Mosbys Respiratory Care Equipment 9th Edition By J.M. Cairo – Test Bank
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Sample Test
Chapter 03: Manufacture, Storage, and Transport of Medical Gases
MULTIPLE CHOICE
1. Which
of the following gases support combustion?
Air
Oxygen
Helium
Carbon Dioxide
1. 2
only c.
2, 3
2. 1, 2
d. 1, 3, 4
ANS: B
Oxygen and air support combustion. Helium and carbon
dioxide are not flammable
PTS:
1
REF: Page 57, Table 3-2
2. Which
of the following gases is the least dense?
3. Carbon
dioxide c. Helium
4. Nitrous
oxide d. Air
ANS: C
Helium is the second-lightest element, with a density of 0.165
kg/m3 at 21.1° C and 1 atmospheric pressure (atm). Oxygen is slightly heavier
than air, with a density of 1.326 kg/m3 at 21.1° C and 760 mm Hg.
PTS:
1
REF: Page 57, Table 3-3
3. Which
gas has been used successfully in the treatment of pulmonary hypertension of
the newborn?
4. Oxygen
c.
Nitrous oxide
5. Nitric
oxide d.
Helium-oxygen mixture
ANS: B
At very low concentrations (2 to 80 parts per million) combined
with oxygen, nitric oxide has been used to successfully treat persistent
pulmonary hypertension of the newborn. Nitrous oxide is used as a central
nervous system depressant (anesthetic). Helium-oxygen mixtures decrease the
work of breathing by decreasing turbulent airflow.
PTS:
1
REF: Page 56
4. In
high concentrations, which of the following gases is a potent anesthetic?
5. Nitric
oxide
c.
Carbon dioxide
6. Nitrous
oxide d.
Helium-oxygen mixture
ANS: B
The major use for nitrous oxide is a central nervous system
depressant. As such, it is a potent anesthetic when administered in high
concentrations. At very low concentrations (2 to 80 parts per million) combined
with oxygen, nitric oxide has been used successfully to treat persistent
pulmonary hypertension of the newborn. Carbon dioxide is nonflammable, but it
supports combustion. Helium-oxygen mixtures decrease the work of breathing by
decreasing turbulent airflow.
PTS:
1
REF: Page 56
5. Which
of the following gases is used to decrease the work of breathing associated
with severe airway obstruction?
6. Nitric
oxide c.
Helium-oxygen mixture
7. Nitrous
oxide d.
Carbon dioxide–oxygen mixture
ANS: C
A helium-oxygen mixture decreases the work of breathing by
decreasing turbulent airflow.
PTS:
1
REF: Page 56
6. Chemical
pneumonitis and pulmonary edema can be caused by which of the following?
7. Nitrous
oxide
8. Carbon
dioxide
9. Excess
amounts of nitric oxide
10. A
combination of nitric oxide and nitrogen dioxide
ANS: D
Nitric oxide and nitrogen dioxide combine to form a potent
irritant that can cause chemical pneumonitis and pulmonary edema. Nitrous
oxide, which is nicknamed laughing gas, can cause brain damage or death if
inhaled without a sufficient oxygen supply.
PTS:
1
REF: Page 56
7. Carbon
dioxide can be obtained by which of the following methods?
8. Heating
uranium ore
9. Combustion
of natural gas
10. Fractional
distillation of liquid air
11. Oxidizing
ammonia at high temperatures
ANS: B
Unrefined carbon dioxide can be obtained from the combustion of
coal, natural gas, or other carbonaceous fuels. Helium can be obtained by
heating uranium ore. The two methods most commonly used to prepare oxygen are
the fractional distillation of liquid air and the physical separation of
atmospheric air. Nitric oxide can be prepared by oxidizing ammonia at high
temperatures (i.e., 500° C
and above).
PTS:
1
REF: Page 55
8. Which
agency is responsible for the regulations that govern the manufacture, storage,
and transport of compressed gases?
9. Bureau
of Medical Devices
10. Compressed
Gas Association (CGA)
11. U.S.
Department of Transportation (DOT)
12. U.S.
Food and Drug Administration (FDA)
ANS: C
Metal cylinders have been used for storing compressed gases
since 1888. Federal regulations issued by the DOT require that all cylinders
used to store and transport compressed gases conform to specifications. The FDA
sets purity standards for medical gas. The CGA provides standards and safety
systems for compressed gas systems.
PTS:
1
REF: Page 57
9. Which
agency sets purity standards for medical gases?
10. CGA
11. DOT
12. FDA
13. International
Standards Organization (ISO)
ANS: C
The FDA sets purity standards for medical gas. The DOT governs
the manufacture, storage, and transport of compressed gases. The CGA sets
standards and provides safety systems for compressed gas systems. The ISO is an
international agency that sets standards for technology.
PTS:
1
REF: Page 55, Box 3-2
10. Safety
systems for medical gases are recommended and provided by:
11. DOT.
12. CGA.
13. FDA.
14. National
Fire Protection Association (NFPA).
ANS: B
The CGA sets standards and provides safety systems for
compressed gas systems. The FDA sets purity standards for medical gas. The DOT
regulates the manufacture, storage, and transport of compressed gases. The NFPA
is an independent agency that provides information on fire protection and
safety.
PTS:
1
REF: Page 54, Box 3-2
11. A
cylinder has “DOT 3AA 2015” stamped on it. What does the 3AA stand for?
12. Ownership
mark c.
Non–heat-treated carbon-steel
13. Manufacturer’s
mark d.
Heat-treated, high-strength steel
ANS: D
3AA stands for heat-treated, high-strength steel. Type 3A
cylinders are made of carbon-steel (non–heat-treated).
PTS:
1
REF: Page 57
12. A
cylinder has “DOT 3AL 2015” stamped on it. What does the 3AL stand for?
13. Manufacturer’s
initials
14. Constructed
of heat-treated, high-strength steel
15. Required
to undergo hydrostatic testing every 3 years
16. Constructed
of specially prescribed seamless aluminum alloys
ANS: D
3AL means that the cylinder is constructed of specially
prescribed seamless aluminum alloys and must be examined every 5 years to test
its expansion characteristics. Type 3AA is constructed of heat-treated,
high-strength steel.
