Egan’s Fundamentals of Respiratory Care 10th Edition By Kacmarek – Stoller – Test Bank A+

Description

1. Which of the following statements about liquids is NOT true?

a.	They exhibit the phenomenon of flow.
b.	They assume the shape of their container.
c.	They are difficult to compress.
d.	They expand to fill their container.

ANS: D

Liquid molecules also exhibit mutual attraction. However, because these forces are much weaker in liquids than in solids, liquid molecules can move about freely (Figure 6-1, B). This freedom of motion explains why liquids take the shape of their containers and are capable of flow. However, like solids, liquids are dense and cannot easily be compressed or expanded.

DIF: Application REF: p. 103 OBJ: 1

1. Which of the following statements correctly describe(s) gases?
2. Gases exhibit the phenomenon of flow.
3. Molecular forces of attraction are minimal.
4. Gases are easily compressible.
5. Gases expand to fill their container.

a.	1 and 2
b.	1, 2, and 3
c.	2, 3, and 4
d.	1, 2, 3, and 4

ANS: D

In a gas, molecular attractive forces are very weak. Thus, gas molecules, which lack restriction to their movement, exhibit rapid, random motion with frequent collisions (Figure 6-1, C). Gases have no inherent boundaries and are easily compressed and expanded. Moreover, like liquids, gases can flow.

DIF: Application REF: p. 103 OBJ: 1

1. At what temperature does all kinetic activity of matter cease?

a.	0°K
b.	0°C
c.	32°C
d.	0°F

ANS: A

The SI (Systeme Internationale) units for temperature are degrees Kelvin, with a zero point equal to absolute zero (0°K).

DIF: Recall REF: p. 105 OBJ: 3

1. A patient has a recorded body temperature of 106° F. What is this temperature in degrees Celsius?

a.	41°C
b.	98°C
c.	39°C
d.	22°C

ANS: A

To convert degrees Fahrenheit to degrees Celsius, use the following formula: °C = 5/9 ´ (° F – 32).

DIF: Analysis REF: p. 106 OBJ: 3

1. A near-drowning patient has a recorded body temperature of 30° C. What is the equivalent temperature in degrees Fahrenheit?

a.	–4°F
b.	86°F
c.	32°F
d.	77°F

ANS: B

To convert degrees Celsius to degrees Fahrenheit, simply reverse the formula given in question 4: ° F = (9/5 ´ ° C) + 32.

DIF: Analysis REF: p. 106 OBJ: 3

1. By which of the following means can the internal energy of a substance be increased?
2. cooling the substance
3. performing work on the substance
4. heating the substance

a.	2 and 3
b.	1 and 2
c.	2
d.	1, 2, and 3

ANS: A

You can increase the internal energy of an object by heating it or by performing work on it.

DIF: Application REF: p. 104 OBJ: 2

1. What term is used for the transfer of heat by the direct interaction of atoms or molecules in a hot area with atoms or molecules in a cooler area?

a.	radiation
b.	convection
c.	condensation
d.	conduction

ANS: D

Conduction is the transfer of heat by direct contact between hot and cold molecules.

DIF: Recall REF: p. 104 OBJ: 2

1. Which of the following would be the worst heat conductor?

a.	water
b.	glass
c.	air
d.	copper

ANS: C

With fewer molecular collisions than in solids and liquids, gases exhibit low thermal conductivity.

DIF: Application REF: p. 104 OBJ: 2

1. What is the primary means by which heat transfer occurs in fluids?

a.	convection
b.	radiation
c.	conduction
d.	evaporation

ANS: A

Heat transfer in both liquids and gases occurs mainly by convection.

DIF: Application REF: p. 104 OBJ: 2

1. Which of the following is a good clinical example of using the principle of convection to transfer heat?

a.	humidifiers with immersion heaters
b.	heated, enclosed infant incubators
c.	wire-heated pneumotachometers
d.	heated ventilator exhalation valves

ANS: B

This is the principle behind forced-air heating in houses and convection heating in infant incubators.

OB: 2

DIFF: Application

DIF: Application REF: p. 104 OBJ: 2

1. Which of the following methods of heat transfer requires no direct contact between the warmer and cooler substances?

a.	conduction
b.	convection
c.	evaporation
d.	radiation

ANS: D

While conduction and convection require direct contact between two substances, radiant heat transfer occurs without direct physical contact.

DIF: Application REF: p. 104 OBJ: 2

1. Which of the following would help to decrease a patient’s loss of body heat?
2. Increase the temperature of the room.
3. Increase the exposed skin surface area.
4. Move the patient away from cold windows.

a.	1 and 2
b.	2 and 3
c.	1, 2, and 3
d.	1 and 3

ANS: D

In simple terms, for an object with a given emissivity, the larger the surface area (relative to mass) and the lower the surrounding temperature, the greater is the radiant heat loss per unit time.

DIF: Application REF: p. 105 OBJ: 2

1. Which of the following is FALSE about evaporation?

a.	Evaporation is a type of vaporization.
b.	The process of evaporation warms the surrounding air.
c.	Evaporation is the change of a liquid substance into a gas.
d.	For evaporation to occur, heat energy is needed.

ANS: B

Vaporization is the change of state from liquid to gas. Vaporization requires heat energy. According to the first law of thermodynamics, this heat energy must come from the surroundings. In one form of vaporization, called evaporation, heat is taken from the air surrounding the liquid, thereby cooling the air.

DIF: Application REF: p. 105 OBJ: 5

1. What is the physical process whereby the gaseous form of a substance is changed back into its liquid state?

a.	condensation
b.	sublimation
c.	vaporization
d.	radiation

ANS: A

During condensation, a gas turns back into a liquid.

DIF: Application REF: p. 105 OBJ: 4

1. Which of the following is/are TRUE of liquids?
2. They are hard to compress.
3. They exert pressure.
4. They exert buoyant force.
5. They conform to their containers.

a.	2 and 4
b.	1, 2, and 3
c.	1 and 3
d.	1, 2, 3, and 4

ANS: D

Liquids exhibit flow and assume the shape of their container. Liquids also exert pressure, which varies with depth and density. Variations in liquid pressure within a container produce an upward supporting force, called buoyancy.

DIF: Application REF: p. 107 OBJ: 1

1. Which of the following equations can be used to calculate the pressure exerted by a liquid?

a.	liquid pressure = liquid depth ¸ liquid density
b.	liquid pressure = liquid depth ´ surface area
c.	liquid pressure = liquid density ´ liquid viscosity
d.	liquid pressure = liquid density ´ liquid depth

ANS: D

The pressure exerted by a liquid depends on both its height (depth) and weight density (weight per unit volume), which is shown in equation form:

P_L = h ´ dw.

DIF: Analysis REF: p. 107 OBJ: 4

1. According to Pascal’s principle, the pressure exerted by a liquid in a container depends on which of the following?
2. depth of the liquid
3. density of the liquid
4. shape of the container

a.	1, 2, and 3
b.	1 and 2
c.	2 and 3
d.	1 and 3

ANS: B

The pressure exerted by a liquid depends on both its height (depth) and weight density (weight per unit volume), which is shown in equation form:

P_L = h ´ dw.

DIF: Application REF: p. 107 OBJ: 4

1. Archimedes’ principle is applied clinically in which of the following devices?

a.	nebulizer
b.	capillary tube
c.	hydrometer
d.	humidifier

ANS: C

Clinically, Archimedes’ principle is used to measure the specific gravity of certain liquids. A hydrometer is used to measure the specific gravity of certain liquids.

DIF: Application REF: p. 108 OBJ: 4

1. What is the internal force that opposes the flow of fluids (equivalent to friction between solid substances)?

a.	conductivity
b.	kinetic energy
c.	viscosity
d.	density

ANS: C

Viscosity is the force opposing a fluid’s flow.

