Question 1

The level of applied PEEP should be set at what point on the pressure-volume curve?

Accepted Answer

A)  At the upper inflection point of the inflation curve. 
B)  Above the lower inflection point of the deflation curve. 
C)  At the peak inspiration point of the inflation curve. 
D)  Above the upper inflection point of the deflation curve 
A)  At the upper inflection point of the inflation curve. 
B)  Above the lower inflection point of the deflation curve. 
C)  At the peak inspiration point of the inflation curve. 
D)  Above the upper inflection point of the deflation curve D

Question 2

How long after PEEP is increased should all ventilatory and available hemodynamic parameters be measured and calculated?

Accepted Answer

A)  5 minutes 
B)  15 minutes 
C)  25 minutes 
D)  40 minutes 
A)  5 minutes 
B)  15 minutes 
C)  25 minutes 
D)  40 minutes B

Question 3

A patient with ARDS has the slow pressure-volume loop shown below.Based on this loop,at what level should PEEP be set?

Accepted Answer

A)  10 cm H2O 
B)  12 cm H2O 
C)  18 cm H2O 
D)  22 cm H2O 
A)  10 cm H2O 
B)  12 cm H2O 
C)  18 cm H2O 
D)  22 cm H2O D

Question 4

What is the optimal PEEP level given the following information?

Accepted Answer

A)  8 cm H2O 
B)  10 cm H2O 
C)  12 cm H2O 
D)  15 cm H2O 
A)  8 cm H2O 
B)  10 cm H2O 
C)  12 cm H2O 
D)  15 cm H2O

Question 5

What is the Pflex on the following pressure-volume loop?

Accepted Answer

A)  10 cm H2O 
B)  15 cm H2O 
C)  19 cm H2O 
D)  23 cm H2O 
A)  10 cm H2O 
B)  15 cm H2O 
C)  19 cm H2O 
D)  23 cm H2O

Question 6

Thirty minutes after intubation and initiation of mechanical ventilation,a patient's PaO2 = 55 mm Hg and the FIO2 = 0.5.To what should the FIO2 be set to obtain a PaO2 of 80 mm Hg?

Accepted Answer

A)  0.65 
B)  0.75 
C)  0.85 
D)  0.95 
A)  0.65 
B)  0.75 
C)  0.85 
D)  0.95

Question 7

Regardless of the procedure used to establish an appropriate PEEP level,ventilating pressures should not be allowed to exceed which of the following?

Accepted Answer

A)  Upper inflation point on the inspiratory limb (UIPi) 
B)  2 to 3 cm H2O above the UIPi 
C)  30 cm H2O 
D)  Lower inflection point on the inspiratory limb 
A)  Upper inflation point on the inspiratory limb (UIPi) 
B)  2 to 3 cm H2O above the UIPi 
C)  30 cm H2O 
D)  Lower inflection point on the inspiratory limb

Question 8

Assessing the outcome of PEEP at levels set above 15 to 20 cm H2O is best done using which of the following?

Accepted Answer

A)  Static compliance measurements 
B)  Pressure-volume loop graphics 
C)  Pulmonary artery occlusion pressure 
D)  Central venous pressure measurements 
A)  Static compliance measurements 
B)  Pressure-volume loop graphics 
C)  Pulmonary artery occlusion pressure 
D)  Central venous pressure measurements

Question 9

The level of PEEP that is most appropriate for a patient with the information shown below is which of the following?

Accepted Answer

A)  8 cm H2O 
B)  10 cm H2O 
C)  12 cm H2O 
D)  15 cm H2O 
A)  8 cm H2O 
B)  10 cm H2O 
C)  12 cm H2O 
D)  15 cm H2O

Question 10

A patient is being ventilated with a PEEP of 10 cm H2O and an FIO2 of 0.4.The arterial blood gas results show that the patient remains hypoxemic,and the respiratory therapist increases the PEEP to 18 cm H2O,maintaining the FIO2 at 0.4.The patient's static compliance changes from 28 mL/cm H2O to 22 mL/cm H2O just after this change.The respiratory therapist should do which of the following?

