Question 1

What would be the calculated RSBI (f/VT) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

Accepted Answer

A)  17 breaths /min/L 
B)  61 breaths/min/L 
C)  87 breaths /min/L 
D)  102 breaths/min/L 
A)  17 breaths /min/L 
B)  61 breaths/min/L 
C)  87 breaths /min/L 
D)  102 breaths/min/L B

Question 2

The following patients were recorded from a patient receiving mechanical ventilation: corrected tidal volume = 520 mL, peak inspiratory pressure = 42 cm H2O, plateau pressure = 29 cm H2O, PEEP = 10 cm H2O. What is the calculated static compliance, and is it acceptable based on the criteria for weaning?

Accepted Answer

A)  16 mL/cm H2O, acceptable 
B)  16 mL/cm H2O, unacceptable 
C)  27 mL/cm H2O, acceptable 
D)  27 mL/cm H2O, unacceptable 
A)  16 mL/cm H2O, acceptable 
B)  16 mL/cm H2O, unacceptable 
C)  27 mL/cm H2O, acceptable 
D)  27 mL/cm H2O, unacceptable D

Question 3

Which of the following trends may be used as indicators of weaning failure?

Accepted Answer

A)  Increasing VT, decreasing PaCO2, decreasing static compliance 
B)  Increasing PaCO2, decreasing PaCO2, decreasing static compliance 
C)  Increasing VT, increasing PaCO2, decreasing static compliance 
D)  Increasing VT, increasing PaCO2, decreasing PaCO2 
A)  Increasing VT, decreasing PaCO2, decreasing static compliance 
B)  Increasing PaCO2, decreasing PaCO2, decreasing static compliance 
C)  Increasing VT, increasing PaCO2, decreasing static compliance 
D)  Increasing VT, increasing PaCO2, decreasing PaCO2 B

Question 4

A mechanically ventilated patient has a PaO2 of 77 mm Hg on 30% oxygen. What is the PaO2/FIO2 (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

Accepted Answer

A)  25.6, acceptable 
B)  25.6, unacceptable 
C)  256, acceptable 
D)  256, unacceptable 
A)  25.6, acceptable 
B)  25.6, unacceptable 
C)  256, acceptable 
D)  256, unacceptable

Question 5

Terminal weaning is best defined as withholding of mechanical ventilation:

Accepted Answer

A)  in patients who are in a vegetative state (brain death). 
B)  in patients who then die as a result. 
C)  in patients who terminally ill. 
D)  that likely results in death of the patient. 
A)  in patients who are in a vegetative state (brain death). 
B)  in patients who then die as a result. 
C)  in patients who terminally ill. 
D)  that likely results in death of the patient.

Question 6

Which of the following are potential benefits from a tracheostomy tube to enhance the weaning process?

Accepted Answer

A)  Reduced mechanical dead space volume, reduced airway edema, less work of breathing, increased V̇/Q̇ matching 
B)  Reduced mechanical dead space volume, less work of breathing, increased V̇/Q̇ matching 
C)  Reduced airway edema, increased V̇/Q̇ matching 
D)  Reduced mechanical dead space volume, less work of breathing 
A)  Reduced mechanical dead space volume, reduced airway edema, less work of breathing, increased V̇/Q̇ matching 
B)  Reduced mechanical dead space volume, less work of breathing, increased V̇/Q̇ matching 
C)  Reduced airway edema, increased V̇/Q̇ matching 
D)  Reduced mechanical dead space volume, less work of breathing

Question 7

The oxygenation status of a 29-year-old postoperative patient shows: PaO2= 58 mm Hg, SaO2 = 85%, Qs/Qt = 25%, PaO2/FIO2 = 105 mm Hg, FIO2 = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

Accepted Answer

A)  should begin because three of the measurements presented are within recommended thresholds. 
B)  should not begin because none of the measurements presented are within recommended thresholds. 
C)  should begin because all of the measurements presented are within recommended thresholds. 
D)  should not begin because only two of the five measurements presented are within recommended thresholds. 
A)  should begin because three of the measurements presented are within recommended thresholds. 
B)  should not begin because none of the measurements presented are within recommended thresholds. 
C)  should begin because all of the measurements presented are within recommended thresholds. 
D)  should not begin because only two of the five measurements presented are within recommended thresholds.

Question 8

Of the choices provided, which one is the leading cause of failure for attempts to liberate patients from mechanical ventilation?