PTS:
1
REF: Page 57
13. Which
type of cylinder is produced from non–heat-treated carbon-steel?
14. 3
c. 3AA
15. 3A
d. 3AAA
ANS: B
3AA means heat-treated, high-strength steel; 3 and 3AAA are not
applicable.
PTS:
1
REF: Page 56
14. If
the maximum filling pressure is marked as 2050 lb-force per square inch gauge
(psig), this cylinder is capable of holding _____ psig.
15. 1845
c. 2255
16. 2050
d. 2460
ANS: C
Compressed gas cylinders should be capable of holding up to 10%
more than the maximum filling pressure as marked. 10% ´ 2050 = 205 + 2050 =
2255 psig.
PTS:
1
REF: Page 57
15. An
asterisk following the reexamination date on a cylinder indicates that the
cylinder:
16. has
passed the test.
c. must
be retested every 10 years.
17. must
be retested every 5 years.
d. has been
sold to another company.
ANS: C
An asterisk after the reexamination date on the cylinder
markings (see Figure 3-4) indicates that the cylinder must be retested every 10
years.
PTS:
1
REF: Page 57
16. Which
size cylinder would be most appropriate for use during patient transport?
17. H
c. M
18. G
d. E
ANS: D
Size “E” cylinders are used for emergencies and for transport.
The other cylinders are too large to be used for transport.
PTS:
1
REF: Page 60
17. Which
of the following is not marked on a cylinder?
18. Ownership
marks
19. Method
of production
20. Serial
number of the cylinder
21. Type
of material used to construct the cylinder
ANS: B
The method of production is not required to be on the cylinder.
All the other options are a requirement.
PTS:
1
REF: Pages 60-61
18. A
plus sign after an examination date indicates that the cylinder:
19. may
be retested in 5 years.
20. may
be retested in 10 years.
21. has been
sold to another company.
22. has
complied with the requirements of the test.
ANS: D
The plus sign means that the cylinder has complied with the
requirements of the test. An asterisk following the reexamination date on the
cylinder markings indicates that the cylinder must be retested every 10 years.
PTS:
1
REF: Page 61
19. The
color codes for cylinders are prescribed by the:
20. U.S.
National Formulary.
c. FDA.
21. CGA.
d. American
Standards Association.
ANS: A
The U.S. National Formulary sets the color-code standards.
PTS:
1
REF: Page 61
20. What
is the cylinder color for nitrous oxide?
21. Red
c.
Brown
22. Black
and white d.
Light blue
ANS: D
Nitrous oxide is light blue. Ethylene is red. Compressed air is
black and white. Helium is brown. See Table 3-4.
PTS:
1
REF: Page 61, Table 3-4
21. What
is the international color code for compressed air?
22. Gray
c.
Yellow
23. Black
d. Black and
white
ANS: D
The international color code for compressed air is black and
white. Yellow is the color set by the U.S. National Formulary.
PTS:
1
REF: Page 61
22. Which
of the following appear(s) on the labels of gas cylinders?
23. Chemical
symbol of the contents
24. Precautionary
measures for the gas
25. Specific
hazards related to use of the gas
26. Volume
of the cylinder marked in liters at 70° F
27. 1
c. 1,
2, and 3
28. 1 and
4 d. 1, 2, 3,
and 4
ANS: D
The CGA and the American Standards Association specify that all
labels should include the chemical symbol of the contents, precautionary
measures, specific hazards related to the gas, and the volume of the cylinder
marked in liters at 70° F.
PTS:
1
REF: Page 62
23. Which
agency sets standards for the purity of medical gases?
24. U.S.
National Formulary
c. FDA
25. CGA
d. American
Standards Association
ANS: C
Only the FDA sets the purity standards for medical gases.
PTS:
1
REF: Page 62
24. A 97%
purity standard is required for which of the following gases?
25. Ethylene
c.
Nitric oxide
26. Nitrogen
d. Nitrous
oxide
ANS: D
See Table 3-4.
PTS:
1
REF: Page 61, Table 3-4
25. What
is the purity standard for oxygen?
26. 99%
c. 97%
27. 98%
d. 95%
ANS: A
See Table 3-4.
PTS:
1
REF: Page 61, Table 3-5
26. Which
of the following statement(s) is (are) true about cylinder valves?
27. Diaphragm
valves can withstand pressure greater than 1500 psig.
28. Direct-acting
valves are used for pressure less than 1500 psig.
29. Diaphragm
valves should be used with flammable gases.
30. Leakage
cannot occur with direct-acting valves.
31. 3
c. 2
and 3
32. 1
d. 1 and 4
ANS: A
Diaphragm valves can withstand pressures less than 1500 psig and
should be used with flammable gases because they do not allow leaks. A direct-acting
valve contains two washers and a Teflon packing to prevent gas leakage around
the threads.
PTS:
1
REF: Page 63
27. Which
of the following statement(s) is (are) not true about cylinder valves?
28. Diaphragm
valves cannot withstand pressure greater than 1500 psig.
29. Direct-acting
valves are used for pressure greater than 1500 psig.
30. Diaphragm
valves should not be used with anesthetic gases.
31. Stem
leakage can occur with direct-acting valves.
32. 3
c. 1
and 4
33. 2 and
4 d. 1, 2,
and 3
ANS: A
Diaphragm valves are ideal for situations in which no gas leaks
can be allowed, such as with flammable anesthetics.
PTS:
1
REF: Page 63
28. Which
of the following statement(s) is (are) true about diaphragm type of valves?
29. A
partial rotation of a diaphragm type of valve will not open the stem.
30. The
valve seat in a diaphragm type of valve does not turn.
31. The
diaphragm type of valve contains two fiber washers.
32. The
diaphragm type of valve uses a threaded stem.
33. 2
c. 3
and 4
34. 1 and
4 d. 2 and 4
ANS: D
The valve seat does not turn and is therefore resistant to
scoring; it also uses a threaded stem in place of the packing found on the
direct-acting valves. The direct-acting valve has two fiber washers.
PTS:
1
REF: Page 63
29. The
diaphragms of a diaphragm type of valve are made of:
30. steel.
31. copper.