Accepted Answer

A)  Decrease PEEP to 10 cm H2O and increase the FIO2 to 0.6. 
B)  Decrease PEEP to 15 cm H2O and measure static compliance. 
C)  Keep PEEP at 18 cm H2O and increase the FIO2 to 0.6. 
D)  Increase PEEP to 20 cm H2O and measure static compliance. 
A)  Decrease PEEP to 10 cm H2O and increase the FIO2 to 0.6. 
B)  Decrease PEEP to 15 cm H2O and measure static compliance. 
C)  Keep PEEP at 18 cm H2O and increase the FIO2 to 0.6. 
D)  Increase PEEP to 20 cm H2O and measure static compliance.

Question 11

The highest pressure attained during the slow-flow (quasi-static)technique should be ______ cm H2O.

Accepted Answer

A)  25 
B)  35 
C)  45 
D)  55 
A)  25 
B)  35 
C)  45 
D)  55

Question 12

The point on a static pressure-volume curve (SPV)where the alveoli begin to open is referred to as which of the following?

Accepted Answer

A)  Lower inflection point on the inflation limb 
B)  Upper inflection point on the inflation limb 
C)  Upper inflection point on the deflation limb 
D)  Lower inflection point on the deflation limb 
A)  Lower inflection point on the inflation limb 
B)  Upper inflection point on the inflation limb 
C)  Upper inflection point on the deflation limb 
D)  Lower inflection point on the deflation limb

Question 13

A recruitment maneuver (RM)is being performed on a patient receiving mechanical ventilation with PCV.During the maneuver the mode remains in PCV,rate = 10/min,I:E = 1:2,and PIP = 35 cm H2O.The following information is documented during the RM:   After the RM,the lungs are reinflated.At what level should the PEEP be set for this patient?

Accepted Answer

A)  12 cm H2O 
B)  17 cm H2O 
C)  22 cm H2O 
D)  27 cm H2O 
A)  12 cm H2O 
B)  17 cm H2O 
C)  22 cm H2O 
D)  27 cm H2O

Question 14

To perform a slow-flow (quasi-static)technique for determining the appropriate PEEP level,the most appropriate ventilator flow setting is which of the following?

Accepted Answer

A)  2 L/min 
B)  6 L/min 
C)  10 L/min 
D)  14 L/min 
A)  2 L/min 
B)  6 L/min 
C)  10 L/min 
D)  14 L/min

Question 15

During mechanical ventilation of a patient with COPD,the PaO2 = 58 mm Hg and the FIO2 = 0.5.If the desired PaO2 is 65 mm Hg,the FIO2 needs to be changed to which of the following?

Accepted Answer

A)  0.44 
B)  0.56 
C)  0.65 
D)  0.74 
A)  0.44 
B)  0.56 
C)  0.65 
D)  0.74

Question 16

Despite the risk,it is still important to use PEEP,because it can prevent alveolar collapse during exhalation and reopening,even when a low VT is used.It now is theorized that it is important to use the pressure-volume loop to set PEEP _____________________.

Accepted Answer

A)  at the upper inflection point detected during inflation of the lung 
B)  above the upper inflection point detected during deflation of the lung 
C)  at the lower inflection point detected during inflation of the lung 
D)  at the peak inspiration point detected during inflation of the lung 
A)  at the upper inflection point detected during inflation of the lung 
B)  above the upper inflection point detected during deflation of the lung 
C)  at the lower inflection point detected during inflation of the lung 
D)  at the peak inspiration point detected during inflation of the lung

Question 17

"Loose atelectasis," or compression atelectasis,is most often associated with _____________.

Accepted Answer

A)  ALI 
B)  ARDS 
C)  anesthesia 
D)  pulmonary fibrosis 
A)  ALI 
B)  ARDS 
C)  anesthesia 
D)  pulmonary fibrosis

Question 18

In which ventilator mode should a patient receiving a sustained inflation technique be placed?

