Question 1

For patients with respiratory insufficiency, pressure-supported ventilation (PSV) has all of the following advantages over spontaneous breathing except:

Accepted Answer

A)  decreased respiratory rate. 
B)  increased VT. 
C)  decreased O2 consumption. 
D)  increased muscle activity. 
A)  decreased respiratory rate. 
B)  increased VT. 
C)  decreased O2 consumption. 
D)  increased muscle activity. D

Question 2

Which of the following conditions may require higher initial respiratory rates?
1) Metabolic alkalosis
2) ARDS
3) Increased intracranial pressure
4) Metabolic acidosis

Accepted Answer

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

Question 3

Inspection of the airway pressure waveform of a patient receiving volume-controlled continuous mandatory ventilation assist-control with constant flow reveals a large dip or drop in pressure at the beginning of inspiration. Which of the following problems is most likely?

Accepted Answer

A)  The trigger setting is improper. 
B)  The inspiratory flow is inadequate. 
C)  The set volume is too large. 
D)  The pressure limit is too low. 
A)  The trigger setting is improper. 
B)  The inspiratory flow is inadequate. 
C)  The set volume is too large. 
D)  The pressure limit is too low. A

Question 4

Which of the following modes of ventilatory support combines the advantages of pressure-controlled and volume-controlled ventilation?

Accepted Answer

A)  Volume-assured pressure-supported ventilation 
B)  Pressure-supported ventilation 
C)  Bilevel positive airway pressure 
D)  Airway pressure-release ventilation 
A)  Volume-assured pressure-supported ventilation 
B)  Pressure-supported ventilation 
C)  Bilevel positive airway pressure 
D)  Airway pressure-release ventilation

Question 5

The increased work of breathing associated with auto-positive end expiratory pressure (PEEP) during mechanical ventilation is due to:
1) Hyperinflation or impaired contractility of the diaphragm.
2) Large alveolar pressure drops required to trigger breaths.
3) Increased volume of the intrathoracic airways.

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 6

Which of the following are considered safe settings for a recruitment maneuver?
1) Pressures up to 50 cm H2O
2) Pressures up to 35 cm H2O
3) Pressures applied for 5 to 10 min
4) Pressures applied for 1 to 3 min

Accepted Answer

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

Question 7

The volume delivered by a pressure-limited ventilator will decrease under which of the following conditions?
1) The patient's lung or thoracic (chest wall) compliance falls.
2) Airway resistance rises (inspiratory time 3 times the time constant).

Accepted Answer

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

Question 8

Which of the following statements are true about negative-pressure ventilation (NPV)?
1) NPV is similar to spontaneous breathing.
2) Airway (mouth) pressure during NPV is zero.
3) Expiration during NPV is by passive recoil.
4) NPV decreases pressure at the body surface.

Accepted Answer

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

Question 9

In which mode of ventilatory support does the patient breathe spontaneously at an elevated airway pressure, with short, intermittent decreases in pressure to a lower level?

Accepted Answer

A)  Volume-assured pressure-supported ventilation 
B)  Pressure-controlled inverse ratio ventilation 
C)  Bilevel positive airway pressure 
D)  Airway pressure-release ventilation 
A)  Volume-assured pressure-supported ventilation 
B)  Pressure-controlled inverse ratio ventilation 
C)  Bilevel positive airway pressure 
D)  Airway pressure-release ventilation

Question 10

Which of the following is considered an acceptable tidal volume for mechanical ventilation?

Accepted Answer

A)  3 to 5 ml/kg 
B)  5 to 7 ml/kg 
C)  4 to 8 ml/kg 
D)  8 to 10 ml/kg 
A)  3 to 5 ml/kg 
B)  5 to 7 ml/kg 
C)  4 to 8 ml/kg 
D)  8 to 10 ml/kg

Question 11

During volume-assured pressure-supported ventilation, the breath will be pressure-limited under what conditions?

Accepted Answer

A)  The delivered tidal volume (VT) is greater than the preset minimum VT. 
B)  The patient's lung or thoracic compliance decreases from the baseline. 
C)  The delivered VT is less than the preset minimum VT. 
D)  The patient's Raw increases from baseline. 
A)  The delivered tidal volume (VT) is greater than the preset minimum VT. 
B)  The patient's lung or thoracic compliance decreases from the baseline. 
C)  The delivered VT is less than the preset minimum VT. 
D)  The patient's Raw increases from baseline.

Question 12

During pressure-controlled continuous mandatory ventilation, when the patient's lung compliance increases, which of the following will occur?

Accepted Answer

A)  The tidal volume will increase. 
B)  The FRC will increase. 
C)  The peak airway pressure will increase. 
D)  The inspiratory time will decrease. 
A)  The tidal volume will increase. 
B)  The FRC will increase. 
C)  The peak airway pressure will increase. 
D)  The inspiratory time will decrease.

