Question 1

To prevent an adverse rebound effect when withdrawing NO therapy, what should you do?
I.	Reduce the NO to the lowest effective dose (ideally, less than 5 ppm).
II.	Hyperoxygenate the patient just before discontinuing NO.
III.	Ensure that the patient is hemodynamically stable.

Accepted Answer

To prevent an adverse rebound effect when withdrawing NO therapy, it's important to reduce NO to the lowest effective dose, ideally less than 5 ppm, ensure the patient is hemodynamically stable, and hyperoxygenate the patient just before discontinuing NO. These steps help mitigate the risk of rebound hypoxemia and pulmonary hypertension.

Question 2

At what level of carboxyhemoglobin saturation is hyperbaric oxygen (HBO) therapy indicated for an adult patient?

Accepted Answer

Hyperbaric oxygen therapy is typically indicated for adult patients with carboxyhemoglobin levels greater than 25%. This treatment is used to rapidly reduce the half-life of carboxyhemoglobin, thereby decreasing the time that tissues are exposed to hypoxia.

Question 3

Potential adverse effects associated with NO therapy include all of the following except:

Accepted Answer

While NO therapy can have some adverse effects, such as poor or paradoxical response, increased left ventricular filling pressures, and rebound hypoxemia or pulmonary hypertension, increased blood clotting is not typically associated with this therapy.

Question 4

What is the recommended initial dose of inhaled NO in neonates with respiratory distress syndrome?

Accepted Answer

The recommended initial dose of inhaled nitric oxide (NO) for neonates with respiratory distress syndrome is typically 20 ppm.

Question 5

Physiologic effects of inhaled nitric oxide (NO) include all of the following except:

Accepted Answer

Inhaled nitric oxide (NO) primarily acts as a selective pulmonary vasodilator, which helps in decreasing pulmonary vascular resistance and improving blood flow to ventilated alveoli, thereby reducing intrapulmonary shunting. However, it does not directly recruit collapsed alveoli.

Question 6

Which of the following is FALSE about NO₂?

Accepted Answer

The answer of Which of the following is FALSE about...

Question 7

What is the most common complication of hyperbaric oxygentherapy?

Accepted Answer

Ear or sinus barotrauma is the most common complication of hyperbaric oxygen therapy, occurring in up to 6% of treatments. The increase in air pressure can cause pressure imbalances and damage to the delicate tissues in the ears and sinuses, leading to symptoms such as ear pain, ringing in the ears, dizziness, or sinus pain. Other complications such as air embolism, pneumothorax, or seizures are much less common.

Question 8

Potential uses for inhaled NO include all of the following except:

Accepted Answer

Inhaled nitric oxide (NO) is used for treating conditions like acute respiratory distress syndrome (ARDS), persistent pulmonary hypertension of the newborn, and primary pulmonary hypertension due to its vasodilating properties, which can improve oxygenation. However, it is not typically used for treating status asthmaticus, which is an acute exacerbation of asthma.

Question 9

Compared to air, the density of an 80% He and 20% O₂mixture is about which of the following?

Accepted Answer

The density of a gas mixture can be approximated by the average of its components' densities, weighted by their proportion in the mixture. Helium (He) is much less dense than air, while the "O₂" seems to be a typographical error and does not correspond to a known gas. Assuming it meant to refer to a gas denser than air (or simply a placeholder for the purpose of this question), the mixture would still be significantly lighter than air due to the large proportion of helium. Given helium's low density, a mixture of 80% helium and 20% of a denser gas would likely be closer to one-third the density of air, considering air's average density is around 1.225 kg/m³ at sea level and 15°C, and helium's density is about 0.1786 kg/m³ under the same conditions.

Question 10

Which of the following is an indication for the use of helium-O₂mixtures?

Accepted Answer

Helium-Oxygen mixtures are used for large-airway obstruction because helium is less dense than air or oxygen, and therefore can more easily pass through narrow airways. This helps to decrease the work of breathing and prevent air trapping.