Accepted Answer

A)  VC-CMV 
B)  APRV 
C)  PC-IMV 
D)  CPAP/spontaneous 
A)  VC-CMV 
B)  APRV 
C)  PC-IMV 
D)  CPAP/spontaneous

Question 19

Calculate the pulmonary shunt fraction for a patient with the following data: Pb = 760 mm Hg;Hb = 10 g/dL;respiratory quotient = 0.8;FIO2 = 0.6;PaO2 = 100 mm Hg;SaO2 = 93%;PaCO2 = 45 mm Hg;   = 36 mm Hg;   = 70%.

Accepted Answer

A)  13 % 
B)  26% 
C)  30 % 
D)  41% 
A)  13 % 
B)  26% 
C)  30 % 
D)  41%

Question 20

An absolute contraindication to PEEP is which of the following?

Accepted Answer

A)  Emphysema 
B)  Bronchopleural fistula 
C)  Untreated tension pneumothorax 
D)  Elevated intracranial pressures 
A)  Emphysema 
B)  Bronchopleural fistula 
C)  Untreated tension pneumothorax 
D)  Elevated intracranial pressures

The level of applied PEEP should be set at what point on the pressure-volume curve?

How long after PEEP is increased should all ventilatory and available hemodynamic parameters be measured and calculated?

A patient with ARDS has the slow pressure-volume loop shown below.Based on this loop,at what level should PEEP be set?

What is the optimal PEEP level given the following information?

What is the P_flex on the following pressure-volume loop?

Thirty minutes after intubation and initiation of mechanical ventilation,a patient's PaO₂ = 55 mm Hg and the F_IO₂ = 0.5.To what should the F_IO₂ be set to obtain a PaO₂ of 80 mm Hg?

Regardless of the procedure used to establish an appropriate PEEP level,ventilating pressures should not be allowed to exceed which of the following?

Assessing the outcome of PEEP at levels set above 15 to 20 cm H₂O is best done using which of the following?

The level of PEEP that is most appropriate for a patient with the information shown below is which of the following?

The highest pressure attained during the slow-flow (quasi-static)technique should be ______ cm H₂O.

The point on a static pressure-volume curve (SPV)where the alveoli begin to open is referred to as which of the following?

To perform a slow-flow (quasi-static)technique for determining the appropriate PEEP level,the most appropriate ventilator flow setting is which of the following?

During mechanical ventilation of a patient with COPD,the PaO₂ = 58 mm Hg and the F_IO₂ = 0.5.If the desired PaO₂ is 65 mm Hg,the F_IO₂ needs to be changed to which of the following?

Despite the risk,it is still important to use PEEP,because it can prevent alveolar collapse during exhalation and reopening,even when a low V_T is used.It now is theorized that it is important to use the pressure-volume loop to set PEEP _____________________.

"Loose atelectasis," or compression atelectasis,is most often associated with _____________.

In which ventilator mode should a patient receiving a sustained inflation technique be placed?

An absolute contraindication to PEEP is which of the following?

Basic Terms and Concepts of Mechanical Ventilation

How Ventilators Work

How a Breath Is Delivered

Establishing the Need for Mechanical Ventilation

Selecting the Ventilator and the Mode

Initial Ventilator Settings

Final Considerations in Ventilator Setup

Initial Patient Assessment

Ventilator Graphics

Assessment of Respiratory Function

Hemodynamic Monitoring

Methods to Improve Ventilation in Patient-Ventilator Management

Ventilator-Associated Pneumonia

Sedatives,Analgesics,and Paralytics

Extrapulmonary Effects of Mechanical Ventilation

Effects of Positive Pressure Ventilation on the Pulmonary System

Troubleshooting and Problem Solving

Basic Concepts of Noninvasive Positive Pressure Ventilation

Discontinuation and Weaning From Mechanical Ventilation

Long Term Ventilation

Neonatal and Pediatric Ventilation

Special Techniques in Ventilatory Support

Filters

Exam 13: Improving Oxygenation and Management of Ards

The level of applied PEEP should be set at what point on the pressure-volume curve?