DIF: Recall REF: p. 108 OBJ: 4

1. Which of the following is FALSE about viscosity?

a.	The greater the viscosity, the greater is the opposition to flow.
b.	Viscosity is most important under conditions of turbulent flow.
c.	The stronger the cohesive forces, the greater the viscosity.
d.	Fluid viscosity is equivalent to friction between solids.

ANS: B

Laminar flow consists of concentric layers of fluid flowing parallel to the tube wall at velocities that increase toward the center.

DIF: Application REF: p. 108 OBJ: 4

1. After placing a liquid into a small-diameter glass tube, you observe the formation of a convex (upwardly curved) meniscus. What conclusion is correct?

a.	The liquid must have a very low surface tension.
b.	Strong adhesive forces exist between the liquid and glass.
c.	The liquid must have an extremely high viscosity.
d.	Strong cohesive forces exist among the liquid molecules.

ANS: D

When the liquid is water, the meniscus is concave because the water molecules at the surface adhere to the glass more strongly than they cohere to each other. In contrast, a mercury meniscus is convex. In this case, the cohesive forces pulling together the mercury atoms exceed the adhesive forces trying to attract the mercury to the glass.

DIF: Application REF: p. 109 OBJ: 4

1. What force is responsible for the spherical shape of liquid droplets and their ability to keep this shape when placed into an aerosol suspension?

a.	cohesion
b.	adhesion
c.	viscosity
d.	surface tension

ANS: D

Surface tension is a force exerted by like molecules at a liquid`s surface. A small drop of fluid provides a good illustration of this force. As shown in Figure 6-8, cohesive forces affect molecules inside the drop equally from all directions. However, only inward forces affect molecules on the surface. This imbalance in forces causes the surface film to contract into the smallest possible surface area, usually a sphere or curve (meniscus). This phenomenon explains why liquid droplets and bubbles retain a spherical shape.

DIF: Application REF: p. 109 OBJ: 4

1. Which of the following liquids has the lowest surface tension?

a.	whole blood
b.	ethyl alcohol
c.	plasma
d.	mercury

ANS: B

Ethyl alcohol has the lowest surface tension of the listed liquids. Table 6-2 lists the surface tensions of selected liquids in dynes/cm (cgs).

DIF: Recall REF: p. 109 OBJ: 4

1. Which of the following is FALSE about liquid bubbles?

a.	The smaller the bubble, the greater is the necessary inflation pressure.
b.	Inflation pressure can be lowered if surface tension is increased.
c.	The smaller the bubble, the greater is surface tension pressure.
d.	When connected, small bubbles tend to empty into larger bubbles.

ANS: B

The equation for a liquid bubble follows:

P = 4ST ¸ r

where P is the pressure in the bubble, ST is the surface tension, and r is the bubble radius. Figure 6-9 demonstrates this relationship for two bubbles of different sizes, each with the same surface tension.

DIF: Application REF: p. 110 OBJ: 4

1. What is the phenomenon whereby a liquid in a small tube tends to move upward against the force of gravity?

a.	capillary action
b.	shear stress
c.	surface tension
d.	buoyancy

ANS: A

Capillary action is a phenomenon in which a liquid in a small tube moves upward, against gravity.

DIF: Recall REF: p. 110 OBJ: 4

1. Which of the following is/are good clinical examples of the principle of capillary action?
2. capillary stick blood samples
3. absorbent humidifier wicks
4. certain surgical dressings

a.	1, 2, and 3
b.	1 and 2
c.	2 and 3
d.	2

ANS: A

Capillary action is the basis for blood samples obtained by use of a capillary tube. The absorbent wicks used in some gas humidifiers are also an application of this principle, as are certain types of surgical dressings.

DIF: Application REF: p. 111 OBJ: 4

1. What is the temperature at which the vapor pressure of a liquid equals the pressure exerted on the liquid by the surrounding atmosphere?

a.	boiling point
b.	dew point
c.	triple point
d.	melting point

ANS: A

The boiling point of a liquid is the temperature at which its vapor pressure equals atmospheric pressure.

DIF: Recall REF: p. 111 OBJ: 4

1. Which of the following is/are TRUE about boiling?
2. Boiling a liquid requires more energy than does evaporating it.
3. A liquid’s boiling point varies with the atmospheric pressure.
4. The greater the ambient pressure, the lower is the boiling point.

a.	2 and 3
b.	1 and 3
c.	1 and 2
d.	1, 2, and 3

ANS: C

Because the weight of the atmosphere retards the escape of vapor molecules, the greater the ambient pressure, the greater is the boiling point.

DIF: Application REF: p. 111 OBJ: 4

1. What is the change in state of a substance from liquid to gaseous form occurring below its boiling point?

a.	evaporation
b.	sublimation
c.	boiling
d.	vaporization

ANS: A

A liquid also can change into a gas at temperatures lower than its boiling point through a process called evaporation.

DIF: Application REF: p. 111 OBJ: 4

1. Which of the following is/are TRUE about molecular water vapor?
2. Water vapor exhibits kinetic activity.
3. Molecular water vapor can be seen.
4. Water vapor exerts pressure.

a.	1 and 2
b.	2 and 3
c.	1, 2, and 3
d.	1 and 3

ANS: D

To be distinguished from visible particulate water, such as mist or fog, this invisible gaseous form of water is called molecular water. Molecular water obeys the same physical principles as other gases and therefore exerts a pressure called water vapor pressure.

DIF: Application REF: p. 111 OBJ: 5

1. What occurs during the evaporation of water?

a.	The adjacent air is warmed.
b.	The adjacent air is cooled.
c.	The water temperature rises.
d.	Heat is given up to the air.

ANS: B

As the surrounding air loses heat energy, it cools. This is the principle of evaporation cooling.

DIF: Recall REF: p. 111 OBJ: 5

1. What is the equilibrium condition in which a gas holds all the water vapor molecules that it can?

a.	Evaporation
b.	Stabilization
c.	Saturation
d.	body humidity

ANS: C

At this point, the air over the water is saturated with water vapor. However, vaporization does not stop once saturation occurs.

DIF: Recall REF: p. 111 OBJ: 5

1. Which of the following methods would increase the rate of evaporation of a container of water?
2. Increase the temperature of the surrounding air.
3. Decrease the pressure of the surrounding air.
4. Increase the temperature of the water.

a.	1 and 2
b.	2 and 3
c.	1 and 3
d.	1, 2, and 3

ANS: D

The warmer the air, the more vapor it can hold. Specifically, the capacity of air to hold water vapor increases with temperature. The warmer the air making contact with a water surface, the faster is the rate of evaporation.

DIF: Application REF: p. 111 OBJ: 5

1. Which of the following represents a direct measure of the kinetic activity of water vapor molecules?

a.	absolute humidity
b.	water vapor pressure
c.	percent body humidity
d.	relative humidity

ANS: B

Water vapor pressure represents the kinetic activity of water molecules in air.

DIF: Application REF: p. 111 OBJ: 5

1. What is the term for the actual content or weight of water present in a given volume of air?

a.	percent body humidity
b.	water vapor pressure
c.	absolute humidity
d.	relative humidity

ANS: C

Absolute humidity can be measured by weighing the water vapor extracted from air using a drying agent.

DIF: Application REF: p. 112 OBJ: 6

1. What is the absolute humidity (water vapor content) of saturated gas at normal body temperature (37°C)?

a.	47.0 mg/L
b.	37.0 mg/L
c.	98.6 mg/L
d.	43.8 mg/L

ANS: D

For example, air that is fully saturated with water vapor at 37° C and 760 mm Hg has a water vapor pressure of 47 mm Hg and an absolute humidity of 43.8 mg/L.

DIF: Recall REF: p. 112 OBJ: 6

1. What is the water vapor pressure of saturated gas at normal body temperature (37°C)?

a.	47.0 mm Hg
b.	43.8 mm Hg
c.	37.0 mm Hg
d.	98.6 mm Hg

ANS: A

For example, air that is fully saturated with water vapor at 37°C and 760 mm Hg has a water vapor pressure of 47 mm Hg and an absolute humidity of 43.8 mg/L.

