3089606
Descripción
Test por jacquleenwskinner, actualizado hace más de 1 año
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Creado por jacquleenwskinner
hace casi 9 años
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Pregunta 1
Pregunta
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?
Respuesta
-
Pressure-targeted, flow-cycled ventilation
-
Volume-targeted, flow-cycled ventilation
-
Volume-Targeted, time-cycled ventilation
-
Volume-targeted, pressure-cycled ventilation
Pregunta 2
Pregunta
Which of the following are common phase variables for PC-CMV?
1. Flow Trigger
2. Pressure Limit
3. Time Cycle
4. Flow Limit
Respuesta
-
1 and 2 only
-
2,3, and 4 only
-
1,2, and 3 only
-
2 and 4 only
Pregunta 3
Pregunta
What is the normal range of PAO2-PaO2 for healthy young adults breathing room air?
Respuesta
-
5-10 mmHg
-
10-20 mmHg
-
20-30 mmHg
-
50-90 mmHg
Pregunta 4
Pregunta
Under normal physiological circumstances, how many mL of O2 are capable of combining with 1 g of Hb?
Respuesta
-
0.003 mL
-
0.45 mL
-
0.82 mL
-
1.34 mL
Pregunta 5
Pregunta
Calculate the Total Oxygen content: Hb=18, PaO2= 40 SaO2=73%?
Respuesta
-
19.5 mL/dL
-
17.7 mL/dL
-
16.5 mL/dL
-
14.8 mL/dL
Pregunta 6
Pregunta
Calculate the FiO2 needed if the a/A ratio=0.55 and the physician wants a PaO2 of 100 mmHg?
Respuesta
-
47%
-
80%
-
33%
-
39%
Pregunta 7
Pregunta
What is the VD/VT ratio if their PaCO2 is 40 mmHg and the PeCO2 is 28 mmHg?
Respuesta
-
45%
-
40%
-
35%
-
30%
Pregunta 8
Pregunta
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?
Respuesta
-
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
Pregunta 9
Pregunta
Mechanical ventilation is commonly used to manage all of the following conditions except:
Respuesta
-
correcting severe hypoxemia
-
correction of hypercarbia
-
support of ventilatory failure
-
compensation of acid base balance
Pregunta 10
Pregunta
Mechanical ventilation is commonly used to manage all of the following conditions except:
Respuesta
-
ventilatory failure
-
metabolic acidosis
-
chest trauma
-
postoperative recovery
Pregunta 11
Pregunta
Airflow obstruction may be caused by all of the following changes except:
Respuesta
-
Increased lung compliance
-
retained secretions in the airway
-
neoplasm of the bronchial muscle structure
-
tumors compressing the airway
Pregunta 12
Pregunta
During mechanical ventilation, one of the strategies to reduce airflow resistance is to:
Respuesta
-
lengthen the ET tube
-
use the smallest ET tube possible
-
remove the secretions in the ET tube
-
add water to the ventilator circuit
Pregunta 13
Pregunta
On the pressure-volume loop, increase in bowing of the inspiratory limb suggests:
Respuesta
-
excessive inspiratory flow
-
insufficient inspiratory flow
-
increased lung compliance
-
decreased lung compliance
Pregunta 14
Pregunta
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?
Respuesta
-
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
Pregunta 15
Pregunta
In conditions where the lung compliance is decreased, the:
Respuesta
-
PIP is increased
-
Pplat is decreased
-
PIP and Pplat are both increased
-
PIP and Pplat are both decreased
Pregunta 16
Pregunta
In conditions where the lung compliance is decreased, the:
Respuesta
-
static compliance is increased
-
dynamic compliance is decreased
-
static and dynamic compliance are both increased
-
static and dynamic compliance are both decreased
Pregunta 17
Pregunta
Measurement of the physiologic deadspace to tidal volume ratio requires:
Respuesta
-
arterial blood gas sample
-
mixed expired gas sample
-
pulmonary artery blood gas sample
-
arterial and expired gas samples
Pregunta 18
Pregunta
Which of the following conditions is least likely a cause of alveolar hypoventilation?
Respuesta
-
metabolic acidosis
-
depression of breathing centers
-
neuromuscular disease
-
airway obstruction
Pregunta 19
Pregunta
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?
Respuesta
-
Spinal cord injury at C-2 level
-
Drug Overdose
-
Chest Trauma
-
Head Injury
Pregunta 20
Pregunta
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?
