Question 1

What are the clinical manifestations associated with oxygen toxicity?

Accepted Answer

A)  Substernal chest pain that increases with deep breathing 
B)  Moist cough and tracheal irritation 
C)  Pleuritic pain occurring on inhalation, followed by dyspnea 
D)  Increasing CO₂ 
E)  Sore throat and eye and ear discomfort 
A)  Substernal chest pain that increases with deep breathing 
B)  Moist cough and tracheal irritation 
C)  Pleuritic pain occurring on inhalation, followed by dyspnea 
D)  Increasing CO₂ 
E)  Sore throat and eye and ear discomfort A,C,E

Question 2

Which airway would be the most appropriate for a patient requiring intubation longer than 21 days?

Accepted Answer

A)  Oropharyngeal airway 
B)  Esophageal obturator airway 
C)  Tracheostomy tube 
D)  Endotracheal intubation 
A)  Oropharyngeal airway 
B)  Esophageal obturator airway 
C)  Tracheostomy tube 
D)  Endotracheal intubation C

Question 3

A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning.When entering the room,the ventilator inoperative alarm sounds.What action should the nurse take FIRST?

Accepted Answer

A)  Troubleshoot the ventilator until the problem is found. 
B)  Take the patient off the ventilator and manually ventilate. 
C)  Call the respiratory therapist for help. 
D)  Silence the ventilator alarms until the problem is resolved. 
A)  Troubleshoot the ventilator until the problem is found. 
B)  Take the patient off the ventilator and manually ventilate. 
C)  Call the respiratory therapist for help. 
D)  Silence the ventilator alarms until the problem is resolved. B

Question 4

A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is not tolerating weaning?

Accepted Answer

A)  A decrease in heart rate from 92 to 80 beats/min 
B)  An SpO₂ of 92% 
C)  An increase in respiratory rate from 22 to 38 breaths/min 
D)  Spontaneous tidal volumes of 300 to 350 mL 
A)  A decrease in heart rate from 92 to 80 beats/min 
B)  An SpO₂ of 92% 
C)  An increase in respiratory rate from 22 to 38 breaths/min 
D)  Spontaneous tidal volumes of 300 to 350 mL

Question 5

The Passy-Muir valve is contraindicated in which patient?

Accepted Answer

A)  A patient who is trying to relearn normal breathing patterns 
B)  A patient who has minimal secretions 
C)  A patient with laryngeal or pharyngeal dysfunction 
D)  A patient who wants to speak while on the ventilator 
A)  A patient who is trying to relearn normal breathing patterns 
B)  A patient who has minimal secretions 
C)  A patient with laryngeal or pharyngeal dysfunction 
D)  A patient who wants to speak while on the ventilator

Question 6

What is the therapeutic blood level for theophylline (Xanthines)?

Accepted Answer

A)  5 to 10 mg/dL 
B)  10 to 20 mg/dL 
C)  20 to 30 mg/dL 
D)  35 to 45 mg/dL 
A)  5 to 10 mg/dL 
B)  10 to 20 mg/dL 
C)  20 to 30 mg/dL 
D)  35 to 45 mg/dL

Question 7

Which ventilator phase variable initiates the change from exhalation to inspiration?

Accepted Answer

A)  Cycle 
B)  Trigger 
C)  Flow 
D)  Pressure 
A)  Cycle 
B)  Trigger 
C)  Flow 
D)  Pressure

Question 8

Which oxygen delivery device is considered a low-flow system?

Accepted Answer

A)  Nasal cannula 
B)  Simple face mask 
C)  Reservoir cannula 
D)  Air-entrainment nebulizer 
A)  Nasal cannula 
B)  Simple face mask 
C)  Reservoir cannula 
D)  Air-entrainment nebulizer

Question 9

Which statements regarding rotation therapies are accurate?