Accepted Answer

A)  Cardiomyopathy 
B)  Bronchospasm 
C)  Pulmonary edema 
D)  Respiratory muscle weakness 
A)  Cardiomyopathy 
B)  Bronchospasm 
C)  Pulmonary edema 
D)  Respiratory muscle weakness

Question 9

Which of the following options would be able to provide "partial" ventilatory support via providing part of a patient's minute volume requirement?

Accepted Answer

A)  SIMV mode, PAV mode, ASV mode 
B)  SIMV mode, assist/control mode, PAV mode, ASV mode 
C)  SIMV mode, T-piece system, assist/control mode, PAV mode 
D)  T-piece system, assist/control mode, ASV mode 
A)  SIMV mode, PAV mode, ASV mode 
B)  SIMV mode, assist/control mode, PAV mode, ASV mode 
C)  SIMV mode, T-piece system, assist/control mode, PAV mode 
D)  T-piece system, assist/control mode, ASV mode

Question 10

A mechanically ventilated patient has the following oxygen content measurements: CcO2 = 19.8 vol%, CaO2 = 17.9 vol %, CvO2 = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

Accepted Answer

A)  17%, mild 
B)  22%, moderate 
C)  31%, severe 
D)  38%, significant 
A)  17%, mild 
B)  22%, moderate 
C)  31%, severe 
D)  38%, significant

Question 11

Which of the following would likely delay the start weaning a patient from mechanical ventilation?

Accepted Answer

A)  Frequent dysrhythmias, ventilator failure, use of 5 cm H2O PEEP 
B)  Severe acidosis, ventilator failure, use of 5 cm H2O PEEP 
C)  Frequent dysrhythmias, severe acidosis, ventilator failure 
D)  Frequent dysrhythmias, severe acidosis, use of 5 cm H2O PEEP 
A)  Frequent dysrhythmias, ventilator failure, use of 5 cm H2O PEEP 
B)  Severe acidosis, ventilator failure, use of 5 cm H2O PEEP 
C)  Frequent dysrhythmias, severe acidosis, ventilator failure 
D)  Frequent dysrhythmias, severe acidosis, use of 5 cm H2O PEEP

Question 12

The PaO2 of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO2 is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

Accepted Answer

A)  410 mm Hg, 12% 
B)  410 mm Hg, 16% 
C)  525 mm Hg, 21% 
D)  525 mm Hg, 33% 
A)  410 mm Hg, 12% 
B)  410 mm Hg, 16% 
C)  525 mm Hg, 21% 
D)  525 mm Hg, 33%

Question 13

Which of the following sets of pulmonary measurements suggest readiness for a weaning attempt?

Accepted Answer

A)  MIP = −15 cm H2O, VD /VT = 44%, f/VT = 80 breaths/min/L 
B)  MIP = −15 cm H2O, VD /VT = 44%, static compliance = 36 mL/cm H2O 
C)  MIP = −15 cm H2O, static compliance = 36 mL/cm H2O, f/VT = 80 breaths/min/L 
D)  VD /VT = 44%, static compliance = 36 mL/cm H2O, f/VT = 80 breaths/min/L 
A)  MIP = −15 cm H2O, VD /VT = 44%, f/VT = 80 breaths/min/L 
B)  MIP = −15 cm H2O, VD /VT = 44%, static compliance = 36 mL/cm H2O 
C)  MIP = −15 cm H2O, static compliance = 36 mL/cm H2O, f/VT = 80 breaths/min/L 
D)  VD /VT = 44%, static compliance = 36 mL/cm H2O, f/VT = 80 breaths/min/L

Question 14

Which of the following best describes prolonged weaning from mechanical ventilation?

Accepted Answer

A)  Patients who wean from mechanical ventilation in one to two SBT attempts. 
B)  Patients who wean from mechanical ventilation in one to three SBT attempts. 
C)  Patients who fail at least three SBT attempts and require a more gradual approach. 
D)  Patients who wean within one to three SBT attempts but require more than a week of weaning from the first SBT attempt. 
A)  Patients who wean from mechanical ventilation in one to two SBT attempts. 
B)  Patients who wean from mechanical ventilation in one to three SBT attempts. 
C)  Patients who fail at least three SBT attempts and require a more gradual approach. 
D)  Patients who wean within one to three SBT attempts but require more than a week of weaning from the first SBT attempt.

