Question 1

During volume-controlled ventilation, which of the following factors influences the peak inspiratory pressure?

Accepted Answer

A)  Pulmonary capillary perfusion 
B)  Ventilation-perfusion relationships 
C)  Pulmonary compliance 
D)  Volume compressed in the ventilatory circuit at end inspiration 
A)  Pulmonary capillary perfusion 
B)  Ventilation-perfusion relationships 
C)  Pulmonary compliance 
D)  Volume compressed in the ventilatory circuit at end inspiration C

Question 2

Which of the following adjustments should the therapist consider to improve ventilation on a patient undergoing HFV?

Accepted Answer

A)  Increase frequency 
B)  Increase 
C)  Increase inspiratory time 
D)  Decrease frequency 
A)  Increase frequency 
B)  Increase 
C)  Increase inspiratory time 
D)  Decrease frequency D

Question 3

Which of the following factors influences the gas volume compressed in the ventilator circuit?

Accepted Answer

A)  Ventilation time constant 
B)  Water level in the humidifier 
C)  Location of the exhalation valve 
D)  Size (inner diameter) of the endotracheal tube 
A)  Ventilation time constant 
B)  Water level in the humidifier 
C)  Location of the exhalation valve 
D)  Size (inner diameter) of the endotracheal tube B

Question 4

While checking the ventilator of a pediatric patient, the therapist observes the following volume-time scalar: What action should the therapist take at this time?

Accepted Answer

A)  Increase the sensitivity setting. 
B)  Increase the tidal volume and increase the pressure setting. 
C)  Increase both the inspiratory flow and the pressure setting. 
D)  Check the patient-ventilator system for the presence of auto-PEEP. 
A)  Increase the sensitivity setting. 
B)  Increase the tidal volume and increase the pressure setting. 
C)  Increase both the inspiratory flow and the pressure setting. 
D)  Check the patient-ventilator system for the presence of auto-PEEP.

Question 5

On the basis of the following pressure-volume loop, what ventilator setting change should the therapist make?

Accepted Answer

A)  Check the inflation pressure on the endotracheal tube cuff. 
B)  Increase the pressure limit. 
C)  Increase the delivered tidal volume. 
D)  Increase the inspiratory flow. 
A)  Check the inflation pressure on the endotracheal tube cuff. 
B)  Increase the pressure limit. 
C)  Increase the delivered tidal volume. 
D)  Increase the inspiratory flow.

Question 6

Which of the following are indications for HFV?

Accepted Answer

A)  Diffuse, heterogeneous lung disease 
B)  Existing pulmonary air leak syndrome 
C)  Severe bronchiolitis 
D)  PaO2/FiO2 ratio of 300 
A)  Diffuse, heterogeneous lung disease 
B)  Existing pulmonary air leak syndrome 
C)  Severe bronchiolitis 
D)  PaO2/FiO2 ratio of 300

Question 7

When airway pressure release ventilation is used, what physiologic process occurs as the higher pressure is released and the lower is achieved?

Accepted Answer

A)  Increased functional residual capacity 
B)  Increased tidal volume 
C)  Improved oxygenation 
D)  Exhalation of carbon dioxide 
A)  Increased functional residual capacity 
B)  Increased tidal volume 
C)  Improved oxygenation 
D)  Exhalation of carbon dioxide

Question 8

What is a frequent requirement when employing the low-volume strategy while ventilating a neonatal patient with pulmonary interstitial emphysema by HFV?

Accepted Answer

A)  High inspiratory flow 
B)  Positive end-expiratory pressure 
C)  High FiO2 
D)  Longer inspiratory time 
A)  High inspiratory flow 
B)  Positive end-expiratory pressure 
C)  High FiO2 
D)  Longer inspiratory time

Question 9

During HFOV, which of the following factors has a direct influence on a neonate's delivered tidal volume?

