Question 1

Nasal CPAP should be administered to a neonate with _______________.

Accepted Answer

A)  cleft palate 
B)  choanal atresia 
C)  apnea of prematurity 
D)  tracheoesophageal fistula 
A)  cleft palate 
B)  choanal atresia 
C)  apnea of prematurity 
D)  tracheoesophageal fistula C

Question 2

A neonate is being ventilated with PRVC.The respiratory therapist responds to a low volume alarm.After checking the patient and the ventilator,the respiratory therapist finds no disconnects.The most appropriate action is which of the following?

Accepted Answer

A)  DRₐᴡa sample for arterial blood gas evaluation. 
B)  Increase the target volume. 
C)  Put the patient in the PC-CMV mode. 
D)  Recommend surfactant replacement therapy. 
A)  DRₐᴡa sample for arterial blood gas evaluation. 
B)  Increase the target volume. 
C)  Put the patient in the PC-CMV mode. 
D)  Recommend surfactant replacement therapy. B

Question 3

The mode of ventilation that allows a neonate to breathe at a high and a low CPAP setting is which of the following?

Accepted Answer

A)  SiPAP 
B)  HFOV 
C)  Nasal IMV 
D)  Nasal HFV 
A)  SiPAP 
B)  HFOV 
C)  Nasal IMV 
D)  Nasal HFV A

Question 4

Neonatal patients are more vulnerable to rapid deterioration because of ________________.

Accepted Answer

A)  high chest wall compliance 
B)  low functional residual capacity 
C)  smaller surface area for gas exchange 
D)  presence of fetal hemoglobin 
A)  high chest wall compliance 
B)  low functional residual capacity 
C)  smaller surface area for gas exchange 
D)  presence of fetal hemoglobin

Question 5

The patient with which of the following conditions should be considered for HFV?

Accepted Answer

A)  Status asthmaticus 
B)  Bronchopleural fistula 
C)  Meconium aspiration 
D)  Cystic fibrosis 
A)  Status asthmaticus 
B)  Bronchopleural fistula 
C)  Meconium aspiration 
D)  Cystic fibrosis

Question 6

The pressure manometer should be placed at which point in the following CPAP system?

Accepted Answer

A)  Point A 
B)  Point B 
C)  Point C 
D)  Point D 
A)  Point A 
B)  Point B 
C)  Point C 
D)  Point D

Question 7

A newborn of 32 weeks' gestation is currently receiving nasal CPAP.The respiratory therapist recently increased the CPAP level from 8 to 10 cm H₂O; the FɪO₂ is 0.6.On the new setting,the PₐO₂ is 52 mm Hg and the PₐCO₂ increased from 48 to 55 mm Hg.The most likely cause of this is which of the following?

Accepted Answer

A)  Barotrauma 
B)  Alveolar overdistention 
C)  Ventilator-induced lung injury 
D)  Increased pulmonary vascular resistance 
A)  Barotrauma 
B)  Alveolar overdistention 
C)  Ventilator-induced lung injury 
D)  Increased pulmonary vascular resistance

Question 8

A 5-year-old patient diagnosed with tracheomalacia after a long intubation has had numerous failures to wean and extubate.What should the respiratory therapist recommend to help alleviate spontaneous breathing problems associated with tracheomalacia until a stent can be placed in the airway?

Accepted Answer

A)  BiPAP 
B)  Nasal HFV 
C)  Nasal SiPAP 
D)  Tracheostomy and CPAP 
A)  BiPAP 
B)  Nasal HFV 
C)  Nasal SiPAP 
D)  Tracheostomy and CPAP

Question 9

NIV can be used successfully in neonates for which of the following?

Accepted Answer

A)  Severe ventilatory impairment 
B)  Persistent apnea 
C)  After extubation 
D)  Cleft palate 
A)  Severe ventilatory impairment 
B)  Persistent apnea 
C)  After extubation 
D)  Cleft palate

Question 10

Which type of trigger allows for better synchronization during neonatal ventilation?

Accepted Answer

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

Question 11

Bubble CPAP should_________________________________.

