Deck 9: Ventilator Graphics

Question 1

Identify the improperly set ventilator parameter using the scalars shown below.

A) Mode
B) Flow rate
C) Sensitivity
D) Tidal volume

Answer 1

Sensitivity

Question 2

The ventilator graphics generated by mechanical ventilation with pressure-controlled continuous mandatory ventilation (PC-CMV),rate 18,peak inspiratory pressure (PIP)25 cm H₂O,positive-end-expiratory pressure (PEEP)5 cm H₂O,are shown in the scalars below.Interpretation of these scalars reveals which of the following?

A) The flow rate is set too high and should be reduced.
B) There is air trapping that could be due to a high respiratory rate.
C) The ventilator settings are appropriate and there are no problems.
D) There is a leak in the system that needs to be identified and corrected.

Answer 2

There is air trapping that could be due to a high respiratory rate.

Question 3

What is the expiratory time shown in the flow-time scalar below?

A) 1 second
B) 1.5 seconds
C) 2 seconds
D) 2.5 seconds

Answer 3

1.5 seconds

Question 4

What is the inspiratory time shown in the flow-time scalar below?

A) 0.5 second
B) 1 second
C) 1.5 seconds
D) 2 seconds

Question 5

The respiratory therapist observes the pressure-time scalar seen below.Wave A was generated at 1300 hour and wave B at 1600 hour.The action that is most appropriate for this situation is which of the following?

A) Add positive-end-expiratory pressure (PEEP).
B) Change the endotracheal tube (ET).
C) Change to pressure-controlled continuous mandatory ventilation (PC-CMV).
D) Administer a bronchodilator.

Question 6

The most important factor to affect the degree of resistance in the airways is which of the following?

A) Flow rate of the gas
B) Viscosity of the gas
C) Length of the airways
D) Diameter of the airways

Question 7

What is the trigger variable for the "A" breath shown in the figure below?

A) Flow
B) Time
C) Pressure
D) Volume

Question 8

Identify the sinusoidal (or sine)waveform in the figure below.

A) Figure A
B) Figure B
C) Figure C
D) Figure D

Question 9

The type of flow curve produced by volume ventilation with constant flow is which of the following?

A) Sinusoidal
B) Rectangular
C) Descending ramp
D) Exponential decay

Question 10

Calculate the airway resistance (R_aw)using the information from the scalar below.

A) 0.9 cm H₂O/L/sec
B) 1.1 cm H₂O/L/sec
C) 22.4 cm H₂O/L/sec
D) 60 cm H₂O/L/sec

Question 11

The respiratory therapist sees the following scalars on the screen of a ventilator providing support to a patient in the ICU.What action should the respiratory therapist take?

A) Switch to the volume-controlled synchronized intermittent mandatory ventilation (VC-SIMV)mode.
B) Increase the flow rate to 60 L/min.
C) Decrease the sensitivity to 2 cm H₂O.
D) Increase the tidal volume to 550 mL.

Question 12

The respiratory therapist observes the following pressure-time and flow-time scalars following a patient being intubated and placed on a mechanical ventilator using volume ventilation.The most appropriate action is which of the following?

A) Increase the set flow rate.
B) Switch to pressure control.
C) Increase the set tidal volume.
D) Change to a decelerating flow pattern.

Question 13

The volume curve on a volume-time scalar is consistently dropping below the baseline during exhalation.The first action to take is which of the following?

A) Measure the plateau pressure.
B) Measure the endotracheal (ET)tube cuff pressure.
C) Check the ventilator circuit for a leak.
D) Assess the patient for active exhalation.

Question 14

A patient is receiving full ventilatory support with volume ventilation.At 0700 the respiratory therapist observes the pressure-,volume-,and flow-time scalars shown in "A" below.Six hours later the respiratory therapist observes the scalars shown in "B." The most appropriate action to take is which of the following?

A) Increase the positive-end-expiratory pressure (PEEP)level.
B) Check the circuit for a leak.
C) Administer a bronchodilator.
D) Switch to pressure ventilation.

Question 15

Calculate the static compliance using the information from the scalar below.

