RSPT 1429 PEFR and Pulse-oximetry
Name: roster # date: 2002
1.As the airway smooth muscle constricts:
a.The lumen diameter gets larger
b.The lumen diameter gets smaller
c.The RAW increases
d.A and c
e.B and c
2.As Raw increases due to bronchospasm, the patient's measured – decrease.
a.Inhaled flow rates
b.Exhaled flow rates
3.The PEFR flowmeter will measure the:
a.fastest exhaled flow
b.slowest exhaled flow
c.the velocity in L/minute or L/sec
d.a and c
e.b and c
4.When there is increased RAW, the RCP can hear:
a.Expiratory Wheezes
b.Prolonged inspiration
c.Prolonged exhalation
d.A and b
e.A and c
5.When the expiratory time gets longer, this will effect the I:E by:
a.Increasing Ti [increasing I]
b.Increasing Te [increasing E]
6.When the RAW is increased, one can see these changes:
a.Retractions happen because of increased WOB
b.Vital signs deteriorate because of increased WOB
c.Patient may be breathless
d.A, b and c
e.B and c only
7.The peak flow meter is a form of
a. Pneumotachometer
b. Spirometer
c. Air-speed-measure device
d.a and c
e.b and c
8.Persons who will be assessed via the peak flow meter would be:
a.Persons with asthma or COPD
b.Persons with atelectasis
c.Persons who wheeze
d.A and c
e.B and c
9.If a person doesn't wheeze but he had improvement in his peak flow [PEFR] before and after he is given a bronchodilator then one can safely decide that this person does have:
a.Atelectasisb. bronchospasm
10.Anybody who has the flu or other viral pneumonia may present with wheezing.
a.Trueb. false
11.Persons with emphysema can wheeze.
a.Trueb. false
12.Contraindications for PEFR include:
a.Children under ten years old
b.Persons who are so sick that they cannot do the procedure
c.Persons who may not be wheezing but are ordered on bronchodilators
13.An asthmatic who is in great distress may respond to the PEFR procedure by:
a.Decrease in wheezing
b.Increase in both cough and wheezing
14.Hazards of the peak flow meter include:
a.can become hypoxic if he is removed from his 02 to do the PEFR
b.cross contamination if the RCP doesn't use one-way valves for PEFR
c.increased atelectasis
d.a and b only
e.a, b and c
15.The peak flow meter is the most popular bedside pulmonary function study done, as well as the most accurate.
a.True
b.False
16.What is the problem with the PEFR measurement?
a.the measuring devices are frequently cheap and might stick
b.the study is effort dependent, the patient can falsify data too easily
c.both
d.none
17.How can the RCP make sure that his data collected by the PEFR is as valid as possible?
a.Repeat the study more than ten times
b.Get at least five statistically reproducible PEFR results
c.Get at least two statistically reproducible PEFR results
d.None of these
18.How close do the PEFR results have to be to be considered statistically reproducible?
a.Two must be exact
b.Two must be within 1% of each other
c.Two must be within 10% of each other
d.Two must be within 50% of each other
e.None of these
19.Which of these PEFR studies is the one to be reported?
335 lpm
336 lpm
454 lpm
a.335 lpm
b.336 lpm
c.454 lpm
d.none of these, do another PEFR
20.Which of these PEFR studies is the one to be reported?
335 lpm
345 lpm
348 lpm
a.335 lpm
b.345 lpm
c.348 lpm
d.none of these, do one more PEFR
21.Which of these PEFR studies is the one to be reported?
305 lpm
315 lpm
320 lpm
a. 305 lpm
b.313 lpm
c.320 lpm
d.none of these, do one more PEFR
22.After you get your reproducible results, what is the next step?
a.Chart the best PEFR
b.Compare the best PEFR to the predicted PEFR
c.Chart the % predicted
d.You could do all of these depending on what your doctor wants calculated
23.Your best PEFR is 300 lpm and the predicted PEFR for your patient is 400 lpm. What is the % predicted?
a.75%
b.100%
c.1.33%
d.none of these
24.Your best PEFR is 355 lpm and the predicted PEFR for your patient is 510 lpm. What is the % predicted?
