RES 120N Medical Gases Practice Final Exam Flashcards

Terms Definitions
What is the absolute humidity (water vapor content) of saturated gas at normal body temperature (37°C)?
D) 43.8 mg/L
What is the change in state of a substance from liquid to gaseous form occurring below its boiling point?
A) Evaporation
Which of the following would be the worst heat conductor?
C) Air
The peak pressure on a ventilator reads 40 cm H2O. What is the equivalent pressure in mm Hg?
B) 29.6 mm Hg
In what processes of gas compression or expansion does the temperature remain constant?
A) Isothermal
Which of the following is a good clinical example of using the principle of convection to transfer heat?
B) Heated, enclosed infant incubators.
Which of the following occurs when water vapor is added to a dry gas at a constant pressure? The volume occupied by the gas mixture increases. The relative humidity of the mixture increases.The partial pressure of the original gas is reduced.
B) I, II, and III I. The volume occupied by the gas mixture increases. II. The relative humidity of the mixture increases. III. The partial pressure of the original gas is reduced.
Which of the following factors determine how much of a given gas can dissolve in a liquid? I. Solubility coefficient of the gas. II. Temperature of the liquid. III. Gas pressure above the liquid.
D) I, II, and III I. Solubility coefficient of the gas. II. Temperature of the liquid. III. Gas pressure above the liquid.
Which of the following medical gases can be maintained in the liquid form at room temperature? I. Nitrous oxide II. Carbon dioxide III. Oxygen IV. Helium
A)I and III. Nitrous oxide II. Carbon dioxide
If the absolute humidity in a medical gas being delivered to a patient is 14 mg/L, then what is the body humidity (BH)?
D) 32%
What is the water vapor pressure of saturated gas at normal body temperature (37°C)?
A) 47.0 mm Hg
One atmosphere (1 atm) of pressure is equivalent to which of the following? I. 29.9 inches Hg II. 14.7 lb/in2 III. 1034.0 g/cm2 IV. 760.0 mm Hg
D) I, II, III, and IV I. 29.9 inches Hg II. 14.7 lb/in2 III. 1034.0 g/cm2 IV. 760.0 mm Hg
Respiratory therapists must ensure that any oil or dust is cleared from high-pressure medical-gas delivery systems before pressurization. Why is this action needed?
D) Adiabatic compression could ignite the oil or dust.
What is the term for the actual content or weight of water present in a given volume of air?
C) Absolute humidity
What is the maximum FIO2 expected to be delivered by most air-entrainment masks?
C) 50%
What does 1 atmospheric pressure absolute (ATA) equal? I. 101 kPa II. 50 psi III. 760 mm Hg
I. 101 kPa III. 760 mm Hg C) I and III
What is the phenomenon whereby a liquid in a small tube tends to move upward against the force of gravity?
A) Capillary action
What is the pattern of flow in which a fluid moves in discrete cylindrical streamlines?
C) Laminar
A patient has a recorded body temperature of 106° F. What is this temperature in degrees Celsius?
A) 41°C
A near-drowning patient has a recorded body temperature of 30° C. What is the equivalent temperature in degrees Fahrenheit?
B) 86°F
What is the physical process whereby the gaseous form of a substance is changed back into its liquid state?
A) Condensation
Which of the following is/are good clinical examples of the principle of capillary action? I. Capillary stick blood samples II. Absorbent humidifier wicks III. Certain surgical dressings
A) I, II, and III I. Capillary stick blood samples II. Absorbent humidifier wicks III. Certain surgical dressings
What key property of He makes it useful as a therapeutic gas?
D) Low density
What is the key difference between small compressed gas cylinders (sizes AA to E) and their larger counterparts (sizes F to K)?
D) Small gas cylinders use a yoke (not threaded) connector.
What cylinder factor is used to compute the duration of flow for a 22 cu/ft O2 or air E cylinder?
A) 0.28
What is the U.S. Food and Drug Administration (FDA) purity standard for O2?
D) 99%
What device is used to reduce the pressure and control the flow of a compressed medical gas?
B) Regulator
Which of the following medical gases support combustion? I. O2 II. N2O III. compressed air IV. CO2
C) I, II, and III I. O2 II. N2O III. compressed air
The pressure of O2 or air in a bulk supply system is reduced to what standard working pressure?