DIF: Recall REF: p. 112 OBJ: 6

1. What is the term for the ratio of the actual water vapor present in a gas compared with the capacity of that gas to hold the vapor at a given temperature?

a.	relative humidity
b.	absolute humidity
c.	water vapor pressure
d.	percent body humidity

ANS: A

When a gas is not fully saturated, its water vapor content can be expressed in relative terms using a measure called relative humidity.

DIF: Application REF: p. 112-113 OBJ: 6

1. At a room temperature of 22°C, air has the capacity to hold 19.4 mg/L of water vapor. If the absolute humidity in the air is 7.4 mg/L, then what is the relative humidity (RH)?

a.	45%
b.	58%
c.	70%
d.	38%

ANS: D

If the absolute humidity is 7.4 mg/L, then the RH is calculated as follows:

%RH = 7.4 mg/L ¸ 19.4 mg/L ´ 100

%RH = 0.38´100

%RH = 38%

DIF: Analysis REF: p. 113 OBJ: 6

1. When the water vapor content of a volume of gas equals its capacity, what is the relative humidity (RH) of this gas?

a.	80%
b.	100%
c.	40%
d.	60%

ANS: B

When the water vapor content of a volume of gas equals its capacity, the RH is 100%. When the RH is 100%, a gas is fully saturated with water vapor.

DIF: Application REF: p. 112 OBJ: 6

1. A gas at 50° C with a relative humidity of 100% is cooled to 37° C. Which of the following will occur?
2. condensation on surfaces
3. visible droplet formation
4. warming of the adjacent air

a.	1, 2, and 3
b.	1 and 2
c.	1 and 3
d.	2 and 3

ANS: A

Condensed moisture deposits on any available surface, such as on the walls of a container or delivery tubing, or even on particles suspended in the gas. Condensation returns heat to and warms the surrounding environment, whereas vaporization of water cools the adjacent air.

DIF: Analysis REF: p. 113 OBJ: 6

1. What is the term for the temperature at which the water vapor in a gas begins to condense back into a liquid?

a.	triple point
b.	critical pressure
c.	dew point
d.	boiling point

ANS: C

The temperature at which condensation begins is called the dew point.

DIF: Recall REF: p. 113 OBJ: 6

1. What occurs when the temperature of a saturated gas drops down to its dew point?

a.	Excess water vapor will condense as visible droplets.
b.	The temperature of the surrounding air decreases.
c.	Any liquid water present will quickly evaporate.
d.	The relative humidity of the gas begins to decrease.

ANS: A

Cooling a saturated gas below its dew point causes increasingly more water vapor to condense into liquid water droplets.

DIF: Application REF: p. 113 OBJ: 6

1. The American National Standards Institute has set a water vapor content level of 30 mg/L as the minimum absolute humidity required for patients whose upper airways have been bypassed. This equals what body humidity (BH)?

a.	68%
b.	47%
c.	75%
d.	100%

ANS: A

The %BH of a gas is the ratio of its actual water vapor content to the water vapor capacity in saturated gas at body temperature (37° C). Thus, %BH is the same as relative humidity, except that the capacity (or denominator) is fixed at 43.8 mg/L.

DIF: Analysis REF: p. 112-113 OBJ: 6

1. If the absolute humidity in a medical gas being delivered to a patient is 14 mg/L, then what is the body humidity (BH)?

a.	7%
b.	16%
c.	24%
d.	32%

ANS: D

The %BH of a gas is the ratio of its actual water vapor content to the water vapor capacity in saturated gas at body temperature (37° C). Thus %BH is the same as RH, except that the capacity (or denominator) is fixed at 43.8 mg/L.

DIF: Analysis REF: p. 112-113 OBJ: 6

1. What is the term for the ratio of the amount of water vapor in a volume of gas compared to the amount of the water in gas saturated at a normal body temperature of 37°C?

a.	percent body humidity (BH)
b.	relative humidity (RH)
c.	absolute humidity
d.	water vapor pressure

ANS: A

The %BH of a gas is the ratio of its actual water vapor content to the water vapor capacity in saturated gas at body temperature (37°C). Thus, %BH is the same as RH, except that the capacity (or denominator) is fixed at 43.8 mg/L.

DIF: Application REF: p. 113 OBJ: 6

1. Which of the following properties of gases distinguish them from liquids—that is, are unique to the gaseous phase of matter?
2. Gases fill the available space.
3. Gases exhibit viscosity.
4. Gases exert pressure.
5. Gases are readily compressed.
6. Gases are capable of flow.

a.	2, 3, 4, and 5
b.	1, 3, and 4
c.	2, 3, and 4
d.	1 and 4

ANS: D

Unlike liquids, gases are readily compressed and expanded and fill the spaces available to them by diffusion.

DIF: Application REF: p. 114 OBJ: 1

1. Which of the following occurs when the temperature of a gas rises?
2. The kinetic activity of the gas increases.
3. The rate of molecular collisions increases.
4. The pressure exerted by the gas rises.

a.	1, 2, and 3
b.	1 and 2
c.	2 and 3
d.	3

ANS: A

The velocity of gas molecules is directly proportional to temperature. As a gas is warmed, its kinetic activity increases, its molecular collisions increase, and its pressure rises.

DIF: Recall REF: p. 114 OBJ: 7

1. According to Avogadro’s law, which of the following is/are TRUE?
2. One gram of any substance contains the same number of particles.
3. Equal volumes of gases at standard temperature, standard pressure, dry (STPD) have the same number of molecules.
4. Equal numbers of gas molecules at STPD occupy the same volume.

a.	1 and 2
b.	1, 2, and 3
c.	2 and 3
d.	1

ANS: D

Avogadro’s law states that the 1-g atomic weight of any substance contains exactly the same number of atoms, molecules, or ions.

DIF: Recall REF: p. 114 OBJ: 7

1. In International System (SI) units, what is any quantity of matter that contains 6.023 ´ 10²³ atoms, molecules, or ions?

a.	pound (lb)
b.	gram (g)
c.	ounce (oz)
d.	mole (mol)

ANS: D

One mole of a gas, at a constant temperature and pressure, should occupy the same volume as 1 mole of any other gas. This ideal volume is termed the molar volume.

DIF: Recall REF: p. 114 OBJ: 7

1. According to Avogadro’s law, under standard conditions of temperature and pressure (0°C and 760 mm Hg), 1 mole of any gas occupies which of the following?

a.	1.34 L
b.	22.40 L
c.	7.48 L
d.	28.30 L

ANS: B

At standard temperature and pressure, dry (STPD), the ideal molar volume of any gas is 22.4 L.

DIF: Analysis REF: p. 114 OBJ: 7

1. What is the density of a mixture of 40% oxygen and 60% helium at STPD?

a.	0.34 g/L
b.	0.55 g/L
c.	0.68 g/L
d.	1.25 g/L

ANS: C

For the density of a gas mixture to be calculated, the percentage or fraction of each gas in the mixture must be known. For example, to calculate the density of air at STPD, the following equation is used:

dwair = (FN₂ ´ gmw N₂) + (FO₂ ´ gmw O₂) ¸ 22.4 L

dwair = (0.79 ´ 28) + (0.21 ´ 32) ¸ 22.4 L

dwair = 1.29 g/L

DIF: Analysis REF: p. 115 OBJ: 7

1. What is the physical process whereby atoms or molecules tend to move from an area of higher concentration or pressure to an area of lower concentration or pressure?

a.	Sublimation
b.	Melting
c.	Diffusion
d.	capillary action

ANS: C

Diffusion is the process whereby molecules move from areas of high concentration to areas of lower concentration.

DIF: Application REF: p. 115 OBJ: 7

1. According to Graham’s law, which of the following gases would diffuse most quickly?

Gas density

a.	W 1.432 g/L
b.	X 0.543 g/L
c.	Y 0.834 g/L
d.	Z 1.213 g/L

ANS: B

Mathematically, the rate of diffusion of a gas is inversely proportional to the square root of its gram molecular weight. According to this principle, lighter gases diffuse rapidly, whereas heavy gases diffuse more slowly. Moreover, because diffusion is based on kinetic activity, anything that increases molecular activity will quicken diffusion; thus, heating and mechanical agitation speed diffusion.

