Question 1

Which of the following clinical findings is least likely to be seen in a patient with acute hypoxic respiratory failure?

Accepted Answer

A)  Confusion 
B)  Tachycardia 
C)  Hypotension 
D)  Dyspnea 
A)  Confusion 
B)  Tachycardia 
C)  Hypotension 
D)  Dyspnea

Question 2

When is the PEEP/CPAP level optimum?

Accepted Answer

A)  O2 delivery to the tissues is maximized. 
B)  Pressures are maintained below 15 cm H2O. 
C)  CaO2-CvO2 is maximized. 
D)  The PaO2 is 60 to 100 mm Hg. 
A)  O2 delivery to the tissues is maximized. 
B)  Pressures are maintained below 15 cm H2O. 
C)  CaO2-CvO2 is maximized. 
D)  The PaO2 is 60 to 100 mm Hg.

Question 3

What goal(s) does the practitioner hope to achieve when selecting initial ventilatory support settings?
1) Optimize oxygenation.
2) Optimize ventilation.
3) Maintain acid-base balance.
4) Avoid harmful side effects.

Accepted Answer

A) 1 only 
B) 2 and 3 only 
C) 1, 3, and 4 only 
D) 1, 2, 3, and 4 
A) 1 only 
B) 2 and 3 only 
C) 1, 3, and 4 only 
D) 1, 2, 3, and 4

Question 4

Which of the following trigger levels is appropriate when setting a ventilator for pressure triggering?

Accepted Answer

A)  0.5 to 1.5 cm H2O above the baseline pressure 
B)  1.5 to 2.5 cm H2O below the baseline pressure 
C)  0.5 to 1.5 cm H2O below the baseline pressure 
D)  2.5 to 3.5 cm H2O below the baseline pressure 
A)  0.5 to 1.5 cm H2O above the baseline pressure 
B)  1.5 to 2.5 cm H2O below the baseline pressure 
C)  0.5 to 1.5 cm H2O below the baseline pressure 
D)  2.5 to 3.5 cm H2O below the baseline pressure

Question 5

Which of the following techniques can be used to improve oxygenation beyond increasing the FiO2 or PEEP level?
1) Proning the patient
2) Use of an expiratory pause
3) Use of inverse I:E ratio ventilation

Accepted Answer

A) 1 only 
B) 1 and 2 only 
C) 2 and 3 only 
D) 1 and 3 only 
A) 1 only 
B) 1 and 2 only 
C) 2 and 3 only 
D) 1 and 3 only

Question 6

For which of the following patients requiring ventilatory support would you recommend against using a heat-moisture exchanger (HME) for airway humidification?
1) Patient with an expired VT less than 70% of the delivered VT
2) Patient with a spontaneous minute ventilation of 14 L/min
3) Patient with body temperature less than 32° C

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 7

A physician orders intubation and mechanical ventilation in the continuous mandatory ventilation assist-control mode for a 125-lb adult woman with normal lungs. Which of the following initial settings would you recommend? Rate VT

Accepted Answer

A)  10 breaths/min 550 ml 
B)  14 breaths/min 400 ml 
C)  18 breaths/min 450 ml 
D)  12 breaths/min 470 ml 
A)  10 breaths/min 550 ml 
B)  14 breaths/min 400 ml 
C)  18 breaths/min 450 ml 
D)  12 breaths/min 470 ml

Question 8

When adjusting a patient's oxygenation during mechanical ventilatory support, what should your goal be?

Accepted Answer

A)  SaO2 of 80% to 90% 
B)  PaO2 of 100 to 150 mm Hg 
C)  SaO2 of 95% to 100% 
D)  PaO2 of 60 to 100 mm Hg 
A)  SaO2 of 80% to 90% 
B)  PaO2 of 100 to 150 mm Hg 
C)  SaO2 of 95% to 100% 
D)  PaO2 of 60 to 100 mm Hg

Question 9

Which of the following is false about flow triggering of spontaneous breaths during mechanical ventilation?

