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Mosbys Respiratory Care Equipment-9th-Edition, Text Bank

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  • ISBN-10 ‏ : ‎ 9780323096218
  • ISBN-13 ‏ : ‎ 978-0323096218

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Mosbys Respiratory Care Equipment-9th-Edition, Text Bank

Chapter 10: Blood Gas Monitoring

MULTIPLE CHOICE

  1. Which of the following are the most common sites for the percutaneous sampling of arterial blood for blood gas analysis?
  2. Earlobe
  3. Radial artery
  4. Brachial artery
  5. Side of the heel

a.

1 and 2

c.

3 and 4

b.

2 and 3

d.

1 and 4

ANS: B

Specimens for arterial blood gas analysis can be drawn from a peripheral artery by means of a percutaneous needle puncture or from an indwelling intravascular cannula. Blood is most often drawn from the radial, brachial, or femoral arteries or the dorsalis pedis artery of the foot.

PTS: 1 REF: Page 319

  1. Which of the following statements is true concerning capillary blood gases?

a.

They can be drawn from an earlobe.

b.

They coincide with arterial blood gases.

c.

They can be drawn from a peripheral artery.

d.

They require the performance of an Allen test.

ANS: A

Capillary blood samples from an earlobe or the side of the heel can be substituted when arterial blood cannot be obtained, although the results may vary considerably from arterial blood gas values.

PTS: 1 REF: Page 319

  1. When an Allen test result is negative, blood for blood gas analysis should be drawn from which of the following sites?

a.

Earlobe

c.

Brachial artery

b.

Radial artery

d.

Side of the heel

ANS: C

Another sampling site, such as the brachial artery, should be chosen if the result of a modified Allen test is negative.

PTS: 1 REF: Page 319

  1. The purpose of an Allen test is to check blood flow in the _____ artery.
  2. ulnar
  3. radial
  4. brachial

4 posterior tibial

  1. lateral plantar

a.

1, 2, and 3

c.

1, 4, and 5

b.

2, 3, and 4

d.

3, 4, and 5

ANS: C

An Allen test should always be done before a radial artery puncture is performed to ensure that there is collateral circulation in the ulnar artery. An Allen type of test should be performed to ensure collateral circulation in the posterior tibial and lateral plantar arteries when drawing arterial blood from the dorsal artery of the foot.

PTS: 1 REF: Page 319

  1. Which is the correct sequence of events when one is obtaining arterial blood from the radial artery of a patient?
  2. Perform the modified Allen test.
  3. Remove any air bubbles from the sample.
  4. Apply direct pressure to the puncture site.
  5. Clean the puncture site with a suitable antiseptic solution.
  6. Use a 23-gauge needle and a plastic syringe containing an anticoagulant.

a.

1, 4, 3, 5, 2

c.

1, 4, 5, 3, 2

b.

4, 1, 5, 2, 3

d.

1, 5, 2, 4, 3

ANS: C

Collateral circulation must be ensured before the puncture by performing a modified Allen test. After the test shows sufficient collateral circulation, the site should be prepared for the puncture by cleaning with a suitable antiseptic solution. Blood samples should be obtained with a small-gauge needle (i.e., 23 to 25 gauge). After blood has been withdrawn and the needle removed, direct pressure should be applied to the puncture site to prevent the formation of a hematoma. Air bubbles should then be removed because their presence can produce erroneous measurements.

PTS: 1 REF: Pages 319-320

  1. Which size of needle should be used to draw arterial blood from an adult?

a.

22 gauge

c.

26 gauge

b.

24 gauge

d.

28 gauge

ANS: B

Blood samples from adult patients should be obtained with 23- to 25-gauge needles.

PTS: 1 REF: Page 321

  1. Which is the correct order of steps to perform the modified Allen test?
  2. Pressure is applied to both the radial and ulnar arteries.
  3. The fist is opened but not fully extended.
  4. Pressure on the ulnar artery is removed.
  5. The hand is clenched into a tight fist.
  6. The palm and fingers are blanched.

a.

4, 1, 2, 5, 3

c.

1, 4, 3, 2, 5

b.

4, 5, 1, 3, 2

d.

4, 2, 1, 3, 5

ANS: A

The order for the modified Allen test is as follows: (1) the hand is clenched into a tight fist; (2) pressure is applied to both the radial and ulnar arteries; (3) the hand is opened but not fully extended; (4) the palm and fingers are blanched; and (5) pressure on the ulnar artery is removed—this should result in flushing of the entire hand.

PTS: 1 REF: Page 322, Figure 10-1

  1. Capillary blood gas samples should not be used to measure which of the following?
  2. Partial pressure of arterial carbon dioxide (PaCO2)
  3. Partial pressure of arterial oxygen (PaO2)
  4. pH
  5. Hemoximetry oxygen saturation (SaO2)

a.

1 and 3

c.

1 and 4

b.

2 and 4

d.

1 and 2

ANS: C

The correlation between capillary and arterial pH and partial pressure of carbon dioxide (PCO2) measurements is better than the correlation between capillary and arterial partial pressure of oxygen (PO2) measurements. Consequently, capillary blood gases are more often used to discern acid-base balance rather than to assess a patient’s oxygenation status.

PTS: 1 REF: Page 321

  1. Which of the following factors will cause analysis of blood gas samples to be erroneous?
  2. Warming the sample
  3. Low leukocyte counts
  4. The presence of air bubbles in the sample
  5. Icing the sample between obtaining and analyzing
  6. Prolonged time delay between obtaining and analyzing a sample

a.

2 and 3

c.

1, 3, and 5

b.

2 and 4

d.

1, 2, 4, and 5

ANS: C

A prolonged delay between obtaining and analyzing a specimen (i.e., longer than 5 minutes) can lead to erroneous results. This problem is particularly evident in patients with high leukocyte counts. Chilling the specimen to below 5° C by placing the syringe in ice water can reduce the metabolic rate of the white blood cells, minimizing this problematic effect.

PTS: 1 REF: Page 322

  1. The maximum amount of blood that should be discarded from the indwelling arterial catheter of an infant is ____ mL.

a.

0.3

c.

0.8

b.

0.5

d.

1.0

ANS: B

The discarded volume for an infant is typically only approximately 0.2 to 0.5 mL.

PTS: 1 REF: Page 321

  1. Hydrogen ion activity can be expressed as which of the following?

a.

pH = log10[H]

c.

pH = –log10[H+]

b.

[H+] = log ´ 10

d.

pH = 1 ´ 107 mol/L

ANS: C

 

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