using ventilator graphics?

To determine best FIO2.

An occasional premature ventricular complex (PVC) is not of major concern.

True

Sources for the electrical impulse that triggers cardiac contraction that lie outside the sinoatrial node are referred to as ectopic foci

True

The electrocardiogram (ECG) is primarily used to evaluate the patient with symptoms suggestive of acute myocardial disease.

True

How does the Clark polarographic O2 electrode function?

Uses O2 to produce a reduction-oxidation reaction.

What is the best measure of the efficiency of gas exchange in the lung?

VDS/VT

What parameter is measured on the vertical axis of the ECG paper?

Voltage

All of the following are grounds for finding an alternative site for arterial puncture except:

anticoagulation therapy.

What structure serves as the backup pacemaker for the heart?

atrioventricular (AV) node

The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing:

reduces turnaround time

While monitoring patients, signals, or values are susceptible to variability due to all of the following, except:

seasonal variation.

What type of medications may lead to first-degree heart block?

ß-blockers