Question 1

What is the normal range for PaO2/FIO2?

Accepted Answer

A) 350 to 450 
B) 250 to 350 
C) 150 to 250 
D) 75 to 150 
A) 350 to 450 
B) 250 to 350 
C) 150 to 250 
D) 75 to 150

Question 2

Which of the following modes of ventilatory support would you recommend for a severely hypoxemic patient with acute lung injury or acute respiratory distress syndrome (ARDS)?

Accepted Answer

A) continuous positive airway pressure 
B) high VT volume-cycled ventilation 
C) pressure-controlled ventilation 
D) bilevel pressure support by mask 
A) continuous positive airway pressure 
B) high VT volume-cycled ventilation 
C) pressure-controlled ventilation 
D) bilevel pressure support by mask

Question 3

Which of the following measures is/are useful indicators in assessing the adequacy of a patient's oxygenation?
I.PaO2-PaO2
II.PaO2-to-FIO2 ratio
III.VD/VT
IV.pulmonary shunt ( $\dot { Q }$ s/ $\dot { Q }$ t)

Accepted Answer

A) I and II 
B) I and III 
C) II and III 
D) I, II, and III 
A) I and II 
B) I and III 
C) II and III 
D) I, II, and III

Question 4

What is the most common cause of low mixed venous oxygen?

Accepted Answer

A) liver disease 
B) cardiac disease 
C) neuromuscular disease 
D) vascular disease 
A) liver disease 
B) cardiac disease 
C) neuromuscular disease 
D) vascular disease

Question 5

What type of disease is associated with perfusion/diffusion impairment?

Accepted Answer

A) liver disease 
B) renal disease 
C) neuromuscular disease 
D) vascular disease 
A) liver disease 
B) renal disease 
C) neuromuscular disease 
D) vascular disease

Question 6

Which of the following is a feature of Guillain-Barré?

Accepted Answer

A) ascending muscle weakness 
B) descending muscle weakness 
C) limited to lower extremities 
D) limited to trunk 
A) ascending muscle weakness 
B) descending muscle weakness 
C) limited to lower extremities 
D) limited to trunk

Question 7

Because an elevated PaCO2 increases ventilatory drive in normal subjects, the clinical presence of hypercapnia indicates which of the following?
I.inability of the stimulus to get to the muscles
II.weak or missing central nervous system response to the elevated PCO2
III.pulmonary muscle fatigue

Accepted Answer

A) I and II 
B) I and III 
C) II and III 
D) I, II, and III 
A) I and II 
B) I and III 
C) II and III 
D) I, II, and III

Question 8

A patient who just suffered severe closed-head injury and has a high intracranial pressure (ICP) is about to be placed on ventilatory support. Which of the following strategies could help to lower the ICP?

Accepted Answer

A) Maintain a PaCO2 from 25 to 30 mm Hg (deliberate hyperventilation). 
B) Allow as much spontaneous breathing as possible (SIMV). 
C) Maintain a high mean pressure using PEEP levels of 10 to 15 cm H2O. 
D) Maintain a PaCO2 of 50 to 60 mm Hg (deliberate hypoventilation). 
A) Maintain a PaCO2 from 25 to 30 mm Hg (deliberate hyperventilation). 
B) Allow as much spontaneous breathing as possible (SIMV). 
C) Maintain a high mean pressure using PEEP levels of 10 to 15 cm H2O. 
D) Maintain a PaCO2 of 50 to 60 mm Hg (deliberate hypoventilation).

Question 9

A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO2 = 89; HCO3- = 27; PO2 = 48. Which of the following best describes this patient's condition?

Accepted Answer

A) chronic hypoxemic respiratory failure 
B) chronic hypercapnic respiratory failure 
C) acute hypoxemic respiratory failure 
D) acute hypercapnic respiratory failure 
A) chronic hypoxemic respiratory failure 
B) chronic hypercapnic respiratory failure 
C) acute hypoxemic respiratory failure 
D) acute hypercapnic respiratory failure

Question 10

Which of the following indicators are useful in assessing respiratory muscle strength?
I.	maximum voluntary ventilation (MVV)
II.	forced vital capacity (FVC)
III.	dead space?to?tidal volume ratio (VD/VT)
IV.	maximum inspiratory pressure (MIP)

