WorksheetsLPN Oxygenation
Total questions: 144
Worksheet time: 5hrs 48mins
TRUE/FALSE: External respiratory happens at the tissue level.
True
False
SELECT ALL THAT APPLY: Which of the following are functions of the upper airway?
Conduct air to lower airway
Air conduction to alveoli
Protect lower airway from foreign matter
Warm, filter and humidify inspired air
Mucociliary clearance
SELECT ALL THAT APPLY: Which are parts of the pharynx?
Nasopharynx
Oropharynx
Laryngopharynx
Esophopharynx
SELECT ALL THAT APPLY: Which of the following are functions of the lower airway?
Air conduction to alveoli
Mucociliary clearance
Pulmonary surfactant production
Warm, filter and humidify inspired air
SELECT ALL THAT APPLY: The mediastinum is comprised of the...
Trachea
Heart
Carina
Lungs
The pressure in the lungs is...
Low
High
During bronchospasm, we are getting how much airflow?
None, our airway is closing up
The normal amount, the airway is just shaking
Higher airflow, our airway swells and we panic and breath more in
How much mucus do lungs make in a day?
25mls
50mls
75mls
100mls
TRUE/FALSE: Every alveoli has a capillary bed surrounding it.
True
False
What is the definition of atelectasis?
Having collapsed alveoli
Having widened alveoli
Having collapsed trachea
Having collapsed pharynx
How does a pressure gradient work?
Gases move from lower pressure to higher pressure
Gases don't move according to pressure
Gases move from higher pressure to lower pressure
Gases go where they want
If a respiratory membrane is thickened past its normal state, that makes diffusion....
Easier, more cells means more ability to diffuse faster
It has no effect on diffusion
Harder, gases cannot pass through thick tissue as easily
SELECT ALL THAT APPLY: How does surface area affect diffusion?
Decreasing the surface level decreases diffusion
Increasing the surface level decreases diffusion
Increasing the surface level increases diffusion
Decreasing the surface level increases diffusion
The least amount of perfusion happens in what part of the lungs?
The apex of both lungs
The right lung
The left lung
The base of both lungs
How much percent of oxygen is carried in plasma?
1%
3%
5%
7%
Carbon dioxide has what effect on our acid-base balance?
It makes us more acidic
It makes us more alkaline
It doesn't have an effect
Carbonic anhydrase is an enzyme that allows CO2 to pick up what kind of molecule?
H2O
O2
CHO
HO2
TRUE/FALSE: The visceral pleural touches the lungs.
True
False
How much pleural fluid do we have per lung?
10ml
15ml
20ml
25ml
TRUE/FALSE: The diaphragm moves down when exhaling.
True
False
SELECT ALL THAT APPLY: Which of the following are major muscle groups that help us breathe?
Scalene
Diaphragm
Abdominal muscles
Intercostal muscles
Sternocleidomastoid
TRUE/FALSE: External intercostals allow us to inhale by pulling the ribs up.
True
False
What does surfactant do?
Increase surface tension
Make things oily
Break down water
Decrease surface tension
What cells produce surfactant?
Type I alveolar cells
Type II alveolar cells
Type III alveolar cells
Typer IV alveolar cells
How much percent of atmospheric air is made up of nitrogen?
1%
21%
87%
78%
How much percent of atmospheric air is made up of oxygen?
12%
21%
87%
78%
At sea level, what is the pressure of atmospheric air?
752 mmHg
760 mmHg
755 mmHg
758 mmHg
SELECT ALL THAT APPLY: With Boyle's law, which statements are true?
Increase in volume, increase in pressure
Increase in volume, decrease in pressure
Increase in pressure, decrease in volume
Increase in pressure, increase in volume
Which nerve stimulates the diaphragm?
Long thoracic
Thoracodorsal
Phrenic
Diaphragmic
When the phrenic nerve stimulates the diaphragm, what happens?
It relaxes and moves down
It contracts and moves down
It contracts and moves up
It relaxes and moves up
When our external intercostal muscles contract, what is happening to the chest?