Accepted Answer

A)  Continuous lateral rotation therapy (CLRT) can be effective for improving oxygenation if used for at least 18 hours/day. 
B)  Kinetic therapy can decrease the incidence of ventilator-acquired pneumonia in neurologic and postoperative patients. 
C)  Use of rotational therapy eliminates the need for other pressure ulcer prevention strategies. 
D)  CLRT helps avoid hemodynamic instability secondary to the continuous, gentle turning of the patient. 
E)  CLRT has minimal pulmonary benefits for critically ill patients. 
A)  Continuous lateral rotation therapy (CLRT) can be effective for improving oxygenation if used for at least 18 hours/day. 
B)  Kinetic therapy can decrease the incidence of ventilator-acquired pneumonia in neurologic and postoperative patients. 
C)  Use of rotational therapy eliminates the need for other pressure ulcer prevention strategies. 
D)  CLRT helps avoid hemodynamic instability secondary to the continuous, gentle turning of the patient. 
E)  CLRT has minimal pulmonary benefits for critically ill patients.

Question 10

What nursing interventions should be included in the nursing management of the patient receiving a neuromuscular blocking agent?

Accepted Answer

A)  Withholding all sedation and narcotics 
B)  Protecting the patient from the environment 
C)  Keeping the patient supine 
D)  Speaking to the patient only when necessary 
A)  Withholding all sedation and narcotics 
B)  Protecting the patient from the environment 
C)  Keeping the patient supine 
D)  Speaking to the patient only when necessary

Question 11

Which route for endotracheal (ET)tube placement is usually used in an emergency intubation?

Accepted Answer

A)  Orotracheal 
B)  Nasotracheal 
C)  Nasopharyngeal 
D)  Trachea 
A)  Orotracheal 
B)  Nasotracheal 
C)  Nasopharyngeal 
D)  Trachea

Question 12

Use of oxygen therapy in the patient who is hypercapnic may result in which situation?

Accepted Answer

A)  Oxygen toxicity 
B)  Absorption atelectasis 
C)  Carbon dioxide retention 
D)  Pneumothorax 
A)  Oxygen toxicity 
B)  Absorption atelectasis 
C)  Carbon dioxide retention 
D)  Pneumothorax

Question 13

Which statement best describes the effects of positive-pressure ventilation on cardiac output?

Accepted Answer

A)  Positive-pressure ventilation increases intrathoracic pressure, which increases venous return and cardiac output. 
B)  Positive-pressure ventilation decreases venous return, which increases preload and cardiac output. 
C)  Positive-pressure ventilation increases venous return, which decreases preload and cardiac output. 
D)  Positive-pressure ventilation increases intrathoracic pressure, which decreases venous return and cardiac output. 
A)  Positive-pressure ventilation increases intrathoracic pressure, which increases venous return and cardiac output. 
B)  Positive-pressure ventilation decreases venous return, which increases preload and cardiac output. 
C)  Positive-pressure ventilation increases venous return, which decreases preload and cardiac output. 
D)  Positive-pressure ventilation increases intrathoracic pressure, which decreases venous return and cardiac output.

Question 14

Which statement is correct concerning endotracheal tube cuff management?

Accepted Answer

A)  The cuff should be deflated every hour to minimize pressure on the trachea. 
B)  A small leak should be heard on inspiration if the cuff has been inflated using the minimal leak technique. 
C)  Cuff pressures should be kept between 20 to 30 mm Hg to ensure an adequate seal. 
D)  Cuff pressure monitoring should be done once every 24 hours. 
A)  The cuff should be deflated every hour to minimize pressure on the trachea. 
B)  A small leak should be heard on inspiration if the cuff has been inflated using the minimal leak technique. 
C)  Cuff pressures should be kept between 20 to 30 mm Hg to ensure an adequate seal. 
D)  Cuff pressure monitoring should be done once every 24 hours.

Question 15

Which statement describes the assist-control mode of ventilation?

Accepted Answer

A)  It delivers gas at preset volume, at a set rate, and in response to the patient's inspiratory efforts. 
B)  It delivers gas at a preset volume, allowing the patient to breathe spontaneously at his or her own volume. 
C)  It applies positive pressure during both ventilator breaths and spontaneous breaths. 
D)  It delivers gas at preset rate and tidal volume regardless of the patient's inspiratory efforts. 
A)  It delivers gas at preset volume, at a set rate, and in response to the patient's inspiratory efforts. 
B)  It delivers gas at a preset volume, allowing the patient to breathe spontaneously at his or her own volume. 
C)  It applies positive pressure during both ventilator breaths and spontaneous breaths. 
D)  It delivers gas at preset rate and tidal volume regardless of the patient's inspiratory efforts.

