How is the suction level set on a three bottle chest tube drainage system

A by increasing or decreasing the setting on the vacuum regulator

B by the height of the patient in comparison to the drainage system

C By the depth of the water in the vacuum control

D by the use of an under water seal

A newborn infant has: pink extremities, grimaces on nasal suction with bulb syringe, a weak cry, a heart rate of 90 beats/minute, and some flexion of extremities. The APGAR score for this infant at one minute is: 

A. 6  B. 7  C. 8  D. 9  E. 10

The Doctor asks you to increase the amount of suction pressure what would you do?  

A add more water to water seal bottle 

B lower tube on suction control bottle 

C raise tube on water seal bottle 

D increase the amount of suction through tube suction control bottle B

Intra aortic balloon pump functions in which of the following ways? 

A. Reduces venous return  

B. Increases venous return  

C. Reduces afterload 

D. Increases afterload

IABP placement is achieved via which of the following methods?

A. Venous drag on an inflatable balloon "sail" 

B Arterial drag on an inflatable balloon "sail" 

C. Arterial to venous pressure differential

D. Fluoroscopy

The intra-aortic balloon pump accomplishes its intended purpose by which of the following methods?

A. Synchronized pumping of arterial blood 

B. Inflating on the P-wave

C. Inflating on the T-wave

D. Deflating precisely at diastole

The intent of the intra-aortic balloon pump is:

I. Increase left ventricular preload     

II. Decrease left ventricular end diastolic pressure 

III. Decrease pulmonary vascular resistance           

IV. Decrease myocardial work load

V. Increase left ventricular afterload                    

VI. Decrease left ventricular afterload  

A.I, II, and V only       B. II and V only              C. II, III, and IV only  D II, IV, and VI only       E. II, III, IV, and V only

The normal inflating volume of the IABP is:

A. 30 cc  B. 40 cc  C. 50 cc  D. 60 cc

The most commonly used gas used to inflate the balloon on the Intra-aortic catheter is:

A. Helium

B. Carbon dioxide 

C. Nitrogen

D. Oxygen

For the most accurate determination of Pv02, blood should be aspirated from the:

A. right atrium 

B. right ventricle 

C. internal jugular vein 

D. pulmonary artery

Which of the following changes occurs in hypovolemic shock?

I. Increased heart rate           

II. Decreased right atrial pressure

III. Increased mean pulmonary artery pressure 

IV. Increased mean femoral artery pressure 

V. Decreased femoral systolic pressure

A. I and II only B. I, II, and V only C. II and IV only D. III and IV only

A patient's blood pressure has been recorded using a cuff and sphygmomanometer at 150/90 torr. What is the mean arterial pressure? 

A. 75 torr            B. 80 torr           C. 98 torr              D. 107 torr

Where is the catheter placed when measuring CVP?

A. R. Ventricle

B. Pulmonary Artery

C. At the base of the L. Atrium 

D. At the base of the R. Atrium 

E. At the base of the vena cava

Hypovolemia will have all the following effects EXCEPT:

A. CVP will decrease

B. Mean pulmonary artery pressure will be less than 10 mmHg 

C. BP will remain constant

D. Systemic vascular resistance will decrease

Given the following cardiovascular data, calculate the patient's stroke volume: Blood pressure: 125/80 mmHg

C.O.: 6.0 L/min Heart rate: 100 beats/min Cardiac Index: 2.65 L/min/m2  

A.40 ml       

B:60 ml        

C.70 ml         

D.80 ml

Which of the following is indicative of a tension pneumothorax?

I. a shift in the mediastinum toward the affected side 

II. hyperlucency of the affected area 

III. a shift in the mediastinum away from the affected side  IV. absence of vascular markings 

A. I only     B. I, II only       C.III, IV only        D. II, III, IV only

Which of the following is the least appropriate site for pulmonary artery cannulation?

A. Carotid artery 

B. Jugular vein 

C. Femoral vein 

D. Subclavian vein

Normal mean pulmonary arterial pressure is:

A. 93 mmHg 

B. 53 mmHg 

C. 33 mmHg

D. 23 mmHg 

E. 13 mmHg

Timing of the intra-aortic balloon pump is critical; simply turning on the pump without first synchronizing balloon inflation and deflation with cardiac efforts, would be disastrous for the patient. By which of the following methods is it possible to initiate the balloon pump without harming the patient?