32. aluminum.
33. chrome-molybdenum.
34. 2
c. 3
and 4
35. 2 and
3 d. 1 and 2
ANS: D
The diaphragm type of valve has two diaphragms, one made of
steel and one made of copper. Aluminum and chrome-molybdenum are metals that
are used in the construction of cylinders.
PTS:
1
REF: Page 63
30. Wood’s
metal is used to make:
31. gas
cylinders.
32. fusible-plug
pressure-relief valves.
33. rupture-disk
pressure-relief valves.
34. spring-loaded
pressure-relief devices.
ANS: B
Fusible-plug pressure-relief valves are made of a metal alloy
that melts when the temperature of the gas in the tank exceeds a predetermined
temperature. This is called Wood’s metal.
PTS:
1
REF: Page 64
31. Which
type of valve operates on the principle that as the pressure in a cylinder
increases, the temperature of the gas increases?
32. Direct-acting
valves
c.
Rupture-disk pressure-relief valves
33. Fusible-plug
pressure-relief valves
d.
Spring-loaded pressure-relief valves
ANS: B
Fusible-plug pressure-relief valves operate on the principle
that as the pressure in a tank increases, the temperature of the gas increases,
causing the plug to melt. Spring-loaded devices are designed to release
excessive cylinder pressure and reseal, preventing further release of gas from
the cylinder after the cause of the excessive pressure is removed. The
rupture-disk will buckle when the pressure inside the cylinder exceeds a
certain predetermined limit. Direct-acting valves are not pressure-relief
valves; instead, they are controlling devices that seal the contents of a
compressed cylinder until it is ready for use.
PTS:
1
REF: Page 58, Box 3-2
32. Which
agency designed the safety systems for outlet connections of cylinder valves?
33. Z-79
Committee
34. CGA
35. FDA
36. American
National Standards Institute (ANSI)
ANS: B
The CGA designed the safety systems for outlet connections of
cylinders. The Z-79 Committee establishes standards for anesthetic and
ventilatory devices. The FDA sets purity standards. ANSI is a private nonprofit
organization that coordinates the voluntary development of national standards
in the United States.
PTS:
1
REF: Page 64
33. Medical
gas cylinder valve outlets always have connections that are _____-handed and
_____.
34. right;
external
c.
left; external
35. right;
internal d.
left; internal
ANS: A
External and right-handed is the standard for medical gas
cylinder valve outlets.
PTS:
1
REF: Page 66
34. Which
safety system is used with small cylinders, sizes “A” through “E”?
35. Pin
Index Safety System
36. Diameter
Index Safety System
37. Direct-Acting
Valve Safety System
38. American
Standard Index Safety System
ANS: A
Small cylinders (i.e., sizes “A” to “E”) with post type of
valves use a different American Standard indexing system called the Pin Index
Safety System.
PTS:
1
REF: Page 65, Figure 3-8
35. The
cylinder outlet diameter for a “G” size oxygen cylinder is _____ inches.
36. 0.830
c.
0.960
37. 0.903
d. 0.965
ANS: B
See Figure 3-8.
PTS:
1
REF: Page 65, Figure 3-8
36. A
nitrous oxide “H” size cylinder cannot be attached to oxygen equipment because
the nitrous oxide cylinder has which of the following?
37. A different
outlet size
38. A
different thread type
39. An
outer threading system
40. Internal
threading; and oxygen has an external threading
41. 1, 2,
3, and 4
c. 2
and 3
42. 2, 3,
and 4 d. 1
and 2
ANS: D
See Figure 3-8.
PTS:
1
REF: Page 65, Figure 3-8
37. Which
of the following types of threading does a compressed air cylinder have?
38. Right-handed
39. Left-handed
40. Internal
41. External
42. 2 and
3 c. 2
and 4
43. 1 and
4 d. 1 and 3
ANS: B
See Figure 3-8.
PTS:
1
REF: Page 66, Figure 3-9
38. What
are the pin positions for an “E” size oxygen cylinder?
39. 2 and
4 c. 2
and 6
40. 2 and
5 d. 3 and 5
ANS: B
See Figure 3-9.
PTS:
1
REF: Page 66, Figure 3-9
39. What
are the pin positions for an “E” size compressed air cylinder?
40. 1 and
5 c. 2
and 5
41. 1 and
6 d. 3 and 5
ANS: A
See Figure 3-9.
PTS:
1
REF: Page 66, Box 3-4
40. Which
of the following procedures should be followed in setting up a compressed gas
cylinder at a patient’s bedside?
41. Inspect
the cylinder and valve for dirt, debris, and oil.
42. Make
sure the cylinder is properly secured.
43. Tighten
the regulator with a pipe wrench.
44. Open
the cylinder valve completely.
45. 3 and
4 c. 1,
2, 3, and 4
46. 1 and
2 d. 1, 2,
and 4
ANS: B
See Box 3-4.
PTS:
1
REF: Page 66, Box 3-4
41. The
best position for the cylinder valve when it is being used is:
42. completely
open.
43. two
turns toward the left.
44. one
turn, open toward the right.
45. one
half-turn back from completely open.
ANS: D
See Box 3-4.
PTS:
1
REF: Page 67
42. After
connecting an oxygen regulator to an “H” cylinder and turning the direct-acting
valve on, the respiratory therapist attempts to turn on the flow of oxygen. The
desired gas flow is not achieved. Which of the following is (are) the most
likely problem(s)?
43. The
therapist is using the wrong regulator.
44. The
pressure in the cylinder is inadequate.
45. The
regulator outlet is obstructed.
46. There
is a leak in the connection between the cylinder outlet and the regulator.
47. 1
c. 2
and 3
48. 2 and
4 d. 1, 2,
and 4
ANS: C
Failure to achieve a desired gas flow from a cylinder regulator
can result from inadequate pressure or from an obstruction at the regulator
outlet. There would be a hissing noise if there was a leak. Safety systems
prevent the wrong regulator from fitting an oxygen cylinder.
PTS:
1
REF: Page 67
43. An
“E” size cylinder is turned on, and the flowmeter is off. Which of the
following is (are) the most likely cause(s) of a hissing sound?