An increase in lateral-medial diameter
A decrease in lateral-medial diameter
A decrease in anterior-posterior diameter
An increase in anterior-posterior diameter
TRUE/FALSE: Inhalation is a passive process
True
False
What part of the brain is the respiratory center in?
Cerebellum
Pons
Cerebrum
Medulla
For a normal, healthy patient, what is the most common stimulation to breathe?
Increase in hydrogen ions
Low oxygen levels
Respirations aren't stimulated, happen at an interval
Increased concentration in carbon dioxide in the blood
In a patient with chronically raised CO2 levels, what is the stimulant to breathe for them?
Mega high levels of CO2
Increase in hydrogen ions
There is no stimulation, they must breathe manually every time
Low oxygen levels
SELECT ALL THAT APPLY: What are some conditions that decrease lung compliance
Scar tissue
Edema
Exercise regime
Atelectasis
Any condition that destroys lung tissue
What is the normal respiratory rate for a newborn?
12-20 breaths/min
20-25 breaths/min
30-35 breaths/min
45-50 breaths/min
Why does our respiratory rate go down when we age?
Increase in ability to hold breath
We need less oxygen since we aren't growing
We have more alveoli as we age
Our respiratory rate never changes
SELECT ALL THAT APPLY: Which factors affect our breathing?
Temperature
Lifestyle
Environmental Factors
Narcotics
You find a patient with shortness of breath, what is your first action?
Have them cough and deep breath
Raise the head of bed
Lower the head of bed
Do an incentive spirometer with them
What is hypoxemia?
Low levels of oxygen in the brain
Low levels of oxygen in the tissues
Low levels of oxygen in the blood
Low levels of oxygen in the lungs
If a patient in hypoxic and has to turn to anaerobic metabolism to make energy, what is the effect of the pH balance of the body?
It becomes lower
It becomes higher
It doesn't change
SELECT ALL THAT APPLY: What are some effects of hypoventilation?
Hypercapnia
Increase in energy
Increased pulse
Confusion
SELECT ALL THAT APPLY: What are some signs of hypoxia?
Flaring of the nares
Slowed pulse
Intercostal retractions
Restlessness
Dyspnea
SELECT ALL THAT APPLY: Select descriptions of normal healthy sputum.
Cream color
Clear
No odor
Thin
Foamy
What kind of chest pain description is associated with pleural chest pain?
Pressure
Stabbing
Burning
Cramping
How do you find crepitus?
Auscultation
Palpation
Percussion
Inspection
Pleural friction rub is what?
The inflamed visceral pleural wall rubbing against the wall of the thoracic cavity
The inflamed parietal pleural wall rubbing against the thoracic cavity
The inflamed pleural walls rubbing against each other
Something is trapped between the pleural walls and is trying to come out
SELECT ALL THAT APPLY: What are some effects of hyperventilation?
Acidosis
Alkalosis
Lightheadedness
Tetany
Muscle Twitching
TRUE/FALSE: Low activity hobbies like building model trains have no effect on our respiratory system.
True
False
TRUE/FALSE: If your patient is awaiting the results of culture, they cannot be on any antibiotics.
True
False
What is a good RBC blood count for men?
3.6-5
4.6-6
5.6-7
6.6-8
What is a good RBC for women?
2-3
3-4
4-5
5-6
What is a good hemoglobin for men?
14-18
16-20
18-22
20-24
What is a good hemoglobin for women?
10-14
12-16
14-18
16-20
What is a good hematocrit for men?
40-54%
36-46%
38-48%
42-56%
What is a good hematocrit for women?
34-44%
36-46%
38-48%
40-50%
What is a good WBC range?
3-7
5-10
7-12
10-15
When doing a throat swab, where do you swab?
Oropharynx and tonsillar regions
Nasopharynx
Laryngopharynx
Anywhere in the mouth
What is a true statement about group A beta-hemolytic streptococci?
If you think you have strep, don't worry about getting tested
Strep loves to move to different organs
Typically found in the nose
You can kill strep by drinking a lot of milk
In a chest X-ray, solids are represented by what color?
