Question 1

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

Accepted Answer

See the AARC Clinical Practice Guideline: Oxygen Therapy for Adults in the Acute Care Facility-2002 Revision and Update,Clinical Practice Guideline 4-1.

Question 2

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

Accepted Answer

This relationship is important to remember when administering heliox because the actual flow rate of gas delivered will be greater than the set flow.

Question 3

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

Accepted Answer

Transcutaneous monitoring has proven to be valuable in the assessment of the overall oxygenation status of a patient undergoing hyperbaric therapy.Arterial blood gas monitoring can provide information on the oxygenation status of patients receiving hyperbaric therapy and can also give an indication of their ventilatory status.

Question 4

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

Accepted Answer

For non-intubated patients,a well-fitted nonrebreathing mask attached to a reservoir bag should be used.The flow rate of gas should be high enough to prevent the reservoir bag from collapsing during inspiration.Nasal cannulas are ineffective for delivering heliox because of leakage; instead,nonrebreathing masks are the most effective.

Question 5

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.

Accepted Answer

Conversion for 70:30 = 1.6 * 8 L/min = 12.8 L/min.

Question 6

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.

Accepted Answer

Conversion for 80:20 = 1.8 * 10 L/min = 18 L/min.

Question 7

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):

Accepted Answer

The increase in gas density results in increased work of breathing,which is not noticeable and can easily be accommodated in healthy subjects.In patients with reduced lung reserves,however,this increased work can present problems and necessitate ventilatory support.

Question 8

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

Accepted Answer

If pneumothorax occurs during hyperbaric treatment,chest tubes should be immediately inserted; failure to treat pneumothorax can have dire consequences.Gas-trapping can result in barotraumas for those with obstructive bronchial diseases.Similarly,patients who have upper respiratory infections and nasal congestion are usually unable to clear their ears during compression and decompression and thus are prone to eardrum rupture during treatment.

Question 9

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

Accepted Answer

Hyperbaric oxygenation is achieved by having the patient breathe oxygen by mask or through a specially designed hood while being exposed to elevated barometric pressures in the compressed-air chamber.Treatment schedules are tailored to the specific needs of the patient.Generally,patients are placed on schedules in which intermittent air-breathing periods of 5 minutes or more are programmed approximately every 20 minutes to prevent oxygen toxicity to the patient.

Question 10

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

Accepted Answer

Nitric oxide has been shown to be a potent pulmonary vasodilator.

Question 11

The therapeutic dose of nitric oxide is _____ ppm.

Accepted Answer

The therapeutic dose of nitric oxide is 2 to 80 ppm.

Question 12

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?

Accepted Answer

Carbogen is used to treat hiccups and carbon monoxide poisoning; furthermore,it is used as a stimulant/depressant of ventilation and to prevent the complete washout of CO₂ during cardiopulmonary bypass.

Question 13

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

Accepted Answer

See the AARC Clinical Practice Guideline: Oxygen Therapy for Adults in the Acute Care Facility-2002 Revision and Update,Clinical Practice Guideline 4-1.

Question 14

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?

Accepted Answer

Heliox mixtures have been used on a limited basis to treat patients with airway obstruction,specifically in the management of asthmatic patients with acute respiratory failure.

Question 15

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

Accepted Answer

See the AARC Clinical Practice Guideline: Oxygen Therapy for Adults in the Acute Care Facility-2002 Revision and Update,Clinical Practice Guideline 4-1.

Question 16

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

Accepted Answer

Pulse,arterial blood pressure,and minute volume normally increase as the patient breathes carbogen,but the rapidity and level of these changes depend on the concentration of the mixture.

Question 17

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

Accepted Answer

Neonates are obligate nose-breathers,so the mouth and nose are the most accurate location,because it is the area closest to the nares.

Question 18

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.

Accepted Answer

Formula: PAO₂ = (PB - PH₂O)FɪO₂ - PaCO₂ (1.25).
PAO₂ = (760 - 47)0.80 - 68 (1.25).
PAO₂ = 570.4 - 85.
PAO₂ = 485.4 mm Hg.

Question 19

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

Accepted Answer

Specifically,heliox has been used to manage asthmatic patients with acute respiratory failure,to treat postextubation stridor in pediatric trauma patients,as an adjunct in the treatment of pediatric patients with refractory croup,to administer anesthetic gases to patients via small-diameter endotracheal tubes,and to provide ventilatory support for patients with severe airway obstruction caused by chronic bronchitis and emphysema.

Question 20

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

Accepted Answer

The origin of retinopathy of prematurity,especially with regard to the role of oxygen,is controversial.Nonetheless,care should be taken when supplemental oxygen is provided to preterm infants (<37 weeks' gestation).It is suggested that oxygen supplementation should not result in a PaO₂ >80 mm Hg.

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

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

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

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

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 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.

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) :

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

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

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

The therapeutic dose of nitric oxide is _____ ppm.

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

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

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

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

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.

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

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