Question 1

Which of the following agents is recommended by the American Respiratory Care Foundation for disinfection of respiratory home care equipment?

Accepted Answer

High-level disinfection with glutaraldehyde is initially recommended.

Question 2

To determine the need for long-term home O₂ therapy after initial justification, when should blood gas analysis be repeated?

Accepted Answer

To guide practitioners in providing quality care, the AARC has published a Clinical Practice Guideline on Oxygen Therapy in the Home or Extended Care Facility. Excerpts appear on p. 1291-1292.

Question 3

Which of the following would you recommend as the solution used to fill a bubble humidifier used for home O₂ therapy?

Accepted Answer

Because the mineral content of tap water may be high (hard water), water used in these humidifiers should be distilled.

Question 4

Factors to consider when advising a patient on selection of durable medical equipment (DME) include which of the following?
1) Accreditation
2) Finder's fees
3) Cost
4) Availability

Accepted Answer

1) Accreditation ensures that the DME provider is following established standards for quality and patient safety.
2) Finder's fees should not be a factor in selecting DME, as they can create conflicts of interest and lead to inappropriate equipment or services being provided. 
3) Cost is an important consideration, as some DME can be expensive and patients may need to consider insurance coverage or other financial options. 
4) Availability is important to ensure that the patient can obtain the necessary equipment in a timely manner.

Question 5

To determine if a home setting can support the equipment needs of a mechanically ventilated patient being considered for discharge, which of the following would you assess?
1) Available space for equipment
2) Amperage of power supply
3) Number and location of grounded outlets
4) Presence of hazardous appliances

Accepted Answer

To ensure a home setting can support the equipment needs of a mechanically ventilated patient, it's important to assess the available space for equipment, the amperage of the power supply to ensure it can handle the equipment's electrical load, the number and location of grounded outlets to safely plug in the equipment, and the presence of hazardous appliances that could pose a risk to the patient or interfere with the equipment's operation.

Question 6

Which of the following are acceptable methods of documenting the presence of hypoxemia in patients being considered for home O₂ therapy? 1) Blood gas analysis 2) Pulse oximetry 3) Physical examination

Accepted Answer

Blood gas analysis and pulse oximetry are objective methods to document hypoxemia, while physical examination alone is subjective and not sufficient for this purpose.

Question 7

Which of the following are acceptable indicators of hypoxemia for purposes of justifying home O₂ therapy? 1) Resting PaO₂ of 55 mm Hg (room air) 2) Drop in SaO₂ below 89% during ambulation 3) Resting arterial SaO₂ below 88% (room air)

Accepted Answer

All listed indicators (resting PaO2 of 55 mm Hg on room air, drop in SaO2 below 89% during ambulation, and resting arterial SaO2 below 88% on room air) are acceptable indicators of hypoxemia that can justify home oxygen therapy.

Question 8

CMS regulations require that prescriptions for home O₂ therapy be based on:

Accepted Answer

As indicated in the practice guideline, O₂ prescriptions must be based on documented hypoxemia, as determined by either blood gas analysis or oximetry.

Question 9

Durable medical equipment (DME) companies usually provide which of the following respiratory home care services?
1) Third-party insurance processing
2) Most respiratory care modalities
3) 24-hr/7-days-a-week service
4) Home instruction and follow-up

Accepted Answer

Durable medical equipment (DME) companies offer a comprehensive range of services including third-party insurance processing, a variety of respiratory care modalities, 24/7 service, and home instruction and follow-up to ensure patients receive the care and support they need.

Question 10

Which of the following is false about home O₂ therapy?

Accepted Answer

As-needed O₂ is no longer acceptable in the postacute care setting.

Question 11

Physical hazards associated with home O₂ therapy equipment include which of the following? 1) Unsecured cylinders 2) Gaseous explosions 3) Ungrounded equipment 4) Liquid O₂ burns

Accepted Answer

Unsecured cylinders can fall and cause injury, ungrounded equipment can lead to electrical hazards, and liquid O2 can cause burns due to its extremely cold temperature.

Question 12

Once the need for long-term home O₂ therapy has been documented, why should repeated laboratory assessment (ABG or oximetry) be conducted? 1) To follow the course of the disease 2) To assess changes in clinical status 3) To facilitate changes in the prescription

Accepted Answer

Repeated laboratory assessments, such as ABG (arterial blood gas) or oximetry, are important for monitoring the progression of the disease, evaluating any changes in the patient's clinical status, and making necessary adjustments to the therapy prescription. These assessments help ensure that the therapy remains effective and appropriate for the patient's current condition.

Question 13

Disadvantages of using compressed O₂ cylinders in the home include which of the following? 1) High-pressure hazards 2) Limited volume of O₂ 3) Gas waste when not used 4) Need for frequent deliveries

Accepted Answer

The use of compressed O₂ cylinders in the home has several disadvantages including high-pressure hazards, limited volume of O₂, and the need for frequent deliveries. Moreover, if not used properly, there is also a risk of gas waste. Therefore, options A, C, and D are incorrect. The best choice is option B, as it includes all three disadvantages.

Question 14

Home O₂ therapy can be justified in patients with PaO₂ values greater than 55 mm Hg in which of the following conditions? 1) Cor pulmonale 2) Erythrocythemia (hematocrit >56%) 3) Congestive heart failure 4) Peripheral vascular disease

Accepted Answer

Home oxygen therapy is indicated for patients with chronic respiratory or cardiac conditions that lead to hypoxemia. It is justified in patients with partial pressure of arterial oxygen (PaO2) values greater than 55 mm Hg if they have conditions such as cor pulmonale, erythrocythemia (hematocrit >56%), or congestive heart failure, as these conditions can be exacerbated by or contribute to hypoxemia. Peripheral vascular disease is not directly related to the need for oxygen therapy based on PaO2 values.

