Quiz 6: Patient Monitoring Technology
Nursing
Q 1Q 1
Which of the following is NOT analyzed in arterial blood gas tests?
A) SaO2
B) PaO2
C) pCO2
D) O2
Free
Multiple Choice
D
Q 2Q 2
You are working in the ED, caring for a 55-year-old female patient with a long history of COPD. She is more short of breath today than usual, and states that she has an increased cough. She has a tympanic temperature of 99.8°F. You have drawn arterial blood gases with the patient on room air; when the report comes back, it shows that the patient has a PaO2 of 92 mmHg. Which of the following is most likely?
A) You have inadvertently drawn a venous sample.
B) The patient is critically hypoxic and requires assisted ventilation.
C) This is the typical value for this patient.
D) The lab performed the test incorrectly.
Free
Multiple Choice
C
Q 3Q 3
An arterial blood gas analysis includes all of the following EXCEPT:
A) perfusion.
B) ventilation.
C) electrolyte balance.
D) acid-base balance.
Free
Multiple Choice
C
Q 4Q 4
Most carbon dioxide from cellular metabolism reaches the alveoli by being transported:
A) bound to hemoglobin.
B) as bicarbonate ion.
C) dissolved in plasma.
D) as carbonic anhydrase.
Free
Multiple Choice
Q 5Q 5
Your patient is a 44-year-old woman, alert and oriented, in moderate distress and complaining of difficulty breathing. She gives a one-week history of fever and malaise, with shortness of breath developing three days ago. She also has left-sided chest pain with deep inspiration and a "phlegmy" cough. Physical examination reveals hot, pale, dry skin, and rhonchi and crackles throughout the left lung. The right lung sounds are clear. HR = 134, BP = 88/64, RR = 24, SaO2 = 92%. She has a history of two previous myocardial infarctions and takes nitroglycerin as needed. Which of the following is the best course of prehospital management?
A) Endotracheal intubation, ventilation with supplemental oxygen, nebulized albuterol and Atrovent, and corticosteroids IV
B) Albuterol via nebulizer with 100 percent oxygen
C) Oxygen via nonrebreather mask
D) Oxygen via CPAP
Free
Multiple Choice
Q 6Q 6
Capnometry measures the partial pressure of CO2 in:
A) venous blood.
B) arterial blood.
C) expired air.
D) inspired air.
Free
Multiple Choice
Free
Multiple Choice
Q 8Q 8
Your patient is a 62-year-old woman with a history of COPD. She is slightly more short of breath than usual today. She is alert and speaks three to four words between breaths. Her SpO2 is 93 percent on room air. Which of the following devices should be used for the administration of oxygen to this patient?
A) Nonrebreather mask
B) Nasal cannula
C) CPAP
D) BVM
Free
Multiple Choice
Q 9Q 9
Your patient is a 15-year-old asthmatic who has been having difficulty breathing for 45 minutes, but does not have his Xopenex inhaler with him. Capnography shows an ETCO2 of 45 mmHg. What is the best way to interpret this finding?
A) This is a normal ETCO2, indicating that this is a mild asthma attack.
B) The patient's ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels.
C) This is a high ETCO2, and the patient requires immediate ventilatory assistance to prevent respiratory arrest.
D) This is a low ETCO2, indicating that the patient is hyperventilating, and thus in the early stages of an asthma attack.
Free
Multiple Choice
Q 10Q 10
In which of the following situations is a significant amount of carboxyhemoglobin most likely to be present?
A) A patient who is being treated with nitrites for cyanide poisoning
B) A patient with COPD who is short of breath with an SpO2 of 90 percent
C) A patient found unresponsive in an apartment in which there is a gas furnace
D) A patient who inhaled anhydrous ammonia fumes
Free
Multiple Choice
Q 11Q 11
You have applied a CO-oximeter to your patient, and it is displaying an SpCO of 15 percent. Which of the following is the most appropriate interpretation of this finding?
