Question 1

Which of the following is a feature of Guillain-Barré?

Accepted Answer

A) Ascending muscle weakness 
B) Descending muscle weakness 
C) Limited to lower extremities 
D) Limited to trunk 
A) Ascending muscle weakness 
B) Descending muscle weakness 
C) Limited to lower extremities 
D) Limited to trunk

Question 2

Ventilatory support may be indicated when the VC falls below what level?

Accepted Answer

A)  45 ml/kg 
B)  65 ml/kg 
C)  10 ml/kg 
D)  30 ml/kg 
A)  45 ml/kg 
B)  65 ml/kg 
C)  10 ml/kg 
D)  30 ml/kg

Question 3

Which of the following measures are useful indicators in assessing the adequacy of a patient's oxygenation?
1) PaO2-PaO2
2) PaO2-to-FiO2 ratio
3) VD/VT
4) Pulmonary shunt

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 only 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 only

Question 4

What is the normal range for PaO2/FiO2?

Accepted Answer

A)  350 to 450 
B)  250 to 350 
C)  150 to 250 
D)  75 to 150 
A)  350 to 450 
B)  250 to 350 
C)  150 to 250 
D)  75 to 150

Question 5

Which of the following clinical signs suggest more severe hypoxemia?

Accepted Answer

A)  Tachycardia 
B)  Cyanosis with polycythemia 
C)  Central nervous system dysfunction 
D)  Use of accessory muscles 
A)  Tachycardia 
B)  Cyanosis with polycythemia 
C)  Central nervous system dysfunction 
D)  Use of accessory muscles

Question 6

In intubated patients, what do sources of increased imposed work of breathing include?
1) Endotracheal tube
2) Ventilator circuit
3) Auto-PEEP

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 7

A diagnosis of respiratory failure can be made if which of the following are present?
1) PaO2 55 mm Hg, FiO2 0.21, PB 760 mm Hg
2) PaCO2 57 mm Hg, FiO2 0.21, PB 760 mm Hg
3) P(A-a)O2 45 mm Hg, FiO2 1.0, PB 760 mm Hg
4) PaO2/FiO2 400, PB 750 mm Hg

Accepted Answer

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

Question 8

A patient develops acute hypercapnic respiratory failure due to muscle fatigue. Which of the following modes of ventilatory support would you consider for this patient?
1) Assist-control ventilation with adequate backup
2) Continuous positive airway pressure
3) Intermittent mandatory ventilation with adequate backup rate
4) Bilevel pressure support by mask

Accepted Answer

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

Question 9

A reversible impairment in the response of an overloaded muscle to neural stimulation best describes which of the following?

Accepted Answer

A)  Central respiratory muscle fatigue 
B)  Transmission respiratory muscle fatigue 
C)  Contractile respiratory muscle fatigue 
D)  Chronic respiratory muscle fatigue 
A)  Central respiratory muscle fatigue 
B)  Transmission respiratory muscle fatigue 
C)  Contractile respiratory muscle fatigue 
D)  Chronic respiratory muscle fatigue

Question 10

What is the optimal treatment of intrapulmonary shunt?

Accepted Answer

A)  Increase the FiO2. 
B)  Decrease the FiO2. 
C)  Surgery. 
D)  Alveolar recruitment. 
A)  Increase the FiO2. 
B)  Decrease the FiO2. 
C)  Surgery. 
D)  Alveolar recruitment.

Question 11

Breathing 100% O2, a patient has a PaO2-PaO2 of 60 mm Hg. Based on this information, what might you conclude?

Accepted Answer

A)  The patient has severe hypoxemia. 
B)  The patient has an excessive work of breathing. 
C)  The patient has acceptable oxygenation. 
D)  The patient has inadequate ventilation. 
A)  The patient has severe hypoxemia. 
B)  The patient has an excessive work of breathing. 
C)  The patient has acceptable oxygenation. 
D)  The patient has inadequate ventilation.

Question 12

What is the most common cause of low mixed venous oxygen?

Accepted Answer

A)  Liver disease 
B)  Cardiac disease 
C)  Neuromuscular disease 
D)  Vascular disease 
A)  Liver disease 
B)  Cardiac disease 
C)  Neuromuscular disease 
D)  Vascular disease

Question 13

What are some causes of dynamic hyperinflation?
1) Increased expiratory time
2) Increased airway resistance
3) Decreased expiratory flow rate

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 14

A patient who just suffered severe closed-head injury and has a high intracranial pressure (ICP) is about to be placed on ventilatory support. Which of the following strategies could help to lower the ICP?

Accepted Answer

A)  Maintain a PaCO2 from 25 to 30 mm Hg (deliberate hyperventilation). 
B)  Allow as much spontaneous breathing as possible (SIMV). 
C)  Maintain a high mean pressure using PEEP levels of 10 to 15 cm H2O. 
D)  Maintain a PaCO2 of 50 to 60 mm Hg (deliberate hypoventilation). 
A)  Maintain a PaCO2 from 25 to 30 mm Hg (deliberate hyperventilation). 
B)  Allow as much spontaneous breathing as possible (SIMV). 
C)  Maintain a high mean pressure using PEEP levels of 10 to 15 cm H2O. 
D)  Maintain a PaCO2 of 50 to 60 mm Hg (deliberate hypoventilation).

Question 15

Which of the following measures should be used in assessing the adequacy of a patient's alveolar ventilation?
1) PaO2
2) Arterial pH
3) PaCO2
4) HCO3-

Accepted Answer

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

Question 16

Which of the following are associated with hypercapnic respiratory failure due to increased work of breathing?
1) Asthma
2) COPD
3) Obesity
4) Kyphoscoliosis

Accepted Answer

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

Question 17

Which of the following information best helps to distinguish chronic hypercapnic respiratory failure from acute hypercapnic respiratory failure?

