Deck 4: Administering Medical Gases: Regulators, Flowmeters, and

Question 1

A float that jumps and falls to zero when the needle valve is closed and is attached to a bulk system is indicative of a _____ flowmeter.

A) crack in the
B) Bourdon
C) non-compensated
D) pressure-compensated

Answer 1

D
This floating movement occurs because the source gas must pass through the indicator tube before it reaches the needle valve.

Question 2

A patient with chronic bronchitis comes to your emergency department; she is discovered to have a pulse oximetry oxygen saturation (SpO₂)of 78% with room air.On the basis of these data,which oxygen-delivery device would you use with the patient?

A) 6-L nasal cannula
B) Transtracheal catheter
C) Simple mask
D) Venturi mask

Answer 2

D
A patient with chronic obstructive pulmonary disease requires a precise FɪO₂ because of carbon dioxide (CO₂)retention issues.The only precise FɪO₂ device is a Venturi mask,which is considered a high-flow device.

Question 3

If the air-entrainment port on a Venturi mask is occluded,which of the following will happen?
1)A decrease in flow
2)A decrease in FɪO₂
3)An increase in flow
4)An increase in FɪO₂

A) 1 and 2
B) 1 and 3
C) 1 and 4
D) None of the choices

Answer 3

C
Partial obstruction of oxygen flow downstream of the jet orifice or partial obstruction of the entrainment ports will decrease the amount of room air entrained,thus raising the FɪO₂ of the delivered gas.

Question 4

What device helps reduce high-pressure gases from cylinders or bulk storage units to a lower working pressure?

A) Regulator
B) Kinetic tube
C) Bourdon gauge
D) Thorpe tube

Question 5

Which regulator supports the theory that gas pressure is gradually reduced as gas flows from a high-pressure source through a series of stages to the outlet?

A) Single-stage regulator
B) Flowmeter
C) Preset regulator
D) Multistage regulator

Question 6

The characteristic(s)of low-flow devices is (are):
1)fractional inspired oxygen (FɪO₂)from 0.22 to 0.60.
2)make use of a nasal cannula.
3)make use of a Venturi mask.
4)make use of a transtracheal catheter.

A) 1,2,and 4
B) 1 and 4
C) 1
D) 1,2,3,and 4

Question 7

A nasal cannula that delivers 5 L/min translates to what approximate FɪO₂?

A) 36%
B) 28%
C) 40%
D) 44%

Question 8

O₂-induced hypoventilation is more likely to occur with which oxygen-delivery device?

A) Simple mask
B) Nasal cannula
C) Venturi mask
D) Large-volume nebulizer

Question 9

The chamber located above the diaphragm of a single-stage regulator is which of the following?

A) Lower chamber
B) Pressure-relief valve
C) High-pressure chamber
D) Adjustable regulator

Question 10

Which of the following are disadvantages of the nasal cannula?
1)Pressure necrosis
2)Drying nasal mucosa
3)FɪO₂ not precise
4)Claustrophobia

A) 1 and 4
B) 1 and 2
C) 1,2,and 3
D) 2 and 3

Question 11

The most commonly used flowmeter in respiratory care is which of the following?

A) Thorpe tube flowmeter
B) Bourdon gauge
C) Flow restrictor
D) Reducing valve

Question 12

High-flow devices include which of the following?
1)Nasal cannula
2)Venturi mask
3)Mask with reservoir bag
4)Oxygen hoods

A) 1 and 2
B) 2 and 3
C) 3 and 4
D) 2 and 4

Question 13

Which device uses the following principle? As the driving pressure is increased,the flow from the flowmeter outlet increases.

A) Compensated Thorpe tube flowmeter
B) Fixed-orifice flowmeter
C) Bourdon flowmeter
D) Non-compensated pressure flowmeter

Question 14

What is (are)the type(s)of flow restrictor(s)?
1)Fixed-orifice
2)Adjustable,multiple-orifices
3)Compensated orifice
4)Non-compensated orifice

A) 1
B) 2
C) 1,2,3,and 4
D) 1 and 2

Question 15

The gas flow into the high-pressure side regulator is dependent on what two opposing forces?
1)Gas pressure above the diaphragm
2)Gas pressure at the diaphragm
3)Spring tension below the diaphragm
4)Spring tension above the diaphragm

A) 1 and 3
B) 2 and 3
C) 2 and 4
D) 1 and 4

Question 16

In theory,a nasal cannula can deliver what amount of FɪO₂ to a patient?