Accepted Answer

A)  Flow triggering lowers the patient's work of breathing. 
B)  Flow triggering is preferred for initiating spontaneous breaths. 
C)  Flow triggering reduces the work of breathing due to small endotracheal tubes. 
D)  Flow triggering results in better patient-ventilator synchrony. 
A)  Flow triggering lowers the patient's work of breathing. 
B)  Flow triggering is preferred for initiating spontaneous breaths. 
C)  Flow triggering reduces the work of breathing due to small endotracheal tubes. 
D)  Flow triggering results in better patient-ventilator synchrony.

Question 10

Which of the following statements are true regarding the use of controlled ventilation?
1) May allow the muscles of breathing to rest.
2) Can use larger 1:E ratio and may improve oxygenation.
3) Requires use of paralytic agents in spontaneously breathing patients.
4) Therapist has little control of needed inspiratory flow and pressure.

Accepted Answer

A) 1 and 3 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 2, 3, and 4 only 
A) 1 and 3 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 2, 3, and 4 only

Question 11

In which of the following clinical conditions would noninvasive ventilation (NIV) be recommended?
1) Management of acute exacerbation of chronic obstructive pulmonary disease (COPD)
2) Management of premature extubation
3) Management of cardiogenic pulmonary edema
4) Management of acute respiratory distress syndrome (ARDS)

Accepted Answer

A) 1 and 3 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 2, 3, and 4 only 
A) 1 and 3 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 2, 3, and 4 only

Question 12

Which of the following is one of the modes of ventilation that may be considered when partial ventilatory support is indicated?

Accepted Answer

A)  Assist-control pressure ventilation 
B)  Proportional assist ventilation (PAV) 
C)  Volume-control continuous mandatory ventilation 
D)  Assist-control volume ventilation 
A)  Assist-control pressure ventilation 
B)  Proportional assist ventilation (PAV) 
C)  Volume-control continuous mandatory ventilation 
D)  Assist-control volume ventilation

Question 13

On some ventilators, which of the following can occur if a trigger setting is set too sensitive on a mechanical ventilator?

Accepted Answer

A)  Autotriggering 
B)  Flow dyssynchrony 
C)  Barotrauma 
D)  Increased workload 
A)  Autotriggering 
B)  Flow dyssynchrony 
C)  Barotrauma 
D)  Increased workload

Question 14

If the patient is being ventilated via a mechanical ventilator via intermittent mandatory ventilation with partial ventilatory support, what would probably happen to PaCO2 if the patient suddenly had no spontaneous breathing?

Accepted Answer

A)  Increase 
B)  Decrease 
C)  Stay the same 
D)  Change according to FiO2 
A)  Increase 
B)  Decrease 
C)  Stay the same 
D)  Change according to FiO2

Question 15

Which of the following situations is most likely to call for ventilator settings of low volume and high rate while allowing for permissive hypercapnia?

Accepted Answer

A)  Patient with ARDS 
B)  Patient with neuromuscular disease 
C)  Patient with chronic obstructive pulmonary disease 
D)  Child with croup 
A)  Patient with ARDS 
B)  Patient with neuromuscular disease 
C)  Patient with chronic obstructive pulmonary disease 
D)  Child with croup

Question 16

Which of the following represents a clinical situation where partial ventilatory support is commonly used?

Accepted Answer

A)  Patient with head trauma 
B)  During weaning from continuous mandatory ventilation 
C)  While ventilating an asthmatic 
D)  In a drug overdose case 
A)  Patient with head trauma 
B)  During weaning from continuous mandatory ventilation 
C)  While ventilating an asthmatic 
D)  In a drug overdose case

Question 17

In which of the following conditions is PEEP likely to be useful?
1) ARDS
2) Pulmonary edema
3) Acute lung injury
4) Neuromuscular disease

Accepted Answer

A) 1 and 3 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 2, 3, and 4 only 
A) 1 and 3 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 2, 3, and 4 only

Question 18

In which of the following clinical situations is the incidence of auto-PEEP the greatest?
1) Patients with high respiratory rates
2) Intubated patients with obstructive lung disease
3) Patients with low minute volumes

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 19

When performing a lung recruitment strategy, which of the following would cause the therapist to stop?
1) Mean blood pressure drops of 80 to 65 mm Hg.
2) Heart rate increases from 88 to 110/min.
3) Patient has a run of premature ventricular complexes.

