Question 1

Patient's RR is 12 breaths/min, PaCO2 is 60 mm Hg. If a PaCO2 of 40 were desired, the RR be set at what value?

Accepted Answer

A)  18 
B)  23 
C)  35 
D)  40 
A)  18 
B)  23 
C)  35 
D)  40

Question 2

When starting flow-limited ventilatory support on an adult patient, which of the following inspiratory flow settings would you initially select?

Accepted Answer

A)  60 L/min 
B)  50 L/min 
C)  40 L/min 
D)  30 L/min 
A)  60 L/min 
B)  50 L/min 
C)  40 L/min 
D)  30 L/min

Question 3

Which of the following is false about flow-triggered ventilatory support?

Accepted Answer

A)  The work of breathing with flow triggering is less than with pressure triggering. 
B)  Flow-triggered systems respond to changes in flow rather than pressure. 
C)  Pressure triggering on new ventilators may be as sensitive as flow-triggering. 
D)  Flow triggering will decrease the work of breathing in patients with small endotracheal tubes and auto-PEEP. 
A)  The work of breathing with flow triggering is less than with pressure triggering. 
B)  Flow-triggered systems respond to changes in flow rather than pressure. 
C)  Pressure triggering on new ventilators may be as sensitive as flow-triggering. 
D)  Flow triggering will decrease the work of breathing in patients with small endotracheal tubes and auto-PEEP.

Question 4

When the patient stabilizes on mechanical ventilation with a PEEP of 12 cm H2O and the FiO2 has been reduced to 0.40, how should the PEEP level reduce?

Accepted Answer

A)  In increments of 2 cm H2O every 6 hr 
B)  In increments of 3 to 5 cm H2O every 2 hr 
C)  In increments of 3 to 5 cm H2O every 1 hr 
D)  In increments of 5 cm H2O every 2 hr 
A)  In increments of 2 cm H2O every 6 hr 
B)  In increments of 3 to 5 cm H2O every 2 hr 
C)  In increments of 3 to 5 cm H2O every 1 hr 
D)  In increments of 5 cm H2O every 2 hr

Question 5

Which of the following modes of ventilatory support would you recommend for a patient who can breathe spontaneously and only requires assistance to overcome the work of breathing created by the ET tube?

Accepted Answer

A)  Pressure-targeted continuous mandatory ventilation 
B)  Pressure-supported ventilation 
C)  Volume-targeted CMV 
D)  Pressure-targeted intermittent mandatory ventilation 
A)  Pressure-targeted continuous mandatory ventilation 
B)  Pressure-supported ventilation 
C)  Volume-targeted CMV 
D)  Pressure-targeted intermittent mandatory ventilation

Question 6

How frequently should a clinician make changes when weaning from PEEP?

Accepted Answer

A)  10 to 20 min 
B)  30 to 45 min 
C)  1 hr 
D)  6 to 8 hr 
A)  10 to 20 min 
B)  30 to 45 min 
C)  1 hr 
D)  6 to 8 hr

Question 7

When titrating the FiO2 down from 50% to 21%, in what increments should it be reduced?

Accepted Answer

A)  All at once is acceptable. 
B)  No more than 5%. 
C)  5% to 10%. 
D)  10% to 20%. 
A)  All at once is acceptable. 
B)  No more than 5%. 
C)  5% to 10%. 
D)  10% to 20%.

Question 8

If available, the FiO2 alarm should be set to what percentage?

Accepted Answer

A)  ±3% 
B)  ±5% 
C)  ±8% 
D)  ±10% 
A)  ±3% 
B)  ±5% 
C)  ±8% 
D)  ±10%

Question 9

Which of the following would decrease PaCO2 when ventilating a patient using intermittent mandatory ventilation with pressure support?

Accepted Answer

A)  Increase the level of pressure support. 
B)  Decrease the tidal volume. 
C)  Decrease the mechanical rate. 
D)  Increase the FiO2. 
A)  Increase the level of pressure support. 
B)  Decrease the tidal volume. 
C)  Decrease the mechanical rate. 
D)  Increase the FiO2.

Question 10

A patient suffering from postoperative complications has been receiving mechanical ventilation for 6 days with a volume ventilator. A heat-moisture exchanger (HME) is providing control over humidification and airway temperature. Over the past 24 hr, the patient's secretions have decreased in quantity but are thicker and more purulent. Which of the following actions would you suggest at this time?

Accepted Answer

A)  Replace the HME. 
B)  Switch over to a heated wick humidifier. 
C)  Administer acetylcysteine every 2 hr via the nebulizer. 
D)  Increase the frequency of suctioning. 
A)  Replace the HME. 
B)  Switch over to a heated wick humidifier. 
C)  Administer acetylcysteine every 2 hr via the nebulizer. 
D)  Increase the frequency of suctioning.

