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
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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
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2,3, and 4 only
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1,2, and 3 only
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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
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10-20 mmHg
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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?
Question 7
Question
What is the VD/VT ratio if their PaCO2 is 40 mmHg and the PeCO2 is 28 mmHg?
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
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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?
Question 15
Question
In conditions where the lung compliance is decreased, the:
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?
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?
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?
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:
Question 25
Question
Which of the following is not a goal of mechanical ventilation?
Question 26
Question
Initiation of mechanical ventilation is sometimes withheld:
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:
Question 29
Question
Airway resistance may be increased in all of the following clinical conditions except:
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
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?
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
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.
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
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.
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?
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?
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
Question 51
Question
Which is an example of the most physiological normal type of Mechanical Ventilation?
Question 52
Question
Static compliance can be used to assess the disease progression.
Question 53
Question
Refractory hypoxemia does not respond to high FiO2 oxygen therapy?
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:
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?
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:
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:
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