Introduction: Patient monitoring systems are essential in modern clinical care, integrating biomedical sensors, signal processing, alarms, and data transmission to continuously track vital signs. For B.Pharm students, understanding ECG, pulse oximetry, noninvasive blood pressure (NIBP), capnography, invasive hemodynamic monitoring, temperature probes, and telemetry is vital for safe drug therapy and device–drug interactions. Core concepts include sensor principles, artifacts, sampling and filtering, calibration, alarm management, and regulatory standards like IEC 60601. Practical knowledge of interpretating waveforms, accuracy limits, and device limitations helps pharmacists support medication safety in ICU and perioperative settings. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which sensor principle does pulse oximetry primarily rely on?
- Electrical impedance
- Optical absorption at two wavelengths
- Piezoelectric effect
- Thermistor temperature change
Correct Answer: Optical absorption at two wavelengths
Q2. What is the main cause of motion artifact in ECG monitoring?
- Electromagnetic interference from power lines
- Poor electrode-skin contact and electrode movement
- Low battery in monitor
- High ambient temperature
Correct Answer: Poor electrode-skin contact and electrode movement
Q3. In invasive arterial blood pressure monitoring, what does damping of the pressure waveform indicate?
- Underdamped system with exaggerated systolic peaks
- Air bubbles, clot, or compliant tubing causing reduced waveform amplitude
- Correctly calibrated transducer
- Excessive cable length increasing frequency response
Correct Answer: Air bubbles, clot, or compliant tubing causing reduced waveform amplitude
Q4. Capnography primarily measures which parameter?
- End-tidal CO2 concentration
- Inspiratory oxygen fraction
- Arterial CO2 partial pressure directly
- Blood bicarbonate levels
Correct Answer: End-tidal CO2 concentration
Q5. Which filter type is commonly used to remove 50/60 Hz mains interference from physiological signals?
- Low-pass filter
- Notch (band-stop) filter
- High-pass filter
- All-pass filter
Correct Answer: Notch (band-stop) filter
Q6. Which lead placement is standard for a 3-lead ECG used in basic monitoring?
- Right arm, left arm, left leg
- Chest V1, V3, V5
- Both arms and chest V6
- Right arm, right leg, left leg
Correct Answer: Right arm, left arm, left leg
Q7. What does SpO2 measure clinically?
- Arterial oxygen partial pressure
- Percentage of hemoglobin saturated with oxygen in pulsatile blood
- Total hemoglobin concentration
- Oxygen content of venous blood
Correct Answer: Percentage of hemoglobin saturated with oxygen in pulsatile blood
Q8. Which standard addresses electrical safety requirements for medical electrical equipment?
- ISO 9001
- IEC 60601
- FDA 21 CFR Part 11
- IEEE 802.11
Correct Answer: IEC 60601
Q9. In oscillometric NIBP measurement, which parameter is directly detected by the cuff sensor?
- Korotkoff sounds
- Oscillations in cuff pressure from arterial wall motion
- Direct arterial pressure waveform
- Pulse oximetry signal
Correct Answer: Oscillations in cuff pressure from arterial wall motion
Q10. What is the main limitation of pulse oximetry in low perfusion states?
- Overestimation of blood pressure
- Inaccurate SpO2 due to weak pulsatile signal
- Unable to measure heart rate
- Interference with EEG monitoring
Correct Answer: Inaccurate SpO2 due to weak pulsatile signal
Q11. Which parameter is most useful to detect hypoventilation during anesthesia?
- Peripheral temperature
- End-tidal CO2 (ETCO2)
- Noninvasive blood pressure
- Pulse oximetry alone
Correct Answer: End-tidal CO2 (ETCO2)
Q12. What is the typical sampling rate recommended for diagnostic-quality ECG acquisition?
- 100 Hz
- 500–1000 Hz
- 10 Hz
- 5 kHz
Correct Answer: 500–1000 Hz
Q13. Which alarm parameter prioritization concept reduces alarm fatigue?
- Disabling all alarms at night
- Tiered alarm levels with clinically tailored thresholds
- Setting all alarms to maximum sensitivity
- Removing alarm sounds and using only visual alerts
Correct Answer: Tiered alarm levels with clinically tailored thresholds
Q14. What does signal-to-noise ratio (SNR) describe in monitoring systems?
- Ratio of digitized to analog signals
- Ratio of meaningful physiological signal amplitude to background noise amplitude
- Battery life relative to sampling frequency
- Number of sensors connected to a monitor
Correct Answer: Ratio of meaningful physiological signal amplitude to background noise amplitude
Q15. Which monitoring modality is most appropriate to detect ischemic ST-segment changes continuously?
- Pulse oximetry
- Continuous multi-lead ECG monitoring with ST analysis
- Noninvasive blood pressure monitoring
- Capnography
Correct Answer: Continuous multi-lead ECG monitoring with ST analysis
Q16. Why is calibration important for capnography sensors?
