Deck 12: Therapeutic Medical Gases

Question 1

Examples of conditions that cause right-to-left shunts include all except which of the following?

A)Acute respiratory distress syndrome
B)Pulmonary embolism
C)Pulmonary edema
D)Pulmonary fibrosis

Answer 1

Pulmonary embolism

Question 2

Which of the following conditions causes a reduction in ventilation and results in a V/Q mismatch?

A)Interstitial pulmonary fibrosis
B)Pulmonary embolism
C)Heart failure
D)Pulmonary hypertension

Answer 2

Interstitial pulmonary fibrosis

Question 3

A patient is admitted to the emergency room in acute pulmonary edema.The physician asks for your opinion in treating this patient.Which of the following would you recommend?

A)Oxygen therapy with an air-entrainment mask
B)Nitric oxide therapy
C)Helium/oxygen with a nonrebreathing mask
D)Oxygen therapy with continuous positive airway pressure

Answer 3

Oxygen therapy with continuous positive airway pressure

Question 4

Ventilatory depression that causes hypoxemia results from which of the following?

A)A right-to-left shunt
B)A V/Q mismatch
C)An alveolar hypoventilation
D)A low level of atmospheric oxygen

Question 5

The process of hemoglobin releasing oxygen at the tissue level is referred to as:

A)Ventilation.
B)Respiration.
C)External respiration.
D)Internal respiration.

Question 6

You are called to the emergency room to administer oxygen to a patient who is being treated for drug overdose.You notice that the patient's respiratory rate is six breaths per minute and that he is breathing very shallowly.This patient is ordered oxygen therapy to treat which of the following types of hypoxia?

A)Hypoxemic hypoxia
B)Anemic hypoxia
C)Circulatory hypoxia
D)Demand hypoxia

Question 7

You receive an order for oxygen therapy for a patient who has just been admitted to the CCU.Before setting up the patient's oxygen,you review her chart and find that her admitting diagnosis is decreased cardiac output secondary to heart failure.This patient is ordered oxygen therapy to treat which of the following types of hypoxia?

A)Hypoxemic hypoxia
B)Anemic hypoxia
C)Circulatory hypoxia
D)Demand hypoxia

Question 8

Which of the following conditions causes a reduction in perfusion and results in a V/Q mismatch?

A)Pneumonia
B)Lung cancer
C)Pulmonary embolism
D)Emphysema

Question 9

The range of PaO₂ that is classified as moderate hypoxemia is:

A)60 to 79 mmHg.
B)40 to 59 mmHg.
C)30 to 49 mmHg.
D)>30 mmHg.

Question 10

A 70-year-old patient diagnosed with bilateral pneumonia is admitted from a nursing home.Arterial blood gases indicate a mild hypoxemia,and her chest film shows consolidation in both lower lobes.Her respirations are stable and she has a normal breathing pattern.The physician would like to give her a low concentration of oxygen.Which of the following devices would you recommend?

A)A nasal cannula
B)A simple mask
C)An air-entrainment mask
D)A nonrebreathing mask

Question 11

You are called to the ER to see a 37-year-old female with multiple trauma from a car accident.The physician asks that you give her oxygen with as high an FIO₂ as you can provide.Which of the following devices would you select?

A)A nasal cannula
B)A simple mask
C)An air-entrainment mask
D)A nonrebreathing mask

Question 12

A patient with a tracheostomy is weaned successfully from the ventilator and is now breathing spontaneously but needs supplemental oxygen.His arterial blood gases were within normal limits,with an FIO₂ of 40% on the ventilator.Which of the following devices would you recommend?

A)An air-entrainment mask
B)A large-volume nebulizer with tracheostomy collar
C)A simple mask
D)A large-volume nebulizer with face tent

Question 13

Hyperbaric oxygen is used to treat all except which of the following conditions?

A)Carbon monoxide poisoning
B)COPD
C)Decompression sickness
D)Air embolism

Question 14

A known COPD patient comes into the ER in acute distress due to bronchospasm.The patient is moderately hypoxemic,with a respiratory rate of 32.The physician would like him to have oxygen with a device that will deliver a precise FIO₂.Which of the following would you recommend?

A)A nasal cannula
B)A simple mask
C)An air-entrainment mask
D)A nonrebreathing mask

Question 15

An example of a condition that results in anemic hypoxia is:

A)Carbon monoxide poisoning.
B)Hypoventilation.
C)Cyanide poisoning.
D)Hypovolemia.

Question 16

An example of a condition that results in histotoxic hypoxia is:

A)Carbon monoxide poisoning.
B)Hypoventilation.
C)Cyanide poisoning.
D)Hypovolemia.

Question 17

Of the following,which device is most likely to transmit bacteria?

A)A large-volume nebulizer
B)A jet-mixing mask
C)A simple mask
D)A nonrebreathing mask

Question 18

The clinical responses to conditions causing acute hypoxemia include all the following except:

A)Tachycardia.
B)Tachypnea.
C)Polycythemia.
D)Hypertension.

Question 19

A nasal cannula can be used to deliver oxygen in all except which of the following situations?

A)Treatment for carbon monoxide
B)Long-term therapy for COPD
C)To decrease myocardial work
D)To treat mild hypoxemia

Question 20

Oxygen therapy alone will improve PaO₂ levels in all except which of the following conditions?

A)COPD
B)Pulmonary fibrosis
C)ARDS
D)Pulmonary emboli

Question 21

Administration of oxygen to patients with COPD that raises their PaO₂ above 70 mmHg can cause oxygen-induced hypercapnia due to which of the following mechanism?