A) 0.24 to 0.60
B) 0.24 to 0.36
C) 0.24 to 1.00
D) 0.24 to 0.44

Question 17

Delivered pressures on common adjustable regulators are between _____ and ____ pounds per square inch gauge (psig).

A) 0; 50
B) 0; 100
C) 50; 100
D) 50; 200

Question 18

Pressure-compensated flowmeters provide which of the following?

A) Inaccurate estimates of flow
B) Accurate estimates of flow
C) Back pressure
D) A means to estimate leaks

Question 19

The problem most often encountered with a Thorpe tube flowmeter is:

A) patient outlet becomes occluded.
B) gas leaks caused by faulty valve seats.
C) a cracked tube.
D) prolonged heat exposure.

Question 20

Which device is more precise in terms of controlling gas pressure?

A) Bourdon flowmeter
B) Thorpe tube flowmeter
C) Multistage regulator
D) Flow restrictors

Question 21

Which of the following are advantages of transtracheal catheters?
1)Increase patient mobility
2)Improve patient compliance because of an enhanced cosmetic appearance
3)Increase the amounts of nasal irritation
4)Heighten the risk for mucus plugging

A) 1,2,and 3
B) 2 and 3
C) 1 and 2
D) 1,2,3,and 4

Question 22

What liter flow is approximately 32% on a nasal cannula?

A) 2
B) 3
C) 4
D) 5

Question 23

A simple mask can deliver what percentage of FɪO₂ at how many liters/minute?

A) 0.24 to 0.44 at 1-6 L/min
B) 0.35 to 0.50 at 5-10 L/min
C) 0.40 to 0.60 at 10-15 L/min
D) 0.50 to 0.80 at 5-10 L/min

Question 24

The main goal of a pulse-demand oxygen-delivery system is which of the following?
1)To provide oxygen only during expiration
2)To provide oxygen only during inspiration
3)To deliver oxygen to the patient only after a sufficient inspiratory effort is made and the demand valve opens
4)To deliver oxygen at a preset flow rate and close during inspiration to conserve oxygen

A) 1 and 3
B) 2 and 4
C) 2 and 3
D) 1 and 4

Question 25

A patient with pulmonary fibrosis comes to the emergency department with an SpO₂ of 87% and a respiratory rate of 28 breaths/min.The patient is unsure whether her transtracheal catheter is working properly; what is your first action?

A) Intubate her.
B) Examine her for a mucus plug.
C) Place a nasal cannula on her.
D) Place a lavage catheter.

Question 26

The FɪO₂ that is actually delivered to the patient through an oxygen mask depends on which of the following?
1)Flow of the oxygen to the mask
2)Presence of a reservoir bag
3)Humidity of the gas
4)Density of the gas

A) 1 and 2
B) 2 and 3
C) 1 and 4
D) 3 and 4

Question 27

Types of reservoir cannulas include which of the following?
1)Mustache
2)Pulse demand
3)Pendant
4)High flow

A) 1 and 2
B) 2 and 3
C) 1,3,and 4
D) 2,3,and 4

Question 28

The transtracheal oxygen catheter is a guiding principle in which oxygen is delivered directly into the trachea and does which of the following?

A) Provides the patient with adequate oxygen
B) Reduces the amount of oxygen used
C) Provides an overall oxygen savings of 54% to 59%
D) All of the above

Question 29

The statement that is true concerning reservoir cannulas is which of the following?

A) The mustache cannula can hold about 40 mL of gas.
B) The pendant cannula can reduce oxygen supply use by 75%.
C) Patients prefer the mustache cannula to the pendant cannula.
D) Pendant cannulas can be concealed by the patient's clothing.

Question 30

If a Venturi mask is set at 28% and the liter flow is set above the set liter flow prescribed on the device,what FɪO₂ is being delivered?

A) 28%
B) 32%
C) 100%
D) 80%

Question 31

Patients exposed to FɪO₂ greater than or equal to 50% are at risk for which of the following?
1)Chronic obstructive pulmonary disease
2)O₂ toxicity
3)Permanent lung damage
4)Atelectasis

A) 1 and 2
B) 2 and 4
C) 2,3,and 4
D) None of the choices

Question 32

Which of the following O₂ devices has 2 one-way valves and the second valve is at the exhalation ports,which prevents room air from entering the mask during inhalation?

A) Nonrebreathing mask
B) Partial rebreathing mask
C) Aerosol tracheostomy collar mask
D) Simple mask

Question 33

In a pulse-demand oxygen-delivery system,the _____ replaces the flowmeter.