- To align temperature compensation only
- To ensure accurate CO2 concentration readings and compensate for sensor drift
- Calibration is unnecessary for modern capnometers
- To set alarm volume levels
Correct Answer: To ensure accurate CO2 concentration readings and compensate for sensor drift
Q17. Which wireless standard is commonly used for bedside monitor data transmission in hospitals?
- Bluetooth Low Energy for medical telemetry
- Zigbee for high-bandwidth streaming
- Analog radio transmission
- RFID passive tags
Correct Answer: Bluetooth Low Energy for medical telemetry
Q18. What is the significance of common-mode rejection ratio (CMRR) in ECG amplifiers?
- Ability to reject unwanted common signals like mains interference while amplifying differential ECG signal
- Measure of amplifier battery efficiency
- Indicator of frequency response flatness
- Parameter describing thermal noise only
Correct Answer: Ability to reject unwanted common signals like mains interference while amplifying differential ECG signal
Q19. Which physiological sensor type measures core body temperature most accurately in ICU settings?
- Oral digital thermometer
- Esophageal or bladder thermistor probe
- Axillary mercury thermometer
- Infrared forehead scanner only
Correct Answer: Esophageal or bladder thermistor probe
Q20. In hemodynamic monitoring, what does central venous pressure (CVP) assess clinically?
- Left ventricular ejection fraction
- Right atrial pressure as an estimate of intravascular volume status
- Pulmonary artery systolic pressure directly
- Systemic vascular resistance
Correct Answer: Right atrial pressure as an estimate of intravascular volume status
Q21. Which type of electrode gel property improves ECG signal conduction?
- High impedance and low ionic content
- Low impedance and good ionic conductivity
- Hydrophobic consistency to repel sweat
- Strong adhesive without ionic conductivity
Correct Answer: Low impedance and good ionic conductivity
Q22. What is artifact suppression by adaptive filtering useful for in monitoring?
- Eliminating all physiological variability
- Removing predictable interference like powerline or respiratory motion while preserving signal features
- Replacing analog front-end amplifiers
- Automatically diagnosing arrhythmias without clinician input
Correct Answer: Removing predictable interference like powerline or respiratory motion while preserving signal features
Q23. Which patient condition can cause falsely high SpO2 readings with standard pulse oximeters?
- Carbon monoxide poisoning
- Severe anemia with normal oxygenation
- Hypothermia alone
- Pulmonary embolism
Correct Answer: Carbon monoxide poisoning
Q24. What is the primary advantage of invasive arterial monitoring over NIBP?
- Lower infection risk
- Continuous real-time arterial pressure waveform and beat-to-beat values
- No need for calibration
- Less training required to set up
Correct Answer: Continuous real-time arterial pressure waveform and beat-to-beat values
Q25. Which data standard facilitates integration of monitor data into hospital EHR systems?
- JPEG image format
- HL7 messaging standard
- SMTP email protocol
- TCP/IP without higher-level protocol
Correct Answer: HL7 messaging standard
Q26. What is the role of impedance cardiography in patient monitoring?
- Direct measurement of arterial oxygenation
- Noninvasive estimation of stroke volume and cardiac output using thoracic bioimpedance
- Measuring intracranial pressure invasively
- Assessing peripheral arterial occlusion only
Correct Answer: Noninvasive estimation of stroke volume and cardiac output using thoracic bioimpedance
Q27. Which alarm parameter indicates a potential lead disconnection in ECG monitoring?
- Sudden loss of QRS complexes or flatline with heart rate alarm
- Sustained high SpO2 reading above 99%
- Stable respiratory rate with normal ETCO2
- High NIBP diastolic value only
Correct Answer: Sudden loss of QRS complexes or flatline with heart rate alarm
Q28. Which monitoring technique helps detect pulmonary artery pressures and cardiac output invasively?
- Plethysmography at the finger
- Pulmonary artery (Swan-Ganz) catheterization
- Surface ECG monitoring
- Transcutaneous CO2 only
Correct Answer: Pulmonary artery (Swan-Ganz) catheterization
Q29. When interpreting capnography, what does a sudden drop to near-zero ETCO2 likely indicate?
- Improved ventilation and elimination of CO2
- Disconnection or obstruction of the airway or sampling line
- Metabolic acidosis resolving
- Hypertension development
Correct Answer: Disconnection or obstruction of the airway or sampling line
Q30. For safe bedside monitoring, which practice reduces risk of electrical shock to patients?
- Using ungrounded power strips for all devices
- Regular inspection of insulation, proper grounding, and adherence to IEC 60601 isolation requirements
- Connecting monitors to high-voltage outlets to improve performance
- Bypassing equipment earth to reduce interference
Correct Answer: Regular inspection of insulation, proper grounding, and adherence to IEC 60601 isolation requirements
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com