Question 16

Which oxygen therapy device should is used in a patient requiring the delivery of a precise low FiO₂?

Accepted Answer

A)  Simple mask 
B)  Nasal cannula 
C)  Air-entrainment mask 
D)  Partial rebreathing mask 
A)  Simple mask 
B)  Nasal cannula 
C)  Air-entrainment mask 
D)  Partial rebreathing mask

Question 17

A patient was admitted with acute lung failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is ready to be weaned?

Accepted Answer

A)  FiO₂ greater than 50% 
B)  Rapid shallow breathing index less than 105 
C)  Minute ventilation greater than 10 L/min 
D)  Vital capacity/kg greater than or equal to 15 mL 
A)  FiO₂ greater than 50% 
B)  Rapid shallow breathing index less than 105 
C)  Minute ventilation greater than 10 L/min 
D)  Vital capacity/kg greater than or equal to 15 mL

Question 18

What is the preset positive pressure used to augment the patient's inspiratory effort known as?

Accepted Answer

A)  Positive end-expiratory pressure (PEEP) 
B)  Continuous positive airway pressure (CPAP) 
C)  Pressure control ventilation (PCV) 
D)  Pressure support ventilation (PSV) 
A)  Positive end-expiratory pressure (PEEP) 
B)  Continuous positive airway pressure (CPAP) 
C)  Pressure control ventilation (PCV) 
D)  Pressure support ventilation (PSV)

Question 19

Which of the following are complications of endotracheal tubes?

Accepted Answer

A)  Tracheoesophageal fistula 
B)  Cricoid abscess 
C)  Tracheal stenosis 
D)  Tube obstruction 
E)  Hemorrhage 
A)  Tracheoesophageal fistula 
B)  Cricoid abscess 
C)  Tracheal stenosis 
D)  Tube obstruction 
E)  Hemorrhage

Question 20

Which oxygen administration device can deliver oxygen concentrations of 90%?

Accepted Answer

A)  Nonrebreathing mask 
B)  Nasal cannula 
C)  Partial rebreathing mask 
D)  Simple mask 
A)  Nonrebreathing mask 
B)  Nasal cannula 
C)  Partial rebreathing mask 
D)  Simple mask

Exam 20: Pulmonary Therapeutic Management

What are the clinical manifestations associated with oxygen toxicity?

Which airway would be the most appropriate for a patient requiring intubation longer than 21 days?

A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning.When entering the room,the ventilator inoperative alarm sounds.What action should the nurse take FIRST?

A patient was admitted to the critical care unit with acute respiratory failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is not tolerating weaning?

The Passy-Muir valve is contraindicated in which patient?

What is the therapeutic blood level for theophylline (Xanthines)?

Which ventilator phase variable initiates the change from exhalation to inspiration?

Which oxygen delivery device is considered a low-flow system?

Which statements regarding rotation therapies are accurate?

What nursing interventions should be included in the nursing management of the patient receiving a neuromuscular blocking agent?

Which route for endotracheal (ET)tube placement is usually used in an emergency intubation?

Use of oxygen therapy in the patient who is hypercapnic may result in which situation?

Which statement best describes the effects of positive-pressure ventilation on cardiac output?

Which statement is correct concerning endotracheal tube cuff management?

Which statement describes the assist-control mode of ventilation?

Which oxygen therapy device should is used in a patient requiring the delivery of a precise low FiO₂?

A patient was admitted with acute lung failure.The patient has been on a ventilator for 3 days and is being considered for weaning.Which criteria would indicate that the patient is ready to be weaned?

What is the preset positive pressure used to augment the patient's inspiratory effort known as?

Which of the following are complications of endotracheal tubes?

Which oxygen administration device can deliver oxygen concentrations of 90%?

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