D) 50 psig
By what means is oxygen for medical use in a hospital most commonly produced?
C) Fractional distillation
Which of the following devices would you select if the goal was to accurately meter the flow through a jet nebulizer?
D) Compensated Thorpe tube
When used to control the flow of medical gases to a patient, how is a Bourdon gauge classified?
A) Fixed-orifice, variable-pressure flowmeter device
Which of the following equipment could be powered by a small diaphragm or turbine air compressor? I. Small-volume medication nebulizer II. All-purpose large-volume jet nebulizer III. Intermittent positive-pressure breathing device
I. Small-volume medication nebulizer A) I only
Large hospital air compressor systems must be capable of maintaining 50 pounds per square inch gauge (psig) at what flows?
D) 100 L/min
What is the primary purpose of indexed connector systems?
A) To prevent inadvertent misconnections between equipment.
According to the National Institute of Standards and Technology of the U.S. Department of Commerce, a gas cylinder that is color-coded brown and green should contain which of the following?
D) O2-He mixture
To clean a cylinder valve outlet of foreign material, what should you do?
B) Quickly open, then close, the valve.
Which of the following is FALSE about a Bourdon gauge?
D) It will register zero flow when the outlet is completely blocked.
Air for medical use in a hospital should be which of the following? I. Particle-free II. Oil-free III. Dry
D) I, and IIII. Particle-free II. Oil-free III. Dry II,
How can one determine whether a pressure-reducing valve uses multiple stages for pressure reduction?
D) By noting the number of pressure relief vents.
Unlike CO2 or N2O, O2 cannot be stored as a liquid at room temperature but must be kept in special cryogenic containers. Why is this so?
B) O2 has a critical temperature well below room temperature.
Which of the following methods of producing O2 is commonly used in the home care setting?
D) Physical separation
In which of the following clinical situations would you recommend hyperbaric oxygen (HBO) therapy, if available? I. Carbon monoxide poisoning II. Respiratory or cardiac arrest III. Severe trauma IV. Cyanide poisoning
A)I and IV I. Carbon monoxide poisoning IV. Cyanide poisoning
You can determine that a nasal O2 catheter is properly positioned when its tip is where?
D) Retracted just above the uvula.
Which of the following would indicate a need for O2 therapy for an adult or child? I. SaO2 less than 90% II. PaCO2 greater than 45 mm Hg III. PaO2 less than 60 mm Hg
D) I and III I. SaO2 less than 90% III. PaO2 less than 60 mm Hg
What is the minimum flow setting for a simple mask applied to an adult?
B) 5 L/min
You set up an Oxy-Hood with an FIO2 of 0.5 for a newborn infant. What is the maximum time that should pass before assessing this patient’s PaO2 or SaO2?
A) 1 hour
What is the problem with input flows greater than 10 to 15 L/min in an infant Oxy-Hood?
A) Production of harmful noise levels.
Primary safety concerns in the application of hyperbaric oxygenation include which of the following? I. Sudden decompression II. Electrical fires III. CO2 accumulation
I. Sudden decompression II. Electrical fires A) I and II
Before administering a helium-O2 mixture to a patient with large airway obstruction, what should you do?
C) Analyze the O2 concentration of the mixture.
Specific clinical objectives of oxygen (O2) therapy include which of the following? I. Decrease the symptoms caused by chronic hypoxemia. II. Decrease the worklod hypoxemia imposes on the heart and lungs. III. Correct documented arterial hypoxemia.
D) I, II, III,I. Decrease the symptoms caused by chronic hypoxemia. II. Decrease the worklod hypoxemia imposes on the heart and lungs. III. Correct documented arterial hypoxemia.
What are some key patient considerations in selecting O2 therapy equipment? I. Type of airway (natural or artificial) II. Severity and cause of the hypoxemia III. Age group (infant, child, adult) IV. Stability of the minute ventilation
I. Type of airway (natural or artificial) II. Severity and cause of the hypoxemia III. Age group (infant, child, adult) IV. Stability of the minute ventilation D) I, II, III, and IV
Which of the following is an indication for the use of helium-O2 mixtures?