DIF: Analysis REF: p. 115 OBJ: 7

1. Which of the following best describes the physical concept of pressure?

a.	weight ¸ unit volume
b.	mass ´ acceleration
c.	force ´ distance
d.	force ¸ unit area

ANS: D

Pressure is a measure of force per unit area.

DIF: Application REF: p. 115 OBJ: 7

1. What is the common British unit of pressure?

a.	Newton (N)/m2
b.	dyne/cm2
c.	Pascal (Pa)
d.	lb/in2 (psi)

ANS: D

Pounds per square inch (lb/in²), or “psi,” is the British fps pressure unit.

DIF: Recall REF: p. 115 OBJ: 7

1. A mercury barometer reads 770 mm Hg. What is the actual atmospheric pressure in g/cm²?

a.	14.7 g/cm2
b.	1034.0 g/cm2
c.	1020.0 g/cm2
d.	1047.0 g/cm2

ANS: D

At sea level, the average atmospheric pressure will support a column of mercury 76 cm (760 mm) or 29.9 inches in height. If we also know that mercury has a density of 13.6 g/cm³ (0.491 lb/in³), then the average atmospheric pressure (P_B) is calculated as follows:

cgs units: P_B = 77 cm ´ 13.6 g/cm³ = 1047 g/cm^{2 .}

DIF: Analysis REF: p. 116 OBJ: 7

1. One atmosphere (1 atm) of pressure is equivalent to which of the following?
2. 29.9 inches Hg
3. 14.7 lb/in²
4. 1034.0 g/cm²
5. 760.0 mm Hg

a.	1, 2, and 3
b.	2 and 4
c.	1 and 3
d.	1, 2, 3, and 4

ANS: D

At sea level, the average atmospheric pressure will support a column of mercury 76 cm (760 mm) or 29.9 inches in height. If we also know that mercury has a density of

13.6 g/cm³ (0.491 lb/in³), then the average atmospheric pressure (P_B) is calculated as follows:

cgs units: P_B = 76 cm ´ 13.6 g/cm³ = 1034 g/cm²

fps units: P_B = 29.9 in ´ 0.491 lb/in³ = 14.7 lb/in²

DIF: Analysis REF: p. 116 OBJ: 7

1. You obtain a mercury barometric reading of 760 mm Hg at 17°C. Using the following factor table, compute the corrected pressure.

° C	740	750	760
17	2.17	2.20	2.23
18	2.29	2.32	2.35
19	2.38	2.41	2.44

a.	223.0 mm Hg
b.	747.7 mm Hg
c.	757.8 mm Hg
d.	762.3 mm Hg

ANS: C

The U.S. Weather Bureau provides temperature correction factors for barometric readings (see Appendix 1).

DIF: Analysis REF: p. 116 OBJ: 7

1. The peak pressure on a ventilator reads 40 cm H₂O. What is the equivalent pressure in mm Hg?

a.	37.0 mm Hg
b.	29.6 mm Hg
c.	68.3 mm Hg
d.	4.9 mm Hg

ANS: B

Because of mercury’s high density (13.6 g/cm³), it assumes a height that is easy to read for most pressures in the clinical range. Water columns can also be used to measure pressure (in cm H₂O), but only low pressures. Because water is 13.6 times less dense than mercury, 1 atm.

DIF: Analysis REF: p. 116 OBJ: 7

1. The peak pressure on a ventilator reads 30 cm H₂O. What is the equivalent pressure in kilopascals (kPa)?

a.	37.0 kPa
b.	68.0 kPa
c.	4.9 kPa
d.	2.9 kPa

ANS: D

One kPa equals approximately 10.2 cm H₂O or 7.5 mm Hg.

DIF: Analysis REF: p. 117 OBJ: 7

1. From a bedside capnograph (CO₂ measuring device), you obtain a “dry” gas reading of 5.3% CO₂ in a patient’s exhaled gas. Given a barometric pressure of 765 mm Hg, what is the partial pressure of CO₂ in this patient’s exhaled gas?

a.	347 mm Hg
b.	41 mm Hg
c.	164 mm Hg
d.	35 mm Hg

ANS: B

Dalton’s law describes the relationship among the partial pressure and the total pressure in a gas mixture. According to this law, the total pressure of a mixture of gases must equal the sum of the partial pressures of all component gases. Moreover, the principle states that the partial pressure of a component gas must be proportional to its percentage in the mixture.

DIF: Analysis REF: p. 117 OBJ: 7

1. In the lung’s alveoli, there are four gases mixed together: oxygen, carbon dioxide, nitrogen, and water vapor. At a normal barometric pressure of 760 mm Hg, alveolar O₂ exerts a partial pressure of 100 mm Hg, CO₂ 40 mm Hg, and water vapor 47 mm Hg. What is the alveolar partial pressure of nitrogen?

a.	187 mm Hg
b.	713 mm Hg
c.	660 mm Hg
d.	573 mm Hg

ANS: D

Dalton’s law describes the relationship among the partial pressure and the total pressure in a gas mixture. According to this law, the total pressure of a mixture of gases must equal the sum of the partial pressures of all component gases. Moreover, the principle states that the partial pressure of a component gas must be proportional to its percentage in the mixture.

DIF: Analysis REF: p. 117 OBJ: 7

1. Which of the following factors determine how much of a given gas can dissolve in a liquid?
2. solubility coefficient of the gas
3. temperature of the liquid
4. gas pressure above the liquid

a.	2 and 3
b.	1 and 2
c.	1 and 3
d.	1, 2, and 3

ANS: D

Henry’s law predicts how much of a given gas will dissolve in a liquid. According to this principle, at a given temperature, the volume of a gas that dissolves in a liquid is equal to its solubility coefficient times its partial pressure.

DIF: Application REF: p. 118 OBJ: 7

1. At 37° C and 760 mm Hg pressure, 0.023 ml of O₂ can be dissolved in 1 ml of plasma, whereas at the same temperature and pressure, 0.510 ml of CO₂ will dissolve in 1 ml of plasma. What explains this difference?

a.	CO2 diffuses more rapidly than O2.
b.	CO2 is more soluble in plasma than O2.
c.	CO2 has a greater molecular weight than O2.
d.	O2 has less affinity for plasma than CO2.

ANS: B

For example, the solubility coefficient of oxygen in plasma, at 37° C and 760 torr pressure, is 0.023 ml/ml. Under the same conditions, 0.510 ml of CO₂ can dissolve in 1 ml of plasma.

DIF: Application REF: p. 118 OBJ: 7

1. Which of the following will occur when a gas undergoes expansion?
2. The pressure of the gas increases.
3. Molecular collisions decrease.
4. The gas temperature increases.

a.	1 and 2
b.	2 and 3
c.	2
d.	1 and 3

ANS: C

If a gas-filled container could be enlarged, the gas would expand to occupy the new volume. Figure 6-19 illustrates the concepts of gas compression and expansion.

DIF: Application REF: p. 118 OBJ: 7

1. If a given mass of a gas is maintained at a constant temperature, what will decreasing its pressure do?

a.	decrease its volume
b.	increase its mass
c.	increase its volume
d.	decrease its mass

ANS: C

If a gas-filled container could be enlarged, the gas would expand to occupy the new volume. Figure 6-19 illustrates the concepts of gas compression and expansion.

DIF: Application REF: p. 119 OBJ: 7

1. In what processes of gas compression or expansion does the temperature remain constant?

a.	isothermal
b.	adiabatic
c.	hypothermal
d.	neutral kinetic

ANS: A

During isothermal conditions, the temperature of an ideal gas should not change with either expansion or contraction.

