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Res 282
| Question | Answer |
|---|---|
| What is the normal maximum length of the P wave? | 3 mm |
| What is a possible serious complication associated with atrial fibrillation? | Atrial thrombi |
| What medication is most useful for the treatment of premature ventricular contractions? | Lidocaine |
| Which of the following is NOT a common cause of ventricular tachycardia? | Pericarditis |
| What structure normally paces the healthy heart? | Sinoatrial (SA) node |
| What parameter is measured on the vertical axis of the ECG paper? | Voltage |
| 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 |
| An occasional premature ventricular complex (PVC) is not of major concern | True |
| What term is used to define the ability of certain cardiac cells to depolarize without stimulation? | Automaticity |
| What type of medications may lead to first-degree heart block | ß-blockers |
| At what part of the cardiac conduction system does the electrical impulse travel most rapidly? | Purkinje fibers |
| Why is the electrical impulse temporarily delayed at the atrioventricular (AV) node? | To allow better filling of the ventricles. |
| Which of the following waves represents depolarization of the ventricles? | QRS wave |
| What is suggested by inverted T waves on the ECG? | Myocardial ischemia |
| 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 |
| The electrocardiogram (ECG) is primarily used to evaluate the patient with symptoms suggestive of acute myocardial disease. | True |
| What is the normal period of time for the PR interval? | Not longer than 0.20 second |
| Valvular defects in the heart can be detected with a 12-lead ECG | False |
| What condition is often associated with right-axis deviation? | Cor pulmonale |
| Which of the following medications is used to treat sinus bradycardia? | Atropine |
| Atrial flutter is considered to be a life-threatening arrhythmi | False |
| 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 |
| For which of the following arrhythmias would an electronic pacemaker be indicated? | Third-degree block |
| What is the width of the normal QRS complex? | Not wider than 3 mm |
| Which of the following is NOT a common characteristic of a premature ventricular complex (PVC)? | Narrow QRS |
| Which of the following clinical conditions is not associated with tachycardia? | Hypothermia |
| Sources for the electrical impulse that triggers cardiac contraction that lie outside the sinoatrial node are referred to as ectopic foci | True |
| Which of the following criteria applies to third-degree block? | There is no relationship between the P waves and the QRS complexes. |
| Which of the following ECG abnormalities is most life threatening? | Elevated ST segment |
| Which of the following axis placements represents right-axis deviation? | +120 |
| 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 implied by an abnormally prolonged PR interval? | Atrioventricular block |
| Which of the following waves represents repolarization of the ventricles? | T |
| What structure serves as the backup pacemaker for the heart? | atrioventricular (AV) node |
| 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 |
| 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. |
| All of the following are grounds for finding an alternative site for arterial puncture except: | anticoagulation therapy. |
| What is the measurement of CO2 in respiratory gases called? | Capnometry |
| 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 |
| 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. |
| 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. |
| Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry? | 3% to 5% |
| Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except. | Time of last incentive breathing exercise. |
| 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). |
| The equipment necessary for capillary blood sampling includes all of the following except | 1-ml syringe |
| 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 |
| 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 |
| 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. |
| 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 |
| 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. |
| Required equipment and supplies for percutaneous arterial blood sampling of an adult include all of the following except. | Local anesthetic |
| A blood gas analyzer measures all of the following except. | HCO3- |
| All of the following are advantages of mainstream capnometry except | No bulky sensor |
| What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor? | 2 to 6 hours |
| 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. |
| 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 |
| All of the following are indications for capnography except. | Assessing a patient's readiness for weaning from ventilatory support. |
| 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 initial SpO2 against SaO2 |
| All of the following can help avoid the problem of arterial blood sample contamination with air excep | Mixing before expelling air |
| Before performing puncture or cannulation of the radial artery, what should you do? | Perform the Allen test to ensure collateral circulation |
| What is a normal level for CaO2? | 18 to 20 ml/100 ml |
| All of the following will tend to cause false low readings when using a pulse oximeter except. | Dark nail polish |
| Which of the following is false about invasive versus noninvasive monitoring? | Laboratory analysis of gas exchange is usually noninvasive in nature |
| 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. |
| How does the Clark polarographic O2 electrode function? | Uses O2 to produce a reduction-oxidation reaction |
| Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except. | Time of last incentive breathing exercise |
| 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 |
| 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. I and II |
| The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing | reduces turnaround time |
| Which of the following is FALSE about the galvanic fuel cell O2 analyzer? | It requires an external power source (alternating current line or batteries). |
| Under ideal conditions, electrochemical oxygen (O2) analyzers have approximately what degree of accuracy? | 2% |
| 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 |
