Review Questions

Question 1

The oxygen electrode in a blood gas machine

1. Is a Severinghaus
2. Is a polargraphic analyzer
3. Is called a Kent
4. A and B
5. B and C

Answer 1

Is a polargraphic analyzer

Question 2

Obstructive lung disorders

1. Are associated with increased pulmonary compliance
2. Are always intrinsic in nature
3. Often present with lower expiratory flows on PFTs
4. Will have a ground glass appearance on xray

Answer 2

1. Often present with lower expiratory flows on PFTs

Question 3

Non-maleficence

1. Means “do no harm”
2. In health care refers to balancing good with bad effects
3. Is linked to the diagnosis
4. All of the above
5. A and b only

Answer 3

A and b only

Question 4

Compensation for a decreased supply of oxygen to the tissue includes

1. Increased cardiac output
2. Decreased extraction
3. Increased aerobic metabolism
4. All of the above
5. A and b only

Answer 4

1. Increased cardiac output

Question 5

Starlings law of capillaries states that:

1. The volume of the fluid and solutes reabsorbed is normally nearly as large as the volume filtered
2. The volume of fluid and solutes reabsorbed is normally larger than the volume filtered
3. The volume of fluid and solutes filtered at the arterial end is the same as the volume of fluid and solutes filtered at the venous end
4. The pressure of the fluids and solutes filtered is normally as large as the pressure reabsorbed

Answer 5

1. The volume of the fluid and solutes reabsorbed is normally nearly as large as the volume filtered

Question 6

The ABG results on 5 LPM are as follows:

pH 7.01, PaCO2 147 mmHg, PaO2 57 mmHg, HCO3 36 mmol/L, BE 17, Hb 19.8 g/L

Her predicted pH is lower than her actual pH

This is an acute on chronic ABG

She is polycythemic

She is moderately hypoxemic even on oxygen

i, ii, iii, iv

ii, iii

iii, iv

ii, iv

i, ii

Answer 6

i, ii, iii, iv

Question 7

The P-wave in lead II ECG represents?

1. Onset of atrial depolarization
2. Onset of ventricular depolarization
3. Atrial repolarization
4. Ventricular repolarization

Answer 7

1. Onset of atrial depolarization

Question 8

1) The amount of air entrained in a Venturi device is _______ proportional to the size of the Jet and _______ proportional to the size of the entrainment port.
a) Directly, directly
b) Directly, inversely
c) Inversely, directly
d) Inversely, inversely

Answer 8

c) Inversely, directly

Question 9

1) Keeping the relative humidity constant, as the temperature of the air ______ the absolute humidity will _______.
a) decreases, increase
b) Increases, decrease
c) Decreases, decrease
d) Increases, remains constant

Answer 9

Decreases, decrease

Question 10

Pleuritic chest pain

Answer 10

Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling.

Question 11

Spiriva

a) Is dispensed via a turbuhaler
b) Is the trade name for tiotropium bromide
c) Is used to administer a short acting cholinergic
d) All of the above
e) B and c only

Answer 11

Is the trade name for tiotropium bromide

Question 12

What is the root cause of the distended neck veins, severely clubbed fingers and pitting peripheral edema?

a) Severe chronic hypercapnea
b) Severe chronic acidemia
c) Severe chronic hypoxemia
d) Severe chronic hypocapnea

Answer 12

Severe chronic hypoxemia

Question 13

1) In the healthy lung, when the alveolus decreases in size during a normal exhalation, the:
a) Surface tension increases
b) Surfactant to alveolar surface area ratio increases
c) a and b only
d) b and c only

Answer 13

Surfactant to alveolar surface area ratio increases

Question 14

Application of nasal CPAP to neonates can:

a) Be used to treat apnea associated with intraventricular hemorrhage
b) Treat babies with necrotizing entercolitis
c) Be used immediately post extubation
d) Used immediately post-delivery in babies with congenital diaphragmatic hernia
e) None of the above

Answer 14

c) Be used immediately post extubation

Question 15

What effect do glucocorticoids have on beta adrenergic receptors?

a) No effect
b) Stimulates B2receptors to relax bronchial smooth muscle
c) Restores/enhances responsiveness of B2receptors to B2 specific agents
d) Inhibits mast cell release

Answer 15

b) Stimulates B2receptors to relax bronchial smooth muscle

Question 16

Exudative pleural effusions:

a) May demonstrate high levels of epithelial cells
b) May demonstrate high levels of protein
c) Usually caused by CHF
d) a and b only

Answer 16

a and b only

Question 17

Prior to birth, respiratory distress in the baby can be determined by which observation(s)?

a) Variable decelerations on the fetal heart rate monitor
b) Loss of pulse on the fetal heart rate monitor
c) A scalp pH of less than 7.10
d) All of the above
e) b and c

Answer 17

All of the above

Question 18

1) Which of the following agent should be used to kill tubercle bacillus spores?