Respuesta
-
airflow obstruction
-
deadspace ventilation
-
decreased compliance
-
drug overdose
Pregunta 21
Pregunta
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?
Respuesta
-
Hyperkalemia
-
Hypothermia
-
Flail Chest
-
Respiratory Muscle fatigue
Pregunta 22
Pregunta
All of the following clinical conditions may cause the inspiratory phase to end prematurely except:
Respuesta
-
circuit disconnect
-
airway obstruction
-
kinking of ET tube
-
low lung compliance
Pregunta 23
Pregunta
Hypoventilation and abnormalities in gas exchange can cause all of the following conditions except:
Respuesta
-
secondary anemia
-
respiratory acidosis
-
hypoxemia
-
secondary polycythemia
Pregunta 24
Pregunta
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:
Respuesta
-
decreased venous return
-
increased cardiac output and renal perfusion
-
barotrauma
-
increased intracranial pressure
Pregunta 25
Pregunta
Which of the following is not a goal of mechanical ventilation?
Respuesta
-
Prevent lung infection
-
Improve oxygenation and remove carbon dioxide
-
Relieve excessive work of breathing
-
improve lung mechanics
Pregunta 26
Pregunta
Initiation of mechanical ventilation is sometimes withheld:
Respuesta
-
on patients request
-
incases of medical futility
-
to reduce or terminate a patients pain and suffering
-
all of the above
Pregunta 27
Pregunta
Tachycardia may be caused by all of the following clinical conditions except:
Respuesta
-
hypoxemia
-
hypovolemia
-
fever
-
hypothermia
Pregunta 28
Pregunta
Refractory hypoxemia should be treated with oxygen therapy and:
Respuesta
-
mechanical ventilation
-
pressure support
-
hyperbaric oxygen therapy
-
PEEP
Pregunta 29
Pregunta
Airway resistance may be increased in all of the following clinical conditions except:
Respuesta
-
airway obstruction
-
ETT with small internal diameter
-
Condensation in ventilator Circuit
-
Tachycardia
Pregunta 30
Pregunta
CPAP is indicated for treatment of patients with______________?
Respuesta
-
respiratory failure secondary to shunting
-
apnea
-
ventilatory failure with hypercapnia
-
hypoxemia secondary to V/Q mismatch
Pregunta 31
Pregunta
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?
Respuesta
-
increase the FiO2
-
Decrease the volume
-
Increase the rate
-
Increase the PEEP
Pregunta 32
Pregunta
A patient with CHF is placed on the ventilator. The RRT should
Respuesta
-
obtain a sputum sample for culture
-
assess changes in ICP
-
assess changes in BP
-
obtain a chest xray
Pregunta 33
Pregunta
An apneic patient is placed on mechanical ventilation following surgery. What range of rate is typical for initiating mechanical ventilation on an adult patient?
Respuesta
-
4-8
-
8-12
-
12-20
-
20-30
Pregunta 34
Pregunta
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?
Respuesta
-
decreasing the PEEP to 5
-
changing to a closed suctioning system
-
giving a SVN albuterol treatment
-
increasing the FiO2 on the ventilator
Pregunta 35
Pregunta
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?
Respuesta
-
increasing the peak inspiratory flow rate
-
increasing the respiratory rate
-
increasing the set tidal volume
-
increasing the pressure support
Pregunta 36
Pregunta
A 50 kg adult female is mechanically ventilated following a cardiac arrest. What tidal volume setting is recommended for this patient?
Respuesta
-
200 mL
-
300 mL
-
400 mL
-
500 mL
Pregunta 37
Pregunta
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?
Respuesta
-
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
Pregunta 38
Pregunta
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
Respuesta
-
check the alarm settings
-
observe the exhaled volumes
-
manually ventilate the patient with the resuscitation bag
Pregunta 39
Pregunta
Goals of Mechanical Ventilation
Respuesta
-
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
Pregunta 40
Pregunta
Low compliance measurements are usually related to conditions that increase the patients functional residual capacity and total lung capacity.
Respuesta
- True
- False
Pregunta 41
Pregunta
____________ occurs when the patients minute ventilation cannot keep up with CO2 production.
Respuesta
-
ventilatory failure
-
refractory hypoxemia
-
oxygenation failure
-
deadspace ventilation
Pregunta 42
Pregunta
___________________ is reduced oxygen in the body organs and tissues.
Respuesta
-
hypoxemia
-
tachypnea
-
apnea
-
hypoxia
Pregunta 43
Pregunta
Which of the following is a clinical example of a condition that may lead to ventilatory pump failure?
