Question 1

What is the primary pathophysiologic mechanism in alveolar hypoventilation?

Accepted Answer

A)  Decreased minute ventilation 
B)  Increased ventilation/perfusion ratio 
C)  Decreased venous admixture 
D)  Decreased inspired oxygen pressure 
A)  Decreased minute ventilation 
B)  Increased ventilation/perfusion ratio 
C)  Decreased venous admixture 
D)  Decreased inspired oxygen pressure A

Question 2

Which of the following is a critical value for the key clinical indicators in hypercapnic respiratory failure in an adult?
1) pH 7.19
2) Ventilatory rate 35 breaths/min
3) MIP 80 cm H2O
4) VD/VT 35%

Accepted Answer

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

Question 3

Which of the following are abnormal causes of anatomic shunt?
1) Bronchial venous drainage
2) Congenital heart disease
3) Intrapulmonary fistula
4) Vascular lung tumors

Accepted Answer

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

Question 4

You are the respiratory therapist managing an adult male patient receiving mechanical ventilation as a result of hypoxemic respiratory failure. The patient has a pressure time index of 0.16, and rapid shallow breath index of 95, and the cuff-leak test demonstrated the patient could breathe when it was deflated. What would your recommendations to the physician be regarding weaning this patient based on this data?

Accepted Answer

A)  Do not attempt to wean. 
B)  Attempt to wean. 
C)  Reattempt a spontaneous breathing trial to see if RSBI improves before weaning. 
D)  Cannot determine. 
A)  Do not attempt to wean. 
B)  Attempt to wean. 
C)  Reattempt a spontaneous breathing trial to see if RSBI improves before weaning. 
D)  Cannot determine.

Question 5

Which of the following are contraindications for noninvasive ventilation?
1) Facial and head trauma
2) Community-acquired pneumonia
3) Copious, viscous sputum
4) Severe upper GI bleeding

Accepted Answer

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

Question 6

What effect would a pulmonary embolism have on the VD/VT and the  ratios?

Accepted Answer

A)  The VD/VT would increase and the would decrease. 
B)  The VD/VT would decrease and the would increase. 
C)  The VD/VT and the ratios would both increase. 
D)  The VD/VT and the ratios would both decrease. 
A)  The VD/VT would increase and the would decrease. 
B)  The VD/VT would decrease and the would increase. 
C)  The VD/VT and the ratios would both increase. 
D)  The VD/VT and the ratios would both decrease.

Question 7

Which of the following are causes of hypercapnic respiratory?
1) Impending ventilatory failure
2) Apnea
3) Severe refractory hypoxemia
4) Acute ventilatory failure

Accepted Answer

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

Question 8

Which of the following are clinical indicators of type I respiratory failure?
1) Decreased PaO2
2) Increased P(A-a)O2
3) Decreased PaO2/FIO2
4) Decreased

Accepted Answer

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

Question 9

What VD/VT ratio range would you expect to see in a patient receiving mechanical ventilation?

Accepted Answer

A)  20% and 40% 
B)  30% and 50% 
C)  40% and 60% 
D)  50% and 70% 
A)  20% and 40% 
B)  30% and 50% 
C)  40% and 60% 
D)  50% and 70%

Question 10

Which of the following values is the VD/VT value if the PaCO2 is 40 mm Hg and the   is 30 mm Hg?

Accepted Answer

A)  0.25 or 25%. 
B)  0.33 or 33%. 
C)  0.4 or 40%. 
D)  Need more information to determine the value. 
A)  0.25 or 25%. 
B)  0.33 or 33%. 
C)  0.4 or 40%. 
D)  Need more information to determine the value.

Exam 11: Respiratory Insufficiency, Respiratory Failure and Ventilatory Management Protocols

What is the primary pathophysiologic mechanism in alveolar hypoventilation?

Which of the following is a critical value for the key clinical indicators in hypercapnic respiratory failure in an adult? 1) pH 7.19 2) Ventilatory rate 35 breaths/min 3) MIP 80 cm H2O 4) VD/VT 35%

Which of the following are abnormal causes of anatomic shunt? 1) Bronchial venous drainage 2) Congenital heart disease 3) Intrapulmonary fistula 4) Vascular lung tumors

Which of the following are contraindications for noninvasive ventilation? 1) Facial and head trauma 2) Community-acquired pneumonia 3) Copious, viscous sputum 4) Severe upper GI bleeding

What effect would a pulmonary embolism have on the VD/VT and the ratios?

Which of the following are causes of hypercapnic respiratory? 1) Impending ventilatory failure 2) Apnea 3) Severe refractory hypoxemia 4) Acute ventilatory failure

Which of the following are clinical indicators of type I respiratory failure? 1) Decreased PaO2 2) Increased P(A-a)O2 3) Decreased PaO2/FIO2 4) Decreased

What VD/VT ratio range would you expect to see in a patient receiving mechanical ventilation?

Which of the following values is the VD/VT value if the PaCO2 is 40 mm Hg and the is 30 mm Hg?

The Patient Interview

The Physical Examination

The Pathophysiologic Basis for Common Clinical Manifestations

Pulmonary Function Testing

Blood Gas Assessment

Assessment of Oxygenation

Assessment of the Cardiovascular System

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program

Recording Skills and Intra-Professional Communication

Chronic Obstructive Pulmonary Disease, Chronic Bronchitis and Emphysema

Asthma

Cystic Fibrosis

Bronchiectasis

Atelectasis

Pneumonia, Lung Abscess Formation, and Important Fungal Diseases

Tuberculosis

Pulmonary Edema

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Cancer of the Lung, Prevention and Palliation

Interstitial Lung Diseases

Acute Respiratory Distress Syndrome

Guillain-Barré Syndrome

Myasthenia Gravis

Cardiopulmonary Assessment and Care of Patients With Neuromuscular Disease

Sleep Apnea

Newborn Assessment and Management

Pediatric Assessment, Protocols, and Pals Management

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndrome

Respiratory Syncytial Virus Infection Bronchiolitis

Chronic Lung Disease of Infancy

Congenital Diaphragmatic Hernia

Congenital Heart Disease

Croup and Croup-Like Syndromes: Laryngotracheobronchitis, Bacterial Tracheitis, and Acute Epiglottitis

Near Drowningwet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

Filters

Which of the following is a critical value for the key clinical indicators in hypercapnic respiratory failure in an adult? 1) pH 7.19 2) Ventilatory rate 35 breaths/min 3) MIP 80 cm H₂O 4) V_D/V_T 35%

What effect would a pulmonary embolism have on the V_D/V_T and the ratios?

Which of the following are clinical indicators of type I respiratory failure? 1) Decreased PaO₂ 2) Increased P(A-a)O₂ 3) Decreased PaO₂/FIO₂ 4) Decreased

What V_D/V_T ratio range would you expect to see in a patient receiving mechanical ventilation?

Which of the following values is the V_D/V_T value if the PaCO₂ is 40 mm Hg and the is 30 mm Hg?