Question 15

Rapid shallow breathing would most likely cause:

Accepted Answer

A)  an increase static compliance. 
B)  a decrease of Qs/Qt. 
C)  an increase of VD/VT. 
D)  a decrease in PAOP. 
A)  an increase static compliance. 
B)  a decrease of Qs/Qt. 
C)  an increase of VD/VT. 
D)  a decrease in PAOP.

Question 16

All of the following are important actions to consider when preparing patients for a successful weaning outcome. What is the first item to consider when assessing for readiness to start the weaning process?

Accepted Answer

A)  Treat any infection that may exist. 
B)  Achieve acceptable fluid balance. 
C)  Ensure hemodynamic function and stability. 
D)  Ensure that the reason for initiating mechanical ventilation has been adequately resolved. 
A)  Treat any infection that may exist. 
B)  Achieve acceptable fluid balance. 
C)  Ensure hemodynamic function and stability. 
D)  Ensure that the reason for initiating mechanical ventilation has been adequately resolved.

Question 17

A diagnostic spontaneous breathing trial should be at least _____ in duration but may go as long as ______, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.

Accepted Answer

A)  30 minutes, 60 minutes 
B)  30 minutes, 120 minutes 
C)  2 hours, 3 hours 
D)  2 hours, 4 hours 
A)  30 minutes, 60 minutes 
B)  30 minutes, 120 minutes 
C)  2 hours, 3 hours 
D)  2 hours, 4 hours

Question 18

Which of the following values would be satisfactory for considering a ventilator weaning attempt on a 38-year-old patient with no history of chronic lung disease?

Accepted Answer

A)  Spontaneous frequency (f) = 38/min 
B)  Spontaneous VT = 6 mL/kg PBW 
C)  Minute ventilation = 13 L/min 
D)  PaCO2 = 53 mm Hg 
A)  Spontaneous frequency (f) = 38/min 
B)  Spontaneous VT = 6 mL/kg PBW 
C)  Minute ventilation = 13 L/min 
D)  PaCO2 = 53 mm Hg

Question 19

Which of the following is the best definition of success for discontinuing mechanical ventilation?

Accepted Answer

A)  A successful SBT and extubation for at least 48 hours 
B)  Discontinuation of ventilator support with or without extubation 
C)  Removal from mechanical ventilation followed by extubation for at least 12 hours 
D)  Discontinuation of ventilator breaths for 24 hours, with or without CPAP of 5 cm H2O 
A)  A successful SBT and extubation for at least 48 hours 
B)  Discontinuation of ventilator support with or without extubation 
C)  Removal from mechanical ventilation followed by extubation for at least 12 hours 
D)  Discontinuation of ventilator breaths for 24 hours, with or without CPAP of 5 cm H2O

Question 20

An RSBI of 91 breaths/min/L would best be interpreted by which of the following?

Accepted Answer

A)  Borderline acceptable for meeting the RSBI weaning criteria threshold. 
B)  Easily meets the RSBI weaning criteria threshold by a comfortable margin. 
C)  Borderline unacceptable for meeting the RSBI weaning criteria threshold. 
D)  Clearly unacceptable for meeting the RSBI weaning criteria threshold by a wide margin. 
A)  Borderline acceptable for meeting the RSBI weaning criteria threshold. 
B)  Easily meets the RSBI weaning criteria threshold by a comfortable margin. 
C)  Borderline unacceptable for meeting the RSBI weaning criteria threshold. 
D)  Clearly unacceptable for meeting the RSBI weaning criteria threshold by a wide margin.

What would be the calculated RSBI (f/V_T) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

Which of the following trends may be used as indicators of weaning failure?

A mechanically ventilated patient has a PaO₂ of 77 mm Hg on 30% oxygen. What is the PaO₂/F_IO₂ (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

Terminal weaning is best defined as withholding of mechanical ventilation:

Which of the following are potential benefits from a tracheostomy tube to enhance the weaning process?

The oxygenation status of a 29-year-old postoperative patient shows: PaO₂= 58 mm Hg, SaO₂ = 85%, Qs/Qt = 25%, PaO₂/F_IO₂ = 105 mm Hg, F_IO₂ = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

Of the choices provided, which one is the leading cause of failure for attempts to liberate patients from mechanical ventilation?

Which of the following options would be able to provide "partial" ventilatory support via providing part of a patient's minute volume requirement?

A mechanically ventilated patient has the following oxygen content measurements: CcO₂ = 19.8 vol%, CaO₂ = 17.9 vol %, CvO₂ = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

Which of the following would likely delay the start weaning a patient from mechanical ventilation?

