Chapter 26: Arterial Blood Gas Sampling
Multiple Choice
1. When performing an arterial puncture on an adult, which of the following should be the site of
choice?
A. femoral artery
B. radial artery
C. ulnar artery
D! all of the above
ANS: B
2. Prior to arterial puncture, which of the following should the respiratory therapist perform to
assess collateral circulation via the ulnar artery?
A. Allen’s test
B. capillary refill
C. pulse pressure
D. systolic pressure
ANS: A
3. During a cardiac arrest, the preferred site for arterial puncture is which of the following?
A. brachial artery
B. dorsalis pedis
C. femoral artery
D. tibial artery
ANS: C
4. Which of the following must be performed in order to prevent a blood gas analysis error and
inaccurate results?
A. cleaning the puncture site with antiseptic
B! mixing the blood sample and heparin
C! removing visible air bubbles from the sample
D! both B and C
ANS: D
5. When performing a radial artery puncture, which of the following describes the correct needle
and syringe position?
A. bevel facing upward, syringe at a 25° angle
B. bevel facing down, syringe at a 25° angle
C. bevel facing upward, syringe at a 45° angle
D. bevel facing down, syringe at a 45° angle
ANS: C
6. If an air bubble remains in the syringe of an arterial blood sample, which of the following is
likely to occur?
A. there will be an increase in PaCO2 and PaO2
B. there will be a decrease in PaCO2 and PaO2
C. there will be a decrease in PaCO2 and an increase in PaO2
D. there will be an increase in PaCO2 and a decrease in PaO2
ANS: C
7. Complications of arterial punctures include which of the following?
A. introduction of contagion and subsequent infection
B. formation of a hematoma at the puncture site
C. interruption of blood flow distal to the puncture site
D! all of the above
ANS: D
8. The physician requests an arterial blood gas sample for an adult patient who is admitted with
burns over his chest and both arms. Which of the following would be acceptable sites for arterial
access?
A! femoral artery
B! dorsalis pedis artery
C. brachial artery
D! both A and B
ANS: D
9. You are performing an arterial puncture at the radial site on an adult patient. As you advance
the needle, you observe a flash of blood then blood flow stops. Which of the following actions
should you take next?
A. slowly pull back on the needle until blood flow begins
B. pull the needle out completely and attempt another site
C. palpate the artery then redirect the needle to the left or right
D. request that another therapist attempt to draw the sample
ANS: A
10. Which of the following patients would best be suited for an indwelling arterial line?
A. COPD patient admitted with pneumonia
B. mechanically ventilated burn patient with smoke inhalation
C. 2-year-old patient admitted with bronchiolitis
D. emergency room patient in status asthmaticus
ANS: B
NARRBEGIN: Figure 26-11
[[insert figure 26-11A from the book]]
NARREND
11. Which of the following statements is true concerning the position of the valve stem of the
stopcock in this figure?
A. blood from the artery will fill the syringe
B. heparinized solution will fill the syringe
C. heparinized solution is flowing through the line
D. there is no flow from the pressure bag or the patient
ANS: C
NAR: Figure 26-11
12. After withdrawing a sample of blood from an arterial line, you observe that the waveform on
the monitor appears to be over-dampened. This can be the result of which of the following?
A. excessive length of the tubing
B! loose tubing connection
C! deflated pressure bag
D! both B and C
ANS: D
13. When drawing a sample of arterial blood for blood gas and electrolyte analysis, the
respiratory therapist should select a syringe that contains which of the following?
A. sodium heparin
B. dry lithium heparin
C. saline solution
D! none of the above
ANS: B
14. You have been called to the nursery to collect a capillary sample of blood from a newborn. In
order to promote blood flow to the heel, which of the following techniques would you use?
A. squeeze the heel to promote blood flow to the skin surface of the heel
B. place the infant in an upright position to allow blood to flow to the feet
C. warm the heel area for 5 to 10 minutes by wrapping with a warm soak
D. place the infant’s heel under a heat lamp to warm the intended site
ANS: C
15. What is the purpose of using a metal flea and magnet for a capillary tube sample of blood?
A. to mix the heparin in the tube with the blood sample
B. prevents the need for icing the sample of blood
C. stops the metabolism of the blood sample
D. allows for injection of sample into the analyzer
ANS: A
Multiple Response
16. What information must you include with your documentation of the arterial blood gas
analysis? Select all that apply.
A. ventilatory status
B. FIO2 at the time of puncture
C. vital signs
D. urine output
E. patient temperature
ANS: A, B, E
17. What information would you gather from the patient chart prior to performing an arterial
puncture? Select all that apply.
A. physician order and instructions
B. presence of dialysis shunt
C. note any anticoagulant therapy
D. presence of vascular abnormalities
E. time of last bronchodilator treatment
ANS: A, B, C, D
18. Which of the following are acceptable methods of covering the needle once an arterial
sample has been collected? Select all that apply.
A. with two hands, carefully recap the needle using the needle cover
B. with one hand holding the syringe, insert the needle into the rubber stopper
C. break the needle in half with a needle cutting device prior to disposal
D. do not cover the needle if disposing into a sharps biohazard container
E. using one hand, cover the needle using a self-capping needle protection device
ANS: B, E
19. In addition to a prepackaged arterial blood gas kit, what else would you gather before
performing an arterial puncture? Select all that apply.
A. lancets, various sizes
B. container of ice
C. sterile drape
D. heparin vial
E. gloves
ANS: B, C, E
20. Problems associated with capillary sampling that affect the accuracy of the test include which
of the following? Select all that apply.
A. contamination with air
B. presence of fetal hemoglobin
C. formation of clots
D. puncture of lateral aspect of heel
E. insufficient quantity
ANS: A, C, E