DIF: Recall REF: p. 121 OBJ: 7

1. Both a compressed gas cylinder and its regulator are at room temperature with all valves in the off position. After the cylinder is opened and gas begins flowing, you note that the regulator is extremely cold to touch. Which of the following principles best explains this observation?

a.	adiabatic compression
b.	Gay-Lussac’s law
c.	Joule-Thompson effect
d.	Venturi principle

ANS: C

The rapid expansion of real gases causes substantial cooling. This phenomenon of expansion cooling is called the Joule-Thompson Effect Adiabatic compression can also occur in gas delivery systems where rapid compression occurs within a fixed container. The rise in temperature caused by this rapid compression can ignite any combustible material in the system. It is for this reason that RTs must take care to clear any combustible matter from high-pressure gas delivery systems before pressurization.

DIF: Application REF: p. 121 OBJ: 7

1. Respiratory therapists must ensure that any oil or dust is cleared from high-pressure medical-gas delivery systems before pressurization. Why is this action needed?

a.	Inhaled dust particles can cause pneumoconiosis.
b.	The oil or dust can cause a leak in the system.
c.	Oil or dust does not easily mix with medical gases.
d.	Adiabatic compression could ignite the oil or dust.

ANS: D DIF: Application REF: p. 121 OBJ: 7

1. Which of the following occurs when water vapor is added to a dry gas at a constant pressure?
2. The volume occupied by the gas mixture increases.
3. The relative humidity of the mixture increases.
4. The partial pressure of the original gas is reduced.

a.	1 and 2
b.	1, 2, and 3
c.	1 and 3
d.	3

ANS: B

The dry volume of a gas at a constant pressure and temperature is always smaller than its saturated volume. The opposite is also true. Correcting from the dry state to the saturated state always yields a larger gas volume. The pressure exerted by water vapor is independent of the other gases with which it mixes, depending only on the temperature and RH. Therefore, the addition of water vapor to a gas mixture always lowers the partial pressures of the other gases present.

DIF: Application REF: p. 120 OBJ: 7

1. During some pulmonary function tests, saturated gas exhaled from a patient’s lungs is gathered at room temperature. Which of the following correction-factor tables would you use to determine what volume this gas occupied in the patient’s lungs?

a.	standard temperature, standard pressure, dry (STPD) to body temperature, ambient pressure, saturated (BTPS)
b.	BTPS to STPD
c.	ambient temperature, ambient pressure, saturated (ATPS) to BTPS
d.	ATPS to STPD

ANS: C

Correction from ATPS to standard temperature and pressure (0° C and 760 torr), dry (STPD).

DIF: Application REF: p. 120 OBJ: 7

1. Which of the following are true of the behavior of gases at very low temperatures or very high pressures?
2. The actual volume of the gas molecules becomes important.
3. Intermolecular attractive forces have greater impact.
4. Gases begin to deviate from their “ideal” behavior.

a.	1, 2, and 3
b.	1 and 2
c.	1 and 3
d.	2 and 3

ANS: A

At very low temperatures, kinetic activity lessens and these forces become more important. Likewise, very low pressures permit gas molecules to move freely about with little mutual attraction.

DIF: Application REF: p. 120 OBJ: 7

1. For every liquid there is a temperature above which the kinetic activity of its molecules is so great that the attractive forces cannot keep them in a liquid state. This temperature is called the:

a.	critical temperature
b.	melting point
c.	flash temperature
d.	triple point

ANS: A

When a liquid is heated to its critical temperature, it converts to a gas. This temperature is called the critical temperature.

DIF: Application REF: p. 121 OBJ: 4

1. Which of the following is a FALSE statement about oxygen?

a.	No pressure can keep it in a liquid state above –118.8°C.
b.	Below its boiling point, it remains liquid at ambient pressure.
c.	Its critical temperature is above normal room temperature.
d.	It cannot be turned into a liquid at room temperature.

ANS: C

Liquid oxygen is produced by separating it from a liquefied air mixture at a temperature below its boiling point or critical temperature (–183°C or –297°F). After it is separated from air, the oxygen must be maintained as a liquid by being stored in insulated containers below its boiling point. As long as the temperature does not exceed –183°C, the oxygen will remain liquid at atmospheric pressure. If higher temperatures are needed, higher pressures must be used. If at any time the liquid oxygen exceeds its critical temperature of –118.8°C, it will convert immediately to a gas.

DIF: Application REF: p. 121 OBJ: 7

1. Which of the following medical gases can be maintained in the liquid form at room temperature?
2. nitrous oxide
3. carbon dioxide
4. Oxygen
5. Helium

a.	1 and 2
b.	2, 3, and 4
c.	2 and 3
d.	2 and 4

ANS: A

Both CO₂ and N₂O have critical temperatures above normal room temperature (Table 6-5).

DIF: Recall REF: p. 121 OBJ: 7

1. What temperature is necessary to liquefy oxygen at 1 atm pressure?

a.	–118.8° C
b.	–181.1° F
c.	–463.3° F
d.	–183.0° C

ANS: D

Liquid oxygen is produced by separating it from a liquefied air mixture at a temperature below its boiling point (–183°C or –297°F). After it is separated from air, the oxygen must be maintained as a liquid by being stored in insulated containers below its boiling point. As long as the temperature does not exceed –183°C, the oxygen will remain liquid at atmospheric pressure. If higher temperatures are needed, higher pressures must be used. If at any time the liquid oxygen exceeds its critical temperature of –118.8°C, it will convert immediately to a gas.

DIF: Recall REF: p. 121 OBJ: 7

1. With all else equal, under which of the following conditions would the drop in pressure occurring while a fluid flows through a tube be greatest?

	Tube	Diameter	Fluid Viscosity
A.	A	Small	Low
B.	B	Large	Low
C.	C	Large	High
D.	D	Small	High

a.	A; Small; Low
b.	B; Large; Low
c.	C; Large; High
d.	D; Small; High

ANS: D

Available energy decreases because frictional forces oppose fluid flow. Frictional resistance to flow exists both within the fluid itself (viscosity) and between the fluid and the tube wall. In general, the greater the viscosity of the fluid and the smaller the cross-sectional area of the tube, the greater the drop in pressure along the tube.

DIF: Analysis REF: p. 122 OBJ: 8

1. The resistance to flow of a fluid through a tube can be computed according to which of the following formulas?

a.	resistance = flow ´ viscosity
b.	resistance = flow ¸ pressure
c.	resistance = pressure ¸ flow
d.	resistance = flow ´ pressure

ANS: C

For any given tube length, flow resistance equals the difference in pressure between the two points along the tube divided by the actual flow. This is expressed as a formula:

R = (P₁ – P₂) ¸ V

DIF: Application REF: p. 122 OBJ: 8

1. What is the pattern of flow in which a fluid moves in discrete cylindrical streamlines?

a.	Transitional
b.	Turbulent
c.	Laminar
d.	Tracheal

ANS: C

During laminar flow, a fluid moves in discrete cylindrical layers or streamlines.

OB J: 8

DIFF: Application

DIF: Application REF: p. 122 OBJ: 8

1. According to Poiseuille’s law, the pressure needed to drive a fluid through a tube will increase under which of the following conditions?
2. increased fluid viscosity
3. decreased tube length
4. decreased rate of flow
5. decreased tube radius

a.	1 and 2
b.	2, 3, and 4
c.	1 and 4
d.	1, 3, and 4

ANS: C

The difference in pressure required to produce a given flow, under conditions of laminar flow through a smooth tube of fixed size, is defined by Poiseuille’s law:

P = 8nl/r⁴ ,where P is the driving pressure gradient, n is the viscosity of the fluid, l is the tube length, is the fluid flow, r is the tube radius, and and 8 are constants.