Question 11

Features of an ideal delivery system for NO for use with mechanical ventilation include all of the following except:

Accepted Answer

Premixing NO and O2 in a holding reservoir is not ideal as it can cause variability in the delivered dose due to fluctuations in the gas concentrations in the reservoir. Therefore, an ideal delivery system should deliver precise and stable NO doses without premixing NO and O2 in a holding reservoir. The other options mentioned (accurate monitoring of NO and NO₂, maintaining proper ventilator function, and providing precise and stable NO dose delivery) are essential features of an ideal delivery system for NO use with mechanical ventilation.

Question 12

Before administering a helium-O₂mixture to a patient with large airway obstruction, what should you do?

Accepted Answer

In addition to special flow considerations, the respiratory therapist should use an O₂ analyzer to continuously monitor heliox (actually O₂) concentrations between the source of the mixture and the patient.

Question 13

Primary safety concerns in the application of hyperbaric oxygenation include which of the following? I.sudden decompression II.electrical fires III.CO₂ accumulation

Accepted Answer

Sudden decompression and electrical fires are primary safety concerns in the application of hyperbaric oxygenation. Hyperbaric chambers are pressurized environments with high oxygen levels, increasing the risk of fires and making decompression a critical safety issue.

Question 14

Where would you measure the FIO₂ in an NO delivery system used with a mechanical ventilator?

Accepted Answer

The FIO₂ should be measured distal to the NO titration site, as this will give an accurate measurement of the NO concentration that is actually being delivered to the patient. Measuring it proximal to the NO titration site or directly at the site may not take into account any dilution or mixing of the NO gas that occurs before it reaches the patient. Measuring it proximal to the O₂blending system would not be accurate either, as the NO gas may be further diluted or mixed with air/oxygen after this point.

Question 15

You are giving a 80% He:20% O₂mixture to an asthmatic patient through a nonrebreathing mask with a compensated Thorpe tube O₂ flowmeter set at 8 L/min. What is the actual flow being delivered to the patient?

Accepted Answer

The actual flow being delivered to the patient can be calculated by multiplying the flow meter setting by the percentage of oxygen being delivered (in decimal form). So, 8 L/min x 0.8 (80% oxygen) = 6.4 L/min of oxygen. Then, to get the total actual flow being delivered, you add the flow rate of the secondary gas (O₂) to the flow rate of oxygen, which is 6.4 L/min + 7.2 L/min (20% of the flow meter setting) = 13.6 L/min. Rounded to the nearest whole number, the actual flow delivered to the patient is 14 L/min.

Question 16

Toxic side effects of inhaled NO include all of the following except:

Accepted Answer

Sulfhemoglobinemia is not a known side effect of inhaled nitric oxide (NO). The other options are potential toxic side effects associated with its use.

Question 17

A physician orders a 70% He:30% O₂ mixture to reduce the work of breathing in a patient having an acute asthmatic attack. Which of the following delivery systems would be appropriate in this case?

Accepted Answer

A nonrebreathing mask at 10 L/min is the best choice to deliver a 70% He:30% O₂ mixture in order to reduce the work of breathing in a patient having an acute asthmatic attack. This delivery system provides the highest concentration of the gas mixture and a flow rate sufficient enough to ensure delivery of the required amount to the patient. The other delivery systems are not adequate for this purpose.

Quiz 38: Medical Gas Therapy

To prevent an adverse rebound effect when withdrawing NO therapy, what should you do? I. Reduce the NO to the lowest effective dose (ideally, less than 5 ppm) . II. Hyperoxygenate the patient just before discontinuing NO. III. Ensure that the patient is hemodynamically stable.

At what level of carboxyhemoglobin saturation is hyperbaric oxygen (HBO) therapy indicated for an adult patient?

Potential adverse effects associated with NO therapy include all of the following except:

What is the recommended initial dose of inhaled NO in neonates with respiratory distress syndrome?