Black
White
Blue
Brown
When are chest X-rays taken?
Whenever
Right after a big exhale
Right after a big inhale
In the middle of an inspiration
TRUE/FALSE: It is normal for some blood to be found in sputum post bronchoscopy?
True
False
What is the best position for a patient under going thoracentesis to be in?
Sitting up, leaning forward
Prone
Sims
Dorsal recumbant
When doing an ABG draw, how long should you put pressure on the site where it is drawn from?
1-2 minutes
3-5 minutes
2-3 minutes
Whenever it stops bleeding
When determining ABGs, what measurement tells you something is "_____ acidosis"?
pH > 7.35
pH > 7.45
pH < 7.35
pH < 7.45
When determining ABGs, what measurement tells you something is "_____ alkalosis"?
pH < 7.35
pH > 7.35
pH < 7.45
pH > 7.45
What is the normal range for pCO2?
30-40 mmHg
35-45 mmHg
40-50 mmHg
45-55 mmHg
If you get an ABG result of:
pH < 7.35
pCO2 > 45
What would be the correct interpretation?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
If you get an ABG result of:
pH > 7.45
pCO2 < 35
What would be the correct interpretation?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
If you get an ABG result of:
pH > 7.45
HCO3 > 26
What would be the correct interpretation?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
If you get an ABG result of:
pH < 7.35
HCO3 < 22
What would be the correct interpretation?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
What is the normal range for bicarb?
20-24 meq/L
22-26 meq/L
24-28 meq/L
26-30 meq/L
SELECT ALL THAT APPLY: What systems are involved in acid-base balance?
Respiratory
Renal
Intestinal
Cranial
SELECT ALL THAT APPLY: When interpreting ABGs, your pH level comes up normal but CO2 and HCO3 are abnormal, how do you determine if it is respiratory or metabolic?
If the pH is under 7.4, interpret it as acidic
If the pH is under 7.4, interpret it as alkaline
If the pH is over 7.4, interpret it as alkaline
If the pH is over 7.4, interpret it as acidic
Hypoventilation causes what?
Respiratory acidosis
Respiratory alkalosis
SELECT ALL THAT APPLY: What are some causes of respiratory acidosis?
Stimulant use
Sedative/narcotic use
Respiratory muscular paralysis
Blunt force trauma to the chest wall
Disorders of the lung tissue
SELECT ALL THAT APPLY: Select signs and symptoms of respiratory acidosis.
Bradycardia
Diaphoresis
Palpations
Flushed skin
Muscle twitching
What electrolyte abnormality can we see with respiratory acidosis?
Increase in K+
Decrease in K+
Increase in Ca++
Decrease in Ca++
SELECT ALL THAT APPLY: Your patient is experiencing respiratory acidosis. What are some appropriate treatments?
Physically stimulate the patient to increase breathing
Pulmonary toilet
Decrease mechanical ventilation
Increase mechanical ventilation
Diuretics
Hyperventilation causes what?
Respiratory Alkalosis
Respiratory Acidosis
SELECT ALL THAT APPLY: What are some causes of respiratory alkalosis?
Panic attacks
Severe fever
Hypoxia
CNS Depression
SELECT ALL THAT APPLY: What are some signs/symptoms of respiratory alkalosis?
Increased CNS excitability
Headache
Vertigo
Tinnitus
Increased K+
SELECT ALL THAT APPLY: Which electrolyte imbalances can we see with respiratory alkalosis?
Decreased Ca++
Decrease K+
Increase K+
Increased Ca++
SELECT ALL THAT APPLY: What are some signs/symptoms of metabolic acidosis?
CNS Depression
Flushed skin
Nausea
Slow breathing
Kussmaul's respirations
SELECT ALL THAT APPLY: What are some causes for metabolic acidosis?
Diabetic acidosis
Ingestion of acid
Gain of HCO3
Loss of HCO3
SELECT ALL THAT APPLY: What are some electrolyte imbalances of metabolic acidosis?
