Question 1

Why do transcutaneous oxygen tension (PO2) and carbon dioxide tension (PCO2) values differ from PaO2 and PaCO2 measurements?

Accepted Answer

A)  Because of the lag time between the cardiac output and the time the blood reaches the transcutaneous electrode site 
B)  Because the skin is much more permeable to oxygen than carbon dioxide 
C)  Because oxygen is consumed and carbon dioxide is produced in transit from the left ventricle to the electrode site 
D)  Because metabolism in the tissue consumes oxygen and produces carbon dioxide at the site of the electrode 
A)  Because of the lag time between the cardiac output and the time the blood reaches the transcutaneous electrode site 
B)  Because the skin is much more permeable to oxygen than carbon dioxide 
C)  Because oxygen is consumed and carbon dioxide is produced in transit from the left ventricle to the electrode site 
D)  Because metabolism in the tissue consumes oxygen and produces carbon dioxide at the site of the electrode D

Question 2

As the therapist applies a pulse oximeter finger probe to a neonate who is receiving supplemental oxygen, she notices that the SpO2 reading is 100%. What should the therapist do in this situation?

Accepted Answer

A)  The therapist should continue monitoring the patient because the reading is accurate. 
B)  The therapist should obtain an arterial blood sample to confirm SpO2 level. 
C)  The therapist should switch to using a capnometer. 
D)  The therapist should reduce the fraction of inspired oxygen. 
A)  The therapist should continue monitoring the patient because the reading is accurate. 
B)  The therapist should obtain an arterial blood sample to confirm SpO2 level. 
C)  The therapist should switch to using a capnometer. 
D)  The therapist should reduce the fraction of inspired oxygen. B

Question 3

Which of the following is volumetric capnography able to determine?
I. Airway dead space
II. Alveolar tidal volume
III. Shunt fraction
IV. Alveolar minute volume

Accepted Answer

A)  III and IV only 
B)  II, III, and IV only 
C)  I, II, and IV only 
D)  I, II, and III only 
A)  III and IV only 
B)  II, III, and IV only 
C)  I, II, and IV only 
D)  I, II, and III only C

Question 4

Which of the following conditions will preclude the use of indirect calorimetry?
I. Cuffed endotracheal tubes
II. Circuit leaks
III. FiO2 0.40
IV. HFOV

Accepted Answer

A)  I, II, and III only 
B)  II and III only 
C)  II and IV only 
D)  I, III, and IV only 
A)  I, II, and III only 
B)  II and III only 
C)  II and IV only 
D)  I, III, and IV only

Question 5

What is the purpose of indirect calorimetry?

Accepted Answer

A)  To measure heat produced and lost from the body 
B)  To calculate energy expenditure by measuring VO2 and VCO2 
C)  To calculate resting energy expenditure 
D)  To measure gas exchange 
A)  To measure heat produced and lost from the body 
B)  To calculate energy expenditure by measuring VO2 and VCO2 
C)  To calculate resting energy expenditure 
D)  To measure gas exchange

Question 6

How is the percentage of functional hemoglobin that is saturated with oxygen determined via pulse oximetry?

Accepted Answer

A)  The percentage of red light that lands on the photodiode represents the SpO2 (oxygen saturation as determined by pulse oximetry). 
B)  The percentage of infrared light that reaches the photodetector reflects the SpO2. 
C)  The ratio of the red and infrared light that reaches the photodiode signifies the SpO2. 
D)  The sum of the amount of red and infrared absorbed by the tissue determines the SpO2. 
A)  The percentage of red light that lands on the photodiode represents the SpO2 (oxygen saturation as determined by pulse oximetry). 
B)  The percentage of infrared light that reaches the photodetector reflects the SpO2. 
C)  The ratio of the red and infrared light that reaches the photodiode signifies the SpO2. 
D)  The sum of the amount of red and infrared absorbed by the tissue determines the SpO2.

Question 7

Which of the following is the main physiologic factor responsible for deriving accurate transcutaneous data?

Accepted Answer

A)  Heart rate 
B)  Minute ventilation 
C)  Peripheral perfusion 
D)  Ventilation-perfusion ratios 
A)  Heart rate 
B)  Minute ventilation 
C)  Peripheral perfusion 
D)  Ventilation-perfusion ratios

Question 8

A therapist is monitoring a child on the mechanical ventilator who is hemodynamically stable. The PetCO2 is 48 mm Hg. If accurate, what should be the PaCO2?