Question 11

A physician orders intubation and mechanical ventilation in the synchronized intermittent mandatory ventilation mode for a 160-lb adult man with a history of chronic obstructive pulmonary disease. Which of the following settings would you recommend? Rate VT

Accepted Answer

A)  12 breaths/min 500 ml 
B)  15 breaths/min 550 ml 
C)  20 breaths/min 300 ml 
D)  16 breaths/min 500 ml 
A)  12 breaths/min 500 ml 
B)  15 breaths/min 550 ml 
C)  20 breaths/min 300 ml 
D)  16 breaths/min 500 ml

Question 12

Which of the following would you assess immediately after a patient is placed on a ventilatory support device?
1) ABGs
2) Patient's airway
3) Patient's vital signs

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 13

What is the recommended response to a drop in PaO2 when the PEEP level is reduced in a mechanically ventilated patient?

Accepted Answer

A)  Increase the FiO2. 
B)  Return the PEEP to the previous level. 
C)  Increase the rate of mechanical breaths. 
D)  Do nothing. 
A)  Increase the FiO2. 
B)  Return the PEEP to the previous level. 
C)  Increase the rate of mechanical breaths. 
D)  Do nothing.

Question 14

Which of the following are used as alternative lung protective strategies in patients with ARDS?
1) Prone positioning
2) ECMO
3) High-frequency ventilation
4) Pressure support ventilation

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 15

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

Accepted Answer

A)  9 to 11 L/min below baseline flow 
B)  7 to 9 L/min below baseline flow 
C)  4 to 6 L/min below baseline flow 
D)  1 to 2 L/min below baseline flow 
A)  9 to 11 L/min below baseline flow 
B)  7 to 9 L/min below baseline flow 
C)  4 to 6 L/min below baseline flow 
D)  1 to 2 L/min below baseline flow

Question 16

Which of the following is the least frequent cause of acute respiratory failure needing mechanical ventilation?

Accepted Answer

A)  Sepsis 
B)  Postoperative respiratory failure 
C)  Heart failure 
D)  Aspiration 
A)  Sepsis 
B)  Postoperative respiratory failure 
C)  Heart failure 
D)  Aspiration

Question 17

Which of the following statements is false regarding pressure-supported ventilation?

Accepted Answer

A)  It is patient triggered, pressure limited, and flow cycled. 
B)  It can reduce the work of breathing during intermittent mandatory ventilation mode. 
C)  The usual range is 10 to 15 cm H2O. 
D)  It is recommended for use in most patients in the intermittent mandatory ventilation (IMV) mode. 
A)  It is patient triggered, pressure limited, and flow cycled. 
B)  It can reduce the work of breathing during intermittent mandatory ventilation mode. 
C)  The usual range is 10 to 15 cm H2O. 
D)  It is recommended for use in most patients in the intermittent mandatory ventilation (IMV) mode.

Exam 48: Initiating and Adjusting Invasive Ventilatory Support

Patient's RR is 12 breaths/min, PaCO2 is 60 mm Hg. If a PaCO2 of 40 were desired, the RR be set at what value?

When starting flow-limited ventilatory support on an adult patient, which of the following inspiratory flow settings would you initially select?

Which of the following is false about flow-triggered ventilatory support?

When the patient stabilizes on mechanical ventilation with a PEEP of 12 cm H2O and the FiO2 has been reduced to 0.40, how should the PEEP level reduce?

Which of the following modes of ventilatory support would you recommend for a patient who can breathe spontaneously and only requires assistance to overcome the work of breathing created by the ET tube?

How frequently should a clinician make changes when weaning from PEEP?

When titrating the FiO2 down from 50% to 21%, in what increments should it be reduced?

If available, the FiO2 alarm should be set to what percentage?

Which of the following would decrease PaCO2 when ventilating a patient using intermittent mandatory ventilation with pressure support?

A physician orders intubation and mechanical ventilation in the synchronized intermittent mandatory ventilation mode for a 160-lb adult man with a history of chronic obstructive pulmonary disease. Which of the following settings would you recommend? Rate VT

Which of the following would you assess immediately after a patient is placed on a ventilatory support device? 1) ABGs 2) Patient's airway 3) Patient's vital signs

What is the recommended response to a drop in PaO2 when the PEEP level is reduced in a mechanically ventilated patient?

Which of the following are used as alternative lung protective strategies in patients with ARDS? 1) Prone positioning 2) ECMO 3) High-frequency ventilation 4) Pressure support ventilation

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

Which of the following is the least frequent cause of acute respiratory failure needing mechanical ventilation?

Which of the following statements is false regarding pressure-supported ventilation?

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

Patient's RR is 12 breaths/min, PaCO₂ is 60 mm Hg. If a PaCO₂ of 40 were desired, the RR be set at what value?

When the patient stabilizes on mechanical ventilation with a PEEP of 12 cm H₂O and the FiO₂ has been reduced to 0.40, how should the PEEP level reduce?

When titrating the FiO₂ down from 50% to 21%, in what increments should it be reduced?

If available, the FiO₂ alarm should be set to what percentage?

Which of the following would decrease PaCO₂ when ventilating a patient using intermittent mandatory ventilation with pressure support?

A physician orders intubation and mechanical ventilation in the synchronized intermittent mandatory ventilation mode for a 160-lb adult man with a history of chronic obstructive pulmonary disease. Which of the following settings would you recommend? Rate V_T

What is the recommended response to a drop in PaO₂ when the PEEP level is reduced in a mechanically ventilated patient?