44. A
cracked flowmeter
45. Inadequate
pressure in the cylinder
46. An
obstruction at the regulator outlet
47. A
leak in the connection between the yoke and the cylinder opening
48. 2
c. 1
and 3
49. 1 and
2 d. 1 and 4
ANS: D
A hissing noise means that there is a leak somewhere in the
system. Typically, that will occur between the yoke and the cylinder opening or
if there is a crack in the flowmeter. Inadequate pressure or an obstruction
would not cause a hissing sound.
PTS:
1
REF: Page 67
44. A
full “H” size cylinder is used to provide oxygen to an air-entrainment mask at
6 L/min. If the cylinder is replaced at 500 psig, how long will it last?
45. 5
hours c. 10 hours 50 minutes
46. 10
hours 20 minutes
d. 15 hours
23 minutes
ANS: D
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). H cylinder factor = 3.14. Full-size “H” cylinder =
2265 psig. If the cylinder is changed at 500 psi, then 2265 – 500 = 1765 (1765
psi will be used). (3.14 ´
1765)/6 L/min = 923.7 minutes/60 = 15 hours (0.39 ´ 60) = 15 hours 23
minutes.
PTS:
1
REF: Page 67, Box 3-5
45. An
“E” size cylinder with 1600 psig is used to provide oxygen to a simple mask
running at 5 L/min during a transport. The cylinder will last:
46. 8
hours. c.
68 minutes.
47. 56
minutes. d.
89 minutes.
ANS: D
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). “E” size factor = 0.28. A simple mask should run
at a minimum of 5 L/min. Therefore, (1600 ´
0.28)/5 L/min = 448/5 = 89.6 minutes.
PTS:
1
REF: Page 67, Box 3-5
46. An
“E” size oxygen cylinder with 2000 psig in it is being used at 4 L/min. How
much will be used in 45 minutes?
47. 26.2
psig c.
180 psig
48. 140
psig d. 643
psig
ANS: D
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). (2000 ´
0.28)/4 = 140 minutes to use up 2000 psig. Therefore, 2000 psig/140 min = X
psig/1 minute X = 14.3 psig/min ´ 45
minutes = 642.8 psig.
PTS:
1
REF: Page 67, Box 3-5
47. A “G”
size oxygen cylinder with 1450 psig is being used at 5 L/min. This cylinder
will be empty in approximately _____ hour(s) and _____ minutes.
48. 1; 30
c. 11;
30
49. 2; 39
d. 15; 16
ANS: C
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). “G” size cylinder factor = 2.41. Amount of time =
(1450 ´
2.41)/5 = 698.9 minutes/60 = 11 hours 39 minutes.
PTS:
1
REF: Page 67, Box 3-5
48. The K
cylinder at a patient’s bedside contains 1300 psig and is using 7 L/min. It
will take approximately _____ hours to use 800 psig.
49. 3.7 c.
6
50. 9.7
d. 4
ANS: C
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). K factor = 3.14. Time to use 800 psi = (800 ´ 3.14)/7 = 358.8
min/60 = 5 hours 59 minutes.
PTS:
1
REF: Page 57, Box 3-5
49. The E
cylinder on a crash cart contains 900 psig. How long would the cylinder last if
used at 10 L/min?
50. 1
hour c.
3 hours 36 minutes
51. 25
minutes d. 4
hours 42 minutes
ANS: B
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). E factor = 0.28. Time to use 900 psig = (900 ´ 0.28)/10 = 25
minutes.
PTS:
1
REF: Page 67, Box 3-5
50. A “G”
size cylinder with 2000 psig is used for 6 hours at 5 L/min. How much gas was
used during this time?
51. 2000
psig c.
573 psig
52. 750
psig d. 107
psig
ANS: B
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). G factor = 2.41. Time to use 2000 psig = (2000 ´ 2.42)/5 = 964
minutes/60 = 16 hours. 2000 psig /16 hours = X psig/6 hours. X = 750 psig will
be used in 6 hours at 5 L/min.
PTS:
1
REF: Page 67, Box 3-5
51. Which
of the following statements is (are) true with regard to liquid bulk systems?
52. Liquefied
oxygen occupies a fraction of the space required for the storage of gaseous
oxygen.
53. The
CGA regulates the construction of liquid oxygen systems.
54. A
bulk oxygen system contains more than 40,000 ft of oxygen.
55. The
working pressure of a liquid bulk oxygen system is 50 psig.
56. 2
c. 1
and 3
57. 3 and
4 d. 1 and 4
ANS: D
See Box 3-6.
PTS:
1
REF: Page 68, Box 3-6
52. The
function of the vaporizer of a liquid bulk oxygen system is to:
53. act
as a pressure release.
54. reduce
the pressure to 50 psig.
55. convert
liquid oxygen to gaseous oxygen.
56. allow
heat to be released into the environment.
ANS: C
The reservoir stores a mixture of liquid and gaseous oxygen. The
vaporizer acts as a heat exchanger where heat is absorbed from the environment
and used to warm the liquid oxygen to room temperature, thus forming gaseous
oxygen.
PTS:
1
REF: Page 67
53. The
gas above liquid oxygen is maintained:
54. between
its freezing point and its critical temperature.
55. between
its boiling point and its critical temperature.
56. at
its critical pressure.
57. at
its boiling point.
ANS: B
The pressure-release valve allows some of the gas on top of the
liquid to escape if the contents are warmed too much. This release of gas
allows the gas within the container to expand, thus lowering the temperature.
This maintains the gas under pressure between its boiling point and its
critical temperature so that the majority of the reservoir’s contents will be
maintained in the liquid state.
PTS:
1
REF: Page 67
54. The
application of Gay-Lussac’s law in a bulk liquid oxygen system:
55. accounts
for the conversion of the liquid oxygen to gaseous oxygen.
56. allows
the reservoir contents to be maintained in the liquid state.
57. keeps
the liquid oxygen above its critical temperature.
58. allows
the gas to be maintained at 50 psig.
ANS: B
According to Gay-Lussac’s law, if the volume of a gas remains
constant, there is a direct relationship between the absolute pressure of a gas
and its temperature. This release of gas allows the gas within the container to
expand, thus lowering the temperature.
