Quality Assurance - Test Your Knowledge (Workbook) Flashcards

1
Q

What two gas concentrations are used to calibrate an oxygen analyzer prior to analyzing inspired FiO2 values?

A. 0%, 12%
B. 12%, 21%
C. 21%, 60%
D. 21%, 100%

A

D. 21%, 100%

FiO2 calibration values: 21%, 100%
FeO2 calibration values: 12%, 21% (for stress testing)

*page F-12

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2
Q

While using a 3L calibration syringe for quality control testing, the following results were measured:

Trial Volume
1 2.96
2 2.94
3 2.95

According to the ATS-ERS standards, whih of the following statements are true?

  1. the spirometer is accurate
  2. the spirometer is precise
  3. the % error is acceptable

A. 1 only
B. 2 only
C. 2 and 3 only
D. 1, 2, and 3

A

D. 1, 2, and 3

*page F-9

A 3L syringe must be within +/- 3.5% of 3L to be considered accurate (2.9L - 3.1L)

1 is true. The spirometer is considered accurate between 2.9L - 3.1L. The average of all values is 2.95L.

2 i am uncertain of. The measured values are not exactly the same.

  1. is true. The spirometer is within 3.5% of error (2.9L - 3.1L)

I know for certain that 1 and 3 are true. The only answer containing both is D.

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3
Q

Which of the following is used to calibrate and check the accuracy/precision of a pressure differential pneumotachometer used in a flow-type plethysmograph?

A. rotameter
B. mercury barometer
C. sine wave pump
D. isothermal lung model

A

A. rotameter

*page F-13

water or mercury barometers test mouth pressure on the body box

sine wave pumps test box pressure on the body box

rotameters test flow on the body box

an isothermal lung model is used to quality control a body box

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4
Q

Equipment performance standards depend on all of the following parameters, EXCEPT

A. test signals used
B. effort and cooperation
C. type of equipment
D. required maintenance

A

B. effort and cooperation

effort and cooperation is a patient performance standard.

there are 2 types of performance standards: equipment and patient

equipment standards include:
type of equipment
type of maintenance
test signals used for checking accurary/precision

patient performance standards include:
technologist ability to operate equipment
instruction and coaching
patient effort and cooperation
insuring that data meets acceptable standards

*page F-8

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5
Q

The quality control data for a blood gas analyzer shows the following pattern for the pH electrode

See saved image: Quality Assurance - Workbook - Question 5

This pattern would be described as:

A. shift
B. trend
C. in control
D. out of control

A

C. in control

*page F-11

All points are within standard deviation and are not trending or shifting. There is also no random error.

Shift would show a change of baseline
Trend would show a gradual movement of values in one direction
Out of control would show 2 or more values outside the acceptable standard deviation.

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6
Q

Patient performance quality assurance standards will relate to all of the following EXCEPT

A. instrumentation
B. instruction and coaching
C. effort and cooperation
D. technologist skills

A

A. instrumentation

Instrumentation is not a patient performance standard.

there are 2 types of performance standards: equipment and patient

equipment standards include:
type of equipment
type of maintenance
test signals used for checking accurary/precision

patient performance standards include:
technologist ability to operate equipment
instruction and coaching
patient effort and cooperation
insuring that data meets acceptable standards

*page F-8

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7
Q

Proper calibration of gas analyzers will need to consider:

  1. physiologic range
  2. sampling conditions
  3. linearity

A. 1 and 2 only
B. 2 and 3 only
C. 1 and 3 only
D. 1, 2, and 3

A

D. 1, 2, and 3

All gas analyzers should be calibrated before performing quality control

Proper calibration considers 2 factors
Physiologic range to be measured
Sampling conditions

A two point calibration (low and high values) is the most common method of calibration

Multiple point calibration (3 or more points) may be used to determine linearity

*page F-12

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8
Q

A 30 ml sine wave rotary pump is used to calibrate which of the following?

A. mouth pressure transducer
B. box pressure transducer
C. flow transducer
D. strain-gauge transducer

A

B. box pressure transducer

*page F-13

water or mercury barometers test mouth pressure on the body box

sine wave pumps test box pressure on the body box

rotameters test flow on the body box

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9
Q

How large should the inspired volume be when performing a DLCO-SB test?

A. 60% of SVC
B. 70% of FVC
C. 80% of FVC
D. 90% of SVC

A

D. 90% of SVC

IMPORTANT:
“the inspired volume should be greater than 85% of the SVC.”

Of the choices, there was only one answer which was greater than 85% of SVC.

Do not be distracted by varied numbers. Answer D (90% of SVC) is stil “greater than 85% of the SVC”.

*page F-19

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10
Q

Which of the following criteria are considered acceptable for measurement of the thoracic gas volume (Vtg) using the body plethysmograph?