A) This is consistent with a fatal level of carbon monoxide poisoning.
B) This is a normal reading for a smoker and nothing to worry about.
C) This is a normal reading for a nonsmoker and nothing to worry about.
D) This is consistent with mild carbon monoxide poisoning.
Free
Multiple Choice
Q 12Q 12
You are working at the triage desk in the ED when a young man on crutches approaches the desk. He appears moderately short of breath. He states he had a cast put on his left leg seven days ago after surgery for a ruptured Achilles tendon. This morning, while he was watching television, he suddenly became short of breath. He has a history of asthma, for which he takes Xopenex as needed, and is taking Tylenol with codeine for pain related to his surgery. The patient's lung sounds are clear and equal, SpO2 is 90 percent on room air, heart rate is 100 and regular, respirations are 24 and slightly labored, blood pressure is 128/88 mmHg, and the patient is afebrile. These findings are most consistent with:
A) allergic reaction to codeine.
B) COPD exacerbated by recent anesthesia.
C) pneumonia secondary to recent anesthesia.
D) pulmonary embolism associated with immobilization of the lower extremity.
Free
Multiple Choice
Q 13Q 13
A male patient with an acute exacerbation of his emphysema presents in severe distress with decreased air movement and diffuse inspiratory wheezes in all fields. HR = 132, BP = 142/88, RR =30, SaO2 = 88%. Which of the following blood gas values is most likely?
A) pH of 7.6
B) PO2 of 100 mmHg
C) PCO2 of 70 mmHg
D) PCO2 of 35 mmHg
Free
Multiple Choice
Q 14Q 14
The greater the concentration of hydrogen ions in arterial blood, the ________ the pH.
A) more erratic
B) higher
C) more dangerous
D) lower
Free
Multiple Choice
Q 15Q 15
Your patient is a 16-year-old male who attempted suicide. He is unconscious and apneic, lying supine on a garage floor. The family states that they found the patient unconscious in the front seat of a car that was running in an enclosed garage. HR = 70, BP = 100/60, RR = 0. In addition to an IV of normal saline, which of the following is the most appropriate action?
A) Intubate, remove the patient from the garage, and transport to a hospital with a hyperbaric chamber.
B) Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber.
C) Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to the nearest facility.
D) Remove the patient from the garage, intubate, and transport to the nearest hospital.
Free
Multiple Choice
Q 16Q 16
Lung perfusion depends on all of the following EXCEPT:
A) efficient pumping of blood by the heart.
B) intact pulmonary capillaries.
C) an intact alveolar membrane.
D) adequate blood volume.
Free
Multiple Choice
Q 17Q 17
Which of the following statements about pulse oximetry is FALSE?
A) Oxygen saturation is the percentage of hemoglobin that is bound with some molecular structure.
B) Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia.
C) Pulse oximetry should be used on all patients with respiratory complaints.
D) It may be difficult to obtain a reading in patients experiencing peripheral vasoconstriction.
Free
Multiple Choice
Q 18Q 18
Which of the following is the most important determinant of ventilatory rate?
A) Arterial PO2
B) Venous PCO2
C) Venous PO2
D) Arterial PCO2
Free
Multiple Choice
Q 19Q 19
Conditions that can cause an inaccurate pule oximetry ready include all EXCEPT?
A) The presence of methemoglobinemia
B) Hyperfusion
C) Anemia
D) Shivering
Free
Multiple Choice
Q 20Q 20
The valve between the right atrium and right ventricle is the ________ valve.
A) bicuspid
B) pulmonic
C) tricuspid
D) aortic
Free
Multiple Choice
Q 21Q 21
Blood entering the left atrium arrives via the:
A) bicuspid valve.
B) superior and inferior vena cava.
C) pulmonary vein.
D) pulmonary artery.
Free
Multiple Choice
Q 22Q 22
The presence of inverted T waves on an ECG indicates:
A) myocardial infarction.
B) myocardial necrosis.
C) myocardial ischemia.
D) myocardial instability.