Accepted Answer

A)  Long-standing dyspnea that worsens on exertion 
B)  Forced expiratory volume in 1 sec to forced vital capacity ratio (FEV1/FV
C)  of less than 75% predicted 
C)  Kidneys retaining bicarbonate to elevate the blood pH 
D)  Physical signs of hypoxemia, such as cyanosis and clubbing 
A)  Long-standing dyspnea that worsens on exertion 
B)  Forced expiratory volume in 1 sec to forced vital capacity ratio (FEV1/FV
C)  of less than 75% predicted 
C)  Kidneys retaining bicarbonate to elevate the blood pH 
D)  Physical signs of hypoxemia, such as cyanosis and clubbing

Question 18

Which of the following can cause hypoxemia?
1) Diffusion impairment
2) Alveolar hypoventilation
3)   mismatch
4) Intrapulmonary shunting

Accepted Answer

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

Question 19

Which of the following is the normal alveolar-to-arterial difference for a 56-year-old female in the emergency department?

Accepted Answer

A)  12 mm Hg 
B)  14 mm Hg 
C)  16 mm Hg 
D)  18 mm Hg 
A)  12 mm Hg 
B)  14 mm Hg 
C)  16 mm Hg 
D)  18 mm Hg

Question 20

A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO2 = 89; HCO3- = 27; PO2 = 48. Which of the following best describes this patient's condition?

Accepted Answer

A)  Chronic hypoxemic respiratory failure 
B)  Chronic hypercapnic respiratory failure 
C)  Acute hypoxemic respiratory failure 
D)  Acute hypercapnic respiratory failure 
A)  Chronic hypoxemic respiratory failure 
B)  Chronic hypercapnic respiratory failure 
C)  Acute hypoxemic respiratory failure 
D)  Acute hypercapnic respiratory failure

Exam 44: Respiratory Failure and the Need for Ventilatory Support

Which of the following is a feature of Guillain-Barré?

Ventilatory support may be indicated when the VC falls below what level?

Which of the following measures are useful indicators in assessing the adequacy of a patient's oxygenation? 1) PaO2-PaO2 2) PaO2-to-FiO2 ratio 3) VD/VT 4) Pulmonary shunt

What is the normal range for PaO2/FiO2?

Which of the following clinical signs suggest more severe hypoxemia?

In intubated patients, what do sources of increased imposed work of breathing include? 1) Endotracheal tube 2) Ventilator circuit 3) Auto-PEEP

A diagnosis of respiratory failure can be made if which of the following are present? 1) PaO2 55 mm Hg, FiO2 0.21, PB 760 mm Hg 2) PaCO2 57 mm Hg, FiO2 0.21, PB 760 mm Hg 3) P(A-a)O2 45 mm Hg, FiO2 1.0, PB 760 mm Hg 4) PaO2/FiO2 400, PB 750 mm Hg

A reversible impairment in the response of an overloaded muscle to neural stimulation best describes which of the following?

What is the optimal treatment of intrapulmonary shunt?

Breathing 100% O2, a patient has a PaO2-PaO2 of 60 mm Hg. Based on this information, what might you conclude?

What is the most common cause of low mixed venous oxygen?

What are some causes of dynamic hyperinflation? 1) Increased expiratory time 2) Increased airway resistance 3) Decreased expiratory flow rate

A patient who just suffered severe closed-head injury and has a high intracranial pressure (ICP) is about to be placed on ventilatory support. Which of the following strategies could help to lower the ICP?

Which of the following measures should be used in assessing the adequacy of a patient's alveolar ventilation? 1) PaO2 2) Arterial pH 3) PaCO2 4) HCO3-

Which of the following are associated with hypercapnic respiratory failure due to increased work of breathing? 1) Asthma 2) COPD 3) Obesity 4) Kyphoscoliosis

Which of the following information best helps to distinguish chronic hypercapnic respiratory failure from acute hypercapnic respiratory failure?

Which of the following can cause hypoxemia? 1) Diffusion impairment 2) Alveolar hypoventilation 3) mismatch 4) Intrapulmonary shunting

Which of the following is the normal alveolar-to-arterial difference for a 56-year-old female in the emergency department?

A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO2 = 89; HCO3- = 27; PO2 = 48. Which of the following best describes this patient's condition?

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

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

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Respiratory Distress Syndrome

Trauma, Burns and Near Drowning

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

Airway Clearance Therapy Act

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring 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

Which of the following measures are useful indicators in assessing the adequacy of a patient's oxygenation? 1) PaO₂-PaO₂ 2) PaO₂-to-FiO₂ ratio 3) V_D/V_T 4) Pulmonary shunt

What is the normal range for PaO₂/FiO₂?

A diagnosis of respiratory failure can be made if which of the following are present? 1) PaO₂ 55 mm Hg, FiO₂ 0.21, P_B 760 mm Hg 2) PaCO₂ 57 mm Hg, FiO₂ 0.21, P_B 760 mm Hg 3) P(A-a)O₂ 45 mm Hg, FiO₂ 1.0, P_B 760 mm Hg 4) PaO₂/FiO₂ 400, P_B 750 mm Hg

Breathing 100% O₂, a patient has a PaO₂-PaO₂ of 60 mm Hg. Based on this information, what might you conclude?

Which of the following measures should be used in assessing the adequacy of a patient's alveolar ventilation? 1) PaO₂ 2) Arterial pH 3) PaCO₂ 4) HCO₃^-

A patient with an opiate drug overdose is unconscious and exhibits the following blood gas results breathing room air: pH = 7.19; PCO₂ = 89; HCO₃^- = 27; PO₂ = 48. Which of the following best describes this patient's condition?