  1. open loops
  2. 2 acceptable efforts
  3. Vtg within 5% of average

A. 1 only
B. 2 only
C. 3 only
D. 2 and 3 only

A

C. 3 only

*page F-19

Your report should be the average of 3 or more accepetable maneuvers”.

You do not want an open loop. It indicates gas compression, a leak, or the patient is panting too fast.

Your 3 acceptable Vtg measurements should be within 5% of each other.

Only answer 3 is true.

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11
Q

What is the minimum duration for a patient performing a maximum voluntary ventilation study?

A. 10 seconds
B. 12 seconds
C. 15 seconds
D. 30 seconds

A

B. 12 seconds

*page F-17

MVV “tracing should show a continuous, rhythmic effort for at least 12 seconds”

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12
Q

Breath-holding time for an acceptable DLCO-SB is between

A. 8-10 seconds
B. 9-11 seconds
C. 10-12 seconds
D. 12-15 seconds

A

B. 9-11 seconds

*page F-19

“breath hold should be stable for 10 seconds (8-12 seconds)”

There are 3 answers that could be true (a, b, c) but B was the choice that was closest to an ideal effort of 10 seconds throughout the range. There is no explanation for this in the study guide or audio.

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13
Q

With a body plethysmograph, how would the technologist determine the accuracy of the VC?

A. isothermal lung
B. sine wave rotary pump
C. super syringe
D. rotameter

A

A. isothermal lung

*page F-13

accuracy is determined via quality control. an isothermal lung model is used to quality control a body box.

a sine wave rotary pump is used for box pressure calibration, not quality control.
a rotameter is used for flow calibration, not quality control.
a super syringe is not used on a body box for calibration or quality control.

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14
Q

When measuring exhaled oxygen concentrations to evaluate the patient’s response to hypoxemia, the polarographic analyzer should be calibrated

A. below and above the expected oxygen concentrations.
B. at 21% and 100% oxygen
C. at 12% and 24% oxygen
D. at the highest expected FiO2.

A

A. below and above the expected oxygen concentrations.

remember that proper calibration must consider 2 parameters:
physiologic range to be measured****
sampling conditions of the actual test

The question is asking for calibration values related to “exhaled oxygen” (FeO2). None of the choices list the FeO2 calibration values. Choice A, however, says “below and above the expected oxygen concentrations” which is another way of saying the “physiologic range to be measured”.

FiO2 calibration: 21%-100%
FeO2 calibration: 12%-21%

*page F-12

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15
Q

When manual measurement of spirometry results is performed, what is the minimum ATS-ERS Standard for recording devices?

A. volume range 8 liters
B. volume sensitivity 5 ml/min
C. recording speed 20 mm/sec
D. total accumulation time 60 sec

A

A. volume range 8 liters

Your “recording device” is your spirometer. It needs to be able to collect 8 liters.

  • page F-9 (noted in writing)
  • audio lecture @ 00:12:30 and 00:16:50 (the audio explains this best)
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16
Q

While performing quality control runs for a blood gas analyzer, the PCO2 electrode has produced a mean of 32.0 mm Hg with a standard deviation of 2 mm Hg. If the next three control runs produce values of 31, 37, and 34 mm Hg, the electrode is

A. displaying a trend
B. in control
C. displaying a random error
D. out of control

A

C. displaying a random error

there is one value out of range (37), which would indicate a random error.

the analyzer is not “in control” with one error.
there is no “trend” in the values going from 31 to 37 to 34.
the analyzer is not “out of control” with only one error.

*page F-11

17
Q

How many gases are required to demonstrate the linearity of a gas analyzer?

A. 2
B. 3 or more
C. room air plus 1
D. room air plus 100% FiO2.

A

B. 3 or more

To demonstrate linearity, you need a significant range of at least 3 points of measurement.

*page F-5

18
Q

In accordance with ATS-ERS Standards, the “best” test is the test with the:

A. largest FEV1 only
B. largest PEFR only
C. largest of three acceptable FVC values
D. largest sum of FEV1 and FVC

A

D. largest sum of FEV1 and FVC

The best test will be the one with the highest value when adding FVC and FEV1.

*page F-15

19
Q

When performing helium dilution procedures, which of the following is the correct ATS-ERS standard to determine the end of the test?

A. 0.02% helium change over a 30 second interval
B. 0.2% helium change over a 30 second interval
C. 2.0% helium change over a 30 second interval
D. 2.0% helium change over a 60 second interval

A

A. 0.02% helium change over a 30 second interval.

*page F-18

20
Q

A helium dilution test is requiring more and more oxygen to maintain the baseline. The helium fails to stabilize, this would be due to:

A. an increase in the breathing pattern
B. an early “switch in”
C. a leak in the system
D. an early termination of the test

A

C. a leak in the system

“failure to achieve equilibrium indicates a leak.”

*page F-18