Deck 25: Continuous Mechanical Ventilation

Question 1

Recommend tidal volume for initial ventilator setting is _____________________

A)400 mL for women and 500 ml for men.
B)4-9 mL/Kg of ideal body weight.
C)10-15 mL/kg of ideal body weight.
D)800 mL for both males and females.

Answer 1

4-9 mL/Kg of ideal body weight.

Question 2

Type II respiratory failure is which of the following?

A)PaCO₂ greater than 50 mmHg and PaO₂ within normal levels
B)PaCO₂ greater than 50 mmHg and PaO₂ less than 50 mmHg with pH below 7.35
C)High PaCO₂ with a low PO₂ but a normal pH
D)PaO₂ of less than 59 mmHg with a normal PaCO₂

Answer 2

PaCO₂ greater than 50 mmHg and PaO₂ less than 50 mmHg with pH below 7.35

Question 3

A practitioner needs to ventilate a patient with airway resistance and lung compliance that will be changing.Which of the following will give a stable tidal volume and minute volume despite this change.

A)Pressure ventilator
B)Bird Mark 7
C)Volume control ventilator (VCV)
D)Pressure control ventilation

Answer 3

Volume control ventilator (VCV)

Question 4

A family does not want to have their parent with congestive heart failure intubated,but the patient is in need of mechanical ventilation,the therapist should recommend _____________

A)IPPB therapy for 20 minutes every hour.
B)CPAP therapy via nasal mask with 50% oxygen.
C)noninvasive ventilation using IPAP and EPAP pressures.
D)disregarding the wishes of the family and intubate and mechanically ventilate the patient.

Question 5

When considering types of ventilation,which of the following is NOT an advantage of invasive positive-pressure ventilation?

A)Better regulation of minute ventilation especially in volume modes
B)Improved delivery of oxygen therapy
C)Better accuracy in monitoring parameters
D)Enhanced ability to communicate

Question 6

Which of the following are contraindications for sending a patient home on a mechanical ventilator?
I.PEEP greater that 10 cm H₂O
II.Inadequate utilities to operate medical devices
III.Oxygen setting above 40%
IV.Presence of elementary age children in the home

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

Question 7

When assessing the patient for pending respiratory failure,the practitioner should note which of the following?
I.Appearance such as cyanosis
II.Tachypnea
III.Digit clubbing
IV.Hypoxemia

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

Question 8

A practitioner is assigned to a patient on a ventilator.Which of the following is the most appropriate time to do a patient-ventilator system check?

A)After obtaining an arterial blood gas sample.
B)After obtaining a cardiac output measurement.
C)After making changes in the ventilator settings.
D)Prior to changing from PEEP level.

Question 9

To avoid excessive ventilating pressure in a drug overdose patient,a practitioner should consider using which of the following?

A)Pressure control ventilation
B)Volume control ventilation
C)Assist control volume ventilation
D)Manual resuscitator bag without a pressure release valve

Question 10

In the face of changing airway resistance or thoracic compliance,which of the following will occur in volume ventilation?

A)Pressure is selected as the controlled variable
B)Volume will change while pressure will stay the same
C)Pressure will vary but the tidal volume will remain unchanged
D)Pressure will stay the same but FIO₂ will vary with back pressure

Question 11

The first action a practitioner should take with an apneic patient is ____________

A)Apply 100% oxygen by non-rebreather mask
B)Obtain intubation kit and insert an ETT into the airway
C)Insert an oral airway and begin bag/mask ventilation
D)Initiate non-invasive CPAP ventilation

Question 12

A practitioner has decided that the high ventilating pressure in the volume mode could be reduced by switching to the pressure ventilation mode.The practitioner will need to ____________

A)be aware that delivered volume will decrease with increasing airway resistance.
B)be aware that delivered volume will decrease with increasing compliance.
C)adjust FIO₂ according to changes in peak pressure.
D)adjust tidal volume with changes in ventilator pressure alarms.

Question 13

Use of high pressure,large volume and increased oxygen tension can result in ____________

A)VAP (ventilator associated pneumonia).
B)VILI (ventilator induced lung injury).
C)RSBI (rapid shallow breathing index).
D)MOV (maximum occluding volume).

Question 14

In the early stages of an acute asthmatic attack the practitioner will note which of the following?

A)Type I respiratory failure (normal or low PaCO₂ with low PaO₂ )
B)Type II respiratory failure(high PaCO₂ with a low PaO₂
C)Respiratory failure with PaCO₂ greater than 50 and PaO₂ less than 50
D)Near normal arterial PCO₂ and PO₂

Question 15

Type I respiratory failure is which of the following?