Physiologic effects of inhaled nitric oxide (NO) include all of the following except:

Which of the following is FALSE about NO₂?

What is the most common complication of hyperbaric oxygentherapy?

Potential uses for inhaled NO include all of the following except:

Compared to air, the density of an 80% He and 20% O₂mixture is about which of the following?

Which of the following is an indication for the use of helium-O₂mixtures?

Features of an ideal delivery system for NO for use with mechanical ventilation include all of the following except:

Before administering a helium-O₂mixture to a patient with large airway obstruction, what should you do?

Primary safety concerns in the application of hyperbaric oxygenation include which of the following? I.sudden decompression II.electrical fires III.CO₂ accumulation

Where would you measure the FIO₂ in an NO delivery system used with a mechanical ventilator?

You are giving a 80% He:20% O₂mixture to an asthmatic patient through a nonrebreathing mask with a compensated Thorpe tube O₂ flowmeter set at 8 L/min. What is the actual flow being delivered to the patient?

Toxic side effects of inhaled NO include all of the following except:

A physician orders a 70% He:30% O₂ mixture to reduce the work of breathing in a patient having an acute asthmatic attack. Which of the following delivery systems would be appropriate in this case?

Quiz 38: Medical Gas Therapy

To prevent an adverse rebound effect when withdrawing NO therapy, what should you do? I. Reduce the NO to the lowest effective dose (ideally, less than 5 ppm) . II. Hyperoxygenate the patient just before discontinuing NO. III. Ensure that the patient is hemodynamically stable.

At what level of carboxyhemoglobin saturation is hyperbaric oxygen (HBO) therapy indicated for an adult patient?

Potential adverse effects associated with NO therapy include all of the following except:

What is the recommended initial dose of inhaled NO in neonates with respiratory distress syndrome?

Physiologic effects of inhaled nitric oxide (NO) include all of the following except:

Which of the following is FALSE about NO2?

What is the most common complication of hyperbaric oxygen therapy?

Potential uses for inhaled NO include all of the following except:

Compared to air, the density of an 80% He and 20% O2 mixture is about which of the following?

Which of the following is an indication for the use of helium-O2 mixtures?

Features of an ideal delivery system for NO for use with mechanical ventilation include all of the following except:

Before administering a helium-O2 mixture to a patient with large airway obstruction, what should you do?

Primary safety concerns in the application of hyperbaric oxygenation include which of the following? I.sudden decompression II.electrical fires III.CO2 accumulation

Where would you measure the FIO2 in an NO delivery system used with a mechanical ventilator?

You are giving a 80% He:20% O2 mixture to an asthmatic patient through a nonrebreathing mask with a compensated Thorpe tube O2 flowmeter set at 8 L/min. What is the actual flow being delivered to the patient?

Toxic side effects of inhaled NO include all of the following except:

A physician orders a 70% He:30% O2 mixture to reduce the work of breathing in a patient having an acute asthmatic attack. Which of the following delivery systems would be appropriate in this case?

Which of the following is FALSE about NO₂?

What is the most common complication of hyperbaric oxygentherapy?

Compared to air, the density of an 80% He and 20% O₂mixture is about which of the following?

Which of the following is an indication for the use of helium-O₂mixtures?

Before administering a helium-O₂mixture to a patient with large airway obstruction, what should you do?

Primary safety concerns in the application of hyperbaric oxygenation include which of the following? I.sudden decompression II.electrical fires III.CO₂ accumulation

Where would you measure the FIO₂ in an NO delivery system used with a mechanical ventilator?

You are giving a 80% He:20% O₂mixture to an asthmatic patient through a nonrebreathing mask with a compensated Thorpe tube O₂ flowmeter set at 8 L/min. What is the actual flow being delivered to the patient?

A physician orders a 70% He:30% O₂ mixture to reduce the work of breathing in a patient having an acute asthmatic attack. Which of the following delivery systems would be appropriate in this case?