Accepted Answer

A)  Frequency 
B)  Oscillatory amplitude 
C)  Peak inspiratory pressure 
D)  IPAP and EPAP 
A)  Frequency 
B)  Oscillatory amplitude 
C)  Peak inspiratory pressure 
D)  IPAP and EPAP

Question 10

Why may HFOV be considered a suboptimal ventilation strategy for patients who have either fresh particulate meconium aspiration or bronchopulmonary dysplasia?

Accepted Answer

A)  Ventilation time constants will be decreased. 
B)  Large increases in tidal volume delivery can occur. 
C)  Gas trapping may develop. 
D)  Intrapulmonary shunting becomes likely. 
A)  Ventilation time constants will be decreased. 
B)  Large increases in tidal volume delivery can occur. 
C)  Gas trapping may develop. 
D)  Intrapulmonary shunting becomes likely.

Question 11

What frequency defines high-frequency modes of ventilation?

Accepted Answer

A)  >40 breaths per minute 
B)  >100 breaths per minute 
C)  >150 breaths per minute 
D)  >200 breaths per minute 
A)  >40 breaths per minute 
B)  >100 breaths per minute 
C)  >150 breaths per minute 
D)  >200 breaths per minute

Question 12

What is the recommended inspiratory time percent setting for HFOV?

Accepted Answer

A)  20% 
B)  25% 
C)  33% 
D)  50% 
A)  20% 
B)  25% 
C)  33% 
D)  50%

Question 13

Which of the following modes of ventilation attempts to maintain a minimum target tidal volume with a constant pressure by manipulating the inspiratory flow?

Accepted Answer

A)  Synchronized intermittent mandatory ventilation (SIMV) 
B)  Pressure support ventilation (PSV) 
C)  Volume-assured pressure support (VAPS) 
D)  Pressure-regulated volume control (PRV
C)  
A)  Synchronized intermittent mandatory ventilation (SIMV) 
B)  Pressure support ventilation (PSV) 
C)  Volume-assured pressure support (VAPS) 
D)  Pressure-regulated volume control (PRV
C)

Question 14

Which of the following factors need to be considered for HFV ventilator circuits?
I. Time for gas egress during exhalation
II. Circuit compliance
III. Endotracheal tube size
IV. Intrinsic timing mechanisms

Accepted Answer

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

Question 15

During HFOV manipulation of which of the following components establishes the continuous distending pressure?

Accepted Answer

A)  Gas flow through the pneumotachometer during expiration 
B)  Peak inspiratory peak-trough pressure gradient 
C)  Inspiratory valve aperture 
D)  Bias flow 
A)  Gas flow through the pneumotachometer during expiration 
B)  Peak inspiratory peak-trough pressure gradient 
C)  Inspiratory valve aperture 
D)  Bias flow

Question 16

How is the minute ventilation decreased when a patient is being weaned from HFOV?

Accepted Answer

A)  By decreasing peak pressure 
B)  By reducing oscillatory amplitude 
C)  By minimizing 
D)  By shortening the inspiratory time 
A)  By decreasing peak pressure 
B)  By reducing oscillatory amplitude 
C)  By minimizing 
D)  By shortening the inspiratory time

Question 17

Enhanced diffusion in HFV is a function of which of the following factors?

Accepted Answer

A)  Inspiratory flow 
B)  Plateau pressure 
C)  Inspiratory time 
D)  Respiratory frequency 
A)  Inspiratory flow 
B)  Plateau pressure 
C)  Inspiratory time 
D)  Respiratory frequency

Question 18

How is the high-volume strategy achieved when the goal is to deliver a high lung volume to a neonate receiving HFV?

