bitches

What is the point in the respiratory track where inspired gas reaches body temperature, ambient pressure, saturated (BTPS) conditions?

A. point of thermal equilibrium
B. thermal inversion boundary
C. hygroscopic saturation boundary
D. isothermic saturation boundary

2. Which of the following is FALSE about the isothermic saturation boundary (ISB)?
a. Below the ISB, temperature and relative humidity remain constant.
b. Above the ISB, temperature and humidity increase during exhalation.
c. The ISB is normally located just below the larynx (vocal cords).'
d. Above the ISB, temperature and humidity decrease during inspiration.

Which of the following factors cause the isothermic saturation boundary (ISB) to shift farther down into the airways?
1. decreased ambient temperature
2. increased tidal volume (VT)
3. endotracheal intubation
A. 1, 2, and 3
B. 2 and 3
C. 1 and 3
D. 1 and 2

What is the primary goal of humidity therapy?a. decrease airway reactivity to cold
b. maintain normal physiologic conditions
c. deliver drugs to the airway
d. reduce upper airway inflammation

Indications for warming inspired gases include all of the following except:a. treating a patient whose airways are reactive to cold
b. providing humidification when the upper airway is bypassed
c. treating a patient with a low body temperature (hypothermia)
d. reducing upper airway inflammation or swelling

Administration of dry gases at flows exceeding 4 L/min can cause which of the following?
1. structural damage
2. heat loss
3. water loss
A. 2 and 3
B. 1, 2, and 3
C. 1 and 3
D. 1 and 2

Inhalation of dry gases can do which of the following?
1. increase viscosity of secretions
2. impair mucociliary motility
3. increase airway irritability
A. 1 and 2
B. 1 and 3
C. 1, 2, and 3
D. 3

Which of the following inspired conditions should be maintained when delivering medical gases to the nose or mouth?
A. 100% RH at 20° to 22° C
B. 80% RH at 28° to 32° C
C. 50% relative humidity (RH) at 20° to 22° C
D. 100% RH at 32° to 35° C

Which of the following inspired conditions should be maintained when delivering medical gases to the hypopharynx, as when administering oxygen by nasal catheter?a.50% relative humidity (RH) at 20° to 22° C
b.100% RH at 20° to 22° C
c.95% RH at 29° to 32° C
d.100% RH at 32° to 35° C

Which of the following inspired conditions should be maintained when delivering medical gases directly into the trachea through an endotracheal tube or a tracheotomy tube?
A. 50% relative humidity (RH) at 20° to 22° C
B. 95% RH at 29° to 32° C
C. 100% RH at 32° to 35° C
D. 100% RH at 37° to 42° C

Clinical indications for delivering cool humidified gas include which of the following?
1.post-extubation edema
2.upper airway inflammation
3.croup (laryngotracheal bronchitis) 4.epiglottitis
A. 2 and 3
B. 1, 2, 3, and 4
C. 2, 3, and 4
D. 1, 2, and 3

What device adds molecular water to gas?

A. nebulizer
B. agitator
C. humidifier
D. atomizer

Factors affecting a humidifier’s performance include all of the following except:

A. outlet size
B. time of contact
C. surface area
D. temperature

What is the most important factor determining a humidifier’s performance?
A. gas flow
B. surface area
C. time of contact
D. temperature

The greater the temperature of the gas, the:
A. more water vapor it can hold
B. less water vapor it can hold
C. more water vapor is lost
D. less efficient the humidifier is

Gas leaving an unheated humidifier at 10° C and 100% relative humidity (absolute humidity = 9.4 mg/L) would provide what relative humidity at body temperature?
A. about 60%
B. about 40%
C. about 20%
D. about 100%

What is the simplest way to increase the humidity output of a humidifier?
A. Increase the surface area between the water and the gas.
B. Increase the temperature of either the water or the gas.
C. Decrease the water vapor pressure of the gas.
D. Increase the time that the gas and the water are in contact.

Which of the following is a common way to increase the surface area ratio of humidifiers?
1.Generate a water droplet aerosol.
2.Expose the gas to a saturated wick.
3.Use a bubble or diffusion head.
A. 1 and 2
B. 1 and 3
C. 2 and 3
D. 1, 2, and 3

All of the following are TRUE about humidification and contact time except:
A. The rate of gas flow through a humidifier determines contact time.
B. Bubble humidifier contact time depends on the water column depth.
C. Low flows decrease and high flows increase relative humidity output.
D. The longer a gas is exposed to water, the greater is the amount of evaporation.