| Which of the following is false about invasive versus noninvasive monitoring? | Laboratory analysis of gas exchange is usually noninvasive in nature. |
| A PaO2 below what value would be considered severe hypoxemia? | 40 mm Hg |
| What is the best site for capillary puncture in an infant? | Lateral aspect of the heel's plantar surface |
| 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? | PCO2 |
| 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 |
| How is the accuracy of a blood gas analyzer determined? | Comparing the analyzer's measurements to known values. |
| 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. II. Compare the control to an actual patient sample. III. Rerun the control sample a second time. |
| Patient parameters that should be assessed as part of arterial blood sampling include all of the following except. | Blood pressure |
| 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 |
| What is the normal gradient between PaCO2 and PETCO2? | 1 to 5 mm Hg |
| While monitoring patients, signals, or values are susceptible to variability due to all of the following, excep | Seasonal Variation |
| 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 |
| Which of the following is NOT likely to cause errors in SpO2 readings? | Significant tachycardia |
| Which of the following conditions is associated with an increased lung compliance measurement? | Emphysema |
| What is considered normal for the PaO2/FIO2 ratio? | Greater than 400 |
| What is the best single measure of effective ventilation in the intensive care unit patient? | PaCO2 |
| In which of the following disorders would an increased VDS/VT ratio not be likely? | Hypothalamus tumor |
| Which of the following is the Raw of intubated patients receiving ventilatory support? | 5 to 10 cm H2O/L/sec |
| What is the normal approximate value for oxygen consumption? | 250 ml/min |
| Temporary variation in pulmonary artery pressure readings due to movement of the hemodynamic monitoring line is an example of what type of variability? | Artifact |
| What is the average total work of breathing for healthy persons? | 0.3 to 0.5 J/L |
| Which of the following is NOT a cause of increased airway resistance? | Suctioning |
| Which of the following is NOT associated with a decreased end-tidal PCO2? | Increase in lung perfusion |
| What method(s) is/are used to measure oxygen consumption? | I. Fick method III. V/Q scans |
| Which of the following is NOT a common purpose of using ventilator graphics? | To determine best FiO2 |
| What is the best parameter to measure when trying to assess respiratory muscle endurance? | Maximum voluntary ventilation (MVV) |
| Which of the following parameters is NOT a major factor in determining tissue oxygenation? | R/Q Ratio |
| Which of the following factors is not associated with an increased risk for auto-PEEP? | Pulmonary Fibrosis |
| What is the best measure of the efficiency of gas exchange in the lung? | VDS/VT |
| What is the value of determining the lower inflection point during measurement of the pressure-volume curve? | Best PEEP level |
| Above what value for VDS/VT is weaning NOT likely? | 0.60 |
| What is the normal range for lung compliance? | 60 to 100 ml/cm H2O |
| What is the upper limit for plateau airway pressure that is recommended during mechanical ventilation? | Less than 30 cm H2O |
| In low-perfusion patients, what site would be best for monitoring SpO2 | Finger |
| Which of the following does NOT lead to an increased end-tidal PCO2? | Exercise |
| What is the measurement of CO2 in respiratory gases called? | Capnometry |
| Which of the following is the Raw of intubated patients receiving ventilatory support? | 5 to 10 cm H20/L/Sec |
| All of the following will tend to cause false low readings when using a pulse oximeter except | Dark nail polish |
| 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 equipment necessary for capillary blood sampling includes all of the following except | 1 ml syringe |
| Which of the following is FALSE about invasive versus noninvasive monitoring? | Laboratory analysis of gas exchange is usually noninvasive in nature |
| When is capillary blood gas sampling indicated? | ABG analysis is needed, but arterial access is not availble |
| 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 parameters in NOT a major factor in determining tissue oxygenation | R/Q ratio |
| Treatment pararameters that should be assessed as part of arterial blood sampling include all of the following except | Time of last incentive breathing excercise |
| What is the normal approximate value for oxygen consumption | 250 ml/min |
| Which of the following should be monitored during the sampling of arterial blood? | Presence of pulsatile blood return, Presence of air bubbles or clots in sample |
| Factors contributing to imprecision (random) errors during blood gas analysis | Contaminated buffers |
| 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 |
| Which of the following are the reasons monitors are needed? | Continuous assessment and Measurement of values that caregivers cannot detect |
| What is the appropriate interval for changing the site for transcutaneous blood gas monitor sensor | 2 to 6 hours |
| 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 |
| A blood gas analyzer measures all of the following except | HCO3- |
| What is the best parameter to measure when trying to assess respiratory muscle endurance | Maximum voluntary ventilation MVV |
| What is a normal end-tidal PETCO2 range? | 35 to 43 mm Hg |
| During calubration of a Clark polarographic O2 analyzer, you cannot get the sensor to read 100%, even after adjusting its calibration control. The unit has new batteries. Which of the following actions would be correct? | Change the sensor or electrode |
| On inspection of a ECG rhythm strip from a adult patient, you notice the following: regular sawtooth-like waves occuring at a rate of 280/min and a regular ventricular rhythm occuring at a rate of about 140/min. What is the most likely interpretation | Atrial flutter |
| How is the accuracy of a blood gas analyzer determined | Comparing the analyzer's measurements to known values |
| You determine that a blood gas sample that requires analysis has been sitting in a ice slush for 90 minutes. What should you do? | Discard the sample and notify the appropriate clinician |
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