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practice exam for mechanical ventilation introductory course

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Mechanical Ventilation Final 141

Question 1 of 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?

Select one of the following:

  • Pressure-targeted, flow-cycled ventilation

  • Volume-targeted, flow-cycled ventilation

  • Volume-Targeted, time-cycled ventilation

  • Volume-targeted, pressure-cycled ventilation

Explanation

Question 2 of 65

1

Which of the following are common phase variables for PC-CMV?
1. Flow Trigger
2. Pressure Limit
3. Time Cycle
4. Flow Limit

Select one of the following:

  • 1 and 2 only

  • 2,3, and 4 only

  • 1,2, and 3 only

  • 2 and 4 only

Explanation

Question 3 of 65

1

What is the normal range of PAO2-PaO2 for healthy young adults breathing room air?

Select one of the following:

  • 5-10 mmHg

  • 10-20 mmHg

  • 20-30 mmHg

  • 50-90 mmHg

Explanation

Question 4 of 65

1

Under normal physiological circumstances, how many mL of O2 are capable of combining with 1 g of Hb?

Select one of the following:

  • 0.003 mL

  • 0.45 mL

  • 0.82 mL

  • 1.34 mL

Explanation

Question 5 of 65

1

Calculate the Total Oxygen content: Hb=18, PaO2= 40 SaO2=73%?

Select one of the following:

  • 19.5 mL/dL

  • 17.7 mL/dL

  • 16.5 mL/dL

  • 14.8 mL/dL

Explanation

Question 6 of 65

1

Calculate the FiO2 needed if the a/A ratio=0.55 and the physician wants a PaO2 of 100 mmHg?

Select one of the following:

  • 47%

  • 80%

  • 33%

  • 39%

Explanation

Question 7 of 65

1

What is the VD/VT ratio if their PaCO2 is 40 mmHg and the PeCO2 is 28 mmHg?

Select one of the following:

  • 45%

  • 40%

  • 35%

  • 30%

Explanation

Question 8 of 65

1

A 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?

Select one of the following:

  • Pull the tube back to 23 cm

  • Push the tube in to 29 cm

  • Pull the tube back to 19 cm

  • Pull the tube back to 15 cm

Explanation

Question 9 of 65

1

Mechanical ventilation is commonly used to manage all of the following conditions except:

Select one of the following:

  • correcting severe hypoxemia

  • correction of hypercarbia

  • support of ventilatory failure

  • compensation of acid base balance

Explanation

Question 10 of 65

1

Mechanical ventilation is commonly used to manage all of the following conditions except:

Select one of the following:

  • ventilatory failure

  • metabolic acidosis

  • chest trauma

  • postoperative recovery

Explanation

Question 11 of 65

1

Airflow obstruction may be caused by all of the following changes except:

Select one of the following:

  • Increased lung compliance

  • retained secretions in the airway

  • neoplasm of the bronchial muscle structure

  • tumors compressing the airway

Explanation

Question 12 of 65

1

During mechanical ventilation, one of the strategies to reduce airflow resistance is to:

Select one of the following:

  • lengthen the ET tube

  • use the smallest ET tube possible

  • remove the secretions in the ET tube

  • add water to the ventilator circuit

Explanation

Question 13 of 65

1

On the pressure-volume loop, increase in bowing of the inspiratory limb suggests:

Select one of the following:

  • excessive inspiratory flow

  • insufficient inspiratory flow

  • increased lung compliance

  • decreased lung compliance

Explanation

Question 14 of 65

1

Mr. 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?

Select one of the following:

  • the FRC is increased

  • the elastic recoil of the lungs is decreased

  • the pt may have an obstructive lung defect

  • the pts WOB is increased

Explanation

Question 15 of 65

1

In conditions where the lung compliance is decreased, the:

Select one of the following:

  • PIP is increased

  • Pplat is decreased

  • PIP and Pplat are both increased

  • PIP and Pplat are both decreased

Explanation

Question 16 of 65

1

In conditions where the lung compliance is decreased, the:

Select one of the following:

  • static compliance is increased

  • dynamic compliance is decreased

  • static and dynamic compliance are both increased

  • static and dynamic compliance are both decreased

Explanation

Question 17 of 65

1

Measurement of the physiologic deadspace to tidal volume ratio requires:

Select one of the following:

  • arterial blood gas sample

  • mixed expired gas sample

  • pulmonary artery blood gas sample

  • arterial and expired gas samples

Explanation

Question 18 of 65

1

Which of the following conditions is least likely a cause of alveolar hypoventilation?

Select one of the following:

  • metabolic acidosis

  • depression of breathing centers

  • neuromuscular disease

  • airway obstruction

Explanation

Question 19 of 65

1

Decreased 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?

Select one of the following:

  • Spinal cord injury at C-2 level

  • Drug Overdose

  • Chest Trauma

  • Head Injury

Explanation

Question 20 of 65

1

Excessive ventilatory workload is one of the indications for mechanical ventilation. Which of the following conditions is least likely to increase a patients ventilatory workload?

Select one of the following:

  • airflow obstruction

  • deadspace ventilation

  • decreased compliance

  • drug overdose

Explanation

Question 21 of 65

1

Failure 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?