Accepted Answer

A)  By increasing the continuous distending pressure 
B)  By reducing the peak-trough pressure gradient 
C)  By increasing the expiratory flow resistance 
D)  By decreasing the mean airway pressure 
A)  By increasing the continuous distending pressure 
B)  By reducing the peak-trough pressure gradient 
C)  By increasing the expiratory flow resistance 
D)  By decreasing the mean airway pressure

Question 19

The therapist is about to mechanically ventilate a neonate with a ventilator that delivers the volume guarantee mode. Which of the ventilator settings does the therapist need to set for this mode?
I. Minute ventilation
II. Tidal volume
III. Inspiratory time
IV. Inspiratory flow

Accepted Answer

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

Question 20

The therapist notices that gas exchange has dramatically improved in a neonate undergoing HFOV. However, weaning has not been implemented accordingly. What are the consequences of failing to quickly wean a neonatal patient from HFV?

Accepted Answer

A)  Pulmonary overdistention 
B)  Pulmonary hypertension 
C)  Alveolar derecruitment 
D)  Decreased pulse rate 
A)  Pulmonary overdistention 
B)  Pulmonary hypertension 
C)  Alveolar derecruitment 
D)  Decreased pulse rate

Exam 17: Invasive Mechanical Ventilation of the Neonate and Pediatric Patient

During volume-controlled ventilation, which of the following factors influences the peak inspiratory pressure?

Which of the following adjustments should the therapist consider to improve ventilation on a patient undergoing HFV?

Which of the following factors influences the gas volume compressed in the ventilator circuit?

While checking the ventilator of a pediatric patient, the therapist observes the following volume-time scalar: What action should the therapist take at this time?

On the basis of the following pressure-volume loop, what ventilator setting change should the therapist make?

Which of the following are indications for HFV?

When airway pressure release ventilation is used, what physiologic process occurs as the higher pressure is released and the lower is achieved?

What is a frequent requirement when employing the low-volume strategy while ventilating a neonatal patient with pulmonary interstitial emphysema by HFV?

During HFOV, which of the following factors has a direct influence on a neonate's delivered tidal volume?

Why may HFOV be considered a suboptimal ventilation strategy for patients who have either fresh particulate meconium aspiration or bronchopulmonary dysplasia?

What frequency defines high-frequency modes of ventilation?

What is the recommended inspiratory time percent setting for HFOV?

Which of the following modes of ventilation attempts to maintain a minimum target tidal volume with a constant pressure by manipulating the inspiratory flow?

Which of the following factors need to be considered for HFV ventilator circuits? I. Time for gas egress during exhalation II. Circuit compliance III. Endotracheal tube size IV. Intrinsic timing mechanisms

During HFOV manipulation of which of the following components establishes the continuous distending pressure?

How is the minute ventilation decreased when a patient is being weaned from HFOV?

Enhanced diffusion in HFV is a function of which of the following factors?

How is the high-volume strategy achieved when the goal is to deliver a high lung volume to a neonate receiving HFV?

The therapist is about to mechanically ventilate a neonate with a ventilator that delivers the volume guarantee mode. Which of the ventilator settings does the therapist need to set for this mode? I. Minute ventilation II. Tidal volume III. Inspiratory time IV. Inspiratory flow

The therapist notices that gas exchange has dramatically improved in a neonate undergoing HFOV. However, weaning has not been implemented accordingly. What are the consequences of failing to quickly wean a neonatal patient from HFV?

Fetal Lung Development

Fetal Gas Exchange and Circulation

Antenatal Assessment and High-Risk Delivery

Examination and Assessment of the Neonatal and Pediatric Patient

Pulmonary Function Testing and Bedside Pulmonary Mechanics

Radiographic Assessment

Pediatric Flexible Bronchoscopy

Invasive Blood Gas Analysis and Cardiovascular Monitoring

Noninvasive Monitoring in Neonatal and Pediatric Care

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Airway Clearance Techniques and Hyperinflation Therapy

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Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate

Noninvasive Mechanical Ventilation of the Infant and Child

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Pharmacology

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Neonatal Pulmonary Disorders

Surgical Disorders in Childhood That Affect Respiratory Care

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