Increase K+
Increase Cl-
Decrease Cl-
Increase in Ca++
SELECT ALL THAT APPLY: What are some causes of metabolic alkalosis?
Severe vomiting
Antacid overuse
K+ wasting diruretics
Continued gastric suction
Diarrhea
SELECT ALL THAT APPLY: Which are signs and symptoms of metabolic alkalosis?
Diaphoresis
Nausea and vomiting
Shallow breathing
EKG changes
Confusion
TRUE/FALSE: Metabolic alkalosis is very hard to treat and most treatments are just precautionary methods.
True
False
When it comes to activity level for patients, what is recommended?
No activity at all
Stagger activity
Do all activity at once
Limit to only bare bones level
How much water is ideal for a respiratory patient?
1-2 L
2-3 L
0-1 L
3-4 L
If a patient is complaining about pain when coughing, what can we do for them?
Nothing, the coughing will make them feel better after
Splint their chest
Administer whatever pain med you feel like
Administer pain meds that are appropriate
What is the purpose of an antitussive?
To limit or stop a cough
Break down bonds in mucus
Thin secretions
Make them sneeze out secretions
What is the purpose of a mucolytic?
To stop or limit cough
To break up mucus bonds
To thin secretions
To make them sneeze secretions
What is the purpose of an expectorant?
To stop or limit a cough
To break bonds on mucus
To thin secretions
To make them sneeze their secretions
In which of the following patient is it appropriate to use a mist tent?
Kayleigh, a 2 month old infant
Miranda, a 12 year old girl
Benjamin, a 28 year old male
Eveline, a 87 year old female
When it comes to nutrition for a respiratory patient with high CO2 levels, what do we want to limit?
Carbs
Fat
Protein
Water
How often should you do an incentive spirometer on a post op patient?
10 times every hour
5 times every hour
10 times every other hour
Let the patient self direct their use
How often should you encourage use of a Positive Expiratory Pressure (PEP)?
3-4 times a day/10-20 breaths with each use
3-4 times an hour/5-10 breaths with each use
10-20 times a day/3-4 breaths with each use
Whenever the patient feels like it
SELECT ALL THAT APPLY: Which are proper things to do during postural drainage?
Have patient cough between position changes
Patient can sit up during position changes
Do on an empty stomach
Leave patient in position for an hour
TRUE/FALSE: You have a hypoxic patient who you do not have physicians orders to place O2 on them. You must get an order before placing O2.
True
False
SELECT ALL THAT APPLY: What are some common respiratory disorders that makes someone at risk for Oxygen Induced Hypventilation?
Chronic Asthma
Emphysema
Chronic Bronchitis
Respiratory Acidosis
What molecule keeps the alveoli open but does not cross the alveoli membrane?
O
N
H
He
Why can atelectasis happen if we give a patient 100% O2?
They just aren't breathing, we need to up the LPM
We don't have N2 to keep the alveoli open
O2 breaks down surfactant
O2 gives water the ability to bond stronger
What does LPM stand for?
Licensed Practical Murse
Liter Per Minute
Lateral Piercing Movement
Liter Per Month
What is a normal tidal volume?
200 ml
300 ml
400 ml
500 ml
TRUE/FALSE: Low flow exceeds a patient's inspiratory flow demand.
True
False
SELECT ALL THAT APPLY: Which of the following are high flow devices?
Nasal cannula
Simple mask
Non-rebreather
Venturi Mask
Vapotherm
Can we document a low-flow device off FiO2?
No, you cannot always calculate a FiO2 off a low flow device
No, the doctor doesn't like that
Yes, FiO2 or LPM is just your preference?
Yes, we should always
What is the LPM for a nasal cannula?
1-6 LPM
0-6 LPM
1-5 LMP
1-15 LPM
We should add humidification if our patient is receiving this much O2....
Always attach it
2 LPM
3 LPM
4 LPM
SELECT ALL THAT APPLY: Where can we expect skin breakdown on a nasal cannula?
Inside of nose
Throat
Cheeks
Behind ears
What could happen if you don't have a high enough flow rate on a simple mask?
