Quiz
Mechanical Ventilation Final 141
Questions in this quiz (65)
1 During operation of a ventilator, the respiratory therapist sets the Vt at 500 mL, the mandatory rate at 10 breaths/min, and an inspiratory flow of 50 L/min. These settings are associated with what type of ventilation?
- APressure-targeted, flow-cycled ventilation
- BVolume-targeted, flow-cycled ventilation
- CVolume-Targeted, time-cycled ventilation
- DVolume-targeted, pressure-cycled ventilation
2Which of the following are common phase variables for PC-CMV?
1. Flow Trigger
2. Pressure Limit
3. Time Cycle
4. Flow Limit- A1 and 2 only
- B2,3, and 4 only
- C1,2, and 3 only
- D2 and 4 only
3What is the normal range of PAO2-PaO2 for healthy young adults breathing room air?
- A5-10 mmHg
- B10-20 mmHg
- C20-30 mmHg
- D50-90 mmHg
4Under normal physiological circumstances, how many mL of O2 are capable of combining with 1 g of Hb?
- A0.003 mL
- B0.45 mL
- C0.82 mL
- D1.34 mL
5Calculate the Total Oxygen content: Hb=18, PaO2= 40 SaO2=73%?
- A19.5 mL/dL
- B17.7 mL/dL
- C16.5 mL/dL
- D14.8 mL/dL
6Calculate the FiO2 needed if the a/A ratio=0.55 and the physician wants a PaO2 of 100 mmHg?
- A47%
- B80%
- C33%
- D39%
7What is the VD/VT ratio if their PaCO2 is 40 mmHg and the PeCO2 is 28 mmHg?
- A45%
- B40%
- C35%
- D30%
8A 70 kg, 183 cm patient who is receiving MV is noted to have a drop in SaO2 from 98% to 87%. The hemithorax is expanding more than the left, and breath sounds are clear on the right side, but decreased on the left. The pts ETT is at the 28 cm mark at the lip. What is the most appropriate action?
- APull the tube back to 23 cm
- BPush the tube in to 29 cm
- CPull the tube back to 19 cm
- DPull the tube back to 15 cm
9Mechanical ventilation is commonly used to manage all of the following conditions except:
- Acorrecting severe hypoxemia
- Bcorrection of hypercarbia
- Csupport of ventilatory failure
- Dcompensation of acid base balance
10Mechanical ventilation is commonly used to manage all of the following conditions except:
- Aventilatory failure
- Bmetabolic acidosis
- Cchest trauma
- Dpostoperative recovery
11Airflow obstruction may be caused by all of the following changes except:
- AIncreased lung compliance
- Bretained secretions in the airway
- Cneoplasm of the bronchial muscle structure
- Dtumors compressing the airway
12During mechanical ventilation, one of the strategies to reduce airflow resistance is to:
- Alengthen the ET tube
- Buse the smallest ET tube possible
- Cremove the secretions in the ET tube
- Dadd water to the ventilator circuit
13On the pressure-volume loop, increase in bowing of the inspiratory limb suggests:
- Aexcessive inspiratory flow
- Binsufficient inspiratory flow
- Cincreased lung compliance
- Ddecreased lung compliance
14Mr. Jones, a patient diagnosed with adult respiratory distress syndrome, has a static compliance of 15 mL/cm H2O. Based on the compliance value, which of the following assumptions is most likely true?
- Athe FRC is increased
- Bthe elastic recoil of the lungs is decreased
- Cthe pt may have an obstructive lung defect
- Dthe pts WOB is increased
15In conditions where the lung compliance is decreased, the:
- APIP is increased
- BPplat is decreased
- CPIP and Pplat are both increased
- DPIP and Pplat are both decreased
16In conditions where the lung compliance is decreased, the:
- Astatic compliance is increased
- Bdynamic compliance is decreased
- Cstatic and dynamic compliance are both increased
- Dstatic and dynamic compliance are both decreased
17Measurement of the physiologic deadspace to tidal volume ratio requires:
- Aarterial blood gas sample
- Bmixed expired gas sample
- Cpulmonary artery blood gas sample
- Darterial and expired gas samples
18Which of the following conditions is least likely a cause of alveolar hypoventilation?
- Ametabolic acidosis
- Bdepression of breathing centers
- Cneuromuscular disease
- Dairway obstruction
19Decreased respiratory drive is one of the indications for mechanical ventilation. Which of the following conditions is least likely to affect a patients normal respiratory drive?
- ASpinal cord injury at C-2 level
- BDrug Overdose
- CChest Trauma
- DHead Injury
20Excessive ventilatory workload is one of the indications for mechanical ventilation. Which of the following conditions is least likely to increase a patients ventilatory workload?
- Aairflow obstruction
- Bdeadspace ventilation
- Cdecreased compliance
- Ddrug overdose
21Failure of the ventilatory pump is one of the indications for mechanical ventilation. Which of the following conditions does not normally lead to failure of the ventilatory pump?