Free
Multiple Choice
Q 23Q 23
When the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals:
A) 0.08 seconds.
B) 0.12 seconds.
C) 0.20 seconds.
D) 0.24 seconds.
Free
Multiple Choice
Q 24Q 24
There are 15 small boxes between R waves on an ECG tracing. What is the heart rate?
A) 150
B) 120
C) 100
D) 20
Free
Multiple Choice
Q 25Q 25
Which of the following endocrine substances acts as a marker for congestive heart failure?
A) BNP
B) Angiotensin
C) ACTH
D) Troponin
Free
Multiple Choice
Q 26Q 26
To detect life-threatening cardiac dysrhythmias, the paramedic must view the ECG in ________ lead(s).
A) two
B) one
C) three
D) twelve
Free
Multiple Choice
Q 27Q 27
The total duration of ventricular depolarization is represented by the ________ on the ECG.
A) QRS duration
B) QT interval
C) PQ interval
D) R-R interval
Free
Multiple Choice
Q 28Q 28
Which of the following statements concerning Q waves on the ECG is most accurate?
A) Q waves are not a normal finding on the ECG.
B) The absence of a Q wave is a significant pathophysiological finding.
C) A Q wave is significant if it is 0.04 or more seconds wide.
D) A Q wave is significant only in the presence of chest pain.
Free
Multiple Choice
Q 29Q 29
The anterior surface of the heart is best viewed by ECG leads:
A) II, III, aVF.
B) V1-V4.
C) I, aVL.
D) aVR, aVL, aVF.
Free
Multiple Choice
Q 30Q 30
Which of the following is affected by a properly working pacemaker?
A) Automaticity
B) Stroke volume
C) Cardiac rhythm
D) Ejection fraction
Free
Multiple Choice
Q 31Q 31
An ECG monitor is useful for:
A) determining cardiac output.
B) evaluating the heart's electrical conduction system for abnormalities.
C) determining stroke volume.
D) evaluating the effectiveness of cardiac contractions.
Free
Multiple Choice
Q 32Q 32
Which of the following occurs during depolarization of a cardiac cell?
A) Sodium moves out of the cell.
B) The cell becomes relatively more positively charged.
C) Potassium moves into the cell.
D) The cell becomes negatively charged.
Free
Multiple Choice
Q 33Q 33
Your patient is a 73-year-old man who is sitting in a recliner, cyanotic, pulseless, and apneic. The patient's skin is cool and dry. The patient's wife last saw him an hour and a half ago. Which of the following should you do first?
A) Check for rigor mortis.
B) Start CPR.
C) Attach the monitor/defibrillator.
D) Inform the patient's wife that he is dead and nothing can be done for him.
Free
Multiple Choice
Q 34Q 34
The QRS complex represents:
A) ventricular depolarization.
B) atrial repolarization.
C) atrial depolarization.
D) ventricular repolarization.
Free
Multiple Choice
Q 35Q 35
The lead to the left of the sternum at the fourth intercostal space is:
A) V1.
B) V2.
C) V3.
D) V4.
Free
Multiple Choice
Q 36Q 36
The SA and AV nodes are perfused by the ________ artery.
A) anterior descending
B) right coronary
C) left coronary
D) circumflex coronary
Free
Multiple Choice
Q 37Q 37
The mitral valve is open during:
A) systole.
B) cardiac standstill.
C) diastole.
D) repolarization.
Free
Multiple Choice
Q 38Q 38
Which of the following is the correct sequence of cardiac electrical activity?
1) AV node
2) Internodal pathways
3) Bundle of His
4) SA node
5) Purkinje fibers
6) Bundle branches
A) 1, 2, 4, 3, 6, 5
B) 4, 1, 2, 3, 6, 5
C) 1, 2, 4, 3, 5, 6
D) 4, 2, 1, 3, 6, 5
Free
Multiple Choice
Q 39Q 39
A 12-lead ECG that reveals slight ST segment elevation; Q waves in leads II, III, and aVF; and ST elevation in V1 and V2 most indicate which of the following?