Alcohol

Glutaraldehyde

Quaternary compound

Phenols

Answer 18

Glutaraldehyde

Question 19

Which of the following is the recommended care of the ventilator circuit for prevention of VAP?

l. The ventilator circuit must be changed every 4 days
ll. Closed suction systems are recommended
lll. Circuit condensate should be used to instill the patient

lV. Passive humidifiers can be safely used for 48 hours

Answer 19

II, IV

Question 20

1)To maintain your clinical competency in Alberta you must complete __________ hours of practice over the preceding four year period.

48

500

1500

2000

2500

Answer 20

1500

Question 21

Which of the following is/are the major characteristics of increased alveolar dead-space?

a) Minute ventilation out of proportion to the PaCO2
b) Decreased work of breathing
c) Hyperoxemia
d) FiO2> 0.50 and PaO2< 50 mmHg
e) a and c only

Answer 21

Minute ventilation out of proportion to the PaCO2

Question 22

1) Components of the tracheobronchial tree which tend to have turbulent airflow include:
a) Main Stem Bronchi
b) Bronchioles
c) Terminal Bronchioles
d) a and b
e) all of the above

Answer 22

a and b

Question 23

A drug that has both efficacy and affinity is termed:

a) Antagonist
b) Potency
c) Agonist
d) a and c

Answer 23

Agonist

Question 24

A 35 week neonate presents at birth with a scaphoid abdomen and is in need of resuscitation. Your first action should be to:

a) Intubate
b) Provide bag and mask ventilation
c) Insert a UAC
d) Insert an umbilical art line

Answer 24

Intubate

Question 25

1) Drugs indicated to treat tachycardia include: a) Amiodarone b) Epinephrine c) Norepinephrine d) All of the above

Answer 25

Amiodarone

Question 26

1) Comparing non-invasive ventilation (NPPV) to conventional invasive mechanical ventilation, which of the following is false: a) NPPV has lower infection rates b) NPPV may be better tolerated c) NPPV will not result in a correction of arterial blood gases d) NPPV is contra-indicated for a hemodynamically stable patient

Answer 26

c) NPPV will not result in a correction of arterial blood gases

Question 27

1) Which of the following is not recommended for mechanical ventilation of an asthmatic patient? a) High set RR b) Permissive hypercapnia c) Use of minimal extrinsic PEEP d) Using lung recruitment maneuvers e) a and d

Answer 27

a and d

Question 28

Which of the following transcutaneous nerve stimulator results is the best indicator of the safety of using a MR reversal agent? a) Tetany b) Single twitch back c) Two twitches back d) Three twitches back

Answer 28

Three twitches back

Question 29

Ejection Fraction Calculation

Answer 29

Ejection Fraction=(Stroke Volume /End Diastolic Volume)- 100

Question 30

Cardiac Output Calculation

Answer 30

Heart Rate x Stroke Volume

Question 31

1) If a patient has a stroke volume of 80 mLs, a cardiac output of 4.05 L/min and an ejection fraction of 0.60, of the following which is closest to what would their end diastolic volume be? a) 115 mLs b) 120 mLs c) 125 mLs d) 130 mLs

Answer 31

d) 130 mLs

Question 32

1) Mechanical ventilation is indicated for which of the following blood gases? a) pH 7.23, PaCO256 mm Hg, PaO266 mm Hg, HCO3 23 mmol/L b) pH 7.34, PaCO246 mm Hg, PaO251 mm Hg, HCO3 24 mmol/L c) pH 7.31, PaCO250 mm Hg, PaO246 mm Hg, HCO3 24 mmol/L d) pH 7.19, PaCO2 33 mmHg, PaO2 55 mmHg, HCO312 mmol/L

Answer 32

a) pH 7.23, PaCO256 mm Hg, PaO266 mm Hg, HCO3 23 mmol/L

Question 33

Exudative pleural effusions: a) May demonstrate high levels of epithelial cells b) May demonstrate high levels of protein c) Usually caused by CHF d) a and b only