Select one of the following:

  • Hyperkalemia

  • Hypothermia

  • Flail Chest

  • Respiratory Muscle fatigue

Explanation

Question 22 of 65

1

All of the following clinical conditions may cause the inspiratory phase to end prematurely except:

Select one of the following:

  • circuit disconnect

  • airway obstruction

  • kinking of ET tube

  • low lung compliance

Explanation

Question 23 of 65

1

Hypoventilation and abnormalities in gas exchange can cause all of the following conditions except:

Select one of the following:

  • secondary anemia

  • respiratory acidosis

  • hypoxemia

  • secondary polycythemia

Explanation

Question 24 of 65

1

A 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:

Select one of the following:

  • decreased venous return

  • increased cardiac output and renal perfusion

  • barotrauma

  • increased intracranial pressure

Explanation

Question 25 of 65

1

Which of the following is not a goal of mechanical ventilation?

Select one of the following:

  • Prevent lung infection

  • Improve oxygenation and remove carbon dioxide

  • Relieve excessive work of breathing

  • improve lung mechanics

Explanation

Question 26 of 65

1

Initiation of mechanical ventilation is sometimes withheld:

Select one of the following:

  • on patients request

  • incases of medical futility

  • to reduce or terminate a patients pain and suffering

  • all of the above

Explanation

Question 27 of 65

1

Tachycardia may be caused by all of the following clinical conditions except:

Select one of the following:

  • hypoxemia

  • hypovolemia

  • fever

  • hypothermia

Explanation

Question 28 of 65

1

Refractory hypoxemia should be treated with oxygen therapy and:

Select one of the following:

  • mechanical ventilation

  • pressure support

  • hyperbaric oxygen therapy

  • PEEP

Explanation

Question 29 of 65

1

Airway resistance may be increased in all of the following clinical conditions except:

Select one of the following:

  • airway obstruction

  • ETT with small internal diameter

  • Condensation in ventilator Circuit

  • Tachycardia

Explanation

Question 30 of 65

1

CPAP is indicated for treatment of patients with______________?

Select one of the following:

  • respiratory failure secondary to shunting

  • apnea

  • ventilatory failure with hypercapnia

  • hypoxemia secondary to V/Q mismatch

Explanation

Question 31 of 65

1

An 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?

Select one of the following:

  • increase the FiO2

  • Decrease the volume

  • Increase the rate

  • Increase the PEEP

Explanation

Question 32 of 65

1

A patient with CHF is placed on the ventilator. The RRT should

Select one of the following:

  • obtain a sputum sample for culture

  • assess changes in ICP

  • assess changes in BP

  • obtain a chest xray

Explanation

Question 33 of 65

1

An apneic patient is placed on mechanical ventilation following surgery. What range of rate is typical for initiating mechanical ventilation on an adult patient?

Select one of the following:

  • 4-8

  • 8-12

  • 12-20

  • 20-30

Explanation

Question 34 of 65

1

A 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?

Select one of the following:

  • decreasing the PEEP to 5

  • changing to a closed suctioning system

  • giving a SVN albuterol treatment

  • increasing the FiO2 on the ventilator

Explanation

Question 35 of 65

1

A 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?

Select one of the following:

  • increasing the peak inspiratory flow rate

  • increasing the respiratory rate

  • increasing the set tidal volume

  • increasing the pressure support

Explanation

Question 36 of 65

1

A 50 kg adult female is mechanically ventilated following a cardiac arrest. What tidal volume setting is recommended for this patient?

Select one of the following:

  • 200 mL

  • 300 mL

  • 400 mL

  • 500 mL

Explanation

Question 37 of 65

1

You 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?

Select one or more of the following:

  • tidal volume 500, rate 8, fiO2 0.50

  • tidal volume 900, rate 12, fiO2 0.30

  • tidal volume 800, rate 4, FiO2 0.50

  • tidal volume 800, rate 8, fiO2 0.40

Explanation

Question 38 of 65

1

A 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

Select one or more of the following:

  • check the alarm settings

  • observe the exhaled volumes

  • manually ventilate the patient with the resuscitation bag

Explanation

Question 39 of 65

1

Goals of Mechanical Ventilation

Select one or more of the following:

  • Permit lung and airway healing

  • Permit muscle atrophy

  • Improve gas exchange

  • Treat disease process

  • improve pulmonary mechanics

  • avoid complications

  • relieve respiratory distress

  • sedate and control difficult patients

Explanation

Question 40 of 65

1

Low compliance measurements are usually related to conditions that increase the patients functional residual capacity and total lung capacity.

Select one of the following:

  • True
  • False

Explanation

Question 41 of 65

1

____________ occurs when the patients minute ventilation cannot keep up with CO2 production.

Select one of the following:

  • ventilatory failure

  • refractory hypoxemia

  • oxygenation failure

  • deadspace ventilation

Explanation

Question 42 of 65

1

___________________ is reduced oxygen in the body organs and tissues.

Select one of the following:

  • hypoxemia

  • tachypnea

  • apnea

  • hypoxia

Explanation

Question 43 of 65

1

Which of the following is a clinical example of a condition that may lead to ventilatory pump failure?