A) Large-airway obstruction
You set up an Oxy-Hood with an FIO2 of 0.5 for a newborn infant. What is the maximum time that should pass before assessing this patient’s PaO2 or SaO2?
A) 1 hour
What is the problem with input flows greater than 10 to 15 L/min in an infant Oxy-Hood?
A) Production of harmful noise levels.
Before administering a helium-O2 mixture to a patient with large airway obstruction, what should you do?
C) Analyze the O2 concentration of the mixture.
Specific clinical objectives of oxygen (O2) therapy include which of the following? I. Decrease the symptoms caused by chronic hypoxemia.II. Decrease the worklod hypoxemia imposes on the heart and lungs. III. Correct documented arterial hypoxemia.
D) I, II, and III I. Decrease the symptoms caused by chronic hypoxemia. II. Decrease the worklod hypoxemia imposes on the heart and lungs. III. Correct documented arterial hypoxemia.
Primary safety concerns in the application of hyperbaric oxygenation include which of the following? I. Sudden decompression II. Electrical fires III. CO2 accumulation
I. Sudden decompression II. Electrical fires A) I and II
Before administering a helium-O2 mixture to a patient with large airway obstruction, what should you do?
C) Analyze the O2 concentration of the mixture.
Specific clinical objectives of oxygen (O2) therapy include which of the following? I. Decrease the symptoms caused by chronic hypoxemia. II. Decrease the worklod hypoxemia imposes on the heart and lungs. III. Correct documented arterial hypoxemia.
D) I, II, and III I. Decrease the symptoms caused by chronic hypoxemia. II. Decrease the worklod hypoxemia imposes on the heart and lungs. III. Correct documented arterial hypoxemia.
What are some key patient considerations in selecting O2 therapy equipment? I. Type of airway (natural or artificial) II. Severity and cause of the hypoxemia III. Age group (infant, child, adult) IV. Stability of the minute ventilation
D) I, II, III, and IV I. Type of airway (natural or artificial) II. Severity and cause of the hypoxemia III. Age group (infant, child, adult) IV. Stability of the minute ventilation
What does 1 atmospheric pressure absolute (ATA) equal? I. 101 kPa II. 50 psi III. 760 mm Hg
C) I and III I. 101 kPa III. 760 mm Hg
Disadvantages of standard O2 masks include all of the following except:
A) being difficult to apply to patients.
What can properly applied O2 therapy decrease? I. Ventilatory demand II. Work of breathing III. Cardiac output
C) I, II, and III I. Ventilatory demand II. Work of breathing III. Cardiac output
Where would you measure the FIO2 in an NO delivery system used with a mechanical ventilator?
B) Distal to the NO titration site
Criteria for initiating hyperbaric oxygen (HBO) therapy on an adult patient suspected of suffering from acute carbon monoxide poisoning include all of the following except:
B) carboxyhemoglobin saturation less than 20%.
Which of the following is considered an advantage of the transtracheal catheter?
C) It requires 40% to 60% less O2 flow than the nasal cannula.
You start a chronic obstructive pulmonary disease (COPD) patient on a nasal O2 cannula at 2 L/min. What is the maximum time that should pass before assessing this patient’s PaO2 or SaO2?
A) 2 hours
Which of the following inspired conditions should be maintained when delivering medical gases directly into the trachea through an endotracheal tube or a tracheotomy tube?
D) 100% RH at 32° to 35° C
An ideal heat-moisture exchanger (HME) should have an efficiency rating of at least which of the following?
C) 70%
In general, to deliver oxygen to the upper airway, a bubble humidifier is required only when the gas flow exceeds which of the following?
D) 4 L/min
What is the best way to increase the humidity output of a humidifier?
D) Increase the temperature of either the water or the gas.
All of the following are contraindications for heat-moisture exchangers except:
C) when a patient is suffering from hyperthermia.
All of the following are TRUE about humidification and contact time except:
C) Low flows decrease and high flows increase relative humidity output.
The particle size produced by an ultrasonic nebulizer depends mainly on which of the following?
C) Signal frequency
If you had to power a ventilator from a large cylinder of compressed gas, which of the following devices would be required?
C) Reducing valve
When fired inside the mouth, what percentage of the drug dose delivered by a simple metered-dose inhaler (MDI) deposits in the oropharynx?
