Question 1

What mode of ventilation is most often applied to the intensive care unit patient needing mechanical ventilation?

Accepted Answer

A) pressure-supported ventilation 
B) pressure-controlled ventilation 
C) assist-control or synchronized intermittent mandatory ventilation (SIMV) 
D) control mode 
A) pressure-supported ventilation 
B) pressure-controlled ventilation 
C) assist-control or synchronized intermittent mandatory ventilation (SIMV) 
D) control mode

Question 2

Which of the following is/are a disadvantage of negative-pressure ventilation?
I.problems with leaks
II.reduced access to patient
III.reduced patient tolerance

Accepted Answer

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

Question 3

The following data are gathered during a PEEP study (FIO2 = 0.60). Based on these data, what is the optimum PEEP level? $\begin{array}{|l|l|l|l|l|l|l|}
\hline \mathrm{PEEP} \mathrm{cm} \mathrm{H} \mathrm{H}_{2} \mathrm{O} & 0 & 5 & 10 & 15 & 20 & 25 \
\hline \mathrm{PaO}_{2} \mathrm{~mm} \mathrm{Hg} & 46 & 54 & 67 & 73 & 75 & 74 \
\hline \text { Compliance } \mathrm{m} / \mathrm{cm} \mathrm{H}_{2} \mathrm{O} & 18 & 23 & 26 & 30 & 24 & 19 \
\hline \text { Systolic pressure } & 125 & 123 & 114 & 115 & 104 & 94 \
\hline \text { Diastolic pressure } & 90 & 88 & 83 & 84 & 76 & 68 \
\hline
\end{array}$

Accepted Answer

A) 10 cm H2O 
B) 15 cm H2O 
C) 20 cm H2O 
D) 25 cm H2O 
A) 10 cm H2O 
B) 15 cm H2O 
C) 20 cm H2O 
D) 25 cm H2O

Question 4

Which of the following ventilator adjustments would NOT decrease inspiratory time?

Accepted Answer

A) increase the peak flow 
B) increase the tidal volume 
C) change the flow pattern from a sine wave to a square wave 
D) none of the above 
A) increase the peak flow 
B) increase the tidal volume 
C) change the flow pattern from a sine wave to a square wave 
D) none of the above

Question 5

Which of the following statements is NOT true regarding ventilation is the assist-control mode?

Accepted Answer

A) Every breath is supported by the ventilator. 
B) Usually ensures a minimum safe level of ventilation is given. 
C) Assist-control mode is typically applied using the volume control mode. 
D) It is usually applied with a backup rate of 5 to 8 breaths/min. 
A) Every breath is supported by the ventilator. 
B) Usually ensures a minimum safe level of ventilation is given. 
C) Assist-control mode is typically applied using the volume control mode. 
D) It is usually applied with a backup rate of 5 to 8 breaths/min.

Question 6

Compared with a volume-cycled strategy, what are some potential advantages of pressure-targeted ventilatory support?
I.limit and control of peak airway pressures
II.direct control over inspiratory time
III.provision of a decelerating flow pattern

Accepted Answer

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

Question 7

If the patient is being ventilated via a mechanical ventilator via synchronized intermittent mandatory ventilation with partial ventilatory support, what would probably happen to PaCO2 if the patient suddenly had no spontaneous breathing?

Accepted Answer

A) increase 
B) decrease 
C) stay the same 
D) change according to FIO2 
A) increase 
B) decrease 
C) stay the same 
D) change according to FIO2

Question 8

Which of the following techniques can be used to improve oxygenation beyond increasing the FIO2 or PEEP level?
I.proning the patient
II.use of an expiratory pause
III.use of inverse I:E ratio ventilation

Accepted Answer

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

Question 9

When the therapist is initially setting the high-pressure alarm on the ventilator and the patient's plateau pressure is less than 30 cm H2O, what should the high pressure alarm be set at?

Accepted Answer

A) 5 to 10 cm H2O above the peak pressure 
B) 10 to 20 cm H2O above the peak pressure 
C) 10 to 12 cm H2O above the plateau pressure 
D) 10 to 15 cm H2O above the mean airway pressure 
A) 5 to 10 cm H2O above the peak pressure 
B) 10 to 20 cm H2O above the peak pressure 
C) 10 to 12 cm H2O above the plateau pressure 
D) 10 to 15 cm H2O above the mean airway pressure

Question 10

All the following are hazards associated with mechanical ventilation except:

Accepted Answer

A) reduced cardiac output 
B) liver failure 
C) increased work of breathing 
D) acute lung injury 
A) reduced cardiac output 
B) liver failure 
C) increased work of breathing 
D) acute lung injury

Question 11

What limits should be initially set for high and low VT values and/or minute volume alarms on a ventilatory support device?