- AHyperkalemia
- BHypothermia
- CFlail Chest
- DRespiratory Muscle fatigue
22All of the following clinical conditions may cause the inspiratory phase to end prematurely except:
- Acircuit disconnect
- Bairway obstruction
- Ckinking of ET tube
- Dlow lung compliance
23Hypoventilation and abnormalities in gas exchange can cause all of the following conditions except:
- Asecondary anemia
- Brespiratory acidosis
- Chypoxemia
- Dsecondary polycythemia
24A patient has been using PEEP at levels between 15 and 18 cmH2O. The physician asks the therapist to monitor the potential adverse effects caused by PEEP. The therapist should monitor all of the following conditions except:
- Adecreased venous return
- Bincreased cardiac output and renal perfusion
- Cbarotrauma
- Dincreased intracranial pressure
25Which of the following is not a goal of mechanical ventilation?
- APrevent lung infection
- BImprove oxygenation and remove carbon dioxide
- CRelieve excessive work of breathing
- Dimprove lung mechanics
26Initiation of mechanical ventilation is sometimes withheld:
- Aon patients request
- Bincases of medical futility
- Cto reduce or terminate a patients pain and suffering
- Dall of the above
27Tachycardia may be caused by all of the following clinical conditions except:
- Ahypoxemia
- Bhypovolemia
- Cfever
- Dhypothermia
28Refractory hypoxemia should be treated with oxygen therapy and:
- Amechanical ventilation
- Bpressure support
- Chyperbaric oxygen therapy
- DPEEP
29Airway resistance may be increased in all of the following clinical conditions except:
- Aairway obstruction
- BETT with small internal diameter
- CCondensation in ventilator Circuit
- DTachycardia
30CPAP is indicated for treatment of patients with______________?
- Arespiratory failure secondary to shunting
- Bapnea
- Cventilatory failure with hypercapnia
- Dhypoxemia secondary to V/Q mismatch
31An adult patient is being mechanically ventilated following respiratory failure. Settings are:
Vt: 800 mL/Rate: 12/Mode: AC/FiO2: .60/PEEP 3cmh2O
ABG: ph: 7.37 PaCO2: 41 PaO2: 43 HCO3: 22
Which of the following ventilator changes would you recommend at this time?- Aincrease the FiO2
- BDecrease the volume
- CIncrease the rate
- DIncrease the PEEP
32A patient with CHF is placed on the ventilator. The RRT should
- Aobtain a sputum sample for culture
- Bassess changes in ICP
- Cassess changes in BP
- Dobtain a chest xray
33An apneic patient is placed on mechanical ventilation following surgery. What range of rate is typical for initiating mechanical ventilation on an adult patient?
- A4-8
- B8-12
- C12-20
- D20-30
34A patient with ARDS is being mechanically ventilated with a PEEP of 10 cmH2o and an FiO2 of .80. When the patient is removed from the ventilator for suctioning, he experiences decreased oxygen saturationh and increased heart rate. What should the respiratory therpist recommend?
- Adecreasing the PEEP to 5
- Bchanging to a closed suctioning system
- Cgiving a SVN albuterol treatment
- Dincreasing the FiO2 on the ventilator
35A 70 kg patient is ventilated on on IMV mode with a rate of 8, tidal volume of 700, FiO2 of .40 Peep of 4 pressure support of 4 and an inspiratory flowrate of 45 L/min. The patient is breathing 22 times per minute in between the machine breaths with a tidal volume of 150 mL. What change should the respiratory therapist recommend?
- Aincreasing the peak inspiratory flow rate
- Bincreasing the respiratory rate
- Cincreasing the set tidal volume
- Dincreasing the pressure support
36A 50 kg adult female is mechanically ventilated following a cardiac arrest. What tidal volume setting is recommended for this patient?
- A200 mL
- B300 mL
- C400 mL
- D500 mL
37You are working in the CCU and have been asked to set up a ventilator in preparation for Mr. Scott who has just undergone coronary artery bypass surgery. Mr. Scott is 58 years old, 5 ft 10 in tall, weights 180 lbs and has no history of lung disease. Which of the following represents the initial settings you would recommend in mechanically ventilating this patient?
- Atidal volume 500, rate 8, fiO2 0.50
- Btidal volume 900, rate 12, fiO2 0.30
- Ctidal volume 800, rate 4, FiO2 0.50
- Dtidal volume 800, rate 8, fiO2 0.40
38A 42 year old patient with a cervical spine injury is being mechanically ventilated in control mode. As you enter the room, the low pressure alarm is sounding. The patient is connected to the ventilator, but you do not see his chest moving. Your first action would be to
- Acheck the alarm settings
- Bobserve the exhaled volumes
- Cmanually ventilate the patient with the resuscitation bag
39Goals of Mechanical Ventilation
- APermit lung and airway healing
- BPermit muscle atrophy
- CImprove gas exchange
- DTreat disease process
- Eimprove pulmonary mechanics
- Favoid complications
- Grelieve respiratory distress
- Hsedate and control difficult patients
40Low compliance measurements are usually related to conditions that increase the patients functional residual capacity and total lung capacity.