A) Pendant
B) Demand valve
C) Pressure-relief valve
D) Flow valve

Question 34

Which of the following devices could cause CO₂ retention?
1)Simple mask
2)Aerosol face mask
3)Nonrebreathing mask
4)Air-entrainment mask

A) 1 and 3
B) 1 and 2
C) 2 and 3
D) 3 and 4

Question 35

In a typical adult partial rebreathing mask,the reservoir bag has an approximate volume capacity of _____ mL?

A) 150-300
B) 300-500
C) 400-600
D) 500-700

Question 36

Complications of transtracheal oxygen catheters are:

A) subcutaneous emphysema.
B) mucus-plugging.
C) infection.
D) all of the above.

Question 37

Partial rebreathing masks deliver what FɪO₂ at what liter flow?

A) 0.35 to 0.50 at 4-5 L
B) 0.40 to 0.60 at 6-8 L
C) 0.50 to 0.80 at 6-8 L
D) 0 50 to 1.00 at 12-15 L

Question 38

Which of the following are O₂-conserving devices?
1)Transtracheal oxygen catheters
2)Reservoir cannulas
3)Pulse-demand oxygen-delivery systems
4)E size cylinder O₂ tanks

A) 1,2,and 4
B) 1,2,and 3
C) 1,3,and 4
D) 1,2,3,and 4

Question 39

Upon arrival to the emergency department,a patient is found to have an SpO₂ of 75% on a nonrebreathing mask.You notice that the nonrebreathing mask is hooked to a bubble humidifier.The humidifier bottle is whistling and is expanded. What is your next action as the respiratory therapist?

A) Change the bubble humidifier; it's defective.
B) Check for kinks in tubing.
C) Remove the nonrebreathing mask from the humidifier and run off of O₂.
D) Place a Venturi mask on the patient.

Question 40

The benefits of a transtracheal catheter include which of the following?
1)Lower flows are needed to obtain higher SpO₂
2)The ability for the patient to eventually wean off of O₂.3.Improved self-image of the patient.4.Oxygen cost savings of up to 60%.a. 2 and 4
B) 1 and 3
C) 1,3,and 4
D) 1,2,3,and 4

Question 41

Dalton's law states that:

A) The total pressure of a gas mixture equals the sum of the partial pressure of each constituent gas in the mixture.
B) The pressure within a liquid sphere is influenced by the surface tension forces of the liquid and the size of the sphere.
C) There is a direct relationship between the absolute pressure of a gas and its temperature.
D) The volume of a gas is inversely related to its pressure.

Question 42

The concentration of oxygen delivered to the patient with an air-entrainment mask depends on which of the following?
1)Flow of the oxygen exiting the jet nozzle
2)Size of the jet nozzle outlet
3)Size of the entrainment port
4)Size of the Venturi mask

A) 1,2,and 3
B) 2,3,and 4
C) 1,2,and 4
D) 3 and 4

Question 43

An oxygen _____ compresses air and oxygen from a high-pressure source into a chamber where the pressure of the two gases is equalized,usually at 50 psi.

A) blender
B) tent
C) hood
D) delivery devices

Question 44

Current incubators are designed to allow all of the following,except:

A) Variable control of environmental temperature
B) Variable control of environmental humidity
C) Control of FɪO₂ concentration
D) Control of barometric pressure

Question 45

What types of patients are treated with hyperbaric oxygen therapy?
1)Deep sea diving patients with decompression sickness
2)Those with thermal injuries
3)Patients with carbon monoxide poisoning
4)Those with refractory osteomyelitis

A) 1,2,and 3
B) 1,2,and 4
C) 2,3,and 4
D) 1,2,3,and 4

Question 46

A 22-year-old with asthma comes to the emergency department in respiratory distress.The patient has acute shortness of breath (SOB); is febrile,tachypneic,and tachycardic; and has an SpO₂ of 88% on a nasal cannula that delivers 2 L/min.Which of the following actions should the respiratory therapist take at this time?

A) Teach the patient to breathe through pursed lips.
B) Place a simple mask on the patient.
C) Remove the cannula and place a 0.35 air-entrainment mask on the patient.
D) Place a high-flow cannula at 15 L/min on the patient.

Question 47

The total flow for a 50% air-entrainment mask running at 8 L/min is _____ L/min.