D) About 80%
Which type of humidifier “traps” the patient’s body heat and expired water vapor to raise the humidity of inspired gas?
C) Heat-moisture exchanger
Increasing the flow through an unheated bubble humidifier has which of the following effects?
A) Decreasing the water vapor content.
The typical pressure pop-off incorporated into most simple bubble humidifiers releases pressure above which of the following?
D) 2 psig
Hazards and complications of bland aerosol therapy include all of the following except.
D) Hemoconcentration
All of the following are potential hazards of using heat-moisture exchangers except:
D) potential electrical shock.
What measure is used to identify the particle diameter, which corresponds to the most typical settling behavior of an aerosol?
C) Mean mass aerodynamic diameter (MMAD)
Most of the spray generated by the majority of metered-dose inhalers consists of which of the following?
B) Propellant
Exhalation into which device can result in loss of drug delivery?
C) Dry power inhaler
What is the primary hazard of aerosol drug therapy?
A) Adverse drug reactions
Indications for assessment of patient’s response to bronchodilator therapy include all of the following except to:
D) quantify the degree of bronchial hyperresponsiveness.
Which of the following best defines an aerosol?
D) Suspension of liquid or solid particles in a gas.
A physician wants to deliver a therapeutic aerosol to the lung parenchyma (alveolar region). To help ensure maximum deposition in this area, you would select an aerosol generator with an MMAD in what range?
D) less than 1 µm
Which of the following is a common method to measure aerosol particle size?
C) Cascade impaction
What is the primary fate of inhaled aerosol particles that are between 1 and 0.5 µm?
A) Most are cleared during exhalation.
What is the average amount of dead volume in a small-volume jet nebulizer after the device runs dry?
B) 0.5 to 2.5 ml
Advantages of small-volume ultrasonic nebulizers for drug delivery include all of the following except:
D) decreased cost.
All of the following drugs or drug categories have been associated with increased airway resistance and bronchospasm during aerosol administration except:
B) albuterol.
One cubic foot of any gas is equivalent to how many liters of gas?
D) 28.30
Delivery systems that provide only a portion of a patient’s inspired gas are referred to as what?
B) Variable-performance systems
Causes of inadequate mist production with pneumatically powered jet nebulizers include all of the following except:
D) tripped circuit breaker.
At high flow rates, what do some bubble humidifiers produce?
D) Aerosol particles
Which of the following is FALSE about liquid bubbles?
B) Inflation pressure can be lowered if surface tension is increased.
What measure is used to describe the variability of particle diameters in an aerosol?
D) GSD
What physical principle underlies most fluidic circuitry?
D) Coanda effect
Which of the following statements is FALSE about PISS standards?
A) The exact positions of pins and pinholes do not vary for each gas.
You are planning a patient transport that will take about 11/2 hours. The patient requires manual ventilation with 10 L/min of O2. What is the minimum number of full E cylinders you would take with you?
A) 2
When using a chamber-style adapter with a metered-dose inhaler (MDI) to deliver a bronchodilator to a patient receiving mechanical ventilation, with what would you coordinate MDI firing?
A) Beginning of inspiration
Which of the following devices would you select if the goal was to accurately meter the flow through a jet nebulizer?
D) Compensated Thorpe tube
In checking a servo-controlled heated-wire humidifier system, you notice that a few drops of condensate tend to form but only near the patient’s airway. Based on this observation, what can you conclude?
A) The gas at the airway is fully saturated.
When minimal fluctuations in pressure and flow are critical factors, which of the following pressure-reducing valves would be the best choice?
B) Multiple-stage pressure-reducing valve
Assuming a constant flow, what will happen to a fluid if the cross-sectional area of the tube in which it flows decreases?
B) Its velocity will decrease.
Which of the following techniques will increase aerosol deposition by sedimentation in the lungs?
C) 10-second breath-hold
A patient has been supported by a mechanical ventilator using a heat-moisture exchanger for the last 3 days. Suctioning reveals an increase in the amount and tenacity of secretions. Which of the following actions is indicated?
D) Switch the patient to a large-volume heated humidifier.
When checking a patient attached to a servo-controlled heated-wire humidifier breathing circuit you notice no visible condensate anywhere in the tubing.Based on this observation you can conclude that the relative humidity of the delivered gas is which of
D) Less than 100%
Advantages of the dry power inhaler (DPI) drug delivery systems include all of the following except:
D) unaffected by humidity.