- ATrue
- BFalse
41____________ occurs when the patients minute ventilation cannot keep up with CO2 production.
- Aventilatory failure
- Brefractory hypoxemia
- Coxygenation failure
- Ddeadspace ventilation
42___________________ is reduced oxygen in the body organs and tissues.
- Ahypoxemia
- Btachypnea
- Capnea
- Dhypoxia
43Which of the following is a clinical example of a condition that may lead to ventilatory pump failure?
- Aemphysema
- Bhyperkalemia
- Cpulmonary embolism
- DCOPD
44Normal airway resistance in healthy adults is between 0.5 to _________ cm/H2O/sec
- A1.5
- B2.0
- C2.5
- D3.0
45One of the most frequent uses of mechanical ventilation is for the management of postoperative patients recovering from_______.
- Aapnea and impending respiratory arrest
- Banesthesia and medications
- Cacute severe asthma and heart failure
- Dacute brain injury and flail chest
46One of the most common causes of increased airway resistance is COPD.
- ATrue
- BFalse
47Your patient has a PaO2 of 48 mmHg on 40%. The doctor wants a PaO2 of 80 mmHg. WHat FiO2 do you need?
- A48%
- B60%
- C67%
- D82%
48An unconscious patient is admitted to the ED and results on room air are 7.23/81/43/33 SpO2 71%. With no other data available is mechanical ventilation indicated?
- AYes
- BNo
49What settings on the ventilator effect the I:E ratio?
- AInspiratory Flow
- BFrequency
- CTidal Volume
- DFiO2
- EPIP
50Increasing the flow rate will lengthen the I time
- ATrue
- BFalse
51Which is an example of the most physiological normal type of Mechanical Ventilation?
- AChest Cuirass
- BBiPAP
- CCPAP
- DPositive Pressure Ventilation
52Static compliance can be used to assess the disease progression.
- ATrue
- BFalse
53Refractory hypoxemia does not respond to high FiO2 oxygen therapy?
- ATrue
- BFalse
54What could be the problem if static compliance remains the same but dynamic compliance gets worse?
- ADisease process worsening
- Btidal volumes not adaquate
- Cpatient biting down on ETT
- DPneumothorax
55The RT reviews a ventilator flowsheet and finds that the PIP has been gradually rising for the past several hours. Possible causes include:
- Aincreased pulmonary compliance
- Bbronchospasms
- Caccumulation of secretions
56A patient who is being mechanical ventilation has insufficient time to exhale completely. Which ventilator changes might be appropriate to correct this problem?
- Aincreased Flow
- Bdecreased ventilator rate
- Cadd mechanical deadspace
- Dadd inspiratory hold
57Which of the following flow settings is required to maintain an I:E ratio of 1:3 and a RR of 15/min status asthmaticus who is being mechanically ventilated?
- A20 L/min
- B27 L/min
- C36 L/min
- D72 L/min
58In which of the following patients should pressure support be initiated?
- Aa pt with absent or depressed respiratory drives with an ETT in place
- Bpt receiving SIMV who exhibits signs of increased spontaneous ventilatory effort
- Cpt with low lung compliance, atelectasis, and severe refractory hypoxemia
- Da pt in the PACU who requires short term ventilatory support
59How to reduce PaCO2 with ventilator settings?
- AIncrease RR
- Bincrease Vt
- CIncrease Flow
- DIncrease PIP
- EIncrease FiO2
60Airway resistance may be increased in all of the following clinical conditions except:
- Aairway obstruction
- Bsmall diameter ETT
- Ccondensation in ventilator circuit
- Dtachycardia
61Static compliance is primarily affected by a patients ______________ whereas the dynamic compliance is primarily affected by a patients ___________.
- Aelastic property of the lungs, airflow resistance
- Belastic property of the lungs, minute ventilation
- Cairflow resistance, elastic property of the lungs
- Dairflow resistance, minute ventilation
62The most recent blood gas report shows that a patient is hypoventilating with a PaCO2 of 65. The physician asks the therapist to improve the patients alveolar ventilation by making changes to the ventilator settings. The therapist should:
- Adecrease the tidal volume
- Bincrease the mechanical deadspace on the ventilator circuit
- Cincrease the frequency
- Dincrease the FiO2
63Which of the following causes hypoxemia is least likely to be treated successfully by oxygen therapy alone?
- Ahypoventilation
- BV/Q mismatch
- Cintrapulmonary shunting
- Dlow PiO2
64___________ causes decreased O2 pressure gradient.
- Aemphysema
- Bhigh altitude
- Ctachycardia
- Dpulmonary edma
65___________ causes thickening of the AC membrane and decreases diffusion rate.
- Aemphysema
- Bhigh altitude
- Ctachycardia
- Dpulmonary edma
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- practice exam for mechanical ventilation introductory course
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- jacquleenwskinner
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- English
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