A. Utilizing the arterial waveform, inflate the balloon at the peak of systole 

B. Utilizing the arterial waveform, inflate the balloon at end diastole

C. Utilizing the electrocardiograph, inflate the balloon mid-P-wave

D. Utilizing the electrocardiograph, inflate the balloon at the height of the QRS complex

E. Utilizing the electrocardiograph, inflate the balloon at the height of the T-wave

The IABP can be set to augment every heart beat or every third heart beat or every sixth heart beat. When timing the pump the ratio of assisted beats to unassisted beats is:

A. 1:1 B 1:2 C. 1:4 D. 1:6 E. 1:8

Which of the following are possible complications of arterial cannulation?

A. Infection

B. Arterial spasm 

C. Hematoma 

D. All of the above

Which bottle is the underwater seal?

A. 1 (on suction side)

B. 2 (middle)

C. 3 (on patient side)

Which of the following would increase PA pressure?

A. Severe hypoxemia 

B. Pulmonary embolism

C. Acidosis

D. All of the above 

E. None of the above

Your patient has a PA catheter in place and develops sudden hemoptysis. The most likely cause of this undesirable development is:

A. Pneumothorax 

B. Dissecting aorta 

C. Myocardial infarction 

D. Coarctation 

E. Pulmonary infarction

Which of the following would cause CVP to decrease?
A. Left ventricular dysfunction 

B. Spontaneous inspiration

C. Thromboembolism 

D. Hypervolemia

Normal cardiac output is:

A. 3-5 Lpm 

B. 3-8 Lpm

C. 4-6 Lpm 

D. 4.5-7 Lpm 

E. 4-8 Lpm

Normal cardiac index is based on cardiac output and which of the following:

A. Ideal body weight 

B. % body fat

C. Height 

D. Body surface area 
E. Carbon dioxide output/Oxygen uptake

When using a disposable drainage system continuous bubbling should be seen in the

A drainage compartment 

B water seal compartment 

C suction control compartment

D drainage and water seal compartments

A full term baby arrives at your warmer. One minute after birth, her heart rate is 110 beats/minute; her RR is 40 breaths/minute; she is crying and shows peripheral cyanosis; some flexion of her extremities is displayed; and, she sneezed when the nurse passed a suction catheter into her nose.

What is this newborn's 1 minute APGAR score?

A. 0     B. 4      C. 6      D. 8

The medication used to close PDA by inhibition of prostaglandin is:

A. Vecuronium 

B. Indomethacin

C. Tensilon (edruphonium)

D. Cromolyn Sodium

. In persistent fetal circulation, blood bypasses the neonatal lung via:

I. umbilical artery

II. foramen ovale

III. umbilical vein

IV. ductus arteriosus

A. I, II only     B. II, III only      C. I, III only      D. II, IV only

Given the following cardiovascular data, calculate the patient's stroke volume:

blood pressure: 125/80 mmHg       C.O.: 6.0 L/min

Heart rate: 75 beats/min         C.I.: 2.65 L/min/m2

A. 45 ml       B. 65 ml       C. 70 ml       D. 80 ml

Which of the following clinical signs are included in the Apgar score for clinically evaluating a neonate?

I. heart rate

II. ventilatory rate III. color

IV. reflex irritability V. muscle tone

A. I, II, III, IV, V          B. I, II, III only  

C. II, IV, V only             D. I, III, IV, V only

Which of the following is the most sensitive indicator of left ventricular function?

A. systolic pressure of the pulmonary artery

B. pulmonary capillary wedge pressure

C. cardiac output

D. diastolic pressure of the pulmonary artery

. The classic pathology of a pulmonary embolism includes all of the following except:

A. acute dyspnea

B. hypertension

C. shunting in the pulmonary system

D. chest pain

A mixed venous sample, used to determine C(a-v)02, is obtained from which of the following?

A. Central line

B. Arterial catheter

C. Pulmonary artery catheter

D. Central Venous catheter

On an electrocardiogram, the T-wave represents:

A. atrial depolarization

B. ventricular depolarization

D. ventricular repolarization

E. atrial repolarization

Fetal lung maturity is denoted by a lecithin-sphingmyelin ratio of at least along with the presence of in the amniotic fluid.

