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Mechanical Ventilation Final 141

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practice exam for mechanical ventilation introductory course
jacquleenwskinner
Quiz by jacquleenwskinner, updated more than 1 year ago
jacquleenwskinner
Created by jacquleenwskinner over 9 years ago
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Question 1

Question
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?
Answer
  • Pressure-targeted, flow-cycled ventilation
  • Volume-targeted, flow-cycled ventilation
  • Volume-Targeted, time-cycled ventilation
  • Volume-targeted, pressure-cycled ventilation

Question 2

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

Question 3

Question
What is the normal range of PAO2-PaO2 for healthy young adults breathing room air?
Answer
  • 5-10 mmHg
  • 10-20 mmHg
  • 20-30 mmHg
  • 50-90 mmHg

Question 4

Question
Under normal physiological circumstances, how many mL of O2 are capable of combining with 1 g of Hb?
Answer
  • 0.003 mL
  • 0.45 mL
  • 0.82 mL
  • 1.34 mL

Question 5

Question
Calculate the Total Oxygen content: Hb=18, PaO2= 40 SaO2=73%?
Answer
  • 19.5 mL/dL
  • 17.7 mL/dL
  • 16.5 mL/dL
  • 14.8 mL/dL

Question 6

Question
Calculate the FiO2 needed if the a/A ratio=0.55 and the physician wants a PaO2 of 100 mmHg?
Answer
  • 47%
  • 80%
  • 33%
  • 39%

Question 7

Question
What is the VD/VT ratio if their PaCO2 is 40 mmHg and the PeCO2 is 28 mmHg?
Answer
  • 45%
  • 40%
  • 35%
  • 30%

Question 8

Question
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?
Answer
  • 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

Question 9

Question
Mechanical ventilation is commonly used to manage all of the following conditions except:
Answer
  • correcting severe hypoxemia
  • correction of hypercarbia
  • support of ventilatory failure
  • compensation of acid base balance

Question 10

Question
Mechanical ventilation is commonly used to manage all of the following conditions except:
Answer
  • ventilatory failure
  • metabolic acidosis
  • chest trauma
  • postoperative recovery

Question 11

Question
Airflow obstruction may be caused by all of the following changes except:
Answer
  • Increased lung compliance
  • retained secretions in the airway
  • neoplasm of the bronchial muscle structure
  • tumors compressing the airway

Question 12

Question
During mechanical ventilation, one of the strategies to reduce airflow resistance is to:
Answer
  • lengthen the ET tube
  • use the smallest ET tube possible
  • remove the secretions in the ET tube
  • add water to the ventilator circuit

Question 13

Question
On the pressure-volume loop, increase in bowing of the inspiratory limb suggests:
Answer
  • excessive inspiratory flow
  • insufficient inspiratory flow
  • increased lung compliance
  • decreased lung compliance

Question 14

Question
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?
Answer
  • 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

Question 15

Question
In conditions where the lung compliance is decreased, the:
Answer
  • PIP is increased
  • Pplat is decreased
  • PIP and Pplat are both increased
  • PIP and Pplat are both decreased

Question 16

Question
In conditions where the lung compliance is decreased, the:
Answer
  • static compliance is increased
  • dynamic compliance is decreased
  • static and dynamic compliance are both increased
  • static and dynamic compliance are both decreased

Question 17

Question
Measurement of the physiologic deadspace to tidal volume ratio requires:
Answer
  • arterial blood gas sample
  • mixed expired gas sample
  • pulmonary artery blood gas sample
  • arterial and expired gas samples

Question 18

Question
Which of the following conditions is least likely a cause of alveolar hypoventilation?
Answer
  • metabolic acidosis
  • depression of breathing centers
  • neuromuscular disease
  • airway obstruction

Question 19

Question
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?
Answer
  • Spinal cord injury at C-2 level
  • Drug Overdose
  • Chest Trauma
  • Head Injury