Which of the following types of humidifiers are used in clinical practice?
1.heat-moisture exchanger
2.passover humidifier
3.bubble humidifier
A. 2 and 3
B. 1 and 2
C. 1 and 3
D. 1, 2, and 3

Simple unheated bubble humidifiers are commonly used to humidify gases with what type of systems?
A. oronasal oxygen delivery
B. mechanical ventilation
C. aerosol drug delivery
D. tracheal oxygen airway

What is the goal of using an unheated bubble humidifier with oronasal oxygen delivery systems?
A. Cool the gas down to below room temperature.
B. Raise the humidity of the gas to ambient levels.
C. Fully saturate the inspired gas to ambient temperature, ambient pressure, saturated (ATPS) conditions.
D. Fully saturate the inspired gas to body temperature, ambient pressure, saturated (BTPS) conditions.

What is the typical water vapor output of an unheated bubble humidifier?
A. 20 to 25 mg/L
B. 15 to 20 mg/L
C. 10 to 15 mg/L
D. 5 to 10 mg/L

Increasing the flow through an unheated bubble humidifier has which of the following effects?
a.decreasing the water vapor content b.decreasing the relative humidity
c.increasing the water vapor content
d.increasing the relative humidity

Unheated bubble humidifiers are of limited effectiveness at flows above which of the following?
A. 10 L/min
B. 8 L/min
C. 4 L/min
D. 6 L/min

Why should you NOT heat the reservoirs of a bubble humidifier used with an oronasal oxygen delivery system?
A. Heating will melt the reservoir or cause a fire.
B. Condensate will obstruct the delivery tubing.
C. Heating will absorb the extra water vapor.
D. Heating will causes too much aerosol impaction.

The relief valve on a bubble humidifier serves which of the following functions?
1. It indicates when flow has been interrupted.
2.It protects the device from pressure damage.
3.It warns you when the water level is low.
A. 1 and 3
B. 2 and 3
C. 1, 2, and 3
D. 1 and 2

To protect against obstructed or kinked tubing, simple bubble humidifiers incorporate which of the following?
A. pressure relief valve
B. HEPA outlet filter
C. electronic alarm system
D. automatic hygrometer

The typical pressure pop-off incorporated into most simple bubble humidifiers releases pressure above which of the following?
A. 2 psig
B. 250 kPa
C. 10 cm H2O
D. 760 mm Hg

When checking an oxygen delivery system that incorporates a bubble humidifier running at 6 L/min, you occlude the delivery tubing, and the humidifier pressure relief immediately pops off. What does this indicate?
A. normal, leak-free system
B. malfunctioning humidifier
C. malfunctioning flowmeter
D. leak in the delivery tubing

At high flow rates, what do some bubble humidifiers produce?
A. low pressures
B. microorganisms
C. aerosol particles
D. additional heat

What are some types of passover humidifiers? 1.simple reservoir
2.membrane
3.wick
A. 1 and 2
B. 1 and 3
C. 1, 2, and 3
D. 2 and 3

A design that increases surface area and enhances evaporation by incorporating an absorbent material partially submerged in a water reservoir that is surrounded by a heating element best describes what type of humidifier?
A. wick
B. cascade
C. bubble
D. hygroscopic

All of the following are TRUE regarding a membrane-type humidifier except:
A. A small layer of liquid water remains on both sides of the membrane.
B. The membrane is permeable to water vapor but not to liquid water.
C. Water and gas are separated by a hydrophobic membrane.
D. As with other passover humidifiers, there is no bubbling action.

Advantages of passover humidifiers include all of the following except:
A. They add minimal flow resistance to breathing circuits.
B. They do not generate any bacteria-spreading microaerosol.
C. They can maintain water vapor saturation at high flows.
D. They do not require heating to maintain body temperature, ambient pressure, saturated (BTPS) conditions.