Accepted Answer

A)  bubble only on expiration 
B)  bubble only on inspiration 
C)  bubble on inspiration and expiration 
D)  have a gas flow setting of 10 L/min 
A)  bubble only on expiration 
B)  bubble only on inspiration 
C)  bubble on inspiration and expiration 
D)  have a gas flow setting of 10 L/min

Question 12

The inspiratory time setting for an infant with bronchopulmonary dysplasia (BPD),airway resistance of 45 cm H₂O/L/sec,and lung compliance of 0.004 L/cm H₂O should be which of the following?

Accepted Answer

A)  0.25 second 
B)  0.45 second 
C)  0.6 second 
D)  0.9 second 
A)  0.25 second 
B)  0.45 second 
C)  0.6 second 
D)  0.9 second

Question 13

Oxygen delivery and tissue perfusion may be evaluated clinically by which of the following?

Accepted Answer

A)  Mucous membrane color 
B)  Skin color and tone 
C)  Capillary refill 
D)  Chest X-ray 
A)  Mucous membrane color 
B)  Skin color and tone 
C)  Capillary refill 
D)  Chest X-ray

Question 14

Infants with which of the following problems would benefit from nasal CPAP?

Accepted Answer

A)  Cleft palate 
B)  Choanal atresia 
C)  Patent ductus arteriosus 
D)  Tracheoesophageal fistula 
A)  Cleft palate 
B)  Choanal atresia 
C)  Patent ductus arteriosus 
D)  Tracheoesophageal fistula

Question 15

Potential harmful effects of nasal CPAP include which of the following?

Accepted Answer

A)  Volutrauma 
B)  CO₂ retention 
C)  Oxygen toxicity 
D)  Ventilator-induced lung injury 
A)  Volutrauma 
B)  CO₂ retention 
C)  Oxygen toxicity 
D)  Ventilator-induced lung injury

Question 16

Respiratory failure is imminent in infants who demonstrate which of the following?

Accepted Answer

A)  Substernal retractions 
B)  Tachypnea 
C)  Grunting 
D)  Nasal flaring 
A)  Substernal retractions 
B)  Tachypnea 
C)  Grunting 
D)  Nasal flaring

Question 17

A pediatric patient with a 5-mm ET tube is ready to be switched to PSV.What minimum PS level should be used for this patient?

Accepted Answer

A)  4 cm H₂O 
B)  6 cm H₂O 
C)  8 cm H₂O 
D)  10 cm H₂O 
A)  4 cm H₂O 
B)  6 cm H₂O 
C)  8 cm H₂O 
D)  10 cm H₂O

Question 18

A newborn with which of the following clinical manifestations should receive nasal CPAP?

Accepted Answer

A)  Substernal retractions, PₐCO₂ = 65 mm Hg, PₐCO₂ = 48 mm Hg, FɪO₂ = 0.4 
B)  Tachypnea, nasal flaring, PₐCO₂ = 50 mm Hg, PₐCO₂ = 50 mm Hg, FɪO₂ = 0.6 
C)  Grunting, substernal retractions, pH = 7.20, PₐCO₂ = 70 mm Hg, PₐCO₂ = 40 mm Hg, FɪO₂ = 0.7 
D)  Tachypnea, pale skin, pH = 7.32, PₐCO₂ = 45 mm Hg, PₐCO₂ = 75 mm Hg, FɪO₂ = 0.21 
A)  Substernal retractions, PₐCO₂ = 65 mm Hg, PₐCO₂ = 48 mm Hg, FɪO₂ = 0.4 
B)  Tachypnea, nasal flaring, PₐCO₂ = 50 mm Hg, PₐCO₂ = 50 mm Hg, FɪO₂ = 0.6 
C)  Grunting, substernal retractions, pH = 7.20, PₐCO₂ = 70 mm Hg, PₐCO₂ = 40 mm Hg, FɪO₂ = 0.7 
D)  Tachypnea, pale skin, pH = 7.32, PₐCO₂ = 45 mm Hg, PₐCO₂ = 75 mm Hg, FɪO₂ = 0.21

Question 19

A full-term neonate shows signs of respiratory distress after delivery by cesarean section.The baby is placed on nasal CPAP at 4 cm H₂O with an FɪO₂ of 0.6.The ABG results on these settings are: pH = 7.32,PₐCO₂ = 45 mm Hg,PₐO₂ = 48 mm Hg,SₐO₂ = 70%,HCO₃⁻ = 22 mEq/L.The respiratory therapist should recommend which of the following?