OBJ : 8

DIFF: Application

DIF: Application REF: p. 122 OBJ: 8

1. Under conditions of turbulent flow, what is the driving pressure?

a.	proportional to the square of the flow
b.	inversely proportional to the flow
c.	linearly proportional to the flow
d.	inversely proportional to the density

ANS: A

This changeover from laminar to turbulent flow depends on several factors, including fluid density (d), viscosity (h), linear velocity (v), and tube radius (r). In combination, these factors determine Reynold’s number (NR):

NR = v ´ d ´ 2r/h

DIF: Application REF: p. 123 OBJ: 8

1. Which of the following conditions tend to cause laminar flow to become turbulent (producing a high Reynold’s number)?
2. high linear gas velocity
3. high gas density
4. low gas viscosity
5. large tube diameter

a.	2, 3, and 4
b.	2 and 3
c.	1, 2, and 4
d.	1, 2, 3, and 4

ANS: D

In a smooth-bore tube, laminar flow becomes turbulent when NR exceeds 2000 (the number is dimensionless). According to the previous formula, conditions favoring turbulent flow include increased fluid velocity, increased fluid density, increased tube radius, or decreased fluid viscosity. In the presence of irregular tube walls, turbulent flow can occur when NR is less than 2000.

DIF: Recall REF: p. 123 OBJ: 7

1. Assuming a constant flow, what will happen to a fluid if the cross-sectional area of the tube in which it flows decreases?

a.	Its velocity will increase.
b.	Its velocity will decrease.
c.	Its density will decrease.
d.	Its viscosity will decrease.

ANS: B

Throughout the tube, the fluid flows at a constant rate of 5 L/min. At point A, with a cross-sectional area of 5.08 cm², the velocity of the fluid is 16.4 cm/sec. At point B, the cross-sectional area of the tube decreases to 2.54 cm², half its prior value. At this point, the velocity of the fluid doubles to 32.8 cm/sec.

DIF: Application REF: p. 124 OBJ: 8

1. According to Bernoulli’s principle, as a fluid flows through a narrow passage or stricture, which of the following will occur?
2. Fluid velocity will decrease.
3. Lateral pressure will fall.
4. Total energy will increase.

a.	2 and 3
b.	1 and 2
c.	1 and 3
d.	2

ANS: D

When a fluid flows through a tube of uniform diameter, pressure decreases progressively over the tube length. When the fluid passes through a constriction, the pressure drop is much greater. This large pressure drop can be observed in the fourth water column in Figure 6-24. The eighteenth-century scientist Daniel Bernoulli was the first to carefully study this effect, which now bears his name. According to the law of continuity, as the fluid moves into the narrow or constricted portion of the tube, its velocity must increase (v_b > v_a). According to the Bernoulli theorem, the higher velocity at point b should result in a lower lateral pressure at that point (P_b <P_a). Thus, as a fluid flows through the constriction, its velocity increases and its lateral pressure decreases.

DIF: Analysis REF: p. 124 OBJ: 8

1. What is the most common application of Bernoulli’s principle in respiratory care equipment?

a.	fluidic ventilator
b.	Pneumotachygraph
c.	air injector
d.	U-tube manometer

ANS: C

In respiratory care, the most common application of fluid entrainment is the air injector.

DIF: Recall REF: p. 125 OBJ: 8

1. Which of the following design components of an air injector would result in entraining the greatest amount of air?
2. small orifice jet
3. large entrainment ports
4. low-velocity gas flow

a.	1, 2, and 3
b.	1 and 2
c.	1 and 3
d.	3

ANS: B

The amount of air entrained depends on both the diameter of the jet orifice and the size of the air-entrainment ports (Figure 6-27). For a fixed jet size, the larger the entrainment ports, the greater is the volume of air entrained and the higher is the total flow (Figure 6-27, B). The entrained volume can still be altered, with fixed entrainment ports, by changing the jet diameter (Figure 6-27, C). A large jet results in a lower gas velocity and less entrainment, whereas a small jet boosts velocity, entrained volume, and total flow.

DIF: Application REF: p. 125 OBJ: 7

1. For which of the following purposes might a Venturi tube be used?
2. to restore fluid pressure distal to a restricted orifice
3. to help keep entrainment ratios constant with varying flows
4. to make possible entrainment of large volumes of gas

a.	1, 2, and 3
b.	2 and 3
c.	1 and 2
d.	1 and 3

ANS: A

The Venturi tube, as compared with a simple air injector, provides greater entrainment. Moreover, this design helps keep the percentage of entrained fluid constant, even when the total flow varies. A Venturi tube widens just after its jet or nozzle. As long as the angle of dilation is less than 15 degrees, this widening helps restore fluid pressure back toward prejet levels. However, the Venturi tube has one major drawback—any buildup of pressure downstream from the entrainment port decreases fluid entrainment.

DIF: Application REF: p. 125-126 OBJ: 8

1. What physical principle underlies most fluidic circuitry?

a.	Poiseuille’s law
b.	Bernoulli’s principle
c.	law of continuity
d.	Coanda effect

ANS: D

The primary principle underlying most fluidic circuitry is a phenomenon called wall attachment, or the Coanda effect. This effect is observed mainly when a fluid flows through a small orifice with properly contoured downstream surfaces.

DIF: Recall REF: p. 126 OBJ: 8

1. What is/are the forms of vaporization?
2. boiling
3. freezing
4. evaporation
5. sublimation

a.	1 only
b.	1 and 2 only
c.	1 and 3 only
d.	1, 2, and 4 only

ANS: C

Both boiling and evaporation are forms of vaporization.

DIF: Application REF: p. 111 OBJ: 5

1. What is the motion referred to when solid molecules travel until they collide?

a.	Jiggle
b.	jingle
c.	surface tension
d.	boiling point

ANS: A

Solids have a fixed volume and shape. The molecules comprising the solid have the shortest distance to travel until they collide with one another. This motion has been referred to as a “jiggle.”

DIF: Application REF: p. 103 OBJ: 1

1. Solids maintain their shape because their atoms are kept in place by strong mutual attractive forces, called:

a.	van der Waals forces
b.	thermodynamic equilibrium
c.	Buoyancy
d.	Fluidics

ANS: A

Solids maintain their shape because their atoms are kept in place by strong mutual attractive forces, called van der Waals forces.

DIF: Recall REF: p. 103 OBJ: 1

1. A combination of neutral atoms, free electrons, and atomic nuclei describes:

a.	potential energy
b.	kinetic energy
c.	plasma
d.	compressed gases

ANS: C

Plasma has been referred to as the fourth state of matter and is a combination of neutral atoms, free electrons, and atomic nuclei. Plasmas can react to electromagnetic forces and flow freely like a liquid or a gas.

DIF: Recall REF: p. 103 OBJ: 1

1. The ratio of the density of one fluid when compared with the density of another reference substance, which is typically water, describes the fluid’s:

a.	specific gravity
b.	specific weight
c.	atomic mass
d.	atomic volume

ANS: A

The term specific gravity refers to the ratio of the density of one fluid when compared with the density of another reference substance which is typically water.

DIF: Application REF: p. 108 OBJ: 8

1. The sublimation phase transition includes:
2. going directly from solid to vapor form
3. never becoming a liquid
4. skipping the melting phase
5. skipping the gaseous phase

a.	1 and 2 only
b.	1 and 4 only
c.	1, 2, and 3 only
d.	1, 2, 3 and 4

ANS: C

Dry ice will sublimate from its solid form into gaseous carbon dioxide without first melting and becoming liquid CO₂. This occurs because the vapor pressure is low enough for the intermediate liquid not to appear.

DIF: Application REF: p. 107 OBJ: 1

Chapter 07: Computer Applications in Respiratory Care

Test Bank

MULTIPLE CHOICE

1. For which of the following is there the most interest in using eHealth applications to improve health outcomes in a cost effective manner?

a.	lung cancer
b.	pediatric heart disease
c.	chronic diseases
d.	heart attack victims

ANS: C

Thus, there is much interest addressing the historically disjointed, misallocated processes of chronic disease management through advances in eHealth technologies, to improve health outcomes in a cost-effective manner.