Which type of humidifier “traps” the patient’s body heat and expired water vapor to raise the humidity of inspired gas?a.membrane
b.bubble
c.heat-moisture exchanger
d.passover

Heat-moisture exchangers (HMEs) are mainly used to do what?
A. warm and humidify gases delivered to the trachea via ventilator circuits
B. provide extra humidity for a patient with thick or retained secretions
C. warm and humidify dry therapeutic gases delivered to the upper airway
D. humidify therapeutic gases delivered at high flows to the lower airway

Which of the following are types of heat-moisture exchangers (HMEs)?
1.simple condenser
2.hygroscopic condenser
3.hydrophobic condenser
A. 1 and 2
B. 1, 2, and 3
C. 2 and 3
D. 3

Which of the following best describes the performance of a typical hygroscopic condenser HME?
A. 40 mg/L water vapor exhaled; 20 mg/L returned
B. 40 mg/L water vapor exhaled; 27 mg/L returned
C. 44 mg/L water vapor exhaled; 37 mg/L returned
D. 27 mg/L water vapor exhaled; 40 mg/L returned

A heat-moisture exchangers has an efficiency rating of 80%. What does this mean?
A. The device provides 80% relative humidity at body temperature.
B. Of the exhaled water vapor, 20% returns to the patient on inspiration.
C. The inspired temperature is 80% of the expired temperature.
D. Of the exhaled water vapor, 80% returns to the patient on inspiration.

An ideal heat-moisture exchanger (HME) should have an efficiency rating of at least which of the following?
A. 90%
B. 50%
C. 70%
D. 30%

All of the following are features of an ideal heat-moisture exchanger (HME) except:
a.high compliance
b.minimal dead space
c.70% or higher efficiency
d.minimal flow resistance

All of the following are true of heat-moisture exchangers (HMEs) except:
A. Moisture output falls at high volumes and rates of breathing.
B. HMEs reduce bacterial colonization of ventilator circuits.
C. High inspiratory flows and high FIO2 values can decrease HME efficiency.
D. In-use HMEs have little effect on flow resistance to breathing.

For which of the following patients would you select a heated humidifier?
1.patient receiving oxygen through a bypassed upper airway
2.patient receiving long-term mechanical ventilation
3. patient receiving oxygen through an oronasal mask
A. 2
B. 2 and 3
C. 1 and 2
D. 3

Which of the following methods are used to heat the gas delivered by a heated humidifier system?
1.using a wraparound heater (yoke or collar) 2.placing a heating element in-line with gas flow
3.using a reservoir immersion heater
4.placing a “hot plate” at humidifier base
A. 1, 2, 3, and 4
B. 3 and 4
C. 2 and 4
D. 1, 2, and 3

Which of the following is false about a simple heated humidifier (one that does not incorporate a servo-control mechanism)?a.The controller regulates the heating element’s electric power.
b.The controller monitors the temperature of the heating element.
c.The controller varies current to achieve a set airway temperature.
d.The patient’s airway does affect the controller.

Characteristics of a servo-controlled heated humidifier include all of the following except:
A. provides automatic heater shutdown
B. monitors heater temperature
C. includes temperature safety alarms
D. adjusts heater power automatically

A heated humidifier should trigger both auditory and visual alarms and interrupt power to the heater when the delivered temperature exceeds which of the following?
A. 35° C
B. 25° C
C. 30° C
D. 40° C

What should happen when the remote temperature sensor of a heated humidifier becomes disconnected or fails?
1.Power to the heater should be interrupted. 2.Auditory and visual alarms should trigger. 3.The unit’s outlet valve should lock closed.
A. 1 and 3
B. 1, 2, and 3
C. 2 and 3
D. 1 and 2

Conditions that can cause temperature “overshoot” with servo-controlled heated humidifiers include all of the following except:
A. The unit is allowed to warm up without flow.
B. Flow is decreased during normal operation.
C. The airway temperature probe becomes dislodged.
D. The unit reservoir is refilled with sterile water.

The temperature of gas delivered to a patient’s airway by a servo-controlled heated humidifier should not vary by more than how much?
A. 2° C
B. 6° C
C. 8° C
D. 4° C

Which of the following are necessary features to look for in selecting a heated humidifier?
1.water level readily visible
2.over-temperature protection
3.auditory and visual alarms minimal 4,temperature overshoot
A. 1, 2, 3, and 4
B. 2 and 4
C. 1, 2, and 3
D. 3 and 4

Where should you place the thermistor probe for a servo-controlled heated humidifier being used on a patient receiving mechanical ventilation?
A. in the inspiratory limb of the circuit, near but not at the “wye”
B. in the inspiratory limb of the circuit, as close to the “wye” as possible
C. in the expiratory limb of the circuit, near but not at the “wye”
D. in the expiratory limb of the circuit, as close to the “wye” as possible

When using a servo-controlled heated humidifier to deliver gas to an infant, the thermistor probe should be placed where?