You increase the fill volume from 2 to 4 ml in a small-volume jet nebulizer being used to administer a bronchodilator agent with an aerosol. What effect will this have on the amount of drug delivered?
B) Increase
Which of the following is a common way to increase the surface area ratio of humidifiers? I. Generate a water droplet aerosol. II. Expose the gas to a saturated wick. III. Use a bubble or diffusion head.
D) I, II, and II I. Generate a water droplet aerosol. II. Expose the gas to a saturated wick. III. Use a bubble or diffusion head.
What factors affect the combustion-supporting properties of O2? I. Concentration II. Partial pressure III. Humidity
C) I and II I. Concentration II. Partial pressure III. Humidity
What is the preferred method for delivering bronchodilators to spontaneously breathing and intubated, ventilated patients?
C) Metered-dose inhaler
An ultrasonic nebulizer is not putting out any mist After confirming a good electrical power supply are in good working order that carrier gas is actually flowing through the device and that the output control is set at maximum what should you do
B) Inspect the couplant chamber to confirm cleanliness and fill level.
Which of the following factors determine the actual O2 provided by an air-entrainment system? I. O2 reservoir II. Air-to-O2 ratio of the device III. Resistance downstream from the jet
A) II and III II. Air-to-O2 ratio of the device III. Resistance downstream from the jet
For what should sputum collected by aerosol therapy induction be inspected? I. Color II. Volume III. Odor IV. Consistency
D) I II, III, and IV I. Color II. Volume III. Odor IV. Consistency
Which of the following are necessary features to look for in selecting a heated humidifier? I. Water level readily visible II. Over-temperature protection III. Auditory and visual alarms IV. Minimal temperature overshoot
D) I, II, III, and IV I. Water level readily visible II. Over-temperature protection III. Auditory and visual alarms IV. Minimal temperature overshoot
What are some potential problems with manually refilled heated humidifier reservoirs? I. Cross-contamination and infection II. Variable compliance or delivered volume III. Delivery of dry and/or hot gases
D) I, II, and III I. Cross-contamination and infection II. Variable compliance or delivered volume III. Delivery of dry and/or hot gases
For which of the following patients might you recommend administration of a hypertonic saline aerosol?
D) I and III I. Acquired immune deficiency syndrome (AIDS) patient with severe pneumonia symptoms. III. Patient suspected of having tuberculosis.
The risk of overhydration with continuous delivery of bland water aerosols is greatest among which patient group?
D) I and III I. Patients with fluid or electrolyte imbalances. III. Infants and small children.
Which of the following methods can be used to minimize the harmful effects of environmental exposure to ribavirin or pentamidine aerosols?
D) I, II, and III I. Use an isolation booth or tent with HEPA filtered exhaust. II. Have health care personnel wear a HEPA filtered mask. III. Use a negative pressure room with adequate air exchange.
Which of the following factors affect pulmonary deposition of an aerosol? I. Size of the particles II. Shape and motion of the particles III. Physical characteristics of the airways
D) I, II, and III I. Size of the particles II. Shape and motion of the particles III. Physical characteristics of the airways
To minimize problems with environmental safety when aerosol therapy is prescribed for immunosuppressed patients or those with tuberculosis, what precautions should you follow?
A) I, II, and III I. Those for tuberculosis exposure II. Centers for Disease Control and Prevention (CDC) standards and contact precautions III. CDC standards and airborne precautions
To minimize a patient’s infection risk between drug treatments with a small-volume jet nebulizer (SVN), what would you do?
A) Rinse the SVN with sterile water; air dry.
Which of the following groups of patients are most likely to have difficulty using a simple metered-dose inhaler for aerosol drug therapy? I. Patients in acute distress II. Infants and young children III. Elderly persons
D) I, II, and III I. Patients in acute distress II. Infants and young children III. Elderly persons
(SVN) set at 8 L/min flow a patient asks that the head of the bed be lower position Immediately after doing so you observe a significant drop in SVN aerosol output despite there being at least 3 ml of solution left in the reservoir What would you do
C) Reposition the patient so that the SVN is more upright.
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