Accepted Answer

A) 1 only 
B) 2 only 
C) 3 only 
D) 1, 2, and 3 
A) 1 only 
B) 2 only 
C) 3 only 
D) 1, 2, and 3

Question 20

When adjusting the FiO2 setting for a patient receiving mechanical ventilatory support, what should your goal be?

Accepted Answer

A)  Decrease the FiO2 to below 0.70 as soon as possible. 
B)  Maintain the highest possible FiO2 as long as needed. 
C)  Decrease the FiO2 to below 0.30 as soon as possible. 
D)  Decrease the FiO2 to below 0.50 as soon as possible. 
A)  Decrease the FiO2 to below 0.70 as soon as possible. 
B)  Maintain the highest possible FiO2 as long as needed. 
C)  Decrease the FiO2 to below 0.30 as soon as possible. 
D)  Decrease the FiO2 to below 0.50 as soon as possible.

Exam 48: Initiating and Adjusting Invasive Ventilatory Support

Which of the following clinical findings is least likely to be seen in a patient with acute hypoxic respiratory failure?

When is the PEEP/CPAP level optimum?

What goal(s) does the practitioner hope to achieve when selecting initial ventilatory support settings? 1) Optimize oxygenation. 2) Optimize ventilation. 3) Maintain acid-base balance. 4) Avoid harmful side effects.

Which of the following trigger levels is appropriate when setting a ventilator for pressure triggering?

Which of the following techniques can be used to improve oxygenation beyond increasing the FiO2 or PEEP level? 1) Proning the patient 2) Use of an expiratory pause 3) Use of inverse I:E ratio ventilation

A physician orders intubation and mechanical ventilation in the continuous mandatory ventilation assist-control mode for a 125-lb adult woman with normal lungs. Which of the following initial settings would you recommend? Rate VT

When adjusting a patient's oxygenation during mechanical ventilatory support, what should your goal be?

Which of the following is false about flow triggering of spontaneous breaths during mechanical ventilation?

Which of the following is one of the modes of ventilation that may be considered when partial ventilatory support is indicated?

On some ventilators, which of the following can occur if a trigger setting is set too sensitive on a mechanical ventilator?

If the patient is being ventilated via a mechanical ventilator via intermittent mandatory ventilation with partial ventilatory support, what would probably happen to PaCO2 if the patient suddenly had no spontaneous breathing?

Which of the following situations is most likely to call for ventilator settings of low volume and high rate while allowing for permissive hypercapnia?

Which of the following represents a clinical situation where partial ventilatory support is commonly used?

In which of the following conditions is PEEP likely to be useful? 1) ARDS 2) Pulmonary edema 3) Acute lung injury 4) Neuromuscular disease

In which of the following clinical situations is the incidence of auto-PEEP the greatest? 1) Patients with high respiratory rates 2) Intubated patients with obstructive lung disease 3) Patients with low minute volumes

When performing a lung recruitment strategy, which of the following would cause the therapist to stop? 1) Mean blood pressure drops of 80 to 65 mm Hg. 2) Heart rate increases from 88 to 110/min. 3) Patient has a run of premature ventricular complexes.

When adjusting the FiO2 setting for a patient receiving mechanical ventilatory support, what should your goal be?

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

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

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Respiratory Distress Syndrome

Trauma, Burns and Near Drowning

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

Airway Clearance Therapy Act

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring 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

Which of the following techniques can be used to improve oxygenation beyond increasing the FiO₂ or PEEP level? 1) Proning the patient 2) Use of an expiratory pause 3) Use of inverse I:E ratio ventilation

A physician orders intubation and mechanical ventilation in the continuous mandatory ventilation assist-control mode for a 125-lb adult woman with normal lungs. Which of the following initial settings would you recommend? Rate V_T

If the patient is being ventilated via a mechanical ventilator via intermittent mandatory ventilation with partial ventilatory support, what would probably happen to PaCO₂ if the patient suddenly had no spontaneous breathing?

When adjusting the FiO₂ setting for a patient receiving mechanical ventilatory support, what should your goal be?