Accepted Answer

A)  43 to 48 mm Hg 
B)  45 to 48 mm Hg 
C)  50 to 53 mm Hg 
D)  Exactly the same as PetCO2 
A)  43 to 48 mm Hg 
B)  45 to 48 mm Hg 
C)  50 to 53 mm Hg 
D)  Exactly the same as PetCO2

Question 9

The therapist is assessing a mechanically ventilated infant and observes that the transcutaneous electrode temperature is set between 41 and 44°C. What action does the therapist need to take at this time?

Accepted Answer

A)  The temperature range set is appropriate; therefore, no action is necessary. 
B)  The therapist should increase the temperature range to 46 to 48°C. 
C)  The temperature of the transcutaneous electrode needs to be reduced to 36 to 38°C. 
D)  The electrode needs to be repositioned and maintained at the same temperature. 
A)  The temperature range set is appropriate; therefore, no action is necessary. 
B)  The therapist should increase the temperature range to 46 to 48°C. 
C)  The temperature of the transcutaneous electrode needs to be reduced to 36 to 38°C. 
D)  The electrode needs to be repositioned and maintained at the same temperature.

Question 10

The therapist has applied a bandage-type pulse oximetry probe too tightly to an infant's finger. What problem can be expected to occur in this situation?

Accepted Answer

A)  The SpO2 will read erroneously low. 
B)  The SpO2 will read erroneously high. 
C)  The monitor will display a message indicating inadequate pulse. 
D)  The monitor will display fluctuating SpO2 values between being erroneously low and high. 
A)  The SpO2 will read erroneously low. 
B)  The SpO2 will read erroneously high. 
C)  The monitor will display a message indicating inadequate pulse. 
D)  The monitor will display fluctuating SpO2 values between being erroneously low and high.

Question 11

Which of the following features or characteristics apply to mainstream capnography?
I. The mainstream capnograph contains narrow tubing that can become occluded with mucus.
II. Mainstream capnography generally employs infrared spectrometers.
III. The mainstream capnograph does not add much weight to the breathing circuit.
IV. The mainstream capnograph is placed at the proximal end of the endotracheal tube.

Accepted Answer

A)  I and II only 
B)  II and IV only 
C)  I, II, and III only 
D)  I, III, and IV only 
A)  I and II only 
B)  II and IV only 
C)  I, II, and III only 
D)  I, III, and IV only

Question 12

The following capnogram was obtained from a newborn infant receiving mechanical ventilation.   How should the therapist evaluate this capnogram?

Accepted Answer

A)  Airway obstruction 
B)  Hypoventilation 
C)  Hyperventilation 
D)  Increased dead space ventilation 
A)  Airway obstruction 
B)  Hypoventilation 
C)  Hyperventilation 
D)  Increased dead space ventilation

Question 13

While working in the NICU with a mechanically ventilated newborn who is being monitored for PetCO2, the therapist observes the following capnogram.   What interpretation should the therapist make of this capnogram?

Accepted Answer

A)  This capnogram is normal. 
B)  The patient is receiving about 10 cm H2O positive end-expiratory pressure. 
C)  The patient is rebreathing his own exhaled gas. 
D)  The neonate is being hyperventilated. 
A)  This capnogram is normal. 
B)  The patient is receiving about 10 cm H2O positive end-expiratory pressure. 
C)  The patient is rebreathing his own exhaled gas. 
D)  The neonate is being hyperventilated.

Question 14

While attending to a neonatal patient in the NICU, the therapist notices that a transcutaneous electrode is affixed to the upper chest of the neonate. What should the therapist do at this time?

Accepted Answer

A)  The therapist should only continue monitoring the patient since the transcutaneous electrode is properly placed. 
B)  The therapist should reposition the electrode on the neonate's abdomen. 
C)  The therapist needs to move the transcutaneous electrode to the infant's right shoulder. 
D)  The therapist should relocate the electrode on the sternum as close as possible to the heart. 
A)  The therapist should only continue monitoring the patient since the transcutaneous electrode is properly placed. 
B)  The therapist should reposition the electrode on the neonate's abdomen. 
C)  The therapist needs to move the transcutaneous electrode to the infant's right shoulder. 
D)  The therapist should relocate the electrode on the sternum as close as possible to the heart.

Question 15

What clinical parameter is critically important to monitor when mechanical ventilation is administered?

Accepted Answer

A)  Blood pressure 
B)  Heart rate 
C)  Temperature 
D)  Respiratory rate 
A)  Blood pressure 
B)  Heart rate 
C)  Temperature 
D)  Respiratory rate

Question 16

The therapist has been asked to measure preductal oxygen saturation. Where could the therapist place the pulse oximeter probe?