Waste of equipment
Not enough O2
CO2 retention
O2 retention
What is the flow rate for a simple mask?
6-10 LPM
6-15 LPM
1-15 LPM
6-8 LPM
Can a reservoir bag on a non-rebreather deflate?
Yes, it should only inflate when the patient breaths out
No, it is potentially causing CO2 retention if it deflate
Yes, it will only fill up intermittemently
No, that is going to cause your patient to choke
What is the flow rate for a non-rebreather?
10-15 LPM
10-13 LPM
13-15 LPM
0-15 LPM
SELECT ALL THAT APPLY: How do we determine if we have the correct valve on a venturi mask?
The % and LPM are written on them
The color tells you
You just guess
They all have the same LPM and %
What is the maximum amount of O2 a vapotherm can deliver?
15 LPM
20 LPM
30 LPM
40 LPM
SELECT ALL THAT APPLY: Where can we expect breakdown on a patient wearing a vapotherm?
Behind the ears
Cheek
Nasal
Top lip
TRUE/FALSE: You cannot smoke around oxygen.
True
False
Which direction can you place an oropharyngeal airway in?
Right side up
Upside down
Sideways
Whatever way you want
TRUE/FALSE: You can tape a oropharyngeal airway to a patient to prevent dislodging.
True
False
How do you measure the size of an oropharyngeal airway?
Mouth to angle of jaw
Mouth to tragus of ear
Stick your finger in your patient's mouth
Nose to angle of jaw
TRUE/FALSE: You can only put an oropharyngeal airway into an unconscious patient.
True
False
How do you measure a nasopharyngeal airway?
Mouth to tragus and add an inch
Mouth to angle of jaw
Nose to tragus and add an inch
Nose to angle of jaw
What should the diameter of the nasopharyngeal tube be?
Your pinkie
Your patient's pinkie
Your patient's thumb
Your patient's ring finger
How long can you keep an endotracheal tube in?
1 week
2 weeks
3 weeks
As long as the patient needs it
Why does an endotracheal tube have a time limit on how long it can be in the patient?
The cuff starts to break down
Causes tracheal necrosis
The cuff starts to fuse to the patient
There is not a time limit on an ET tube
SELECT ALL THAT APPLY: How often should you do change trach dressing?
8-12 hours
12-24 hours
PRN
4-6 hours
What kind of trach allows a patient to speak?
Fenestrated trach
A disposable trach
None of them
All of them
TRUE/FALSE: If a trach comes out, you can put it back in.
True
False
TRUE/FALSE: You can stand anywhere when doing trach care.
True
False
What should the pressure of your suctioning be at when suctioning an airway?
100-120 mmHg
80-120 mmHg
60-80 mmHg
80-200 mmHg
What is the maximum number of passes you can do in one trach care sitting?
1
2
3
4
SELECT ALL THAT APPLY: What are some side effects of suctioning?
Hypoexmia
Alveolar collapse
Vagal stimulation
Muscosal trauma
How long can you suction for in airway suctioning?
5-15 seconds
10-15 seconds
5-10 seconds
1 minute
How tall should your water seal be?
1 inch
2 inch
1 cm
2 cm
What does it mean if you have continuous bubbling in your water seal.
Air leak
Water leak
That's normal
Your patient is dying
If the tube from the chest tube box comes loose, what can you do with the end that is sticking out of the patient?
Clamp it
Place it in sterile water
Cover it with tape
Place a dressing over it
Your patient just ripped their chest tube out, what do you do?
Place dressing and tape down three sides
Stick a finger with sterile gloves on to plug it up
Pour sterile water on top to flush bacteria off
Place dressing and tape down all sides
When monitoring a chest tube, how much drainage would be a reason to call the provider?
100 mls a day
100 mls an hour
10 mls an hour
1000 mls a day
How do you mark the amount of chest tube drainage?
Write directly on the box at end of shift
Write directly on the box whenever you check the chest tube
Put a sticky note on the box at the end of shift
Write it on the patient's whiteboard
On the air leak meter, what is the most severe number?
1
3
5
7