Question 15

What is the primary use of compressed O₂ cylinders in alternative settings? 1) Ambulation (small cylinders) 2) Backup supply (large cylinders) 3) Primary supply (large cylinders)

Accepted Answer

Compressed O₂ cylinders are commonly used for ambulation due to their small size and portability, as well as for backup supply in case of emergencies or unexpected changes in demand. They are typically not used as a primary supply source for extended periods of time, as larger cylinders or alternative storage solutions are more practical for sustained supply. Therefore, the correct choice is A, as it includes the two most common uses for compressed O₂ cylinders.

Question 16

A home care patient will be receiving nasal O₂ at 0.5 L/min using a large compressed gas cylinder. Which of the following additional equipment would you specify for this patient? 1) Bubble humidifier 2) Pressure-reducing valve 3) Calibrated low-flow flowmeter

Accepted Answer

A pressure-reducing valve and a calibrated low-flow flowmeter are necessary to safely and accurately deliver the prescribed low flow of oxygen from a compressed gas cylinder. A bubble humidifier is not typically required at such a low flow rate.

Question 17

What is the most common respiratory home care modality?

Accepted Answer

Oxygen therapy is by far the most common mode of respiratory care in postacute care settings.

Question 18

Key environmental factors that should be assessed in considering discharge of a patient to the home care setting include which of the following?
1) Heating and ventilation
2) Humidity
3) Lighting
4) Airborne pollutants

Accepted Answer

All four environmental factors should be assessed in considering discharge of a patient to the home care setting. Heating and ventilation, humidity, and lighting can all impact a patient's comfort and safety, while airborne pollutants can exacerbate respiratory conditions or other health concerns. Therefore, options A, C, and D are not correct. Option B is the best choice as it includes all four factors.

Question 19

Home O₂ can be supplied by which of the following systems? 1) REDOX chemical reactors 2) Liquid O₂ systems 3) O₂ concentrators

Accepted Answer

Home O₂ is a liquid that needs to be concentrated to achieve a higher concentration to use it as a fuel. O₂ concentrators can be used for this purpose. However, since it is a chemical reaction product, REDOX chemical reactors can also be used to produce home O₂. Liquid O₂ systems are not used for the production or supply of home O₂. Therefore, the correct choice is B) 2 and 3 only.

Question 20

Advantages of using compressed O₂ cylinders in the home include which of the following? 1) Minimal waste or loss 2) Unlimited storage time 3) Widespread availability 4) Minimal user hazards

Accepted Answer

1) The compressed cylinders have minimal waste or loss as they can be completely emptied, reducing the amount of unused gas being released into the environment.
2) The cylinders also have unlimited storage time as the compressed gas does not deteriorate or expire over time.
3) Compressed cylinders are widely available and can be found at most hardware or home improvement stores.
4) The cylinders have minimal user hazards as they come with safety features such as pressure relief valves and regulator gauges.

Quiz 56: Respiratory Care in Alternative Settings

Which of the following agents is recommended by the American Respiratory Care Foundation for disinfection of respiratory home care equipment?

To determine the need for long-term home O2 therapy after initial justification, when should blood gas analysis be repeated?

Which of the following would you recommend as the solution used to fill a bubble humidifier used for home O2 therapy?

Factors to consider when advising a patient on selection of durable medical equipment (DME) include which of the following? 1) Accreditation 2) Finder's fees 3) Cost 4) Availability

Which of the following are acceptable methods of documenting the presence of hypoxemia in patients being considered for home O2 therapy? 1) Blood gas analysis 2) Pulse oximetry 3) Physical examination

Which of the following are acceptable indicators of hypoxemia for purposes of justifying home O2 therapy? 1) Resting PaO2 of 55 mm Hg (room air) 2) Drop in SaO2 below 89% during ambulation 3) Resting arterial SaO2 below 88% (room air)

CMS regulations require that prescriptions for home O2 therapy be based on:

Durable medical equipment (DME) companies usually provide which of the following respiratory home care services? 1) Third-party insurance processing 2) Most respiratory care modalities 3) 24-hr/7-days-a-week service 4) Home instruction and follow-up

Which of the following is false about home O2 therapy?

Physical hazards associated with home O2 therapy equipment include which of the following? 1) Unsecured cylinders 2) Gaseous explosions 3) Ungrounded equipment 4) Liquid O2 burns

Once the need for long-term home O2 therapy has been documented, why should repeated laboratory assessment (ABG or oximetry) be conducted? 1) To follow the course of the disease 2) To assess changes in clinical status 3) To facilitate changes in the prescription

Disadvantages of using compressed O2 cylinders in the home include which of the following? 1) High-pressure hazards 2) Limited volume of O2 3) Gas waste when not used 4) Need for frequent deliveries

Home O2 therapy can be justified in patients with PaO2 values greater than 55 mm Hg in which of the following conditions? 1) Cor pulmonale 2) Erythrocythemia (hematocrit >56%) 3) Congestive heart failure 4) Peripheral vascular disease

What is the primary use of compressed O2 cylinders in alternative settings? 1) Ambulation (small cylinders) 2) Backup supply (large cylinders) 3) Primary supply (large cylinders)

A home care patient will be receiving nasal O2 at 0.5 L/min using a large compressed gas cylinder. Which of the following additional equipment would you specify for this patient? 1) Bubble humidifier 2) Pressure-reducing valve 3) Calibrated low-flow flowmeter