How long after PEEP is increased should all ventilatory and available hemodynamic parameters be measured and calculated?

A patient with ARDS has the slow pressure-volume loop shown below.Based on this loop,at what level should PEEP be set?

What is the optimal PEEP level given the following information?

What is the Pflex on the following pressure-volume loop?

Thirty minutes after intubation and initiation of mechanical ventilation,a patient's PaO2 = 55 mm Hg and the FIO2 = 0.5.To what should the FIO2 be set to obtain a PaO2 of 80 mm Hg?

Regardless of the procedure used to establish an appropriate PEEP level,ventilating pressures should not be allowed to exceed which of the following?

Assessing the outcome of PEEP at levels set above 15 to 20 cm H2O is best done using which of the following?

The level of PEEP that is most appropriate for a patient with the information shown below is which of the following?

The highest pressure attained during the slow-flow (quasi-static)technique should be ______ cm H2O.

The point on a static pressure-volume curve (SPV)where the alveoli begin to open is referred to as which of the following?

To perform a slow-flow (quasi-static)technique for determining the appropriate PEEP level,the most appropriate ventilator flow setting is which of the following?

During mechanical ventilation of a patient with COPD,the PaO2 = 58 mm Hg and the FIO2 = 0.5.If the desired PaO2 is 65 mm Hg,the FIO2 needs to be changed to which of the following?

Despite the risk,it is still important to use PEEP,because it can prevent alveolar collapse during exhalation and reopening,even when a low VT is used.It now is theorized that it is important to use the pressure-volume loop to set PEEP _____________________.

"Loose atelectasis," or compression atelectasis,is most often associated with _____________.

In which ventilator mode should a patient receiving a sustained inflation technique be placed?

Calculate the pulmonary shunt fraction for a patient with the following data: Pb = 760 mm Hg;Hb = 10 g/dL;respiratory quotient = 0.8;FIO2 = 0.6;PaO2 = 100 mm Hg;SaO2 = 93%;PaCO2 = 45 mm Hg; = 36 mm Hg; = 70%.

An absolute contraindication to PEEP is which of the following?

Basic Terms and Concepts of Mechanical Ventilation

How Ventilators Work

How a Breath Is Delivered

Establishing the Need for Mechanical Ventilation

Selecting the Ventilator and the Mode

Initial Ventilator Settings

Final Considerations in Ventilator Setup

Initial Patient Assessment

Ventilator Graphics

Assessment of Respiratory Function

Hemodynamic Monitoring

Methods to Improve Ventilation in Patient-Ventilator Management

Ventilator-Associated Pneumonia

Sedatives,Analgesics,and Paralytics

Extrapulmonary Effects of Mechanical Ventilation

Effects of Positive Pressure Ventilation on the Pulmonary System

Troubleshooting and Problem Solving

Basic Concepts of Noninvasive Positive Pressure Ventilation

Discontinuation and Weaning From Mechanical Ventilation

Long Term Ventilation

Neonatal and Pediatric Ventilation

Special Techniques in Ventilatory Support

Filters

What is the P_flex on the following pressure-volume loop?

Thirty minutes after intubation and initiation of mechanical ventilation,a patient's PaO₂ = 55 mm Hg and the F_IO₂ = 0.5.To what should the F_IO₂ be set to obtain a PaO₂ of 80 mm Hg?

Assessing the outcome of PEEP at levels set above 15 to 20 cm H₂O is best done using which of the following?

The highest pressure attained during the slow-flow (quasi-static)technique should be ______ cm H₂O.

During mechanical ventilation of a patient with COPD,the PaO₂ = 58 mm Hg and the F_IO₂ = 0.5.If the desired PaO₂ is 65 mm Hg,the F_IO₂ needs to be changed to which of the following?

Despite the risk,it is still important to use PEEP,because it can prevent alveolar collapse during exhalation and reopening,even when a low V_T is used.It now is theorized that it is important to use the pressure-volume loop to set PEEP _____________________.