Chapter Review Questions 1. Which of the following personnel may be required to perform arterial puncture? a. EMTs c. Phlebotomists b. MTs d. All of the above 2. O2 saturation measures the: a. alkalinity of the blood plasma. b. amount of oxygen dissolved in the plasma. c. oxygen pressure in the lungs. d. percent of oxygen bound to hemoglobin. 3. Which is the first-choice artery for ABG collection? a. Brachial c. Radial b. Femoral d. Ulnar 4. Which of the following is the most important criterion for selecting an artery for ABG collection provided that there is no other reason to avoid the site? a. Collateral circulation b. Depth of the artery c. Dominance of the arm d. Strength of the pulse 5. The anticoagulant used in ABG specimen collection is: a. EDTA. c. potassium oxalate. b. heparin. d. sodium citrate. 6. In addition to identification information, which of the following is typically documented before ABG specimen collection? a. FiO2 or L/M c. Room temperature b. History of smoking d. All of the above 7. A phlebotomist must collect an ABG specimen when the patient is breathing room air. The patient has just been taken off the ventilator when the phlebotomist arrives. When can the phlebotomist draw the ABG specimen? a. After 1 hour c. In 5 to 10 minutes b. Immediately d. In 20 to 30 minutes 8. A phlebotomist has a request to collect an ABG specimen on a patient. The patient has a positive Allen test on the right arm. What should the phlebotomist do? a. Collect the specimen by capillary puncture. b. Collect the specimen from the right radial artery. c. Collect the specimen from the right ulnar artery. d. Perform the Allen test on the left arm. 9. Which of the following is an acceptable range of needle gauges for arterial puncture? a. 16 to 21 c. 20 to 25 b. 18 to 23 d. 23 to 28 10. In performing radial artery puncture, the needle should enter the skin: a. at the exact point where the pulse is felt. b. distal to where the pulse is felt. c. lateral to where the pulse is felt. d. proximal to where the pulse is felt. 11. Normally, when the needle enters the artery: a. a flash of blood appears in the syringe. b. the syringe plunger starts to vibrate. c. you may hear a soft swishing sound. d. all of the above can happen. 12. An ABG specimen is most likely to be rejected if it: a. arrives at the laboratory 20 minutes after collection. b. contains only around 2 mL of blood. c. is collected in a glass syringe. d. is determined to be QNS. 13. Which of the following is the best way to tell that the specimen you are collecting is in fact arterial blood? a. A flash of blood appeared in the syringe on needle entry. b. Blood pulsed into the syringe under its own power. c. The color of the blood is bright cherry-red. d. There is no way to tell for certain. 14. A single routine arterial specimen for both ABG and electrolyte testing should be transported: a. at room temperature. c. on ice. b. green-top tube. d. STAT. 15. The risk of hematoma associated with arterial puncture is greatest if: a. a large-diameter needle is used. b. the patient is elderly. c. the patient is on a blood thinner. d. all of the above.
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Critical Thinking 55. A patient in the hospital has an intravenous catheter inserted to allow for the delivery of medications, fluids, and electrolytes. Four days after the catheter is inserted, the patient develops a fever and an infection in the skin around the catheter. Blood cultures reveal that the patient has a blood-borne infection. Tests in the clinical laboratory identify the blood-borne pathogen as Staphylococcus epidermidis, and antibiotic susceptibility tests are performed to provide doctors with essential information for selecting the best drug for treatment of the infection. Antibacterial chemotherapy is initiated and delivered through the intravenous catheter that was originally inserted into the patient. Within 7 days, the skin infection is gone, blood cultures are negative for S. epidermidis, and the antibacterial chemotherapy is discontinued. However, 2 days after discontinuing the antibacterial chemotherapy, the patient develops another fever and skin infection and the blood cultures are positive for the same strain of S. epidermidis that had been isolated the previous week. This time, doctors remove the intravenous catheter and administer oral antibiotics, which successfully treat both the skin and blood-borne infection caused by S. epidermidis. Furthermore, the infection does not return after discontinuing the oral antibacterial chemotherapy. What are some possible reasons why intravenous chemotherapy failed to completely cure the patient despite laboratory tests showing the bacterial strain was susceptible to the prescribed antibiotic? Why might the second round of antibiotic therapy have been more successful? Justify your answers. 56. Why are autoinducers small molecules? 57. Refer to Figure B1 in Appendix B. If the results from a pond water sample were recorded as 3, 2, 1, what would be the MPN of bacteria in 100 mL of pond water? 58. Refer to Figure 9.15. Why does turbidity lose reliability at high cell concentrations when the culture reaches the stationary phase? 59. A microbiology instructor prepares cultures for a gram-staining practical laboratory by inoculating growth medium with a gram-positive coccus (nonmotile) and a gram-negative rod (motile). The goal is to demonstrate staining of a mixed culture. The flask is incubated at 35 °C for 24 hours without aeration. A sample is stained and reveals only gram-negative rods. Both cultures are known facultative anaerobes. Give a likely reason for success of the gram-negative rod. Assume that the cultures have comparable intrinsic growth rates. 60. People who use proton pumps inhibitors or antacids are more prone to infections of the gastrointestinal tract. Can you explain the observation in light of what you have learned? 61. The bacterium that causes Hansen's disease (leprosy), Mycobacterium leprae, infects mostly the extremities of the body: hands, feet, and nose Can you make an educated guess as to its optimum temperature of growth? 62. Refer to Figure 9.29. Some hyperthermophiles can survive autoclaving temperatures. Are they a concern in health care?
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the cytoplasm (cyclosis), and the formation of another vacuole begins. Food vacuoles travel in a defined route through the organism (Fig. 16-3). They first pass posteriorly, then anteriorly, and finally posteriorly to the region of the oral groove where the undigestible contents are eliminated through the cytopyge (anal pore). Locate a food vacuole. Observe that when it is first formed, the vacuole is bright red-orange. Closely observe the vacuole as it moves through the protozoan. You will see that during digestion, its contents change from red-orange to blue-green to yellow-green to yellow and finally back to red-orange (Fig. 16-3). The reason for this color change is that Congo red is an indicator dye that changes color with pH: it is blue-green in acidic conditions and red-orange in alkaline conditions. What does this indicate about the pH of the food vacuole as it moves through the organism? The most common type of reproduction in protozoa is binary fission. In this type of asexual reproduction, the cell divides into two genetically identical daughter cells. In flagellates, the plane of division is longitudinal; in ciliates, the parent cell divides transversely. Examine demonstration slides of Paramecium showing the various stages of binary fission (Fig. 16-4). Occasionally, paramecia reproduce sexually by conjugation (Fig. 16-5), in which micronuclei are exchanged. You can observe conjugation in Paramecium by carrying out the following procedure. For this study, you will use mating strains of Paramecium bursaria, which is symbiotic with a green alga. Supplement your observations by examining commercially prepared slides showing various stages of conjugation. Put a small drop of one of the two mating strains into the depression of a deep-well slide. While observing the paramecia with a stereoscopic microscope, add a drop of the second mating strain. You should observe, almost immediately, the agglutination (or clumping) of opposite mating strains, which brings the cells together for the transfer of nuclear material. Place the slide in a covered petri dish containing moist filter paper to prevent dessication of the culture. Examine periodically. Conjugating paramecia can be seen for up to 48 hours, after which few or no conjugants are found.
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