PTS:
1
REF: Page 67
55. Which
of the following are components of a bulk liquid oxygen system?
56. 3AA
container
57. Insulated
reservoir
58. Pressure-release
valve
59. A
heater for the liquid oxygen
60. 2 and
3 c. 2
and 4
61. 1 and
3 d. 1 and 4
ANS: A
A bulk liquid oxygen system consists of an insulated reservoir,
a vaporizer with associated tubing attached to the reservoir, a
pressure-reducing valve, and an appropriate pressure-release valve.
PTS:
1
REF: Page 67
56. The
NFPA requires bulk oxygen systems to be located:
57. 10
feet from flammable gas storage.
58. 10
feet from public sidewalks.
59. 5
feet from the property line.
60. 5
feet from congested areas.
61. 1 and
4 c. 2,
3, and 4
62. 2 and
3 d. 1, 2, 3,
and 4
ANS: B
See Box 3-6.
PTS:
1
REF: Page 70, Figure 3-11
57. According
to the NFPA, for a nonambulatory patient, the minimum distance from a bulk
oxygen supply is _____ feet.
58. 5
c. 25
59. 10
d. 50
ANS: D
See Figure 3-11.
PTS:
1
REF: Page 70, Figure 3-11
58. One
liter of liquid oxygen weighs _____ oz.
59. 25
c. 86
60. 40
d. 860
ANS: B
One liter of oxygen weighs 2.5 lb. 2.5 lb ´ 16 oz/lb = 40 oz.
PTS:
1
REF: Page 69
59. A
home care patient inquires about how long her portable liquid oxygen system,
currently weighing 30 lb, will last if she uses 3 L/min. The manufacturer says
the weight of an empty container is 8 lb. Her system will last for _____ day(s)
and _____ hours.
60. 1; 18
c. 4;
21
61. 2; 9
d. 8; 12
ANS: A
First subtract 8 lb from 30 lb = 22 lb. Convert 22 lb/2.5 lb/L =
8.8 L. 8.8 L ´ 860
(liter of liquid oxygen multiplied by 860 equals the liters of gaseous oxygen)
= 7568 L. Then divide by liter flow. 7568/3 L/min = 2522 min = 1 day 18 hours.
PTS:
1
REF: Page 70, Box 3-7
60. If a
portable liquid oxygen reservoir is set to deliver 6 L/min and the current
reservoir weight is 38 lb, it will take _____ hours for the reservoir to empty
if the weight of an empty container is 10 lb.
61. 5
c. 27
62. 23
d. 36
ANS: C
Subtract 10 lb from 38 lb = 28 lb. Convert 28 lb/2.5 lb/L = 11.2
lb. 11.2 lb ´ 860
= 9632 L. Then divide by liter flow: 9632 L/6 L/min = 1605 minutes, or 27
hours.
PTS:
1
REF: Page 70, Box 3-7
61. Approximately
how long will a liquid oxygen reservoir last when supplying 3 L/min to your
patient? The current reservoir weight is 20 lb, and the weight of an empty
reservoir is 10 lb.
62. 19
hours
c. 46
hours
63. 38
hours d. 119
hours
ANS: A
Subtract 10 lb from 20 lb = 10 lb. Convert 10 lb/2.5 lb/L= 4 L.
4 ´ 860
= 3440 L. Then divide by the flow 3440 L/3 L/min = 1146 minutes, or 19 hours.
PTS:
1
REF: Page 70
62. During
your home care visit on Monday morning, you weigh the patient’s portable liquid
oxygen reservoir. The liquid oxygen weighs 18 lb, and the patient is using 2
L/min. When should you schedule a visit to fill up the reservoir?
63. The
next Monday
c.
Thursday afternoon
64. Wednesday
morning d.
Friday afternoon
ANS: B
18 lb/2.5 lb/L=7.2 L. 7.2 L ´ 860
= 6192 L/2 L/min = 3096 minutes, or 51 hours 36 minutes, which is 2 days 3
hours 36 minutes. So it would have to be filled on Wednesday.
PTS:
1
REF: Page 70, Box 3-7
63. Which
of the following types of compressor can accommodate a mechanical ventilator?
64. Diaphragm
65. Liquid
air
66. Rotary
67. Piston
68. 1
c. 3
and 4
69. 2 and
4 d. 1, 3,
and 4
ANS: C
Rotary compressors use a rotating vane to compress air from an
intake valve. As the rotating vane turns, gas is drawn into the cylinder
through a one-way valve (Figure 3-16). The rotor turns, which causes the gas to
be compressed as the oval-shaped cylinder becomes smaller. The compressed gas
is then forced out of the compressor through another one-way outflow valve.
Low-pressure rotary compressors are used in ventilators such as the Bennett
MA-1. Piston compressors use the action of a motor-driven piston to compress
atmospheric air. The piston is seated within a cylinder casing and is sealed to
it with a carbon or Teflon ring. Figure 3-14 illustrates the operational
principle of a typical piston air compressor used to power a mechanical
ventilator.
PTS:
1
REF: Page 73
64. Which
of the following is (are) a small nebulizer compressor(s)?
65. Diaphragm
66. Liquid
air
67. Rotary
68. Piston
69. 4
c. 1
and 2
70. 1
d. 1, 3, and
4
ANS: B
A flexible diaphragm is attached to a piston to compress gas. As
the piston moves down, the diaphragm is bent outward and gas is drawn through a
one-way valve into the cylinder. Upward movement of the piston forces the gas
out of the cylinder through a separate one-way outflow valve. Examples of
diaphragm compressors are the Air Shields Diapump and the DeVilbiss small
nebulizer compressor.
PTS:
1
REF: Page 73
65. Which
of the following agencies makes recommendations for medical air supply?
66. ISO
c. CGA
67. NFPA
d. Bureau of
Medical Devices
ANS: B
See Box 3-8.
PTS:
1
REF: Page 72, Box 3-8
66. Which
of the following statements about medical air supplies are false?
67. The
air intake port must be located indoors.
68. The
source of medical air must be from the outside atmosphere.
69. Most
hospital bulk air supply systems use two compressors.
70. Backflow
through the compressors that are cycled off must be prevented manually.