A)Depression of the peripheral chemoreceptors
B)Stimulation of the respiratory center
C)Formation of free radicals
D)Washout of nitrogen in the lungs

Question 22

A 16-year-old asthmatic comes into the ER in acute distress due to bronchospasm.The patient has received two treatments with albuterol,but her condition is deteriorating quickly.The patient is moderately hypoxemic,with a respiratory rate of 32.Which of the following would you recommend to help improve oxygen and medication delivery?

A)50% oxygen via a jet-mixing mask
B)100% oxygen via a nonrebreathing mask
C)Inhalation of 30% oxygen and 70% helium
D)Inhalation of nitric oxide via a nonrebreathing mask

Question 23

______ 10.Nitrous oxide (N₂O)is a potent selective pulmonary vasodilator.
FILL-IN-THE-BLANK
Write the word or phrase that best completes each statement.

Question 24

______ 5.Oxygen therapy alone does not help improve conditions that cause a right-to-left shunt.

Question 25

The physiologic responses in inhaled nitric oxide include all except which of the following?

A)Produces pulmonary vasodilation
B)Decreases pulmonary vascular resistance
C)Improves ventilation/perfusion ratio
D)Decreases systemic blood pressure

Question 26

______ 2.Hypoxemia exists when the levels of oxygen in the blood are below normal and can be verified by measuring an arterial blood gas sample.

Question 27

______ 7.Medical oxygen is regulated by the United States Pharmacopeia (USP)and must be
99% pure.

Question 28

A 56-year-old female is placed on 100% oxygen.Twenty-four hours later,the patient's condition begins to worsen,and her chest film shows diffuse infiltrates and atelectasis.The physician suspects that she is in the early stages of ARDS.The cause of this patient's current condition is most likely which of the following?

A)Absorption atelectasis
B)Oxygen toxicity
C)Oxygen-induced hypoventilation
D)ROP

Question 29

Oxygen-induced hypercapnia can be avoided in COPD patients by maintaining their PaO₂ in which of the following ranges?

A)40 to 50 mmHg
B)50 to 60 mmHg
C)60 to 70 mmHg
D)70 to 80 mmHg

Question 30

Which of the following devices is most frequently used for emergencies that require a moderate FIO₂?

A)A nasal cannula
B)A simple mask
C)A nonrebreathing mask
D)A jet-mixing mask

Question 31

______ 9.The inhalation of helium does not cause any reaction within the body.

Question 32

______ 1."Respiration" is the term used to describe the process of breathing in and out or carrying the oxygen-rich atmosphere from outside of the body to the alveoli.

Question 33

Which of the following patients would benefit from inhalation of nitric oxide?

A)Premature infants with persistent pulmonary hypertension
B)Asthmatic patients in acute bronchospasm
C)Patients with postoperative anesthetized patient
D)Patients with persistent singulation TRUE/FALSE
Write 'T' if the statement is true and 'F' if the statement is false.

Question 34

______ 4.Left-to-right shunt occurs when blood leaves the right heart and bypasses a portion of the pulmonary circulation.

Question 35

Retinopathy of prematurity can be avoided by doing which of the following?

A)Keeping the FIO₂ below 100%
B)Avoiding high FIO₂s for longer than 12 to 24 hours
C)Keeping the PaO₂ in a lower range
D)Keeping the SpO₂ at 100%

Question 36

______ 6.Sickle cell anemia is a condition that leads to hypoxemic hypoxia.

Question 37

Of the following patients,all except which of the following would benefit from inhalation of a helium/oxygen mixture?

A)Pediatric patients with croup
B)Premature infants with ROP
C)Patients with severe asthmatic bronchospasm
D)Patients with postoperative stridor

Question 38

A COPD patient is being discharged to home and requires oxygen therapy.The physician asks you to recommend a device that can be used with his oxygen concentrator.Which of the following would you recommend for this patient?

A)A nasal cannula
B)A simple mask
C)A nonrebreathing mask
D)A jet-mixing mask

Question 39

______ 8.Oxygen toxicity results when too much oxygen forms free radicals,which disrupt tissue formation.

Question 40

______ 3.The PaO₂ represents the amount of oxygen that is dissolved in the blood.

Question 41

Helium/oxygen mixtures have been shown to be beneficial with _______________ airway obstructions.

Question 42

The body's response to a condition of hypoxemia causes _______________ and ________________ vasodilation,and ________________ vasoconstriction.

Question 43

Inhaled nitric oxide is a selective _______________ vasodilator.

Question 44

Which oxygen device is most used in the home to deliver oxygen and why?

Question 45

What are the three primary goals of oxygen therapy?

Question 46

The FIO₂ delivered in _______________ oxygen systems is affected by the patient's rate and depth of breathing.

Question 47

________________ refers to low levels of oxygen to the tissue.

Question 48

PaO₂ represents the measure of oxygen that is ___________________.

Question 49

Breathing high concentrations of oxygen that causes nitrogen to wash out of the lungs can cause a condition called ________________.

Question 50

Is cyanosis a good indicator of hypoxemia?

Question 51

What does the term "affinity" mean in relation to hemoglobin and oxygen?

Question 52

Give two examples of situations in which simple masks may be used.

Question 53

The process of gas exchange that occurs at the alveolar capillary membrane is referred to as ________________.

Question 54

________________ oxygen systems provide enough flow to meet all of the patient's ventilatory demands.

Question 55

Nitric oxide is combined with ________________ in compressed gas cylinders.

Question 56

Any process that impairs the balance between ventilation reaching the alveolus and perfusion to the surrounding capillary is referred to as ________________.