Question 20

Question
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?
Answer
  • airflow obstruction
  • deadspace ventilation
  • decreased compliance
  • drug overdose

Question 21

Question
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?
Answer
  • Hyperkalemia
  • Hypothermia
  • Flail Chest
  • Respiratory Muscle fatigue

Question 22

Question
All of the following clinical conditions may cause the inspiratory phase to end prematurely except:
Answer
  • circuit disconnect
  • airway obstruction
  • kinking of ET tube
  • low lung compliance

Question 23

Question
Hypoventilation and abnormalities in gas exchange can cause all of the following conditions except:
Answer
  • secondary anemia
  • respiratory acidosis
  • hypoxemia
  • secondary polycythemia

Question 24

Question
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:
Answer
  • decreased venous return
  • increased cardiac output and renal perfusion
  • barotrauma
  • increased intracranial pressure

Question 25

Question
Which of the following is not a goal of mechanical ventilation?
Answer
  • Prevent lung infection
  • Improve oxygenation and remove carbon dioxide
  • Relieve excessive work of breathing
  • improve lung mechanics

Question 26

Question
Initiation of mechanical ventilation is sometimes withheld:
Answer
  • on patients request
  • incases of medical futility
  • to reduce or terminate a patients pain and suffering
  • all of the above

Question 27

Question
Tachycardia may be caused by all of the following clinical conditions except:
Answer
  • hypoxemia
  • hypovolemia
  • fever
  • hypothermia

Question 28

Question
Refractory hypoxemia should be treated with oxygen therapy and:
Answer
  • mechanical ventilation
  • pressure support
  • hyperbaric oxygen therapy
  • PEEP

Question 29

Question
Airway resistance may be increased in all of the following clinical conditions except:
Answer
  • airway obstruction
  • ETT with small internal diameter
  • Condensation in ventilator Circuit
  • Tachycardia

Question 30

Question
CPAP is indicated for treatment of patients with______________?
Answer
  • respiratory failure secondary to shunting
  • apnea
  • ventilatory failure with hypercapnia
  • hypoxemia secondary to V/Q mismatch

Question 31

Question
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?
Answer
  • increase the FiO2
  • Decrease the volume
  • Increase the rate
  • Increase the PEEP

Question 32

Question
A patient with CHF is placed on the ventilator. The RRT should
Answer
  • obtain a sputum sample for culture
  • assess changes in ICP
  • assess changes in BP
  • obtain a chest xray

Question 33

Question
An apneic patient is placed on mechanical ventilation following surgery. What range of rate is typical for initiating mechanical ventilation on an adult patient?
Answer
  • 4-8
  • 8-12
  • 12-20
  • 20-30

Question 34

Question
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?
Answer
  • decreasing the PEEP to 5
  • changing to a closed suctioning system
  • giving a SVN albuterol treatment
  • increasing the FiO2 on the ventilator

Question 35

Question
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?
Answer
  • increasing the peak inspiratory flow rate
  • increasing the respiratory rate
  • increasing the set tidal volume
  • increasing the pressure support

Question 36

Question
A 50 kg adult female is mechanically ventilated following a cardiac arrest. What tidal volume setting is recommended for this patient?
Answer
  • 200 mL
  • 300 mL
  • 400 mL
  • 500 mL

Question 37

Question
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?
Answer
  • 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

Question 38

Question
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
Answer
  • check the alarm settings
  • observe the exhaled volumes
  • manually ventilate the patient with the resuscitation bag

Question 39

Question
Goals of Mechanical Ventilation
Answer
  • 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

Question 40

Question
Low compliance measurements are usually related to conditions that increase the patients functional residual capacity and total lung capacity.
Answer
  • True
  • False

Question 41

Question
____________ occurs when the patients minute ventilation cannot keep up with CO2 production.
Answer
  • ventilatory failure
  • refractory hypoxemia
  • oxygenation failure
  • deadspace ventilation