Accepted Answer

A)  Right thumb 
B)  Left leg 
C)  Right leg 
D)  Left earlobe 
A)  Right thumb 
B)  Left leg 
C)  Right leg 
D)  Left earlobe

Exam 9: Noninvasive Monitoring in Neonatal and Pediatric Care

Why do transcutaneous oxygen tension (PO2) and carbon dioxide tension (PCO2) values differ from PaO2 and PaCO2 measurements?

As the therapist applies a pulse oximeter finger probe to a neonate who is receiving supplemental oxygen, she notices that the SpO2 reading is 100%. What should the therapist do in this situation?

Which of the following is volumetric capnography able to determine? I. Airway dead space II. Alveolar tidal volume III. Shunt fraction IV. Alveolar minute volume

Which of the following conditions will preclude the use of indirect calorimetry? I. Cuffed endotracheal tubes II. Circuit leaks III. FiO2 0.40 IV. HFOV

What is the purpose of indirect calorimetry?

How is the percentage of functional hemoglobin that is saturated with oxygen determined via pulse oximetry?

Which of the following is the main physiologic factor responsible for deriving accurate transcutaneous data?

A therapist is monitoring a child on the mechanical ventilator who is hemodynamically stable. The PetCO2 is 48 mm Hg. If accurate, what should be the PaCO2?

The therapist is assessing a mechanically ventilated infant and observes that the transcutaneous electrode temperature is set between 41 and 44°C. What action does the therapist need to take at this time?

The therapist has applied a bandage-type pulse oximetry probe too tightly to an infant's finger. What problem can be expected to occur in this situation?

The following capnogram was obtained from a newborn infant receiving mechanical ventilation. How should the therapist evaluate this capnogram?

While working in the NICU with a mechanically ventilated newborn who is being monitored for PetCO2, the therapist observes the following capnogram. What interpretation should the therapist make of this capnogram?

While attending to a neonatal patient in the NICU, the therapist notices that a transcutaneous electrode is affixed to the upper chest of the neonate. What should the therapist do at this time?

What clinical parameter is critically important to monitor when mechanical ventilation is administered?

The therapist has been asked to measure preductal oxygen saturation. Where could the therapist place the pulse oximeter probe?

Fetal Lung Development

Fetal Gas Exchange and Circulation

Antenatal Assessment and High-Risk Delivery

Examination and Assessment of the Neonatal and Pediatric Patient

Pulmonary Function Testing and Bedside Pulmonary Mechanics

Radiographic Assessment

Pediatric Flexible Bronchoscopy

Invasive Blood Gas Analysis and Cardiovascular Monitoring

Oxygen Administration

Aerosols and Administration of Inhaled Medications

Airway Clearance Techniques and Hyperinflation Therapy

Airway Management

Surfactant Replacement Therapy

Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate

Noninvasive Mechanical Ventilation of the Infant and Child

Invasive Mechanical Ventilation of the Neonate and Pediatric Patient

Administration of Gas Mixtures

Extracorporeal Membrane Oxygenation

Pharmacology

Thoracic Organ Transplantation

Neonatal Pulmonary Disorders

Surgical Disorders in Childhood That Affect Respiratory Care

Congenital Cardiac Defects

Pediatric Sleep-Disordered Breathing

Pediatric Airway Disorders and Parenchymal Lung Diseases

Asthma

Cystic Fibrosis

Acute Respiratory Distress Syndrome

Shock

Pediatric Trauma

Disorders of the Pleura

Neurological and Neuromuscular Disorders

Transport of Infants and Children

Home Care

Quality and Safety

Filters

Why do transcutaneous oxygen tension (PO₂) and carbon dioxide tension (PCO₂) values differ from PaO₂ and PaCO₂ measurements?

As the therapist applies a pulse oximeter finger probe to a neonate who is receiving supplemental oxygen, she notices that the SpO₂ reading is 100%. What should the therapist do in this situation?

Which of the following conditions will preclude the use of indirect calorimetry? I. Cuffed endotracheal tubes II. Circuit leaks III. FiO₂ 0.40 IV. HFOV

A therapist is monitoring a child on the mechanical ventilator who is hemodynamically stable. The PetCO₂ is 48 mm Hg. If accurate, what should be the PaCO₂?

While working in the NICU with a mechanically ventilated newborn who is being monitored for PetCO₂, the therapist observes the following capnogram. What interpretation should the therapist make of this capnogram?