Accepted Answer

A) I and III 
B) II and IV 
C) III and IV 
D) I, II, and IV 
A) I and III 
B) II and IV 
C) III and IV 
D) I, II, and IV

Question 11

A patient with interstitial lung disease who presents with hypoxemia due to diffusion defect would have which of the following clinical signs?
I.fine bibasilar crackles
II.clubbing of the finger nail beds
III.jugular venous distention
IV.increased P2

Accepted Answer

A) I and II 
B) I, III, and IV 
C) III and IV 
D) I, II, III, and IV 
A) I and II 
B) I, III, and IV 
C) III and IV 
D) I, II, III, and IV

Question 12

In intubated patients, what do sources of increased imposed work of breathing include?
I.endotracheal tube
II.ventilator circuit
III.auto-PEEP

Accepted Answer

A) I and II 
B) I and III 
C) II and III 
D) I, II, and III 
A) I and II 
B) I and III 
C) II and III 
D) I, II, and III

Question 13

All of the following would tend to cause hypercapnic respiratory failure except:

Accepted Answer

A) smoke inhalation 
B) opiate drug overdose 
C) chronic obstructive pulmonary disease 
D) hypothyroidism 
A) smoke inhalation 
B) opiate drug overdose 
C) chronic obstructive pulmonary disease 
D) hypothyroidism

Question 14

What are some causes of dynamic hyperinflation?
I.increased expiratory time
II.increased airway resistance
III.decreased expiratory flow rate

Accepted Answer

A) I and II 
B) I and III 
C) II and III 
D) I, II, and III 
A) I and II 
B) I and III 
C) II and III 
D) I, II, and III

Question 15

Which of the following clinical signs is most often associated with hypoxemia due to shunt?

Accepted Answer

A) diffuse wheezing 
B) "white" chest radiograph 
C) stridor 
D) loud P2 
A) diffuse wheezing 
B) "white" chest radiograph 
C) stridor 
D) loud P2

Question 16

A need for some form of ventilatory support is usually indicated when an adult's rate of breathing rises above what level?

Accepted Answer

A) 35/min 
B) 30/min 
C) 25/min 
D) 20/min 
A) 35/min 
B) 30/min 
C) 25/min 
D) 20/min

Question 17

Which of the following indicate severely impaired oxygenation requiring high FIO2s and positive end-expiratory pressure?
I.PaO2-PaO2 greater than 350 mm Hg on 100% O2
II.VC less than 10 ml/kg
III.PaO2/FIO2 less than 200

Accepted Answer

A) I and II 
B) I and III 
C) II and III 
D) I, II, and III 
A) I and II 
B) I and III 
C) II and III 
D) I, II, and III

Question 18

What is the normal P(A-a)O2 range while breathing room air?

Accepted Answer

A) 25 mm Hg to 50 mm Hg 
B) 10 mm Hg to 25 mm Hg 
C) greater than 25 mm Hg 
D) less than 10 mm Hg 
A) 25 mm Hg to 50 mm Hg 
B) 10 mm Hg to 25 mm Hg 
C) greater than 25 mm Hg 
D) less than 10 mm Hg

Question 19

Which of the following information best helps to distinguish chronic hypercapnic respiratory failure from acute hypercapnic respiratory failure?

Accepted Answer

A) long-standing dyspnea that worsens on exertion 
B) forced expiratory volume in 1 second-to-forced vital capacity ratio (FEV1/FV
C)  of less than 75% predicted 
C) kidneys retaining bicarbonate to elevate the blood pH 
D) physical signs of hypoxemia, such as cyanosis and clubbing 
A) long-standing dyspnea that worsens on exertion 
B) forced expiratory volume in 1 second-to-forced vital capacity ratio (FEV1/FV
C)  of less than 75% predicted 
C) kidneys retaining bicarbonate to elevate the blood pH 
D) physical signs of hypoxemia, such as cyanosis and clubbing

Question 20

Which of the following patients has the most serious problem with the adequacy of oxygenation? 
$\begin{array}{lll}\text { Patient }&\mathrm{FIO}_{2}&\underline{\mathrm{PaO}_{2}}\
\text { A. } & 0.70 & 90 \
\text { B. } & 0.40 & 95 \
\text { C. } & 1.00 & 85 \
\text { D. } & 0.28 & 65
\end{array}$

Accepted Answer

The answer of Which of the following patients has the...

