Question Answer
While analyzing a blood gas control sample, you notice a trending of several PCO2 values above the 2 SD range over the last six control samples run. What corrective action would you consider at this time? I. Check the function of the PCO2 electrode. III. Repair or replace any failed components.
Before a sample of capillary blood is taken, what should you do to the site? I. Warmed to 42° C for 10 minutes III. Cleaned with an antiseptic solution
To avoid thermal injury with transcutaneous blood gas monitor sensors, what should you do? I. Carefully monitor the sensor temperature. III. Regularly rotate the sensor site.
Which of the following is FALSE about transcutaneous blood gas monitoring? Transcutaneous blood gas monitoring is most accurate when used with older adults.
Which blood gas analyzer electrode uses a separate reference electrode? pH
Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except. Time of last incentive breathing exercise.
A mechanically ventilated patient exhibits a sudden decrease in end-tidal CO2 levels. All of the following are possible causes of this change except. Increase in CO2 production
Indications for pulse oximetry include all of the following except the need: for measurements of abnormal Hb.
An alert outpatient awaiting bronchoscopy has an SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation? Switch sites or replace the sensor probe.
To avoid transmission of blood-borne diseases when handling a used needle, what should you do? I. Never recap needle without safety device (or scoop method).II. Never handle needle with both hands, or point it towards body.III. Never bend, break, or remove the needle from the syringe by hand.IV. Always dispose of syringe/ needle in sharps container
The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing: reduces turnaround time.
All of the following factors determine the volume needed for an arterial blood sample except. Site used for sampling
After obtaining an arterial blood sample, what should you do? I. Apply pressure to the puncture site until bleeding stops. II. Place the sample in a transport container with ice slush. IV. Mix the sample by rolling and inverting the syringe.
For continuous monitoring of adults and children, you should set a pulse oximeter’s low alarm in what range? 88% to 92%
What is the quality control procedure of analysis and reporting on externally provided control media with unknown values? Proficiency testing
Transcutaneous blood gas monitoring is indicated when what need exists? I. To continuously analyze gas exchange in infants or children. II. To quantify the real-time responses to bedside interventions. III. To continuously monitor for hyperoxia in newborn infants.
When conducting ABG analysis in the laboratory, obvious signs of preanalytical error include all of the following except: unmixed sample.
To validate patient readings obtained from a transcutaneous blood gas monitor, what should you do? Compare the monitor’s readings to those obtained with a concurrent ABG sample.
Factors contributing to bias (systematic) errors during blood gas analysis include all of the following except. Statistical probability
What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor? 2 to 6 hours
An outpatient scheduled for an arterial blood sample enters the pulmonary lab 20 minutes late and out of breath, having run up four flights of stairs. What should you do? Wait 5 minutes before taking the sample.
All of the following can result in falsely high HbO2 readings with a laboratory hemoximeter except. Sickle cell anemia
Which of the following should be monitored during the sampling of arterial blood? II. Presence of pulsatile blood return. III. Presence of air bubbles or clots in sample.
What is a normal end-tidal PETCO2 range? 35 to 43 mm Hg
A patient being monitored by capnography exhibits a sudden rise in end-tidal CO2 levels. All of the following are possible causes of this change except. Massive pulmonary embolism
What size needle would you recommend to obtain an ABG sample through percutaneous puncture of an infant? 25 gauge
Indications for arterial blood sampling by percutaneous needle puncture include all of the following except the need to: assess the adequacy of tissue oxygenation.
If patient pain or anxiety occurs during arterial puncture, which of the following will probably occur? Hyperventilation
Which of the following guidelines should you adhere to when performing pulse oximetry? I. Never mix different sensors among different devices. II. Make sure that the sensors are the correct size and properly applied.III. Avoid using pulse oximetry to monitor hyperoxia in neonates.IV. When possible, validate initial SpO2 against actual SaO2.
Purposes of a needle-capping device include which of the following? I. To isolate the sample from air exposure. II. To help prevent needlestick injuries.
What is the normal range for end-tidal CO2 as measured by capnography? 5% to 6%
You obtain an SpO2 reading of 100% on a patient receiving O2 through a nonrebreathing mask. What range of PaO2 levels is possible in this patient? 100 to 600 mm Hg
After obtaining an arterial blood sample from an arterial line, you would do all of the following except. Aspirate at least 5 ml of fluid or blood (dead space or waste).
Why is the radial artery the preferred site for arterial blood sampling? I. It is near the surface and easy to palpate and stabilize. II. The ulnar artery normally provides good collateral circulation. III. The radial artery is not near any large veins.
What is the process of testing a new blood gas analyzer to confirm a manufacturer’s claims? Performance validation
Which of the following are TRUE about a blood gas analyzer’s waste fluids? I. A strong disinfectant should be added to waste fluid containers. II. Waste fluids should be handled as if they were blood samples. III. Waste fluids should be treated as potentially infectious.