A. 2:1; 1 unit phosphatidylcholine

B. 1:2; phosphatidylinositol present

C.1:2; 2 unit phosphatidylcholine

D. 2:1; phosphatidylglycerol present

Depolarization of the ventricles is represented on the ECG by:

A. the P wave

B. the Q wave

C. the R wave

D. the QRS complex

E. the T wave

When first selecting timing points for a patient of IABP, which of the following is the proper sequence:

A. Initiate based on ECG, deflate between P and QRS, inflate on T

B. Initiate based on ECG, inflate between P and QRS, deflate on T

C. Initiate based on arterial waveform, inflate at dicrotic notch, deflate near patient aortic end diastolic pressure

D. Initiate based on arterial waveform, deflate at dicrotic notch, inflate at patient aortic end diastolic pressure

E. Initiate based on arterial waveform, inflate at peak of patient systolic pressure, deflate at dicrotic notch.

What will happen as water evaporates in the suction control compartment

A suction applied to the intra plural space will increase

B air removal from the inter plural space will increase

C loss of an under water seal might occur

D suction applied to the plural space would decrease

Intra-aortic balloon deflation is adjusted to occur:

A. at the beginning of diastole 

B. at the beginning of systole

When initiating balloon counterpulsation, you can best evaluate the effect of your timing adjustments by initially setting the assist ratio at:

A. 1:1

B. 1:2

C. 1:4

D. 1:8

Using the Fick equation, calculate the cardiac output of the patient with the following values:

V02 150ml/min        Pulse 80 beats/min       BSA   2.0 m2

Hb        15 gm/dL       Ca02     21.0 vol%     Cv02     17.25 vol%

A. 3.0 LPM        B. 4.0 LPM

C. 5.0 LPM        D. 6.0 LPM

Calculate the CO of a patient whose pulse is 80 and left ventricular ejection is 50 ml.

A. 3.0 LPM        B. 4.0 LPM

C. 5.0 LPM        D. 6.0 LPM

You would expect to sterilize a Negative Pressure Manometer

A. ETO gas

B. Pasteurization

C. steam

D. dry heat

When using cidex all of the following are true except

A. It is cidal if soaked for 10 hours

B. It will kill vegatative bacteria in 10 minutes

C. The solution length of time should be monitored

D. It must be activated

E. It is an alkaline solution

Cleaning of respiratory therapy equipment at home

A. makes the equipment sterile

B. guarantees to eliminate the spread of infection

C. reduces the spread of infection

D. is not necessary with modern drugs

Which of the following most correctly describes the term iatrogenic infection?

A. one that results form the use of immunosuppresive agents

B. one that occurs postoperatively

C. one that results form the activities of medical or surgical personnel

D. one that occurs in the hospital

E. one that occurs from the use of broad spectrum antibiotics

Which of the following types of hypoxia is most frequently associated with an increase in the mixed venous 02?

A. hypoxemic

B. anemic

C. circulatory

D. histotoxic

E. A and C are correct

The volume of blood in the ventricle at the end of a diastole is called:

A. pre load

B. after load

C. stroke volume

D. cardiac output

A 73-year-old male enters the emergency room in congestive heart failure with pulmonary edema. The physician orders 5 mg of morphine IV along with 40 mg of Lasix IV. What will be the primary beneficial hemodynamic effects of these drugs on myocardial function?

A. They will reduce the preload

B. They will reduce the afterload

C. They will increase the preload

D. They will increase the afterload

There are many types of shock. Which of the following can lead to shock?

I. An anaphylactic reaction

II. Blood loss following an accident

III. Tachycardia

IV. A systemic septic reaction

A. I only    B. I and III    C. I, II and IV     D. I and IV     E. All of above

A bedside evaluation of Central Venous Pressure might include:

A. PCWP

B. The patients skin color

C. A measurement of cardiac output

D  The patients neck veins

The normal value for PCWP in an adult is:

A. 0-8

B. 2-12 

C. 5-16

D. 0-22

E. 22-40

Ventricular afterload is:

A. The volume of blood in the ventricle at the end of a systole

B. The volume of blood in the ventricle at the end of a diastole

C. The pressure against which the ventricle must eject during a systole D. The pressure in the ventricle at the end of systole

Which of the following is the most common cause of iatrogenic congestive heart failure?

A. Fluid overload

B. Decreased ventricular contractility

C. Mitral stenosis

D. Pericardial effusion