A. inside the circuit, inside the incubator, or away from the radiant warmer
B. outside the circuit, inside the incubator, or away from the radiant warmer
C. inside the circuit, outside the incubator, or away from the radiant warmer
D. outside the circuit, outside the incubator, or away from the radiant warmer

What are some potential problems with manually refilled heated humidifier reservoirs?
1.cross-contamination and infection
2.variable compliance or delivered volume 3.delivery of dry and/or hot gases
A. 1, 2, and 3
B. 1 and 2
C. 1 and 3
D. 2 and 3

Which of the following automatic feed systems are used to regulate water levels when using a humidifier with a continuous feed system?
1.leveling reservoirs
2.flotation controls
3.optical sensors
A. 1, 2, and 3
B. 1 and 2
C. 1 and 3
D. 2 and 3

All of the following are contraindications for heat-moisture exchangers except:

A. when a patient is suffering from hyperpyrexia
B. presence of thick, copious, or bloody secretions
C. presence of a large leak around artificial airway
D. when a patient’s minute ventilation exceeds 10 L/min

All of the following are potential hazards of using heat-moisture exchangers except:

A. failure of low-pressure alarms to detect disconnection
B. hypoventilation due to increased dead space
C. underhydration or impaction of secretions
D. unintended tracheal lavage from condensate

All of the following are potential hazards of using a heated humidifier during mechanical ventilation except:
A. unintended tracheal lavage from condensate
B. underhydration or impaction of secretions
C. hypoventilation due to increased dead space
D. aerosolization of condensate during disconnection

A patient receiving ventilatory support is being provided with humidification using a heat-moisture exchanger (HME). A physician orders a bronchodilator drug administered through a metered-dose inhaler (MDI) via the ventilator circuit. Which of the following must be performed to ensure delivery of the drug to the patient?
A. A heated humidifier should replace the HME when using the MDI.
B. The VT setting of the ventilator should be decreased.
C. The inspiratory flow setting of the ventilator should be increased.
D. The HME must be removed from the circuit during MDI use.

A patient has been supported by a mechanical ventilator using a heat-moisture exchanger for the last 3 days. Suctioning reveals an increase in the amount and tenacity of secretions. Which of the following actions is indicated?
A. Replace the hygroscopic condenser humidifier with a new one.
B. Switch the patient to a large-volume heated humidifier.
C. Reassess the patient’s secretions over the next 24 to 48 hours.
D. Increase the hygroscopic condenser humidifier temperature.

How often should heat-moisture exchangers be inspected and replaced?
A. at least every shift
B. at least every day
C. when contaminated by secretions
D. when condensate is visible

During routine use on an intubated patient, a heated humidifier should deliver inspired gas at which of the following?
A. temperature of 20 ± 2° C, with a minimum of 10 mg/L of water vapor
B. temperature of 33 ± 2° C, with a minimum of 30 mg/L of water vapor
C. temperature of 37 ± 2° C, with a minimum of 44 mg/L of water vapor
D. temperature of 30 ± 2° C, with a minimum of 24 mg/L of water vapor

Which of the following are the proper temperature alarm settings for a heated humidifier used during mechanical ventilation?      
   High   Low
A. 45C 35C
B. 40C 30C
C. 32C 35C
D. 37C 30C

The amount of condensation occurring in a heated, humidified gas delivery system depends on which of the following?
1.length, diameter, and mass of the circuit 2.temperature differential along the circuit 3.ambient temperature
4.rate of gas flow through the circuit
A. 3 and 4
B. 1, 2, and 3
C. 2 and 4
D. 1, 2, 3, and 4

Which of the following is FALSE about heated humidifier condensate?
a.It can block or obstruct the delivery circuit.
b.It must be treated as contaminated waste.
c.It requires that circuits be drained frequently.
d.It poses minimal infection risk.