DIF: Recall REF: p. 131 OBJ: 1

1. Which of the following describes emerging computer applications to help treat tobacco use and dependence (the leading preventable cause of death and chronic diseases in the United States)?

a.	eHarmony
b.	eHealth
c.	AOL
d.	Clinivision

ANS: B

Emerging applications of computer technology, or eHealth applications, are exciting new treatment components for tobacco use and dependence. With the extensive reach of the Internet and the demonstrated efficacy of some applications, the potential impact on health outcomes is immense. More than 10 million Internet users have searched for online information about how to quit smoking.

DIF: Recall REF: p. 130-131 OBJ: 1

1. Which of the following is included in the purposes of Telemedicine?

a.	e-mailing
b.	promote access to patient data and information
c.	allow access to patient’s family members remotely
d.	acquire patient assessment information in order to skip a patient homecare visit

ANS: B

Telemedicine is the use of telecommunication and computer technology to promote access to diagnosis, monitoring, clinical decision support, and treatment for patients at medically underserved sites that are distant from health care providers.

DIF: Application REF: p. 130 OBJ: 1

1. Hospital-based applications for clinical decision support include:
2. cardiac ischemia
3. decreasing fluid given in resuscitation efforts
4. appropriate tidal volume and plateau pressure monitoring in acute respiratory distress syndrome
5. decreasing exacerbations in asthma patients

a.	1 and 2
b.	1, 2 and 3
c.	1, 3, and 4
d.	1, 2, 3, and 4

ANS: C

Clinical decision support have also resulted in decreased unnecessary hospital admissions for inappropriately diagnosed cardiac ischemia, appropriately decreased tidal volume and more consistent monitoring of plateau pressure in patients with acute respiratory distress syndrome, and decreased exacerbations in asthma patients.

DIF: Application REF: p. 130 OBJ: 1

1. Computerized reminders increase:
2. the proportion of indicated influenza vaccinations
3. adherence to medications
4. necessary hospital admissions for appropriately diagnosed cardiac ischemia

a.	2 only
b.	3 only
c.	2 and 3 only
d.	1, 2 and 3

ANS: D

Computerized reminders increased the proportion of indicated influenza vaccinations, and rates of screening, counseling, and adherence to medications. They have also resulted in decreased unnecessary hospital admissions for inappropriately diagnosed cardiac ischemia.

OBJ : 1

DIFF: Application

DIF: Application REF: p. 130 OBJ: 1

1. Clinical decision support is particularly useful in:

a.	preventive care
b.	influenza care
c.	respiratory therapy
d.	post-trauma care

ANS: A

Clinical decision support is associated with improvements in clinicians’ performance, decreased unnecessary care, and adherence to evidence-based clinical practice guidelines. They are particularly useful in preventive care.

DIF: Application REF: p. 130 OBJ: 1

1. Respiratory Care Practitioners use evidence-based patient driven protocols to:

a.	Extend the length of stay.
b.	Allocate and titrate respiratory care services.
c.	Resist automation of treatment based on patient data.
d.	Avoid confrontation with nurses regarding patient care.

ANS: B

Practitioners use evidence-based patient-driven protocols to extend the length of stay, allocate and titrate respiratory care services, resist automation of treatment based on patient data, avoid confrontation with nurses regarding patient care.

DIF: Application REF: p. 130 OBJ: 2

1. What system is capable of point-of-care patient charting using a hand-held computer?

a.	CliniVision MPC
b.	Microsoft Flow
c.	IBM Ready Now
d.	Word Perfect

ANS: A

RCMIS, such as CliniVision MPC and MediLinks, provide point-of-care mobile, charting capabilities via hand-held computers, with wireless transmission of data to hospital information systems.

DIF: Application REF: p. 135 OBJ: 1

1. Which of the following is NOT an advantage of a wireless hand-held computer for charting patient care?

a.	Documentation is more legible.
b.	Documentation is available to others more quickly.
c.	It is less expensive.
d.	There is improved fulfillment of physicians’ orders.

ANS: C

Wireless hand-held computers offer several advantages in comparison to nonwireless systems and paper charts. Hand-held computers facilitate the organization and assignment of workload and the fulfillment of physicians’ orders, and improve documentation. Documentation of patient assessment then becomes immediately available to other members of the health care team in the hospital information system. Moreover, by comparison, computerized documentation is more legible.

DIF: Application REF: p. 130-131 OBJ: 1

1. In what automated respiratory care protocol has it been shown that use of a hand-held computer helped shorten the patient’s stay in the intensive care unit?

a.	ventilator initiation
b.	ventilator weaning
c.	high-flow oxygen therapy
d.	airway care and intubation

ANS: B

An automated protocol for discontinuation of mechanical ventilation with use of a hand-held computer has been associated with a shortened time to the first spontaneous breathing trial and a decreased length of stay in the intensive care unit.

DIF: Application REF: p. 130 OBJ: 1

1. Computers are often used to interpret which of the following tests in respiratory care patients?

a.	chest radiograph
b.	CBC and electrolytes
c.	pulmonary function testing
d.	EEG testing

ANS: C

Computer algorithms use standard reference predicted values to aid in the interpretation of pulmonary function tests (PFTs), including spirometry, lung volume, diffusing capacity, and bronchodilator response.

DIF: Application REF: p. 132 OBJ: 1

1. In what area are computers used to apply quality assurance measures in respiratory care departments?

a.	arterial blood gas analyzers
b.	oxygen delivery systems
c.	interpreting ECGs
d.	equipment cleaning and sterilization

ANS: A

Computer-assisted quality assurance in a blood gas laboratory is a critically important function in a respiratory care department, because the accuracy and precision of blood gas data influence clinical decisions and patient safety.

DIF: Application REF: p. 132 OBJ: 1

1. What respiratory care equipment uses microprocessors for monitoring and control of complex data?

a.	oxygen flowmeters
b.	pulse oximeters
c.	mechanical ventilators
d.	water sealed spirometers

ANS: C

Mechanical ventilators predominantly use microprocessors for monitoring and control of complex data.

DIF: Application REF: p. 129 OBJ: 1

1. Which of the following is considered an emerging application of information technology that may improve national health care issues in the future?

a.	HIPAA
b.	a nationally available electronic health record
c.	medical ID bracelets
d.	the national database for organ donors

ANS: B

In the aftermath of Hurricane Katrina and in the face of a flu pandemic threat, many have begun to focus attention on the development of a seamless network of transferable, widely accessible, electronic health records.

DIF: Application REF: p. 135 OBJ: 1

1. In what way do computers assist smokers who want to quit?

a.	by providing internet sites with smoking cessation plans
b.	by measuring blood carbon monoxide levels
c.	by providing genetic information on the risk of smoking
d.	by allowing smokers to order low risk cigarettes through the internet

ANS: A

Multifaceted, Internet-based, tobacco cessation programs that assess the needs of and tailor treatment to the characteristics of individual patients have demonstrated good outcomes.

DIF: Application REF: p. 130-131 OBJ: 1

1. What program offers access to medically underserved communities through the use of telephones and computer-based education?

a.	Telecare
b.	teletreatment
c.	telemedicine
d.	Teleheart

ANS: C

Telemedicine is the use of telecommunication and computer technology to promote access to diagnosis, monitoring, clinical decision support, and treatment for patients at medically underserved sites that are distant from healthcare providers.

DIF: Recall REF: p. 130 OBJ: 1

1. Which of the following patients would benefit the most from a disease management program?

a.	patient with pneumonia
b.	patient with a sinus infection
c.	patient with hay fever
d.	patient with COPD

ANS: D

Management of chronic diseases, such as asthma and COPD, presents a grave challenge to our U.S. healthcare system.

