Ch. 7: Technology

Question 0

Your ICU patient has ARDS with a PaO2 of 62 mmHg despite mechanical ventilation and oxygenation. What explains this finding?

Answer 0

a problem with gas diffusion in the lung

Question 1

the most important factor in determining the respiratory rate is:

Answer 1

arterial pCO2

Question 2

Hot, pale, dry skinned patient with rhonchi and rales throughout the left lung with clear right lung sounds. HR 134, BP 88/64, RR 24, and SaO2 92%. Hx of 2 previous MIs and takes nitro PRN. What is best prehospital management?

Answer 2

oxygen via NRB and IV of NS with fluid challenge

Question 3

ETCO2 is recorded during which phase of the capnogram?

Answer 3

III

Question 4

Your patient is a 15 y/o asthmatic having dyspnea for 45 minutes but does not have his inhaler. Capnography shows an ETCO2 of 45 mmHg. How can you interpret this finding?

Answer 4

The patient;s ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels

Question 5

A CO-oximeter displays an SpCO of 15%. What is the most appropriate interpretation of this finding?

Answer 5

consistent with mild CO poisoning

Question 6

A male patient with an acute exacerbation of his emphysema presents in severe distress with decreased air movement and diffuse inspiratory wheezes in all fields. HR 132, BP 142/88, RR 30, SaO2 88%. What blood gas value is likely?

Answer 6

pCO2 of 70

Question 7

Patient unconscious and apneic on a garage floor with a running car and closed door. HR 70, BP 100/60, RR 0. In addition to an IV of NS, what should you do?

Answer 7

remove the patient from the garage, initiate BVM ventilations with 100% O2, intubate and transport to a hospital with a hyperbaric chamber

Question 8

What statement about pulse oximetry is FALSE?

Answer 8

pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia

Question 9

What would result in an increased respiratory rate?

Answer 9

stimulation of chemoreceptors by an increase of PCO2

Question 10

blood entering the left atrium arrives via the:

Answer 10

pulmonary vein

Question 11

the presence of inverted T waves on an ECG indicates:

Answer 11

myocardial ischemia

Question 12

when the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals:

Answer 12

0.20 seconds

Question 13

Which endocrine substance acts as a marker for CHF?

Answer 13

BNP

Question 14

the total duration of ventricular depolarization is represented by the ______ on the ECG

Answer 14

QRS duration

Question 15

the anterior surface of the heart is best viewed by ECG leads:

Answer 15

V1-V4

Question 16

an ECG monitor is useful for:

Answer 16

evaluating the heart’s electrical conduction system for abnormalities

Question 17

Which ECG finding is LEAST anticipated in a patient experiencing an acute MI?

Answer 17

osborn wave

Question 18

Your patient is a 73 y.o male who is in a recliner, cyanotic, pulseless and apneic. His skin is cool and dry. His wife last saw him an hour and a half ago. What should you do first?

Answer 18

check for rigor mortis

Question 19

the lead to the left of the sternum at the fourth intercostal space is:

Answer 19

V2

Question 20

the mitral valve is also known as the ________ valve

Answer 20

left atrioventricular

Question 21

A 12-lead ECG that reveals slight ST elevation; Q waves in leads II, III and aVF; and ST elevation in V1 and V2 most indicate:

Answer 21

MI in inferior wall and ischemia extending into the right ventricle

Question 22

an elevation of the ST segment is associated with:

Answer 22

myocardial injury

Question 23

What is the LEAST urgent when evaluating a patient suspected of suffering an acute MI?

Answer 23

NOT breath sounds or ECG… pulse oximetry or BP??

Question 24

What is NOT a traumatic mechanism by which a myocardial injury can be produced?

Answer 24

traumatic brain injury

Question 25

What can be determined by lead II cardiac monitoring?

Answer 25

impulse conduction time

Question 26

what best characterizes successful defibrillation?

Answer 26

uniform mass depolarization of myocardial cells, repolarization, intrinsic pacemaker function resumes

Question 27

at standard speed a 1 mm box on ECG paper represents ______ seconds

Answer 27

0.04

Question 28

artifacts can make assessment of a paced rhythm difficult because:

Answer 28

an artifact can obscure the pacer spikes

Question 29

what artery supplies blood to the left ventricle, interventricular septum, and portions of the cardiac conduction system?

Answer 29

left coronary artery

Question 30

the precordial leads provide a view of the:

Answer 30

horizontal plane of the heart, including the left ventricle and septum

Question 31

what is the ability of a cardiac cell to propagate the electrical impulse to another cell?

Answer 31

conductivity

Question 32

A patient that has SpMet readings of 40% would be expected to have signs and symptoms of methemoglobinemia, such as:

Answer 32

headache, dyspnea, confusion, weakness, and chest pain

Question 33

What cells released from the Islets of Langerhans produce glucagon, which increase blood glucose levels?

Answer 33

alpha cells

Question 34

What cells produce somatostatin, which inhibits the production of glucagon and insulin?

Answer 34

delta cells

Question 35

What cardiac enzyme and biomaker is NOT measured and analyzed to help confirm a MI?

Answer 35

B-natriuretic peptide (BNP)