Which of the following barrier precautions should be used when heated humidifier circuits are changed or removed?
1.wearing gloves
2.wearing goggles
3.5-minute hand scrub
A. 1 and 3
B. 1 and 2
C. 2 and 3
D. 1, 2, and 3

Which of the following are acceptable means to help minimize the problems caused by condensation in heated humidifier circuits? 1.installing water traps in the circuit
2,using a heated wire circuit
3.setting heater temperature to 25° to 28° C
A. 1 and 3
B. 2 and 3
C. 1, 2, and 3
D. 1 and 2

When using water traps to help minimize the problems caused by condensation in a heated humidifier ventilator circuit, where would you place the traps?
A. in the expiratory limb only, at a high point in the circuit
B. in both the expiratory and inspiratory limbs, at high points in the circuit
C. in the expiratory limb only, at a low point in the circuit
D. in both the expiratory and inspiratory limbs, at low points in the circuit

When using nebulizers, where should you place them to minimize risk of contamination?
A. in the inspiratory limb only, at a high point in the circuit
B. in both the expiratory and inspiratory limbs, at high points in the circuit
C. in the expiratory limb only, at a low point in the circuit
D. in both the expiratory and inspiratory limbs, at low points in the circuit

All of the following are TRUE when heated wire circuits are used with heated humidifiers except:
A. The humidifier operates at a higher temperature.
B. There is less condensate and a reduced need for drainage.
C. Cost savings (less water and staff time) are realized.
D. There is less infection risk for both patient and caregivers.

All of the following reduce the risk of nosocomial infection when using heated humidification systems except:
A. use of heated-wire delivery circuits
B. use of wick or membrane humidifiers
C. high humidifier reservoir temperatures
D. frequent changing of delivery circuits

What is the most reliable indicator that the gas delivered by a servo-controlled heated-wire humidifier system is fully saturated at the airway?
A. confirming an airway temperature between 32° and 35° C
B. observing a few drops of condensate at or near the patient’s airway
C. observing condensate over the full length of the delivery tubing
D. observing no visible condensate anywhere in the delivery tubing

In checking a servo-controlled heated-wire humidifier system, you notice that a few drops of condensate tend to form but only near the patient’s airway. Based on this observation, what can you conclude?
A. The temperature setting of the heater is too low.
B. The gas at the airway is fully saturated.
C. The airway temperature exceeds the dew point.
D. The temperature setting of the heater is too high.

When checking a patient attached to a servo-controlled heated-wire humidifier breathing circuit, you notice no visible condensate anywhere in the tubing. Based on this observation, you can conclude that the relative humidity of the delivered gas is which of the following?
a.less than 25%
b.25% to 90%
c.90% to 100%
d.less than 100%

When is a heat-moisture exchanger (HME) performing well?
A. Condensate appears in the attached flex tube.
B. Condensate is visible on the filter or insert.
C. The HME temperature is at least 40° C.
D. No condensate is visible on the filter or insert.

For which of the following patients might you recommend bland aerosol therapy administration?

1.patient with upper airway edema
2.patient with a bypassed upper airway 3.patient who must provide a sputum specimen
A. 1, 2, and 3
B. 1 and 2
C. 2 and 3
D. 1 and 3

For which of the following patients would you NOT recommend bland aerosol therapy administration?
1.patient with a history of airway hyperresponsiveness
2.patient with a bypassed upper airway 3.patient with active bronchoconstriction
A. 1 and 3
B. 1 and 2
C. 2 and 3
D. 1, 2, and 3

Hazards and complications of bland aerosol therapy include all of the following except:
A. bronchospasm
B. overhydration
C. infection
D. hemoconcentration

All of the following indicate a potential need for administration of a water or isotonic saline aerosol except:
A. stridor or brassy, croup-like cough
B. evidence of increased volume of secretions
C. hoarseness after extubation
D. patient discomfort after bronchoscopy

For which of the following patients might you recommend administration of a hypertonic saline aerosol?
1.acquired immune deficiency syndrome (AIDS) patient with severe pneumonia symptoms
2.patient with a bypassed upper airway 3.patient suspected of having tuberculosis
A. 1, 2, and 3
B. 2 and 3
C. 1 and 2
D. 1 and 3

Which of the following would indicate that administration of a bland water aerosol to a patient with post-extubation upper airway edema was having the desired effect? 1.decreased work of breathing
2.improved vital signs
3.decreased stridor or dyspnea
4.improved oxygen saturation
A. 1, 2, and 4
B. 3 and 4
C. 1, 2, 3, and 4
D. 1, 2, and 3