Accepted Answer

A)  Intubate and mechanically ventilate. 
B)  Increase the FɪO₂ to 0.7. 
C)  Increase the CPAP to 6 cm H₂O. 
D)  Intubate and use ventilator CPAP. 
A)  Intubate and mechanically ventilate. 
B)  Increase the FɪO₂ to 0.7. 
C)  Increase the CPAP to 6 cm H₂O. 
D)  Intubate and use ventilator CPAP.

Question 20

The inspiratory time setting for an infant with RDS,airway resistance of 30 cm H₂O/L/sec,and lung compliance of 0.002 L/cm H₂O should be which of the following?

Accepted Answer

A)  0.25 sec 
B)  0.30 sec 
C)  0.45 sec 
D)  0.55 sec 
A)  0.25 sec 
B)  0.30 sec 
C)  0.45 sec 
D)  0.55 sec

Exam 22: Neonatal and Pediatric Ventilation

Nasal CPAP should be administered to a neonate with _______________.

A neonate is being ventilated with PRVC.The respiratory therapist responds to a low volume alarm.After checking the patient and the ventilator,the respiratory therapist finds no disconnects.The most appropriate action is which of the following?

The mode of ventilation that allows a neonate to breathe at a high and a low CPAP setting is which of the following?

Neonatal patients are more vulnerable to rapid deterioration because of ________________.

The patient with which of the following conditions should be considered for HFV?

The pressure manometer should be placed at which point in the following CPAP system?

A 5-year-old patient diagnosed with tracheomalacia after a long intubation has had numerous failures to wean and extubate.What should the respiratory therapist recommend to help alleviate spontaneous breathing problems associated with tracheomalacia until a stent can be placed in the airway?

NIV can be used successfully in neonates for which of the following?

Which type of trigger allows for better synchronization during neonatal ventilation?

Bubble CPAP should_________________________________.

The inspiratory time setting for an infant with bronchopulmonary dysplasia (BPD),airway resistance of 45 cm H₂O/L/sec,and lung compliance of 0.004 L/cm H₂O should be which of the following?

Oxygen delivery and tissue perfusion may be evaluated clinically by which of the following?

Infants with which of the following problems would benefit from nasal CPAP?

Potential harmful effects of nasal CPAP include which of the following?

Respiratory failure is imminent in infants who demonstrate which of the following?

A pediatric patient with a 5-mm ET tube is ready to be switched to PSV.What minimum PS level should be used for this patient?

A newborn with which of the following clinical manifestations should receive nasal CPAP?

The inspiratory time setting for an infant with RDS,airway resistance of 30 cm H₂O/L/sec,and lung compliance of 0.002 L/cm H₂O should be which of the following?

Basic Terms and Concepts of Mechanical Ventilation

How Ventilators Work

How a Breath Is Delivered

Establishing the Need for Mechanical Ventilation

Selecting the Ventilator and the Mode

Initial Ventilator Settings

Final Considerations in Ventilator Setup

Initial Patient Assessment

Ventilator Graphics

Assessment of Respiratory Function

Hemodynamic Monitoring

Methods to Improve Ventilation in Patient-Ventilator Management

Improving Oxygenation and Management of ARDS

Ventilator-Associated Pneumonia

Sedatives, Analgesics, and Paralytics

Extrapulmonary Effects of Mechanical Ventilation

Effects of Positive Pressure Ventilation on the Pulmonary System

Troubleshooting and Problem Solving

Basic Concepts of Noninvasive Positive-Pressure Ventilation

Weaning and Discontinuation from Mechanical Ventilation

Long-Term Ventilation

Special Techniques in Ventilatory Support

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