A physician requests that you obtain and set up an arterial line system for invasive monitoring of blood pressure. Which of the following equipment would you gather? I. Pressurized intravenous bag II. Continuous flush device III. Arterial catheter IV. Pressure transducer V. Amplifier or monitor
How is the accuracy of a blood gas analyzer determined? Comparing the analyzer’s measurements to known values.
Which of the following is FALSE about the galvanic fuel cell O2 analyzer? It requires an external power source (alternating current line or batteries).
During a single-breath capnogram, what does the occurrence of a plateau indicate? Exhalation of mainly alveolar gas.
Because of an extremely low PO2, you suspect that an arterial blood sample taken from a patient’s brachial artery might have been contaminated with venous blood. Which of the following might help to confirm your suspicion? Cross-check the sample with an SpO2 reading.
All of the following can help avoid the problem of arterial blood sample contamination with air except. Mixing before expelling air
Pulse oximeter readings are generally unreliable at saturations below what level? 80%
When performing a modified Allen test on the left hand of a patient, you notice that the palm, fingers, and thumb remain blanched for more than 15 seconds after pressure on the ulnar artery is released. What should you do? Perform the Allen test on the right hand.
A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period? I. PCO2
All of the following sites are used for arterial blood sampling by percutaneous needle puncture except: Carotid
While checking a galvanic fuel cell O2 analyzer, you determine that the device fails to read 100% when exposed to pure O2. Which of the following actions would be the proper first step? Replace the analyzer’s batteries.
Before attaching a transcutaneous blood gas monitor sensor to a patient, what should you do? I. Provide a specified warm-up time and set the probe temperature. II. Check the membrane and prepare a sensor with an adhesive ring and gel. III. Prepare the monitoring site (remove excess hair and clean the skin).
What is the best site for capillary puncture in an infant? Lateral aspect of the heel’s plantar surface.
Question Answer
Analysis Study or interpretation
laboratory analysis refers to discrete measurements of fluids or tissue that must be removed from the body
lab analysis measurments are made by what? a laboratory analyser
Monitoring an ongoing process by which clinicians obtain and evaluate dynamic physiological processes in a timely manner. (over time — trending)
Used to measure the FiO2 O2 Analyser
Monitor a device that provides the data to the clinician in real time
2 ways of measuring blood gases 1. invasive 2. noninvasive
Inasive requires insertion of a sensor or collection device into the body
ABG Analysis self explanatory; interperate data or results
FiO2 can be measured in 2 ways 1. Polarographic 2. Galvanic Cell
Problems with Galvanic Cell include: Low battery Sensor Electric faiure
Under ideal conditions of temp.,pressure, and relative humidity, both types are accurate to within _______% of the actual concentration. +/- 2%
SaO2 normal value can never reach 100%. why? SHUNT
Water has a constant pH of what. 7.0
To obtain accurate results with an o2 analyser, the RT must first __________ it. Calibrate
O2 analyser sensors must be exposed to two gases of different O2 concentrations. What are they? 100% O2 and (room air) 21%
If the analyser fails to read 100%, the device’s ______________ must be adjusted until it reads________%. clibration; 100%
Question Answer
Which of the following is false about invasive versus noninvasive monitoring? Laboratory analysis of gas exchange is usually noninvasive in nature.
If patient pain or anxiety occurs during arterial puncture, which of the following will probably occur? Hyperventilation
When conducting ABG analysis in the laboratory, obvious signs of preanalytical error include all of the following except: unmixed sample.
Which blood gas analyzer electrode uses a separate reference electrode? pH
What is a normal end-tidal PETCO2 range? 35 to 43 mm Hg
Continuous SpO2 monitoring (versus a spot check) is indicated in all of the following situations except. O2 therapy
During capnography monitoring of a mechanically ventilated patient, you note that the PETCO2 has dropped to 0 mm Hg. All of the following are possible causes of this finding except. Increased cardiac output
What is a normal level for CaO2? 18 to 20 ml/100 ml
Statistically derived limits for internal quality control of blood gas samples are usually set at what appropriate level? 2 standard deviations from the mean
Why is the radial artery the preferred site for arterial blood sampling? I. It is near the surface and easy to palpate and stabilize. II. The ulnar artery normally provides good collateral circulation. III. The radial artery is not near any large veins.
What is the greatest hazard of pulse oximetry? False results leading to incorrect decisions.
After obtaining an arterial blood sample, what should you do? I. Apply pressure to the puncture site until bleeding stops. II. Place the sample in a transport container with ice slush.IV. Mix the sample by rolling and inverting the syringe.
A mixed venous blood sample obtained from a pulmonary artery catheter sample has a PO2 of 85 mm Hg and a hemoglobin saturation of 95%. Which of the following is likely? I. The pulmonary artery catheter balloon was not deflated. III. The blood sample was withdrawn too quickly.