What is the most common device used to generate bland aerosols?
A. spinning disk nebulizer
B. ultrasonic nebulizer
C. large-volume jet nebulizer
D. small-volume jet nebulizer

All of the following are true regarding large-volume jet nebulizers except:
A. They are pneumatically powered and attach directly to a flowmeter.
B. Liquid particles are generated by mechanical vibration energy.
C. Baffling causes impaction or removal of large, unstable particles.
D. A variable air-entrainment port allows air mixing and different FIO2 values.

What is the total water output of unheated large-volume jet nebulizers?
A. 16 to 25 mg H2O/L
B. 33 to 55 mg H2O/L
C. 26 to 35 mg H2O/L
D. 10 to 16 mg H2O/L

What is the total water output of heated large-volume jet nebulizers?
a.16 to 25 mg H2O/L
b.26 to 35 mg H2O/L
c.33 to 55 mg H2O/L
d.56 to 75 mg H2O/L

Which of the following nebulizers uses a piezoelectric transducer to generate liquid particle aerosols?
A. centrifugal nebulizer
B. hydrodynamic nebulizer
C. ultrasonic nebulizer
D. jet nebulizer

Which of the following principles is used by the ultrasonic nebulizer to produce aerosol droplets?
A. fractional distillation
B. mechanical baffling
C. high-frequency vibrations
D. evaporative cooling

Which of the following are components of an ultrasonic nebulizer?
1.air-entrainment orifice
2.radiofrequency generator
3.nebulizer chamber
4.piezoelectric transducer
5.blower or fan
A. 1, 3, and 4
B. 3, 4, and 5
C. 1, 2, 3, 4, and 5
D. 2, 3, 4, and 5

The particle size produced by an ultrasonic nebulizer depends mainly on which of the following?
a.blower (fan) speed
b.signal amplitude
c.signal frequency
d.chamber baffling

Which of the following mean mass aerodynamic diameter (MMAD) aerosol suspensions is produced by an ultrasonic nebulizer operated at 1.25 MHz?
A. less than 1 mm
B. 6 to 10 mm
C. 4 to 6 mm
D. 1 to 2 mm

The aerosol output (in mg/L) of an ultrasonic nebulizer depends mainly on which of the following?'
A. chamber baffling
B. source current
C. signal amplitude
D. signal frequency

To produce the highest possible density aerosol from an ultrasonic nebulizer, how would you set the controls?
    Amplitude      Flow
A. High     Low
B. low       High
C. High     High
D. low      low

For which of the following patients might you recommend bland aerosol therapy via an ultrasonic nebulizer (USN)?

1.patient with upper airway edema
2.patient with a bypassed upper airway 3.patient who must provide a sputum specimen
A. 2
B. 3
C. 2 and 3
D. 1, 2, and 3

How often would you recommend that a home care patient disinfect a home ultrasonic room humidifier?
A. per manufacturer’s specifications, or at least every 2 weeks
B. per manufacturer’s specifications, or at least every 3 days
C. per manufacturer’s specifications, or at least every 6 days
D. per manufacturer’s specifications, or at least every day

A physician orders bland water aerosol administration to a patient with an intact upper airway. Which of the following airway appliances could you use to meet this goal? 1. oxygen mask
2.face tent
3.T-tube
4.aerosol mask
A. 2 and 4
B. 2, 3, and 4
C. 1, 2, and 3
D. 3 and 4

A physician orders bland water aerosol administration to a patient with a tracheostomy. Which of the following airway devices could you use to meet this goal? 1.tracheostomy mask
2.face tent 
3.T-tube
4.aerosol mask
A. 2, 3, and 4
B. 2 and 4
C. 1 and 3
D. 1, 2, and 3

Which of the following devices would you recommend to administer bland water aerosol to an infant or small child?
A. T-tube
B. aerosol mask
C. face tent
D. croup tents

What are some problems common to mist tents?
1.heat retention
2.CO2 buildup
3.hypothermia
A. 1, 2, and 3
B. 1 and 2
C. 1 and 3
D. 2 and 3

All mist tents prevent CO2 buildup by what process?
A. using CO2 absorbers
B. recirculating the gas
C. cooling the gas
D. providing high gas flows