71. 1 and
4 c. 2
and 3
72. 1, 2,
and 3 d. 3
and 4
ANS: A
See Box 3-8.
PTS:
1
REF: Page 72, Box 3-8
67. Which
of the following type(s) of air compressors is (are) used in bulk supply
systems?
68. Piston
69. Rotary
70. Liquid
air
71. Diaphragm
72. 1 and
4 c. 1
and 2
73. 1 and
3 d. 2
ANS: C
To power a bulk air supply, either a piston or a rotary
compressor is necessary. Liquid air is not used as a source for bulk supply. A
diaphragm air compressor could not keep up with the requirements of a bulk
system.
PTS:
1
REF: Page 54, Box 3-2
68. The
NFPA requires that bulk oxygen systems be at least how many feet from parked
vehicles?
69. 5
c. 15
70. 10
d. 20
ANS: B
See Figure 3-11.
PTS:
1
REF: Page 70, Figure 3-11
69. If
the working pressure of a bulk oxygen system is 45 psig, all pressure-relief
valves should be set at _____ psig.
70. 45 c.
67
71. 50
d. 80
ANS: C
All pressure-relief valves are set 50% higher than the system
working pressure (e.g., set at 75 psi for a 50-psi system pressure).
PTS:
1
REF: Page 74
70. In
the event of a fire in a hospital, which of the following might be necessary?
71. Provide
supplemental oxygen to patients who require it.
72. Shut
off oxygen zone valves to the affected area.
73. Shut
off the main oxygen valve.
74. Check
oxygen line pressure.
75. 3
c. 2
and 4
76. 1 and
2 d. 3 and 4
ANS: B
In case of fire, affected zones can be isolated, thus preventing
the problem from spreading to other areas of the hospital. And always remember
patient safety in terms of applying the appropriate oxygen to each patient.
PTS:
1
REF: Page 74
71. Which
of the following are safety features incorporated into a medical gas piping
system?
72. Zone
valves
73. Riser
valves
74. Pressure-relief
valves
75. In-line
oxygen analyzers
76. 3 and
4 c. 1
and 4
77. 1 and
3 d. 1, 2,
and 3
ANS: D
See Figure 3-17.
PTS:
1
REF: Page 75
72. Which
safety system(s) is (are) found at station outlets of a medical gas piping
system?
73. Diameter
Index Safety System (DISS)
74. American
Standard Safety System (ASSS)
75. Pin
Index Safety System
76. Quick
Connect
77. 1
c. 2
and 3
78. 1 and
4 d. 2 and 4
ANS: B
Station outlets are designed with safety systems that prevent
the connection of incompatible devices. Two safety systems are currently
available: the DISS and Quick-Connect adapters.
PTS:
1
REF: Page 76
73. The
type of station outlet connection that uses noninterchangeable thread fittings
to connect gas-powered devices to station outlets is known as:
74. regulator.
c. Pin
Index Safety System.
75. quick-connect
adapter. d. DISS.
ANS: D
Figure 3-20 shows an outlet that uses DISS. This system, which
was designed by the CGA, uses noninterchangeable thread fittings to connect
gas-powered devices to station outlets.
PTS:
1
REF: Page 78
74. Which
of the following statements are true concerning station outlets?
75. Check
valves are safety valves that close automatically when an adapter is disengaged
from the outlet.
76. Station
outlets do not have ASSS connections.
77. Quick-connect
adapters use noninterchangeable thread fittings.
78. Check
valves must hold a minimum of 200 psig.
79. 3 and
4 c. 2
and 4
80. 1, 3,
and 4 d. 1
and 2
ANS: D
Station outlets have safety valves that close automatically when
an adapter is disengaged from the outlet (i.e., quick-connect adapters). The
quick-connect adapters and the DISS are the two safety systems that can be at a
station outlet.
PTS:
1
REF: Page 76
75. What
percentage of oxygen does a typical molecular sieve concentrator provide when
it is running at 2 L/min?
76. 100%
c. 85%
77. 90%
d. 40%
ANS: B
The concentration of oxygen leaving the system depends on the
flow rate set. For example, at flows less than 6 L/min, the gas contains
approximately 92% to 97% oxygen.
PTS:
1
REF: Page 79
76. Which
is true about the process of fractional distillation of liquid air?
77. Compressed
air is a by-product.
78. It
produces pure liquid oxygen.
79. Liquid
nitrous oxide is produced.
80. Concentrators
use it to produce oxygen.
ANS: B
The fractional distillation of liquid air creates pure liquid
oxygen. There are no by-products from this method. Oxygen concentrators take in
room air and separate oxygen from nitrogen.
PTS:
1
REF: Page 54, Box 3-1
77. One
liter of liquid oxygen is equivalent to _____ liters of gaseous oxygen.
78. 2.5
c. 348
79. 328
d. 860
ANS: D
Oxygen expands to 860 times its liquid volume at 25° C and 1
atm; therefore, the total volume of gaseous oxygen available can be calculated
by multiplying the number of liters of liquid oxygen by 860.
PTS:
1
REF: Page 67
78. Which
of the following statements are true given that, on one side of a medical gas
cylinder, the only markings to appear are 3 (tw) 84 + *.
79. The
cylinder passed the hydrostatic test.
80. The
cylinder must be retested after 5 years.
81. The
cylinder must be retested after 10 years.
82. The
cylinder was manufactured in March 1984.
83. Hydrostatic
testing was performed in March 1984.
84. 2, 3,
and 4
c. 1,
4, and 5
85. 2, 3,
and 5 d. 1,
2, and 4
ANS: D
See Figure 3-4.
PTS:
1
REF: Page 61
79. Which
of the following statements reflect(s) the recommendations of the NFPA and CGA
for storing cylinders outdoors?
80. Cylinders
should not be stored in an area where the temperature exceeds 125° F.
81. Cylinders
must be protected from the weather.
82. Full
and empty cylinders should be kept separate.
83. Cylinders
should not be stored outside.
84. 4
c. 2
and 3
85. 1 and
2 d. 1, 2,
and 3
ANS: D
See Box 3-3.
PTS:
1
REF: Page 58, Box 3-3
80. Which
of the following large-cylinder safety recommendations is not appropriate?