A) The patient is experiencing myocardial ischemia in her inferior wall that is extending into the septum.
B) The patient is experiencing myocardial injury in her lateral wall.
C) The patient has had a myocardial infarction in her inferior wall and is experiencing ischemia extending into the right ventricle.
D) The patient is experiencing ischemia and injury in her left ventricle and septum.
Free
Multiple Choice
Q 40Q 40
An elevation of the ST segment is associated with:
A) hyperkalemia.
B) left ventricular hypertrophy.
C) slowed conduction through the AV node.
D) myocardial injury.
Free
Multiple Choice
Q 41Q 41
On a properly calibrated ECG machine, 1 mV is equivalent to a height of ________ boxes.
A) five small
B) ten small
C) one large
D) four large
Free
Multiple Choice
Q 42Q 42
Which of the following is LEAST urgent when evaluating a patient suspected of suffering an acute myocardial infarction?
A) Blood pressure
B) ECG
C) Pulse oximetry
D) Breath sounds
Free
Multiple Choice
Q 43Q 43
Which of the following is a traumatic mechanism by which a myocardial injury can be produced?
A) Blunt chest trauma
B) Penetrating chest trauma
C) Traumatic brain injury
D) Rapid deceleration
Free
Multiple Choice
Q 44Q 44
A 12-lead ECG that reveals ST elevation in all of the precordial leads most indicates myocardial:
A) injury to the right ventricle, left ventricle, and septum.
B) injury to the right ventricle and septum.
C) infarction to the left and right ventricles.
D) ischemia to the left ventricle and septum.
Free
Multiple Choice
Q 45Q 45
Which of the following can be determined by lead II cardiac monitoring?
A) Positive deflection
B) Chamber enlargement
C) Axis deviation
D) Presence of a myocardial infarction, but not its location
Free
Multiple Choice
Q 46Q 46
An action potential begins in a myocardial cell when ________ enters the cell, giving it a ________ charge.
A) calcium; positive
B) sodium; positive
C) sodium; negative
D) calcium; negative
Free
Multiple Choice
Q 47Q 47
Slowing of the electrical impulse at the AV node is necessary to allow time for the ________ to fill with blood.
A) coronary sinus
B) coronary arteries
C) ventricles
D) atria
Free
Multiple Choice
Q 48Q 48
At standard speed, a 1 mm box on ECG paper represents ________ seconds.
A) 0.12
B) 0.04
C) 0.08
D) 0.1
Free
Multiple Choice
Q 49Q 49
Ventricular repolarization of the myocardium is represented by the:
A) T wave.
B) beginning of the QRS complex to the apex of the T wave.
C) ST segment.
D) isoelectric line.
Free
Multiple Choice
Q 50Q 50
Artifacts such as muscle tremors can make assessment of cardiac rhythm difficult because:
A) an artifact can obscure the underlying rhythm.
B) an artifact can cause the pacer to fire prematurely.
C) the pacemaker may confuse the artifact with an electrical impulse and not fire.
D) the QRS complexes may be obscured by the pacer spikes.
Free
Multiple Choice
Q 51Q 51
There are three large boxes between R waves on an ECG tracing. What is the heart rate?
A) 50
B) 75
C) 150
D) 100
Free
Multiple Choice
Q 52Q 52
Which of the following arteries supplies blood primarily to the left ventricle and posterior wall?
A) Right coronary
B) Left coronary
C) Posterior descending
D) Marginal
Free
Multiple Choice
Q 53Q 53
The middle tissue layer of the heart is the:
A) epicardium.
B) endocardium.
C) myocardium.
D) pericardium.
Free
Multiple Choice
Q 54Q 54
The precordial leads provide a view of the:
A) lateral plane of the heart, including part of the right ventricle, most of the left ventricle, and the septum.
B) horizontal plane of the heart, including the right ventricle and right atrium.
C) inferior portion of the heart, including the entire right ventricle.