The PaO₂ of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO₂ is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

Which of the following sets of pulmonary measurements suggest readiness for a weaning attempt?

Which of the following best describes prolonged weaning from mechanical ventilation?

Rapid shallow breathing would most likely cause:

All of the following are important actions to consider when preparing patients for a successful weaning outcome. What is the first item to consider when assessing for readiness to start the weaning process?

A diagnostic spontaneous breathing trial should be at least _ in duration but may go as long as __, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.

Which of the following values would be satisfactory for considering a ventilator weaning attempt on a 38-year-old patient with no history of chronic lung disease?

Which of the following is the best definition of success for discontinuing mechanical ventilation?

An RSBI of 91 breaths/min/L would best be interpreted by which of the following?

Principles of Mechanical Ventilation

Classification of Mechanical Ventilation

Modes of Mechanical Ventilation

Non-Invasive and Invasive Airway Management

Initiation of Mechanical Ventilation

Monitoring in Mechanical Ventilation

Waveform Analysis and Application

Management of Mechanical Ventilation

Critical Care Procedures

Pharmacotherapy in Critical Care

Neonatal and Pediatric Mechanical Ventilation

Medical Critical Care Issues

Traumatic Critical Care Issues

Critical Care Guidelines and Bundles

Filters

Exam 11: Weaning From Mechanical Ventilation

What would be the calculated RSBI (f/VT) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

Which of the following trends may be used as indicators of weaning failure?

A mechanically ventilated patient has a PaO2 of 77 mm Hg on 30% oxygen. What is the PaO2/FIO2 (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

Terminal weaning is best defined as withholding of mechanical ventilation:

Which of the following are potential benefits from a tracheostomy tube to enhance the weaning process?

The oxygenation status of a 29-year-old postoperative patient shows: PaO2= 58 mm Hg, SaO2 = 85%, Qs/Qt = 25%, PaO2/FIO2 = 105 mm Hg, FIO2 = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

Of the choices provided, which one is the leading cause of failure for attempts to liberate patients from mechanical ventilation?

Which of the following options would be able to provide "partial" ventilatory support via providing part of a patient's minute volume requirement?

A mechanically ventilated patient has the following oxygen content measurements: CcO2 = 19.8 vol%, CaO2 = 17.9 vol %, CvO2 = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

Which of the following would likely delay the start weaning a patient from mechanical ventilation?

The PaO2 of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO2 is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

Which of the following sets of pulmonary measurements suggest readiness for a weaning attempt?

Which of the following best describes prolonged weaning from mechanical ventilation?

Rapid shallow breathing would most likely cause:

All of the following are important actions to consider when preparing patients for a successful weaning outcome. What is the first item to consider when assessing for readiness to start the weaning process?

A diagnostic spontaneous breathing trial should be at least _____ in duration but may go as long as ______, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.

Which of the following values would be satisfactory for considering a ventilator weaning attempt on a 38-year-old patient with no history of chronic lung disease?

Which of the following is the best definition of success for discontinuing mechanical ventilation?

An RSBI of 91 breaths/min/L would best be interpreted by which of the following?

Principles of Mechanical Ventilation

Classification of Mechanical Ventilation

Modes of Mechanical Ventilation

Non-Invasive and Invasive Airway Management

Initiation of Mechanical Ventilation

Monitoring in Mechanical Ventilation

Waveform Analysis and Application

Management of Mechanical Ventilation

Critical Care Procedures

Pharmacotherapy in Critical Care

Neonatal and Pediatric Mechanical Ventilation

Medical Critical Care Issues

Traumatic Critical Care Issues

Critical Care Guidelines and Bundles

Filters

What would be the calculated RSBI (f/V_T) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

A mechanically ventilated patient has a PaO₂ of 77 mm Hg on 30% oxygen. What is the PaO₂/F_IO₂ (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

The oxygenation status of a 29-year-old postoperative patient shows: PaO₂= 58 mm Hg, SaO₂ = 85%, Qs/Qt = 25%, PaO₂/F_IO₂ = 105 mm Hg, F_IO₂ = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

A mechanically ventilated patient has the following oxygen content measurements: CcO₂ = 19.8 vol%, CaO₂ = 17.9 vol %, CvO₂ = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

The PaO₂ of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO₂ is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

A diagnostic spontaneous breathing trial should be at least _ in duration but may go as long as __, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.