81. Protective
caps are not necessary during storage.
82. Cylinders
should be transported with protective caps.
83. Cylinder
carts used in the operating room must be grounded.
84. Transportation
must occur on an appropriate cart, onto which the cylinder is secured by a
chain.
ANS: A
Large cylinders have a protective cap that fits over the valve
stem. This cap should be kept on cylinders when moving or storing them.
PTS:
1
REF: Page 58, Box 3-3
81. Which
of the following types of oxygen storage device are appropriate for home care?
82. Manifold
83. Compressor
84. Concentrator
85. Bulk
oxygen system
86. Liquid
oxygen cylinder
87. 2 and
5 c. 2,
3, and 5
88. 2 and
4 d. 1, 4,
and 5
ANS: A
Concentrators are used in the home care setting for patients who
require low-flow oxygen. Liquid oxygen cylinders can allow the patient more
time outside of the home during travel. Manifolds and bulk oxygen systems are
not appropriate for home care. Compressors provide medical air, not oxygen.
PTS:
1
REF: Page 79
82. Which
of the following have the fastest diffusion rate through the semipermeable
membrane of an oxygen concentrator?
83. Carbon
dioxide
84. Water
vapor
85. Nitrogen
86. Oxygen
87. 1 and
2 c. 3
and 4
88. 1 and
3 d. 2 and 4
ANS: D
Oxygen concentrators are devices that produce enriched oxygen
from atmospheric air. Thus, oxygen and water vapor diffuse through these
membranes faster than nitrogen.
PTS:
1
REF: Page 77
83. The
concentration of oxygen leaving an oxygen concentrator depends on the:
84. number
of sieves in the unit.
85. number
of compressors used.
86. set
flow rate of the gas exiting.
87. size
of the sodium-aluminum silicate pellets.
ANS: C
Atmospheric gases diffuse through the membrane at different
rates. The rate at which a gas diffuses depends on its diffusion constant and
solubility for the plastic membrane and the pressure gradient for the gas
across the membrane.
PTS:
1
REF: Page 77
84. Bulk
oxygen is produced through which of the following?
85. Molecular
sieves
c.
Semipermeable membranes
86. Fractional
distillation
d. Combustion
of natural gas
ANS: B
Fractional distillation generates bulk oxygen. Molecular sieves
and semipermeable membranes are used in oxygen concentrators. The combustion of
natural gas produces carbon dioxide.
PTS:
1
REF: Page 54
85. Which
of the following gases is used to treat singultus?
86. Air
c.
Nitrous oxide
87. Oxygen
d. Carbon
dioxide
ANS: D
Carbon dioxide is used for the treatment of singultus (hiccups)
and as a stimulant/depressant of the central nervous system.
PTS: 1
REF: Page 55
86. At
–183° C, which of the following gases exists as a pale, bluish liquid that is
slightly heavier than water?
87. Air
c.
Nitrous oxide
88. Oxygen
d. Carbon
dioxide
ANS: B
Oxygen is an elemental gas that is colorless, odorless, and
tasteless at normal temperatures and pressures. It makes up 20.9% of the
Earth’s atmosphere by volume and 23.2% by weight. It constitutes approximately
50% of the Earth’s crust by weight. Oxygen is slightly heavier than air, having
a density of 1.326kg/m3 at 21.1° C and 760 mm Hg (specific gravity = 1.105). At
temperatures less than –183° C (–300° F), oxygen exists as a pale, bluish
liquid that is slightly heavier than water.
PTS:
1
REF: Page 54
87. Which
of the following gases may be used as a refrigerant?
88. Oxygen
c.
Carbon dioxide
89. Nitric
oxide d.
Carbon monoxide
ANS: C
Solid carbon dioxide is used to refrigerate perishable materials
during transport (e.g., food and laboratory specimens). Liquid carbon dioxide
can be used as an expendable refrigerant and is used extensively as a
fire-extinguishing agent in portable and stationary fire-extinguishing systems.
PTS:
1
REF: Page 55
88. Which
of the letters points to the manufacturer’s mark?
1. A
c. C
2. B
d. D
ANS: B
See Figure 3-4.
PTS:
1
REF: Page 61
89. Which
size cylinder is currently used for the storage of nitric oxide?
90. 61.4
cubic feet
c. 110
cubic feet
91. 82
cubic feet d.
152 cubic feet
ANS: B
Before 1997, nitric oxide was supplied in cylinders with a
volume capacity of 152 cubic feet. It is now supplied in smaller cylinders (82
cubic feet) with 626 CGA valve outlets.
PTS:
1
REF: Page 56
90. The
cylinder color for nitric oxide is:
91. red.
c. teal
and black.
92. light
blue. d.
brown and green.
ANS: C
See Table 3-4.
PTS:
1
REF: Page 61
91. Which
gas law is applied in a fusible-plug pressure-relief valve?
92. Boyle’s
c. Dalton’s
93. Charles’
d.
Gay-Lussac’s
ANS: D
The pressure-release valve allows some of the gas on top of the
liquid to escape if the contents are warmed too much. This release of gas
allows the gas within the container to expand, thus lowering the temperature.
This maintains the gas under pressure between its boiling point and its
critical temperature so that the majority of the reservoir’s contents will be
maintained in the liquid state.
PTS:
1
REF: Page 67
92. The
American Standard System connections for all life support gases are
_____-handed and _____.
93. Left;
internal
c.
Right; internal
94. Left;
external d.
Right; external
ANS: D
Note that the connections for oxygen and other life-support
gases are right-handed and external.
PTS:
1
REF: Page 64
93. Which
of the following is the Pin Index Safety System pin position for oxygen?
1. A
c. C
2. B
d. D
ANS: A
Recall that in this system, indexing is accomplished by the
exact placement of two pins into holes in the post valve.
PTS:
1
REF: Page 66, Figure 3-9
94. An “E”
size oxygen cylinder with 2200 psig has a set flow rate of 2 L/min. It will
take _____ hours and _____ minutes until the gauge pressure reaches 400 psig.