A) 18
B) 22
C) 25
D) 30

Question 48

Exposure to elevated barometric pressure during hyperbaric oxygen therapy can directly affect a number of physiologic parameters,including which of the following?
1)Arterial and alveolar partial pressure for oxygen
2)Temperature of the gases being breathed
3)Work of breathing
4)Lung volumes

A) 1 and 2
B) 1 and 4
C) 2,3,and 4
D) 1,2,3,and 4

Question 49

A patient is receiving 0.60 FɪO₂ with a barometric pressure of 755 mm Hg.PCO₂ is 56 mm Hg and PaO₂ 65 mm Hg.The PAO₂ for this patient is _____ mm Hg.

A) 265.6
B) 300.9
C) 354.8
D) 404.0

Question 50

How many liters/minute of air is being entrained for a 50% air-entrainment mask running at 8 L/min?

A) 10
B) 12
C) 14
D) 20

Question 51

_____ therapy exposes patients to a pressure greater than atmospheric pressure while they breathe 100% oxygen,either continuously or intermittently.

A) Aerosol oxygen
B) Hyperbaric oxygen
C) Bronchial hygiene
D) Nitric oxide

Question 52

How many liters/minute of air is being entrained for a 35% air-entrainment mask running at 10 L/min?

A) 43 L/min
B) 53 L/min
C) 60 L/min
D) 65 L/min

Question 53

Theoretically,a nonrebreathing mask can deliver 100% oxygen,assuming that the mask fits appropriately on the patient's face and is the only source of gas being inhaled by the patient.However,in actual practice,the disposable nonrebreathing mask can deliver what percentage of FɪO₂?

A) 0.30-0.50
B) 0.40-0.60
C) 0.60-0.80
D) 0.24-0.50

Question 54

It is important to filter the gas before it enters the blender housing; otherwise,a malfunction will occur.Which of the following can cause a malfunction?
1)Moisture
2)Particulate matter
3)High amounts of FɪO₂
4)Low amounts of FɪO₂

A) 1 and 3
B) 1 and 2
C) 1 and 4
D) 2 and 3

Question 55

Which of the following O₂ devices is appropriate for patients with chronic obstructive pulmonary disease who are hypoxemic?

A) Simple mask
B) Nasal cannula
C) Partial rebreathing mask
D) Air-entrainment mask

Question 56

With oxygen hoods,FɪO₂ must be measured by using what type of device?

A) Incubator
B) Pulse oximeter
C) Heater
D) Analyzer

Question 57

A patient is receiving 0.30 FɪO₂ with a barometric pressure at 750 mm Hg.The partial pressure of carbon dioxide (PCO₂₎ for this patient is 70 mm Hg; the partial pressure of arterial oxygen (PaO₂)is 60 mm Hg.The PAO₂ for this patient is _____ mm Hg.

A) 100.2
B) 123.4
C) 160.0
D) 181.7

Question 58

The total flow for a 35% air-entrainment mask running at 10 L/min is _____ L/min.

A) 43
B) 53
C) 60
D) 65

Question 59

______ law states that if the temperature of a gas remains constant,the volume of a gas is inversely related to its pressure.

A) Henry's
B) Boyle's
C) Dalton's
D) Laplace's

Question 60

The oxygen/air ratio for the 35% air-entrainment mask is:

A) 1:4.3.
B) 1:5.3.
C) 1:6.0.
D) 1:6.5.

Question 61

According to the American Association for Respiratory Care (AARC)Clinical Practice Guideline (2002 Revision & Update),which of the following are considered precautions or complications of oxygen therapy?
1)A PaO₂ >60 mm Hg in spontaneously breathing patients with chronic PaCO₂ levels
2)With FɪO₂ >0.50 and the risk of oxygen toxicity or absorption atelectasis occurring
3)During laser bronchoscopy and high levels of oxygen
4)Acute myocardial infarction

A) 1,2,and 4
B) 1,2,and 3
C) 2,3,and 4
D) 1,2,3,and 4

Question 62

The benefits of breathing heliox are related to its lower density in comparison with pure oxygen or air. The lower density does which of the following? 1.Promotes laminar flow
2)Increases the amount of turbulent flow
3)Reduces the amount of turbulent flow
4)Decreases the laminar flow

A)1 and 2
B)1 and 3
C)2 and 4
D)3 and 4

Question 63

Which types of devices/techniques should be used to monitor the oxygenation status of patients undergoing hyperbaric oxygen therapy?
1)Transcutaneous monitoring
2)Arterial blood gas monitoring
3)End-tidal CO₂ monitoring
4)Spirometer

A) 1 and 2
B) 1 and 4
C) 2 and 3
D) 3 and 4

Question 64

What type of oxygen device is used to administer heliox to a non-intubated patient?