DIF: Application REF: p. 131-132 OBJ: 1

1. Clinical decision support systems perform all the following tasks except:

a.	match individual patients with proper drug doses
b.	provide standing patient care orders
c.	remind patients of when to reorder meds
d.	provide directions to the best local pharmacy

ANS: D

Clinical decision support systems match the characteristics of individual patients and their clinical interventions, drugs, and diagnostic tests to databases of scientific evidence and drug calculations and then generate tailored recommendations, reminders, or even standing orders

DIF: Application REF: p. 130 OBJ: 1

1. What Web site is known for well-respected rigorously conducted systematic evidence-based reviews and provides free access to abstracts and summaries pertaining to relevant clinical questions?

a.	cochrane.org
b.	medsearch.org
c.	hotmail.com
d.	systemview.org

ANS: A

For example, the Cochrane Collaboration (www.cochrane.org), well respected for rigorously conducted systematic evidence-based reviews, provides free access to abstracts and summaries pertaining to relevant clinical questions, including those related to “Airways.”

DIF: Recall REF: p. 133 OBJ: 2

1. What search engine looks for scholarly publications in a wide range of fields and includes peer-reviewed manuscripts, abstracts, theses, and books from academic publishers, professional societies, and university libraries?

a.	medline.org
b.	Google Scholar
c.	minimed.org
d.	cochrane.org

ANS: B

Google Scholar (scholar.google.com) is a search engine for scholarly publications in a wide range of fields. It includes peer-reviewed manuscripts, abstracts, theses, and books from academic publishers, professional societies, and university libraries

DIF: Recall REF: p. 133 OBJ: 2

1. What is the name of the search engine sponsored by the National Library of Medicine for information on health care?

a.	PubMed
b.	HotMed
c.	Up-to-date-Med
d.	NationalMedline

ANS: A

PubMed (www.pubmed.com) is the National Library of Medicine’s free search engine for health information.

DIF: Recall REF: p. 133 OBJ: 2

1. What is the name of the database often purchased and used by hospitals and university libraries to provide key research information on a large variety of medical topics?

a.	SPAN
b.	OVID
c.	CINUP
d.	MITO

ANS: B

OVID is an extensive collection of Web-based information resources, including databases, journals, books, and searching software. In the United States, medical libraries and large hospitals almost universally purchase and use OVID in some form.

DIF: Recall REF: p. 134 OBJ: 2

1. Which of the following devices would be most useful for point-of-care access to data bases related to evidence-based care?

a.	laptop
b.	desktop
c.	personal digital assistant (PDA)
d.	pocket file (PF)

ANS: C

A hand-held computer, also known as a personal digital assistant or PDA, is an effective tool for rapid information retrieval at the point of care to aid in clinical decisions and treatment plans. Hand-held computers interface with computers, networks, and each other via wireless technology or synchronization software. Users can use these devices to access medical records, medication references and interaction checks, calculators, textbooks, and medical evidence. Indeed, the National Library of Medicine has developed MEDLINE Database on Tap and PubMed for Hand-helds to deliver up-to-date medical evidence at the point of care. Table 7-2 presents additional information sources available via hand-held computers.

DIF: Application REF: p. 135 OBJ: 2

1. What is the name of the database management system for documenting and reporting clinical educational activities for nursing and the allied health professions?

a.	DataARC
b.	DataFILE
c.	DataBASE
d.	DataNOW

ANS: A

DataARC (www.dataarc.ws) is a secure, password-protected, and Web-based database management system for documenting and reporting clinical educational activities for nursing and the allied health professions, including respiratory care.

DIF: Recall REF: p. 140 OBJ: 1

1. You are conducting a research project and you need a software program to analyze the data collected. Which of the following would be most useful?

a.	ADDC
b.	SPSS
c.	SOS
d.	DADD

ANS: B

Statistical software programs, such as SPSS, SAS, and Statistica, are instrumental in research. In the hands of respiratory therapists with knowledge of statistics, these powerful programs can perform laborious and complex statistical tests for descriptive, analytical, and inferential analyses and reporting.

DIF: Recall REF: p. 142 OBJ: 1

1. What is the name of the software that monitors the computer use of individuals and reports the results to a central database?

a.	Spyware
b.	Eyeball
c.	FOCUS
d.	FISH

ANS: A

Spyware is a broad class of software that monitors the actions of computer users and reports information back to a central database.

DIF: Recall REF: p. 136 OBJ: 1

1. Microprocessors can benefit mechanical ventilation by doing which of the following?
2. equilibrate measured values with target values on a breath-by-breath basis
3. control ventilator alarms
4. archive the history of set and measured values
5. change clinician set parameters as needed

a.	1 and 3 only
b.	1 and 4 only
c.	1, 2, and 3 only
d.	1, 2, 3, and 4

ANS: C

Microprocessors can equilibrate measures of values with target values, control ventilator alarms, and archive the history of set and measured values, but they cannot change ventilator setting on its own.

DIF: Application REF: p. 129 OBJ: 1

1. Conventional mechanical ventilators using microprocessors are closed-loop, which:

a.	equilibrate measured values with target values
b.	adapt to the patient’s needs instantly
c.	always use neutrally adjusted ventilation
d.	do not limit pressure or flow to the patient

ANS: A

Proportional assist ventilation and neutrally adjusted ventilatory assist, aim to enhance the patient-ventilator synchrony via automation that is highly responsive to the patient.

DIF: Application REF: p. 129 OBJ: 1

1. All of the following are advantages of computerized ventilator charting applications, except:

a.	improve the consistency of ventilator charting
b.	improve the accuracy of ventilator charting
c.	automate ventilator charting with verification by respiratory therapist
d.	other clinicians not allowed to monitor their progress

ANS: D

Computerized ventilator charting applications have the potential to improve the quality and consistency of ventilator charting. Automated ventilator charting, verified, in turn, by respiratory therapists, takes that a step further, with the potential to improve completeness, accuracy, and consistency, as well as efficiency. However, the therapist still has to do all the charting.

OBJ : 1

DIFF: Application

DIF: Application REF: p. 129 OBJ: 1

1. How have new applications in diagnostics changed the way hemodynamic monitoring is done?

a.	Pulmonary artery catheters became obsolete.
b.	Computers now can calculate cardiac output using the thermodilution technique.
c.	Clinicians now rely solely on noninvasive measures.
d.	Swan-ganz catheters became obsolete.

ANS: B

In hemodynamic monitoring via pulmonary artery catheters, computers calculate cardiac output, using the thermodilution technique. The thermistor port of the pulmonary artery catheter is linked to a computer.

DIF: Application REF: p. 132 OBJ: 1

1. The AARC online benchmarking system is valuable in all of the following functions of respiratory care, except:

a.	allowing managers to compare the performance of their department to similar departments
b.	helping to demonstrate the productivity of the department, as well as establish best practices
c.	increasing efforts to implement evidence-based interventions and improve patient outcomes
d.	helping monitor equipment cost and insurance compensations

ANS: D

Benchmarking is valuable in everything mentioned, except it doesn’t monitor equipment or deal with insurance compensations

DIF: Application REF: p. 137 OBJ: 1

1. To safeguard against infiltration by malicious software, hospitals use:

a.	worms
b.	spyware
c.	firewalls
d.	trojan horses

ANS: C

To safeguard against infiltration by malicious software, hospitals and healthc are organizations use firewalls that filter the exchange of data between the Internet and local networks by verifying users` identification, passwords, and registered Internet addresses and restricting certain types of communication.

DIF: Application REF: p. 142 OBJ: 3

1. Which of the following are ways health care workers and facilities conform to HIPPA regulations concerning securing patient confidentiality within electronic medical records?
2. refraining from sharing passwords
3. accessing electronic personal health information on a need to know basis
4. utilizing thumbprint protected security
5. allowing only close family members to view personal health information in the hospital computer

a.	1 and 2 only
b.	1, 3, and 4 only
c.	1, 2, and 3 only
d.	1, 2, 3, and 4

ANS: C

To emphasize two important points concerning electronic personal health information, users of hospital and respiratory care information management systems and researchers must refrain from sharing passwords and access personal health information only on a need-to-know basis. Some respiratory care information management systems, for example, now feature thumbprint protected security.

DIF: Application REF: p. 142-143 OBJ: 3