Treatment parameters that should be assessed as part of arterial blood sampling include all of the following except. Time of last incentive breathing exercise.
Under ideal conditions, pulse oximeter readings patients usually fall in what range of those obtained with invasive hemoximetry? 3% to 5%
What is the normal range for end-tidal CO2 as measured by capnography? 5% to 6%
An alert outpatient awaiting bronchoscopy has an SpO2 reading of 81% breathing room air. The patient appears in no distress and exhibits no signs of hypoxemia. Which of the following would be the best initial action to take in this situation? Switch sites or replace the sensor probe.
Possible complications of capillary blood gas sampling include all of the following except: hypotension.
How long should you wait before drawing an ABG on a chronic obstructive pulmonary disease (COPD) patient whose FIO2 has just been changed? 20 to 30 minutes
Warming a capillary bed to 42° C has which of the following effects? II. It increases blood flow well above tissue needs. III. It “arterializes” the capillary blood.
All of the following are common sites for transcutaneous blood gas electrode placement except the. Thigh
All of the following factors determine the volume needed for an arterial blood sample except. Site used for sampling
Factors contributing to imprecision (random) errors during blood gas analysis include all of the following except. Contaminated buffers
All of the following are advantages of mainstream capnometry except. No bulky sensor
The equipment necessary for capillary blood sampling includes all of the following except. 1-ml syringe
The advantage that point-of-care testing has over traditional laboratory testing is that point-of-care testing: reduces turnaround time.
Which of the following is FALSE about the galvanic fuel cell O2 analyzer? It requires an external power source (alternating current line or batteries).
Which of the following should be monitored during the sampling of arterial blood? II. Presence of pulsatile blood return. III. Presence of air bubbles or clots in sample. IV. Appearance of puncture site.
Precautions and/or possible complications of arterial puncture include which of the following? I. Arteriospasm II. Embolization III. Infection IV. Hemorrhage
A PaO2 below what value would be considered severe hypoxemia? 40 mm Hg
A practitioner forgets to ice an ABG sample and leaves it at room temperature for 45 minutes. Which of the following parameters can you predict will increase in this sample during that period? I only
You are asked to provide continuous monitoring of the FIO2 provided by a humidified O2 delivery system using a galvanic cell analyzer. Where would you install the analyzer's sensor? Proximal to the heated humidifier.
What is the process of testing a new blood gas analyzer to confirm a manufacturer's claims? Performance validation
Capillary puncture should NOT be performed at or through what location? I. Inflamed or edematous tissue II. Localized areas of infection III. The fingers of neonates IV. Previous puncture sites
To avoid the dilution effects caused by too much sodium heparin during ABG sampling of an adult, what should you do? I. Ensure a sample volume greater than 2 ml. II. Use dry heparin instead. III. Fill the needle dead space only.
An outpatient scheduled for an arterial blood sample enters the pulmonary lab 20 minutes late and out of breath, having run up four flights of stairs. What should you do? Wait 5 minutes before taking the sample.
Factors contributing to bias (systematic) errors during blood gas analysis include all of the following except. Statistical probability
Through which pulmonary artery catheter port would you obtain a mixed venous blood sample? Distal (catheter tip) port
What is the quality control procedure of analysis and reporting on externally provided control media with unknown values? Proficiency testing
Precautions and/or possible complications of arterial puncture include which of the following? I. Arteriospasm II. Embolization III. Infection IV. Hemorrhage
To validate patient readings obtained from a transcutaneous blood gas monitor, what should you do? Compare the monitor's readings to those obtained with a concurrent ABG sample.
Which of the following are TRUE about a blood gas analyzer's waste fluids? I. A strong disinfectant should be added to waste fluid containers. II. Waste fluids should be handled as if they were blood samples. III. Waste fluids should be treated as potentially infectious.
Which of the following is FALSE about transcutaneous blood gas monitoring? Transcutaneous blood gas monitoring is most accurate when used with older adults.
All of the following sites are used for arterial blood sampling by percutaneous needle puncture except: Carotid
Why is the radial artery the preferred site for arterial blood sampling? I. It is near the surface and easy to palpate and stabilize. II. The ulnar artery normally provides good collateral circulation. III. The radial artery is not near any large veins.
How often should blood gas calibration verification by control media take place? At least two levels of control media should be analyzed every 8 hours.
A physician requests that you obtain and set up an arterial line system for invasive monitoring of blood pressure. Which of the following equipment would you gather? I. Pressurized intravenous bag II. Continuous flush device III. Arterial catheter IV. Pressure transducer V. Amplifier or monitor
Before performing puncture or cannulation of the radial artery, what should you do? Perform the Allen test to ensure collateral circulation.
Which of the following is NOT a use of capnometry? To assess the condition of the alveolar-capillary membrane.
Which of the following changes would occur if an arterial blood sample of a patient breathing room air were exposed to a large air bubble? I. Decreased PCO2 III. Increased PO2