a.1.43%
b.14%
c.69%
25.If the PEFR is in 2 or 3 digits:
a.the measurement is in lpm
b. the measurement is l/sec
c.it is wrong, you missed a decimal somewhere
26.Your PERF is 3.5 l/second, but your doctor wants the results in lpm. What is the data in the units he wants?
a.350 lpm
b.210 lpm
c..058 lpm
d.none of these
27. The pulse oximeter works on the theory:
- Hemoglobin that carries 02 absorbs light at different degrees than hemoglobin that doesn't carry 0xygen
b.Spectrophotometrics
c.Both
d.None
28.The more 02 bound to the blood's hemoglobin, the -- the color of the blood:
a.Lighter
b.Darker
29.The more 02 bound to the blood's hemoglobin, the -- light will move through the finger into the probe.
a.Less
b.More
c.Same
30.TRUE / FALSE There must be a pulsation of 02 through the finger because it is the differences in the light absorption at different points in the waveform that makes the reading.
a.True
b.False
31.The pulse oximeter is accurate within +/- xx %,
a.2%
b.4%
c.5%
d.10%
32.Saturations of less than --%, the accuracy of the pulse oximeter drops.
a.90%
b.80%
c.70%
d.60%
e.50%
33.TRUE / FALSE Bench hemoximeters can be used to calibrate the pulse oximeter.
a.Trueb. false
34.The pulse oximeter is indicated for:
a.Monitor the oxygenation level of the tissue
b.Assess the effectiveness of the therapy
c.weaning patients from 02 based on serial pulse ox readings
d.all of these
e.a and b only
35.The pulse oximeter is indicated for:
a.Assessing the negative effect of diagnostic procedures on the patient
b.Documentation of the effects of surgery on patients
c.Both
d.None
36.You draw a blood gas that might be a venous gas instead of an arterial gas. If the results of the pulse oximeter match your blood gas [within 4%] then your blood gas was:
a.Arterialb. venous
37.Your patient has suffered smoke inhalation and there is a possibility of carbon monoxide poisoning.
a.The pulse ox reading will be erroneously high
b.b. The pulse ox reading will be erroneously low
38.If you are worried about not only your patient's 02 levels but the levels of his C02 you would:
a.Use the pulse ox reading
b. Need more than the pulse ox reading
39.Define Hb02:
a.Hemoglobin that carries oxygen
b.Oxihemoglobin
c.Both
40.Define Hb:
a.Reduced hemoglobin
b.Hemoglobin that is not carrying oxygen
c.Both
41.Poor perfusion limits the pulse-oximeter's accuracy.
- Yes
- no
42.Which is more accurate?
a.The pulse oximeter
b.The oximetry reading of the blood
c.They are about the same
43.The problem with false negatives for tissue hypoxemia is that they can:
a.lull one into a false sense of security
b.can lead to over-treatment
45.Burns can occur when there is:
a.substitution of incompatible probes
b.fingernail polish on the finger
c.both
46. For your reading to be accurate the RCP must:
a.You want warm vs. cold skin
b.Can attach to the earlobe, but the finger nail works best with all skin pigmentation, which can have an effect on accuracy
c.Both are needed
47.The response time on the finger is between 24-25 seconds and on the ear it is between 9-20 seconds.
- true
- false
48.Edematous tissue is poorly – so the reading may be low or hard to get.
a.Perfused
b.Oxygenated
49.If the patient’s fingers are cool:
a.Bath them in scalding water for 2 seconds
b.Hold a match under them
c.None of these
50.Methods you can use to make sure your pulse ox readings are accurate include:
a.Observe the pulsations of the wave forms
b.Let the probe sit long enough for a reading
c.Note the patient's pulse rate and compare it to your pulse reading
d.All of these work
51.The lights and the photodetector must be directly opposite one another for the reading to be accurate
a.Trueb. false
52.Match these:
Carboxyhemoglobin b
Methemoglobin d
Fetal hemoglobin e
Sickle cell hemoglobin c
Anemia a
a.At a Hb of 8 gr/dl and hemotocrit of 10 or less the pulse ox may be less accurate
b. [Hb0] that is bound to carbon monoxide will read falsely high because CO changes the color of the blood like 02 does.
c.[Hb ss] doesn't effect the reading
d.abnormal hemoglobin created by nitrate poisoning can make the device read falsely low because it changes the color of the blood
e. [Hbf] reads like adult hemoglobin [HbA]