A)PaCO₂ greater than 50 mmHg and PaO₂ within normal levels
B)PaCO₂ greater than 50 mmHg and PaO₂ less than 50 mmHg with pH below 7.35
C)High PaCO₂ with a low PO₂ but a normal pH
D)PaO₂ of less than 59 mmHg with a normal PaCO₂

Question 16

Which of the following is an advantage of using noninvasive ventilation?
I.The reimbursement rate is higher than for mechanical ventilation
II.Intubation can be avoided
III.There is a decreased risk of acquiring a pulmonary infection
IV.Patient maintains ability to communicate

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

Question 17

Respiratory failure is which of the following?
I.PaO₂ of 40-50 mmHg on room air and PaCO₂
II.A syndrome where the lungs are not able to adequately exchange O₂ and CO₂
III.A condition always linked to chronic respiratory diseases
IV.This is a terminal condition with the patient will not recover from

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

Question 18

A practitioner should not use the assist ventilation mode in which of the following conditions?

A)Asthmatic patient prior to extubation
B)Congestive heart failure after delivery of diuretics
C)Resolving pneumonia
D)Post-operative abdominal surgery with sedation

Question 19

Myasthenia gravis,amyotrophic lateral sclerosis,Gullain-Barre syndrome,spinal cord injuries,and multiple sclerosis may all lead to respiratory failure due to _______________

A)interference with the neurotransmission to the ventilatory muscles.
B)failure of the respiratory pump.
C)loss of nervous signals to contract for ventilation.
D)all of the above.

Question 20

The practitioner should consider noninvasive ventilation in which of the following conditions?
I.Pulmonary edema
II.Exacerbation of chronic obstructive pulmonary disease
III.Neuromuscular disease
IV.Hyperventilation syndrome

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

Question 21

The practitioner will determine settings for an alarm to do which of the following?
I.Identify harmful conditions
II.Alert staff of changes in the patient or ventilator condition
III.Provide a method of interaction for the patient

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

Question 22

Excessive length of inspiratory time can result in which of the following?
I.Increased mean airway pressure
II.Reduced cardiac output
III.Hypotension
IV.Reduction in oxygenation

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

Question 23

Which of the following is true of pressure support?
I.Inspiration continues until flow decreases to 25% of peak flow
II.This is an assist mode.
III.It is used to augment the patient's spontaneous breathing
IV.It is a positive pressure delivered on both inspiration and expiration

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

Question 24

The purpose of auscultation includes all of the following EXCEPT _______________

A)the need for suction.
B)distribution of ventilation.
C)changes in breath sounds.
D)as required by procedure.

Question 25

The high pressure limit alarm is used to ____________________

A)prevent ventilator disconnect from the patient.
B)protect the lungs from over distention and injury.
C)identify when unauthorized individuals decrease the volume setting.
D)adjust the pressure limit in PCV.

Question 26

What equipment procedure should be done prior to using a mechanical ventilator on a patient?

A)Perform a ventilator operational verification procedure
B)Identify patient insurance coverage
C)Perform a static compliance measurement
D)Determine alveolar ventilation

Question 27

For the initial ventilator setting,the inspiratory flowrate is ___________________

A)set at 70 lpm.
B)tidal volume time respiratory rate.
C)adjusted to allow adequate expiratory emptying of the lungs.
D)to give a 1:2 I:E ratio.

Question 28

How does a practitioner perform a system leak test?

Question 29

How does a practitioner measure airway resistance on a ventilator?

Question 30

The high and low minute volume alarm is used to ______________________

A)identify hypoventilation and hyperventilation.
B)prevent changing of the tidal volume setting.
C)measure the patient's spontaneous respiratory efforts.
D)alert the staff when there is a change of 5-10 lpm.

Question 31

How is tubing compliance determined?

Question 32

The purpose of a patient ventilator system check (vent check)is all of the following EXCEPT ___________________

A)to assess patient response to mechanical ventilation.
B)to verify the correct operation of the ventilation.
C)to assure use for billing purposes.
D)to verify patient settings and alarms are correct.

Question 33

Which of the following is true of CPAP?
I.It can be applied noninvasively by mask to the patient
II.It is pressure held in the lungs on inspiration and expiration
III.It is Continuous Primary Alveolar Pressure
IV.It can be delivered by endotracheal or tracheostomy tube

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

Question 34

What is the difference in calculating dynamic compliance vs static compliance?