Answer 33

d) a and b only

Question 34

1) A blending device is mixing 11.3 liters of air with 4.7 liters of oxygen. What FIO2is the device producing? a) 0.40 b) 0.45 c) 0.50 0. 55

Answer 34

b) 0.45

Question 35

You set up a dry thoracic drainage unit. How much water will you put into the suction control chamber? a) None b) Fill it to the 2 cm indicator mark c) Fill it to the 20 cm indicator mark d) Start at 10 cm & slowly add fluid until bubbling is seen

Answer 35

a) None

Question 36

1) Small volumes nebulizers a) Should be filled to a minimum of 3 mLs b) Would not have a residual volume that remains in the bottom of the neb after treatment has completed c) Should be set up on a gas flow of between 10-12 LPM d) All of the above e) A and c only

Answer 36

a) Should be filled to a minimum of 3 mLs

Question 37

A 70 kg IBW patient is being weaned from mechanical ventilation. The ventilator settings and ABG are as follows: Mode: SIMV VC Rate: 8 Br/min (total RR is 13 Br/min) VTset: 550 ml Press Supp: 22 cmH2O FiO2: 0.35 ABG: pH: 7.45, CO2 34, PO289 Based on the above information which of the following would you recommend? Increase the SIMV rate Reduce the pressure support Reduce the VT Reduce the FiO2

Answer 37

Reduce the pressure support

Question 38

Once the CVP is in place, the transducer is leveled appropriately and zeroed. The monitor is showing a good waveform, with an “a” wave, “x” descent, “c” wave and “v” wave all present. 40) The CVP pressure reading is 12 mm Hg. Identify the most likely reason her CVP is elevated. a) Volume overload b) Pulmonary hypertension c) Venticular Septal Defect d) Pulmonary embolism

Answer 38

b) Pulmonary hypertension

Question 39

1) In the healthy lung, when the alveolus decreases in size during a normal exhalation, the: a) Surface tension increases b) Surfactant to alveolar surface area ratio increases c) a and b only d) b and c only

Answer 39

b) Surfactant to alveolar surface area ratio increases

Question 40

1) Which of the following ventilator change is most appropriate given the following information for a patient with target CO2of 40-45 mmHg? CMV autoflow RR 15 (measured RR 15 br/min) VT 500 ml PEEP 5 cmH2O FiO20.35 ABG:7.47, 33, 80, 23, 0, 96% a) Decrease minute volume to 5.0 LPM b) Increase PEEP to 7 cmH2O c) Decrease RR to 12 Br/min d) Decrease FiO2to 0.25

Answer 40

c) Decrease RR to 12 Br/min

Question 41

Application of nasal CPAP to neonates can: a) Be used to treat apnea associated with intraventricular hemorrhage b) Treat babies with necrotizing entercolitis c) Be used immediately post extubation d) Used immediately post-delivery in babies with congenital diaphragmatic hernia e) None of the above

Answer 41

c) Be used immediately post extubation

Question 42

What effect do glucocorticoids have on beta adrenergic receptors? a) No effect b) Stimulates B2receptors to relax bronchial smooth muscle c) Restores/enhances responsiveness of B2receptors to B2 specific agents d) Inhibits mast cell release

Answer 42

Stimulates B2 receptors to relax bronchial smooth muscle

Question 43

Prior to birth, respiratory distress in the baby can be determined by which observation(s)? a) Variable decelerations on the fetal heart rate monitor b) Loss of pulse on the fetal heart rate monitor c) A scalp pH of less than 7.10 d) All of the above e) b and c

Answer 43

d) All of the above

Question 44

Which of the following agent should be used to kill tubercle bacillus spores? Alcohol Glutaraldehyde Quaternary compound Phenols

Answer 44

Glutaraldehyde

Question 45

Which of the following is the recommended care of the ventilator circuit for prevention of VAP? 1. The ventilator circuit must be changed every 4 days 2. Closed suction systems are recommended 3. Circuit condensate should be used to instill the patient 4. Passive humidifiers can be safely used for 48 hours

Answer 45

2 and 4

Question 46

Normal CO

Answer 46

4-6 L/min

Question 47

Frank Starling Law

Answer 47

The more that the heart is filled during diastole, the greater the subsequent force of contraction (increase in SV) The ability of the heart to change its force of contraction and therefore stroke volume in response to changes in venous return There is a point however where overstretch can be reached and CO will plateau and then begin to fall The Y axis is the for of contraction= CO In addition to the Frank-Starling mechanism increased stretch in the right atrium will also stretch the SA node which will increase the frequency of the impulse the SA node generates