Exam 41: Respiratory Failure and the Need for Ventilatory Support

What is the normal range for PaO2/FIO2?

Which of the following modes of ventilatory support would you recommend for a severely hypoxemic patient with acute lung injury or acute respiratory distress syndrome (ARDS)?

Which of the following measures is/are useful indicators in assessing the adequacy of a patient's oxygenation? I.PaO2-PaO2 II.PaO2-to-FIO2 ratio III.VD/VT IV.pulmonary shunt ( Q˙\dot { Q }Q˙​ s/ Q˙\dot { Q }Q˙​ t)

What is the most common cause of low mixed venous oxygen?

What type of disease is associated with perfusion/diffusion impairment?

Which of the following is a feature of Guillain-Barré?

Because an elevated PaCO2 increases ventilatory drive in normal subjects, the clinical presence of hypercapnia indicates which of the following? I.inability of the stimulus to get to the muscles II.weak or missing central nervous system response to the elevated PCO2 III.pulmonary muscle fatigue

A patient who just suffered severe closed-head injury and has a high intracranial pressure (ICP) is about to be placed on ventilatory support. Which of the following strategies could help to lower the ICP?

A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO2 = 89; HCO3- = 27; PO2 = 48. Which of the following best describes this patient's condition?

Which of the following indicators are useful in assessing respiratory muscle strength? I. maximum voluntary ventilation (MVV) II. forced vital capacity (FVC) III. dead space?to?tidal volume ratio (VD/VT) IV. maximum inspiratory pressure (MIP)

A patient with interstitial lung disease who presents with hypoxemia due to diffusion defect would have which of the following clinical signs? I.fine bibasilar crackles II.clubbing of the finger nail beds III.jugular venous distention IV.increased P2

In intubated patients, what do sources of increased imposed work of breathing include? I.endotracheal tube II.ventilator circuit III.auto-PEEP

All of the following would tend to cause hypercapnic respiratory failure except:

What are some causes of dynamic hyperinflation? I.increased expiratory time II.increased airway resistance III.decreased expiratory flow rate

Which of the following clinical signs is most often associated with hypoxemia due to shunt?

A need for some form of ventilatory support is usually indicated when an adult's rate of breathing rises above what level?

Which of the following indicate severely impaired oxygenation requiring high FIO2s and positive end-expiratory pressure? I.PaO2-PaO2 greater than 350 mm Hg on 100% O2 II.VC less than 10 ml/kg III.PaO2/FIO2 less than 200

What is the normal P(A-a)O2 range while breathing room air?

Which of the following information best helps to distinguish chronic hypercapnic respiratory failure from acute hypercapnic respiratory failure?

Which of the following patients has the most serious problem with the adequacy of oxygenation? Patient A. 0.70 90 B. 0.40 95 C. 1.00 85 D. 0.28 65

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

What is the normal range for PaO₂/FIO₂?

Which of the following measures is/are useful indicators in assessing the adequacy of a patient's oxygenation? I.PaO₂-PaO₂ II.PaO₂-to-FIO₂ ratio III.V_D/V_T IV.pulmonary shunt ( $\dot { Q }$ _s/ $\dot { Q }$ _t)

Because an elevated PaCO₂increases ventilatory drive in normal subjects, the clinical presence of hypercapnia indicates which of the following? I.inability of the stimulus to get to the muscles II.weak or missing central nervous system response to the elevated PCO₂ III.pulmonary muscle fatigue

A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO₂ = 89; HCO₃^- = 27; PO₂= 48. Which of the following best describes this patient's condition?

Which of the following indicators are useful in assessing respiratory muscle strength? I. maximum voluntary ventilation (MVV) II. forced vital capacity (FVC) III. dead space?to?tidal volume ratio (VD/V_T) IV. maximum inspiratory pressure (MIP)

Which of the following indicate severely impaired oxygenation requiring high FIO₂s and positive end-expiratory pressure? I.PaO₂-PaO₂ greater than 350 mm Hg on 100% O₂ II.VC less than 10 ml/kg III.PaO₂/FIO₂ less than 200

What is the normal P(A-a)O₂ range while breathing room air?