95. 5; 30
c. 4;
30
96. 5; 6
d. 4; 12
ANS: D
Amount of time left in cylinder = (cylinder pressure ´ cylinder factor)/flow
rate of gas (liters/minute). 2200 – 400 = 1800 psig (the amount of gas that
will be used). (1800 ´
0.28)/2 = 252 minutes/60 = 4 hours 12 minutes.
PTS:
1
REF: Page 67, Box 3-5
95. Which
of the following “E” size oxygen cylinders will last the longest?
Pressure
Flow
(psig)
(L/min)
1. 1600
3
c.
800
2
2. 1400
2.5
d.
400
1
ANS: B
This answer was derived from the following formula:
1400 ´ 0.28
= 392/2.5 L/min = 156.8 minutes.
1400 psig at 2.5 L/min will last the longest compared with the
other three.
PTS:
1
REF: Page 67, Box 3-5
96. An
“H” size oxygen cylinder with 1600 psig has a set flow rate of 3 L/min. It will
take _____ hours and _____ minutes to reach 300 psig.
97. 17;
24 c.
22; 40
98. 21;
25 d. 27; 54
ANS: C
The same formula as described in the previous question is used
here; however, you first have to subtract 300 psig from 1600 psig to get the
exact duration for 1300 psig. (1300 ´
3.14)/3 = 1360.7 minutes/60 = approximately 22 hours 40 minutes.
PTS:
1
REF: Page 67, Box 3-5
97. The
following figure represents the components of which of the following?
1. Hydrostatic
testing system
c.
Fractional distillation apparatus
2. Bulk
liquid oxygen system
d.
Alternating oxygen supply system
ANS: B
Recall also Figure 3-10.
PTS:
1
REF: Page 68, Box 3-6
98. Which
of the following “G” size oxygen cylinders will run out of oxygen first?
Pressure Flow
(psig) (L/min)
1. 700
1.5
c.
1100 2.5
2. 900
1.0
d. 1600
3.0
ANS: C
This answer was derived from the following formula:
The cylinder factor is 3.14. 1100 psig has the shortest duration
at 1382 minutes, or 23 hours.
PTS:
1
REF: Page 67, Box 3-5
99. According
to the NFPA, the minimum distance for a place of public assembly from a bulk
oxygen storage system is how many feet?
100.
10
c. 25
101.
15
d. 50
ANS: D
See Figure 3-11.
PTS:
1
REF: Page 70
100.
Storage of a portable liquid oxygen system adjacent to a heat
source will _____ the _____ of the oxygen.
101.
Increase; pressure
c.
Decrease; pressure
102.
Increase; venting
d. Decrease;
venting
ANS: B
Liquid oxygen units should not be located adjacent to heat
sources, which can accelerate the venting of oxygen.
PTS:
1
REF: Page 72, Box 3-8
101.
A stationary liquid oxygen system contains 80 lb of oxygen when
full. A home care patient is using it 8 hours each day, during sleep, at a rate
of 3 L/min. At this usage, how many days will the liquid oxygen last?
102.
6
c. 19
103.
8
d. 27
ANS: C
Use the liquid oxygen duration formula as given previously.
A liter of liquid oxygen weighs 2.5 lb, so: 80 lb/2.5 = 32 L.
Gaseous oxygen occupies a volume that is 860 times the volume of
liquid oxygen, so: liters of liquid ´ 860
= liters of gas.
Duration of supply (minutes) = gas supply remaining (in liters)
÷ flow (liters/minute).
Once you get the answer in minutes, you divide by 60 to obtain
the number of hours. Then divide the number of hours by the usage, which is 8
hr/day; that gives you 19 days.
PTS:
1
REF: Page 70, Box 3-7
Chapter 04: Administering Medical Gases: Regulators, Flowmeters,
and
MULTIPLE CHOICE
1. What
device helps reduce high-pressure gases from cylinders or bulk storage units to
a lower working pressure?
2. Regulator
c.
Bourdon gauge
3. Kinetic
tube d.
Thorpe tube
ANS: A
The regulator is the only device in which pressure is regulated.
The other devices relate to flow.
PTS:
1
REF: Page 84
2. The
chamber located above the diaphragm of a single-stage regulator is which of the
following?
3. Lower
chamber c.
High-pressure chamber
4. Pressure-relief
valve d.
Adjustable regulator
ANS: C
The high-pressure chamber is located above the diaphragm and
contains a valve stem that will close the inlet when the pressure reaches its
setting.
PTS:
1
REF: Page 84
3. The
gas flow into the high-pressure side regulator is dependent on what two
opposing forces?
4. Gas
pressure above the diaphragm
5. Gas
pressure at the diaphragm
6. Spring
tension below the diaphragm
7. Spring
tension above the diaphragm
8. 1 and
3 c. 2
and 4
9. 2 and
3 d. 1 and 4
ANS: A
When the force offered by the high-pressure gas above the
diaphragm equals the force offered by spring tension, the diaphragm is straight
and the inlet valve is closed.
PTS:
1
REF: Page 84
4. Delivered
pressures on common adjustable regulators are between _____ and ____ pounds per
square inch gauge (psig).
5. 0; 50
c. 50;
100
6. 0;
100 d. 50;
200
ANS: B
Most adjustable regulators can be set to deliver pressure
between 0 and 100 psig.
PTS:
1
REF: Page 84
5. Which
regulator supports the theory that gas pressure is gradually reduced as gas
flows from a high-pressure source through a series of stages to the outlet?
6. Single-stage
regulator
c.
Preset regulator
7. Flowmeter
d. Multistage
regulator
ANS: D
Gas from a compressed cylinder (e.g., 2200 psig) enters the
first stage of a two-stage regulator, and the gas pressure is reduced to an
intermediate pressure (e.g., 700 psig). This lower pressure gas then enters
into the second stage of the regulator, where the gas pressure is further
reduced to the desired working pressure (e.g., 50 psig) before the gas reaches
the outlet.
PTS:
1
REF: Page 85
6. Which
device is more precise in terms of controlling gas pressure?
7. Bourdon
flowmeter
c.
Multistage regulator
8. Thorpe
tube flowmeter
d. Flow
restrictors
ANS: C
Multistage regulators can control gas pressure with more
precision than single-stage regulators because the pressure is gradually
reduced.
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