A) Nasal cannula
B) High-flow cannula
C) Simple mask
D) Nonrebreathing mask

Question 65

A patient is placed on a 70:30 heliox mixture at a flow of 8 L/min.The actual flow rate going to the patient is ____ L/min.

A) 11.2
B) 12.8
C) 14.4
D) 16.2

Question 66

A pediatric patient with refractory croup is placed on heliox 80:20 at a flow of 10 L/min.The actual flow going to the patient is _____ L/min.

A) 14
B) 16
C) 18
D) 20

Question 67

As the barometric pressure increases,there is an increase in the density of the gas being breathed. The increase in gas density in turn causes a(n):

A) Decrease in work of breathing
B) Increase in FɪO₂
C) Increase in work of breathing
D) Decrease in FɪO₂

Question 68

Contraindications for hyperbaric oxygen therapy consist of all of the following,except:

A) Pneumothorax
B) Obstructive bronchial diseases
C) Upper respiratory infection
D) Skin grafting

Question 69

Intermittent air-breathing is used in hyperbaric chambers to prevent which of the following?

A) Hyperventilation
B) Oxygen toxicity
C) Hypoventilation
D) Hypertension

Question 70

Which type of therapy has been used to successfully treat persistent pulmonary hypertension in newborns?

A) Helium-oxygen (heliox)
B) Nitric oxide
C) Bronchial hygiene
D) Carbon dioxide-nitrogen (carbogen)

Question 71

The therapeutic dose of nitric oxide is _____ ppm.

A) 2-80
B) 25-115
C) 40-150
D) 30-60

Question 72

A 55-year-old man comes to the emergency department on a nonrebreathing mask with an SpO₂ of 88%.The patient was found unconscious in a running car in the garage.Carbon monoxide poisoning is a concern at this time.What should the respiratory care practitioner recommend to the physician at this time?

A) Place a nasal cannula at 6 L/min on the patient.
B) Begin the patient on heliox therapy 80%:20%.
C) Place the patient on carbogen therapy 5%:95%.
D) Set the patient up on an air-entrainment device at 0.50 FɪO₂.

Question 73

What criteria must a patient meet for home oxygen therapy,according to AARC Clinical Practice Guidelines (2002 Revision)?
1)PaO₂ <55 mm Hg
2)SpO₂ <88% room air at rest
3)SpO₂ <88% room air with exertion
4)PaO₂ >60 mm Hg

A) 1,2,and 4
B) 2,3,and 4
C) 1,2,and 3
D) 2 and 3

Question 74

An 18-year-old with severe asthma is brought into the emergency department on an nonrebreathing mask; he is in acute respiratory distress.He has been given multiple rounds of bronchodilators and corticosteroids and is still in distress,with an SpO₂ of 85% on the nonrebreathing mask.What therapy should the respiratory care practitioner suggest to the physician at this time?

A) Nitric oxide therapy
B) Heliox therapy
C) Carbogen therapy
D) Hyperbaric therapy

Question 75

All oxygen-delivery systems should be checked how often according to the AARC Clinical Practice Guideline (2002 Revision & Update)?

A) At least once a day
B) Twice a week
C) Every 48 hours
D) Once a month

Question 76

To prevent an adverse reaction,it is essential to monitor which of the following when administering carbogen to a patient?
1)Heart rate
2)Blood pressure
3)Respirations
4)The patient's mental status

A) 1,2,and 3
B) 1,2,and 4
C) 2,3,and 4
D) 1,2,3,and 4

Question 77

For a neonate on an oxygen hood,where is the best placement of an oxygen analyzer to measure the correct FɪO₂?

A) Above the patient's head
B) At the nose and mouth
C) On the side near either arm
D) The rear of the hood

Question 78

A patient is receiving 0.80 FɪO₂ with a barometric pressure at 760 mm Hg.PCO₂ is at 68; PaO₂ is 55.The PAO₂ for this patient is _____ mm Hg.

A) 395.6
B) 485.4
C) 510.9
D) 550.0

Question 79

Heliox has been used on a limited basis to treat patients with which of the following?

A) Hyperventilation
B) Thermal burns
C) Airway obstructions
D) Upper respiratory infections

Question 80

Retinopathy of prematurity often occurs in neonates because of which of the following?

A) Increased amounts of FɪO₂
B) Low amounts of FɪO₂
C) Improper placement of the oxygen-delivery device
D) Hyperventilation