Accepted Answer

A) ±5% to 10% 
B) ±10% to 15% 
C) ±15% to 20% 
D) ±20% to 25% 
A) ±5% to 10% 
B) ±10% to 15% 
C) ±15% to 20% 
D) ±20% to 25%

Question 12

For adults with otherwise normal lungs who are receiving ventilatory support in the continuous mandatory ventilation control or assist-control mode, inspiratory flow should be set to provide what I:E?

Accepted Answer

A) 2:1 
B) 3:1 
C) 1:1 
D) 1:2 
A) 2:1 
B) 3:1 
C) 1:1 
D) 1:2

Question 13

When using a heated humidifier during mechanical ventilation, the inspired gas temperature at the airway should be set to what level?

Accepted Answer

A) 29° to 31° C 
B) 31° to 35° C 
C) 35° to 37° C 
D) 38° to 40° C 
A) 29° to 31° C 
B) 31° to 35° C 
C) 35° to 37° C 
D) 38° to 40° C

Question 14

A heat-moisture exchanger (HME) should be avoided in which of the following circumstances?
I.patients with excessive secretions
II.patients with a high FIO2
III.patients with low body temperature

Accepted Answer

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

Question 15

What is the predicted change in PaCO2 for adding 6 inches of dead space to the circuit?

Accepted Answer

A) increase of 5 to 10 mm Hg 
B) increase of 3 to 7 mm Hg 
C) increase of 2 to 3 mm Hg 
D) no change 
A) increase of 5 to 10 mm Hg 
B) increase of 3 to 7 mm Hg 
C) increase of 2 to 3 mm Hg 
D) no change

Question 16

Which of the following is false about flow triggering of spontaneous breaths during mechanical ventilation?

Accepted Answer

A) Flow triggering lowers the patient's work of breathing. 
B) Flow triggering is preferred for initiating spontaneous breaths. 
C) Flow triggering reduces the work of breathing due to small endotracheal tubes. 
D) Flow triggering results in better patient-ventilator synchrony. 
A) Flow triggering lowers the patient's work of breathing. 
B) Flow triggering is preferred for initiating spontaneous breaths. 
C) Flow triggering reduces the work of breathing due to small endotracheal tubes. 
D) Flow triggering results in better patient-ventilator synchrony.

Question 17

Which of the following statements is NOT true regarding the use of an inspiratory pause during mechanical ventilation?

Accepted Answer

A) It may be useful in ARDS patients. 
B) It may be useful when obtaining a chest radiograph. 
C) It has been shown to increase effectiveness of bronchodilator therapy. 
D) It will increase mean airway pressure. 
A) It may be useful in ARDS patients. 
B) It may be useful when obtaining a chest radiograph. 
C) It has been shown to increase effectiveness of bronchodilator therapy. 
D) It will increase mean airway pressure.

Question 18

Which of the following statements is NOT true regarding pressure-supported ventilation?

Accepted Answer

A) It is patient triggered, pressure limited, and flow cycled. 
B) It can reduce the work of breathing during intermittent mandatory ventilation mode. 
C) The usual range is 10 to 15 cm H2O. 
D) It is recommended for use in most patients in the synchronized intermittent mandatory ventilation (SIMV) mode. 
A) It is patient triggered, pressure limited, and flow cycled. 
B) It can reduce the work of breathing during intermittent mandatory ventilation mode. 
C) The usual range is 10 to 15 cm H2O. 
D) It is recommended for use in most patients in the synchronized intermittent mandatory ventilation (SIMV) mode.

Question 19

When is the PEEP/CPAP level optimum?

Accepted Answer

A) Oxygen delivery to the tissues is maximized. 
B) Pressures are maintained below 15 cm H2O. 
C) CaO2 - CvO2 is maximized. 
D) The PaO2 is 60 to 100 mm Hg. 
A) Oxygen delivery to the tissues is maximized. 
B) Pressures are maintained below 15 cm H2O. 
C) CaO2 - CvO2 is maximized. 
D) The PaO2 is 60 to 100 mm Hg.