Which of the following measures can help to ensure a good sputum sample?
A. using an ultrasonic nebulizer instead of a jet nebulizer
B. using the lowest possible aerosol density (high flow and low output)
C. having the patient rinse the mouth or blow the nose before induction
D. using a 5% saline solution instead of a 3% concentration

For what should sputum collected by aerosol therapy induction be inspected?
1.color
2.volume
3.odor
4.consistency
A. 1 and 3
B. 1, 2, and 3
C. 2 and 4
D. 1, 2, 3, and 4

To minimize problems with environmental safety when aerosol therapy is prescribed for immunosuppressed patients or those with tuberculosis, what precautions should you follow?
1.those for tuberculosis exposure
2.Centers for Disease Control and Prevention (CDC) standards and contact precautions 3.CDC standards and airborne precautions
A. 1, 2, and 3
B. 1 and 3
C. 1 and 2
D. 2 and 3

Causes of inadequate mist production with pneumatically powered jet nebulizers include all of the following except:
A. jet orifice misalignment
B. tripped circuit breaker
C. inadequate input flow
D. siphon tube obstruction

An ultrasonic nebulizer is not putting out any mist. After confirming (a) a good electrical power supply (cord, plug, and circuit breakers are in good working order), (b) that carrier gas is actually flowing through the device, and (c) that the output control is set at maximum, what should you do?
A. Hook it up the chamber inlet to a flowmeter set at 10 L/min or higher.
B. Inspect the couplant chamber to confirm cleanliness and fill level.
C. Disassemble the radiofrequency generator and test for electrical leakage.
D. Take the unit out of service and send it to engineering for repair.

  The risk of overhydration with continuous delivery of bland water aerosols is greatest among which patient group?
1.patients with fluid or electrolyte imbalances
2.patients with fever and infection
3.infants and small children
A. 1 and 2
B. 2 and 3
C. 1 and 3
D. 1, 2, and 3

After administering a 30-minute bland water aerosol treatment to a dehydrated elderly patient with chronic bronchitis, you note increased wheezing and a general decrease in the intensity of breath sounds. Which of the following has probably occurred?a.Reactive bronchospasm has occurred and worsened airway obstruction.
b.Inspissated secretions have swollen and worsened airway obstruction.
c.Nothing; this is a normal response to bland aerosol therapy.
d.The patient is developing atelectasis due to overhydration.

A patient with chronic obstructive pulmonary disease (COPD) is receiving heated water aerosol treatments through a jet nebulizer four times daily as a supplement to other bronchial hygiene measures designed to aid in mobilizing retained secretions. After each session, you notice the presence of moderate wheezing. Which of the following recommendations would you make to the physician?
A. Discontinue the heated water aerosol treatments.
B. Discontinue the other bronchial hygiene measures.
C. Consider prior treatment with a bronchodilator.
D. Switch to a higher-density aerosol (e.g., ultrasonic).

A neonatologist is concerned about the possibility of hearing damage occurring to a premature infant receiving bland water aerosol delivered via air-entrainment nebulizers inside an incubator or isolette. Which of the following would you recommend as the best way to overcome this problem?
A. Place sound baffles in the aerosol tubing.
B. Place earplugs in the infant’s outer ears.
C. Use a heated passover humidifier instead.
D. Use an ultrasonic nebulizer system instead.

Key considerations in selecting or recommending humidity or bland aerosol therapy for a patient include which of the following?
1.required gas flow
2.presence of an artificial tracheal airway 3.character of pulmonary secretions
4.need for or duration of mechanical ventilation
4.presence of heat-moisture exchanger (HME) contraindications
A. 1, 2, 3, 4, and 5
B. 2, 3, and 4
C. 3, 4, and 5
D. 1, 2, and 3

n general, to deliver oxygen to the upper airway, a bubble humidifier is required only when the gas flow exceeds which of the following?
A. 4 L/min
B. 2 L/min
C. 1 L/min
D. 3 L/min

A patient receiving nasal oxygen at 3 L/min complains of nasal dryness and irritation. Which of the following actions would be appropriate?
A. adding a humidifier to the delivery system
B. recommending that the flow be decreased to 2 L/min
C. recommending that the flow be increased to 4 L/min
D. switching to a simple mask at 3 L/min