Select one of the following:

  • emphysema

  • hyperkalemia

  • pulmonary embolism

  • COPD

Explanation

Question 44 of 65

1

Normal airway resistance in healthy adults is between 0.5 to _________ cm/H2O/sec

Select one of the following:

  • 1.5

  • 2.0

  • 2.5

  • 3.0

Explanation

Question 45 of 65

1

One of the most frequent uses of mechanical ventilation is for the management of postoperative patients recovering from_______.

Select one of the following:

  • apnea and impending respiratory arrest

  • anesthesia and medications

  • acute severe asthma and heart failure

  • acute brain injury and flail chest

Explanation

Question 46 of 65

1

One of the most common causes of increased airway resistance is COPD.

Select one of the following:

  • True
  • False

Explanation

Question 47 of 65

1

Your patient has a PaO2 of 48 mmHg on 40%. The doctor wants a PaO2 of 80 mmHg. WHat FiO2 do you need?

Select one of the following:

  • 48%

  • 60%

  • 67%

  • 82%

Explanation

Question 48 of 65

1

An 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?

Select one of the following:

  • Yes

  • No

Explanation

Question 49 of 65

1

What settings on the ventilator effect the I:E ratio?

Select one or more of the following:

  • Inspiratory Flow

  • Frequency

  • Tidal Volume

  • FiO2

  • PIP

Explanation

Question 50 of 65

1

Increasing the flow rate will lengthen the I time

Select one of the following:

  • True
  • False

Explanation

Question 51 of 65

1

Which is an example of the most physiological normal type of Mechanical Ventilation?

Select one of the following:

  • Chest Cuirass

  • BiPAP

  • CPAP

  • Positive Pressure Ventilation

Explanation

Question 52 of 65

1

Static compliance can be used to assess the disease progression.

Select one of the following:

  • True
  • False

Explanation

Question 53 of 65

1

Refractory hypoxemia does not respond to high FiO2 oxygen therapy?

Select one of the following:

  • True
  • False

Explanation

Question 54 of 65

1

What could be the problem if static compliance remains the same but dynamic compliance gets worse?

Select one of the following:

  • Disease process worsening

  • tidal volumes not adaquate

  • patient biting down on ETT

  • Pneumothorax

Explanation

Question 55 of 65

1

The RT reviews a ventilator flowsheet and finds that the PIP has been gradually rising for the past several hours. Possible causes include:

Select one or more of the following:

  • increased pulmonary compliance

  • bronchospasms

  • accumulation of secretions

Explanation

Question 56 of 65

1

A patient who is being mechanical ventilation has insufficient time to exhale completely. Which ventilator changes might be appropriate to correct this problem?

Select one or more of the following:

  • increased Flow

  • decreased ventilator rate

  • add mechanical deadspace

  • add inspiratory hold

Explanation

Question 57 of 65

1

Which 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?

Select one of the following:

  • 20 L/min

  • 27 L/min

  • 36 L/min

  • 72 L/min

Explanation

Question 58 of 65

1

In which of the following patients should pressure support be initiated?

Select one of the following:

  • a pt with absent or depressed respiratory drives with an ETT in place

  • pt receiving SIMV who exhibits signs of increased spontaneous ventilatory effort

  • pt with low lung compliance, atelectasis, and severe refractory hypoxemia

  • a pt in the PACU who requires short term ventilatory support

Explanation

Question 59 of 65

1

How to reduce PaCO2 with ventilator settings?

Select one or more of the following:

  • Increase RR

  • increase Vt

  • Increase Flow

  • Increase PIP

  • Increase FiO2

Explanation

Question 60 of 65

1

Airway resistance may be increased in all of the following clinical conditions except:

Select one of the following:

  • airway obstruction

  • small diameter ETT

  • condensation in ventilator circuit

  • tachycardia

Explanation

Question 61 of 65

1

Static compliance is primarily affected by a patients ______________ whereas the dynamic compliance is primarily affected by a patients ___________.

Select one of the following:

  • elastic property of the lungs, airflow resistance

  • elastic property of the lungs, minute ventilation

  • airflow resistance, elastic property of the lungs

  • airflow resistance, minute ventilation

Explanation

Question 62 of 65

1

The 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:

Select one of the following:

  • decrease the tidal volume

  • increase the mechanical deadspace on the ventilator circuit

  • increase the frequency

  • increase the FiO2

Explanation

Question 63 of 65

1

Which of the following causes hypoxemia is least likely to be treated successfully by oxygen therapy alone?

Select one of the following:

  • hypoventilation

  • V/Q mismatch

  • intrapulmonary shunting

  • low PiO2

Explanation

Question 64 of 65

1

___________ causes decreased O2 pressure gradient.

Select one of the following:

  • emphysema

  • high altitude

  • tachycardia

  • pulmonary edma

Explanation

Question 65 of 65

1

___________ causes thickening of the AC membrane and decreases diffusion rate.

Select one of the following:

  • emphysema

  • high altitude

  • tachycardia

  • pulmonary edma

Explanation

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