D) horizontal plane of the heart, including the left ventricle and septum.
Free
Multiple Choice
Q 55Q 55
A 45-year-old man is alert and oriented, complaining of chest pain. He describes a two-day history of worsening pain, described as a burning sensation below his left breast that radiates across his chest. He states that the pain seems to get better right after eating, but then worsens again. Medical history includes myocardial infarction, hypertension, and type 2 diabetes. His medications include Inderal, Vasotech, Glucotrol, and Lopid. Physical examination reveals cool, dry skin; clear lungs; and no JVD or peripheral edema. HR = 102, BP = 132/86, RR = 12, SaO2 = 98%. The patient is on oxygen by nasal cannula at 4 liters per minute. Which of the following should be done next?
A) Give 81 mg aspirin by mouth.
B) Start precautionary IV of normal saline and transport.
C) Give 0.4 mg nitroglycerin sublingually.
D) Do a 12-lead ECG.
Free
Multiple Choice
Q 56Q 56
Which of the following describes the ability of a cardiac cell to propagate the electrical impulse to another cell?
A) Conductivity
B) Contractility
C) Excitability
D) Automaticity
Free
Multiple Choice
Q 57Q 57
When oxygen is not bound to the iron molecule of hemoglobin, the iron molecule is in the ferrous (Fe2+) charge state, rather than when oxygen changes the charge of iron to the ferric (Fe3+) state. A dangerous form of hemoglobin that is unable to oxidize is:
A) methemoglobin (MetHb).
B) deoxyhemoglobin (DeoHb).
C) oxyhemoglobin (OxHb).
D) carboxyhemoglobin (COxHb).
Free
Multiple Choice
Q 58Q 58
A patient who has SpMet readings of 40 percent would be expected to have signs and symptoms of methemoglobinemia, such as:
A) all signs and symptoms normal-asymptomatic.
B) headache, dyspnea, confusion, weakness, and chest pain.
C) cyanosis, but otherwise asymptomatic.
D) fatality.
Free
Multiple Choice
Q 59Q 59
The normal range of hemoglobin (Hb) levels in the adult male patient would be closest to:
A) 9.9-14.5 g/dL.
B) 9.9-14.5 mg/dL.
C) 14-17.4 g/dL.
D) 14-17.4 mg/dL.
Free
Multiple Choice
Q 60Q 60
Which of the following cells released from the islets of Langerhans produce glucagon, which increases the blood glucose levels?
A) Alpha cells
B) Beta cells
C) Gamma cells
D) Delta cells
Free
Multiple Choice
Q 61Q 61
Which of the following cells released from the islets of Langerhans produce insulin, which decreases the blood glucose levels?
A) Alpha cells
B) Beta cells
C) Gamma cells
D) Delta cells
Free
Multiple Choice
Q 62Q 62
Which of the following cells released from the islets of Langerhans produce somatostatin, which inhibits production of glucagon and insulin?
A) Alpha cells
B) Beta cells
C) Gamma cells
D) Delta cells
Free
Multiple Choice
Q 63Q 63
The color of the blood tube that is usually first in sequence for filling and is without an anticoagulant (used for blood typing and cross-matching) is:
A) blue.
B) green.
C) red.
D) gray.
Free
Multiple Choice
Q 64Q 64
Which of the following cardiac enzymes and biomarkers is NOT measured and analyzed to help confirm a myocardial infarction?
A) Creatine kinase (CK-II MB)
B) Myoglobin
C) Troponin I
D) B-natriuretic peptide (BNP)
Free
Multiple Choice
Q 65Q 65
Which of the following uses for ultrasound is NOT indicated in the prehospital setting?
A) Suprapubic, to identify the outline of the urinary bladder and uterus
B) Cardiac, to identify the cardiac wall motion and pericardial space
C) Umbilical, to identify the gestation age and sex of the fetus
D) Left upper quadrant, to identify the diaphragm and the spleen
Free
Multiple Choice