A) 10 mL/cm H₂O
B) 16 mL/cm H₂O
C) 20 mL/cm H₂O
D) 80 mL/cm H₂O

Question 16

During pressure-controlled continuous mandatory ventilation (PC-CMV)the respiratory therapist observes the pressure-time scalar shown below.The most appropriate action to take is which of the following?

A) Adjust the inspiratory time.
B) Increase the flow rate setting.
C) Adjust the inspiratory rise time control.
D) Increase the peak inspiratory pressure setting.

Question 17

What is the inspiratory time for the ventilator breath shown in section B of the figure below?

A) 0.5 seconds
B) 1.0 seconds
C) 1.5 seconds
D) 2.0 seconds

Question 18

The two waveforms that are common for pressure scalars are which of the following?

A) Sinusoidal and ascending ramp
B) Rectangular and exponential rise
C) Descending ramp and ascending ramp
D) Exponential decay and descending ramp

Question 19

An inadequate flow setting during volume ventilation will cause which of the following to occur?

A) The volume curve will drop below the zero baseline.
B) The volume curve will not drop to the zero baseline.
C) The exhaled flow will take longer to rise to the zero baseline.
D) The pressure-time curve will appear concave during inspiration.

Question 20

The peak inspiratory flow rate on the flow-time scalar below is which of the following?

A) 25 L/min
B) 40 L/min
C) 46 L/min
D) 55 L/min

Question 21

An increase in airway resistance during pressure ventilation will result in which of the following?

A) Plateau pressure (P_Plateau)will increase.
B) Volume curve will resemble an igloo.
C) Inspiration will end prior to flow tapering to zero.
D) Pressure curve will become concave on inspiration.

Question 22

During a patient-ventilator system check the respiratory therapist notices that the pressure-volume loop begins at zero on the x-axis but does not return to zero during expiration.The cause of this is which of the following?

A) Active exhalation
B) Inadequate sensitivity
C) Ventilator circuit leak
D) Decreased compliance

Question 23

What is the flow-cycle setting for the pressure support ventilation (PSV)breaths shown in the scalars below?

A) 10%
B) 25%
C) 40%
D) 50%

Question 24

A reduction in compliance during pressure ventilation will cause which of the following?

A) Volume delivered will drop.
B) Volume curve will end under the zero line.
C) Inspiration will end prior to flow tapering to zero.
D) Pressure curve will become concave on inspiration.

Question 25

The type of breath shown in the flow-volume loop below is which of the following?

A) Pressure support ventilation (PSV)
B) Continuous positive airway pressure (CPAP)
C) Pressure-controlled continuous mandatory ventilation (PC-CMV)
D) Spontaneous without support

Question 26

A patient is receiving ventilation with volume-controlled continuous mandatory ventilation (VC-CMV).During a patient-ventilator system check the respiratory therapist sees the flow-volume loop below.The most appropriate action is to do which of the following?

A) Add positive-end-expiratory pressure (PEEP).
B) Switch to pressure-controlled continuous mandatory ventilation (PC-CMV).
C) Administer a bronchodilator.
D) Check the endotracheal (ET)tube cuff pressure.

Question 27

Calculate the static compliance using the information from the pressure-volume loop below.

A) 15 mL/cm H₂O
B) 20 mL/cm H₂O
C) 25 mL/cm H₂O
D) 30 mL/cm H₂O

Question 28

Delayed termination during pressure support ventilation (PSV)can be avoided with patients who have chronic obstructive pulmonary disease (COPD)by doing which of the following?

A) Increase inspiratory time.
B) Increase flow-cycle percent.
C) Change the flow pattern.
D) Decrease peak inspiratory pressure.

Question 29

Which of the following conditions causes a pressure-volume loop during volume-controlled continuous mandatory ventilation (VC-CMV)to extend farther to the right and flatten out?

A) Asthma
B) Bronchitis
C) Emphysema
D) Pneumonia

Question 30

Identify the type of flow waveform the ventilator is delivering from the flow-volume loop below.

A) Ascending ramp
B) Rectangular
C) Descending ramp
D) Exponential decay

Question 31

What is the cause of the change from pressure-volume loop A to pressure-volume loop B during volume-controlled continuous mandatory ventilation (VC-CMV)?

A) Decreased compliance
B) Increased compliance
C) Decreased airway resistance
D) Increased airway resistance