Question 42

Question
___________________ is reduced oxygen in the body organs and tissues.
Answer
  • hypoxemia
  • tachypnea
  • apnea
  • hypoxia

Question 43

Question
Which of the following is a clinical example of a condition that may lead to ventilatory pump failure?
Answer
  • emphysema
  • hyperkalemia
  • pulmonary embolism
  • COPD

Question 44

Question
Normal airway resistance in healthy adults is between 0.5 to _________ cm/H2O/sec
Answer
  • 1.5
  • 2.0
  • 2.5
  • 3.0

Question 45

Question
One of the most frequent uses of mechanical ventilation is for the management of postoperative patients recovering from_______.
Answer
  • apnea and impending respiratory arrest
  • anesthesia and medications
  • acute severe asthma and heart failure
  • acute brain injury and flail chest

Question 46

Question
One of the most common causes of increased airway resistance is COPD.
Answer
  • True
  • False

Question 47

Question
Your patient has a PaO2 of 48 mmHg on 40%. The doctor wants a PaO2 of 80 mmHg. WHat FiO2 do you need?
Answer
  • 48%
  • 60%
  • 67%
  • 82%

Question 48

Question
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?
Answer
  • Yes
  • No

Question 49

Question
What settings on the ventilator effect the I:E ratio?
Answer
  • Inspiratory Flow
  • Frequency
  • Tidal Volume
  • FiO2
  • PIP

Question 50

Question
Increasing the flow rate will lengthen the I time
Answer
  • True
  • False

Question 51

Question
Which is an example of the most physiological normal type of Mechanical Ventilation?
Answer
  • Chest Cuirass
  • BiPAP
  • CPAP
  • Positive Pressure Ventilation

Question 52

Question
Static compliance can be used to assess the disease progression.
Answer
  • True
  • False

Question 53

Question
Refractory hypoxemia does not respond to high FiO2 oxygen therapy?
Answer
  • True
  • False

Question 54

Question
What could be the problem if static compliance remains the same but dynamic compliance gets worse?
Answer
  • Disease process worsening
  • tidal volumes not adaquate
  • patient biting down on ETT
  • Pneumothorax

Question 55

Question
The RT reviews a ventilator flowsheet and finds that the PIP has been gradually rising for the past several hours. Possible causes include:
Answer
  • increased pulmonary compliance
  • bronchospasms
  • accumulation of secretions

Question 56

Question
A patient who is being mechanical ventilation has insufficient time to exhale completely. Which ventilator changes might be appropriate to correct this problem?
Answer
  • increased Flow
  • decreased ventilator rate
  • add mechanical deadspace
  • add inspiratory hold

Question 57

Question
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?
Answer
  • 20 L/min
  • 27 L/min
  • 36 L/min
  • 72 L/min

Question 58

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

Question 59

Question
How to reduce PaCO2 with ventilator settings?
Answer
  • Increase RR
  • increase Vt
  • Increase Flow
  • Increase PIP
  • Increase FiO2

Question 60

Question
Airway resistance may be increased in all of the following clinical conditions except:
Answer
  • airway obstruction
  • small diameter ETT
  • condensation in ventilator circuit
  • tachycardia

Question 61

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

Question 62

Question
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:
Answer
  • decrease the tidal volume
  • increase the mechanical deadspace on the ventilator circuit
  • increase the frequency
  • increase the FiO2

Question 63

Question
Which of the following causes hypoxemia is least likely to be treated successfully by oxygen therapy alone?
Answer
  • hypoventilation
  • V/Q mismatch
  • intrapulmonary shunting
  • low PiO2

Question 64

Question
___________ causes decreased O2 pressure gradient.
Answer
  • emphysema
  • high altitude
  • tachycardia
  • pulmonary edma

Question 65

Question
___________ causes thickening of the AC membrane and decreases diffusion rate.
Answer
  • emphysema
  • high altitude
  • tachycardia
  • pulmonary edma
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