Respuesta
-
emphysema
-
hyperkalemia
-
pulmonary embolism
-
COPD
Pregunta 44
Pregunta
Normal airway resistance in healthy adults is between 0.5 to _________ cm/H2O/sec
Respuesta
-
1.5
-
2.0
-
2.5
-
3.0
Pregunta 45
Pregunta
One of the most frequent uses of mechanical ventilation is for the management of postoperative patients recovering from_______.
Respuesta
-
apnea and impending respiratory arrest
-
anesthesia and medications
-
acute severe asthma and heart failure
-
acute brain injury and flail chest
Pregunta 46
Pregunta
One of the most common causes of increased airway resistance is COPD.
Respuesta
- True
- False
Pregunta 47
Pregunta
Your patient has a PaO2 of 48 mmHg on 40%. The doctor wants a PaO2 of 80 mmHg. WHat FiO2 do you need?
Respuesta
-
48%
-
60%
-
67%
-
82%
Pregunta 48
Pregunta
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?
Respuesta
-
Yes
-
No
Pregunta 49
Pregunta
What settings on the ventilator effect the I:E ratio?
Respuesta
-
Inspiratory Flow
-
Frequency
-
Tidal Volume
-
FiO2
-
PIP
Pregunta 50
Pregunta
Increasing the flow rate will lengthen the I time
Respuesta
- True
- False
Pregunta 51
Pregunta
Which is an example of the most physiological normal type of Mechanical Ventilation?
Respuesta
-
Chest Cuirass
-
BiPAP
-
CPAP
-
Positive Pressure Ventilation
Pregunta 52
Pregunta
Static compliance can be used to assess the disease progression.
Respuesta
- True
- False
Pregunta 53
Pregunta
Refractory hypoxemia does not respond to high FiO2 oxygen therapy?
Respuesta
- True
- False
Pregunta 54
Pregunta
What could be the problem if static compliance remains the same but dynamic compliance gets worse?
Respuesta
-
Disease process worsening
-
tidal volumes not adaquate
-
patient biting down on ETT
-
Pneumothorax
Pregunta 55
Pregunta
The RT reviews a ventilator flowsheet and finds that the PIP has been gradually rising for the past several hours. Possible causes include:
Respuesta
-
increased pulmonary compliance
-
bronchospasms
-
accumulation of secretions
Pregunta 56
Pregunta
A patient who is being mechanical ventilation has insufficient time to exhale completely. Which ventilator changes might be appropriate to correct this problem?
Respuesta
-
increased Flow
-
decreased ventilator rate
-
add mechanical deadspace
-
add inspiratory hold
Pregunta 57
Pregunta
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?
Respuesta
-
20 L/min
-
27 L/min
-
36 L/min
-
72 L/min
Pregunta 58
Pregunta
In which of the following patients should pressure support be initiated?
Respuesta
-
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
Pregunta 59
Pregunta
How to reduce PaCO2 with ventilator settings?
Respuesta
-
Increase RR
-
increase Vt
-
Increase Flow
-
Increase PIP
-
Increase FiO2
Pregunta 60
Pregunta
Airway resistance may be increased in all of the following clinical conditions except:
Respuesta
-
airway obstruction
-
small diameter ETT
-
condensation in ventilator circuit
-
tachycardia
Pregunta 61
Pregunta
Static compliance is primarily affected by a patients ______________ whereas the dynamic compliance is primarily affected by a patients ___________.
Respuesta
-
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
Pregunta 62
Pregunta
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:
Respuesta
-
decrease the tidal volume
-
increase the mechanical deadspace on the ventilator circuit
-
increase the frequency
-
increase the FiO2
Pregunta 63
Pregunta
Which of the following causes hypoxemia is least likely to be treated successfully by oxygen therapy alone?
Respuesta
-
hypoventilation
-
V/Q mismatch
-
intrapulmonary shunting
-
low PiO2
Pregunta 64
Pregunta
___________ causes decreased O2 pressure gradient.
Respuesta
-
emphysema
-
high altitude
-
tachycardia
-
pulmonary edma
Pregunta 65
Pregunta
___________ causes thickening of the AC membrane and decreases diffusion rate.
Respuesta
-
emphysema
-
high altitude
-
tachycardia
-
pulmonary edma
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