Question 20

Which of the following remedies is NOT commonly used in patients ventilated in the assist-control mode with a high ventilatory drive to avoid hyperventilation?

Accepted Answer

A) synchronized intermittent mandatory ventilation 
B) tranquilizers 
C) analgesics 
D) reduced inspiratory flow 
A) synchronized intermittent mandatory ventilation 
B) tranquilizers 
C) analgesics 
D) reduced inspiratory flow

Exam 44: Initiating and Adjusting Ventilatory Support

What mode of ventilation is most often applied to the intensive care unit patient needing mechanical ventilation?

Which of the following is/are a disadvantage of negative-pressure ventilation? I.problems with leaks II.reduced access to patient III.reduced patient tolerance

The following data are gathered during a PEEP study (FIO2 = 0.60). Based on these data, what is the optimum PEEP level? 0 5 10 15 20 25 46 54 67 73 75 74 Compliance / 18 23 26 30 24 19 Systolic pressure 125 123 114 115 104 94 Diastolic pressure 90 88 83 84 76 68

Which of the following ventilator adjustments would NOT decrease inspiratory time?

Which of the following statements is NOT true regarding ventilation is the assist-control mode?

Compared with a volume-cycled strategy, what are some potential advantages of pressure-targeted ventilatory support? I.limit and control of peak airway pressures II.direct control over inspiratory time III.provision of a decelerating flow pattern

If the patient is being ventilated via a mechanical ventilator via synchronized intermittent mandatory ventilation with partial ventilatory support, what would probably happen to PaCO2 if the patient suddenly had no spontaneous breathing?

Which of the following techniques can be used to improve oxygenation beyond increasing the FIO2 or PEEP level? I.proning the patient II.use of an expiratory pause III.use of inverse I:E ratio ventilation

When the therapist is initially setting the high-pressure alarm on the ventilator and the patient's plateau pressure is less than 30 cm H2O, what should the high pressure alarm be set at?

All the following are hazards associated with mechanical ventilation except:

What limits should be initially set for high and low VT values and/or minute volume alarms on a ventilatory support device?

For adults with otherwise normal lungs who are receiving ventilatory support in the continuous mandatory ventilation control or assist-control mode, inspiratory flow should be set to provide what I:E?

When using a heated humidifier during mechanical ventilation, the inspired gas temperature at the airway should be set to what level?

A heat-moisture exchanger (HME) should be avoided in which of the following circumstances? I.patients with excessive secretions II.patients with a high FIO2 III.patients with low body temperature

What is the predicted change in PaCO2 for adding 6 inches of dead space to the circuit?

Which of the following is false about flow triggering of spontaneous breaths during mechanical ventilation?

Which of the following statements is NOT true regarding the use of an inspiratory pause during mechanical ventilation?

Which of the following statements is NOT true regarding pressure-supported ventilation?

When is the PEEP/CPAP level optimum?

Which of the following remedies is NOT commonly used in patients ventilated in the assist-control mode with a high ventilatory drive to avoid hyperventilation?

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Airway Management

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

Filters

The following data are gathered during a PEEP study (FIO₂ = 0.60). Based on these data, what is the optimum PEEP level? 0 5 10 15 20 25 46 54 67 73 75 74 Compliance / 18 23 26 30 24 19 Systolic pressure 125 123 114 115 104 94 Diastolic pressure 90 88 83 84 76 68

If the patient is being ventilated via a mechanical ventilator via synchronized intermittent mandatory ventilation with partial ventilatory support, what would probably happen to PaCO₂ if the patient suddenly had no spontaneous breathing?

Which of the following techniques can be used to improve oxygenation beyond increasing the FIO₂ or PEEP level? I.proning the patient II.use of an expiratory pause III.use of inverse I:E ratio ventilation

When the therapist is initially setting the high-pressure alarm on the ventilator and the patient's plateau pressure is less than 30 cm H₂O, what should the high pressure alarm be set at?

What limits should be initially set for high and low V_T values and/or minute volume alarms on a ventilatory support device?

A heat-moisture exchanger (HME) should be avoided in which of the following circumstances? I.patients with excessive secretions II.patients with a high FIO₂ III.patients with low body temperature

What is the predicted change in PaCO₂ for adding 6 inches of dead space to the circuit?