Question 13

Which of the following gastrointestinal conditions are commonly associated with long-term positive-pressure ventilation (PPV)?
1) Bleeding
2) Ulceration
3) Diarrhea

Accepted Answer

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

Question 14

Detrimental effects of positive end expiratory pressure (PEEP) include which of the following?
1) Increased incidence of barotrauma
2) Decreased venous return or cardiac output
3) Increased pulmonary vascular resistance
4) Increased CL

Accepted Answer

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

Question 15

All of the following factors would tend to increase mean airway pressure except:

Accepted Answer

A)  short inspiratory times. 
B)  increased mandatory breaths. 
C)  increased levels of positive inspiratory pressure (PIP). 
D)  increased levels of positive end expiratory pressure (PEEP). 
A)  short inspiratory times. 
B)  increased mandatory breaths. 
C)  increased levels of positive inspiratory pressure (PIP). 
D)  increased levels of positive end expiratory pressure (PEEP).

Question 16

What are some physiological advantages of volume-assured pressure-supported ventilation?
1) Improved patient-ventilator synchrony
2) Increased pressure-time product
3) Decreased work of breathing

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 17

Compared with a square wave flow pattern, a decelerating flow waveform has which of the following potential benefits?
1) Reduced peak pressure
2) Improved cardiac output
3) Less inspiratory work
4) Decreased volume of dead space-to-tidal volume ratio (VD/VT)

Accepted Answer

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

Question 18

Which of the following occur with positive-pressure ventilation (PPV)?
1) During inspiration, pleural pressure decreases.
2) During inspiration, pressure in the alveoli increases.
3) The pressure gradients of normal breathing are reversed.
4) During inspiration, alveolar pressure exceeds pleural pressure.

Accepted Answer

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

Question 19

In which of the following patients is positive end expiratory pressure (PEEP) most indicated? FiO2 PaO2

Accepted Answer

A)  0.3 80 mm Hg 
B)  0.5 80 mm Hg 
C)  0.3 50 mm Hg 
D)  0.5 50 mm Hg 
A)  0.3 80 mm Hg 
B)  0.5 80 mm Hg 
C)  0.3 50 mm Hg 
D)  0.5 50 mm Hg

Question 20

Volume-controlled (VC) modes of mechanical ventilation include which of the following?
1) VC continuous mandatory ventilation
2) VC intermittent mandatory ventilation
3) Volume-assured, pressure-controlled
4) Bilevel positive airway pressure

Accepted Answer

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

Exam 46: Physiology of Ventilatory Support

For patients with respiratory insufficiency, pressure-supported ventilation (PSV) has all of the following advantages over spontaneous breathing except:

Which of the following conditions may require higher initial respiratory rates? 1) Metabolic alkalosis 2) ARDS 3) Increased intracranial pressure 4) Metabolic acidosis

Inspection of the airway pressure waveform of a patient receiving volume-controlled continuous mandatory ventilation assist-control with constant flow reveals a large dip or drop in pressure at the beginning of inspiration. Which of the following problems is most likely?

Which of the following modes of ventilatory support combines the advantages of pressure-controlled and volume-controlled ventilation?

Which of the following are considered safe settings for a recruitment maneuver? 1) Pressures up to 50 cm H2O 2) Pressures up to 35 cm H2O 3) Pressures applied for 5 to 10 min 4) Pressures applied for 1 to 3 min

Which of the following statements are true about negative-pressure ventilation (NPV)? 1) NPV is similar to spontaneous breathing. 2) Airway (mouth) pressure during NPV is zero. 3) Expiration during NPV is by passive recoil. 4) NPV decreases pressure at the body surface.

In which mode of ventilatory support does the patient breathe spontaneously at an elevated airway pressure, with short, intermittent decreases in pressure to a lower level?

Which of the following is considered an acceptable tidal volume for mechanical ventilation?

During volume-assured pressure-supported ventilation, the breath will be pressure-limited under what conditions?

During pressure-controlled continuous mandatory ventilation, when the patient's lung compliance increases, which of the following will occur?

Which of the following gastrointestinal conditions are commonly associated with long-term positive-pressure ventilation (PPV)? 1) Bleeding 2) Ulceration 3) Diarrhea

Detrimental effects of positive end expiratory pressure (PEEP) include which of the following? 1) Increased incidence of barotrauma 2) Decreased venous return or cardiac output 3) Increased pulmonary vascular resistance 4) Increased CL

All of the following factors would tend to increase mean airway pressure except:

What are some physiological advantages of volume-assured pressure-supported ventilation? 1) Improved patient-ventilator synchrony 2) Increased pressure-time product 3) Decreased work of breathing

Compared with a square wave flow pattern, a decelerating flow waveform has which of the following potential benefits? 1) Reduced peak pressure 2) Improved cardiac output 3) Less inspiratory work 4) Decreased volume of dead space-to-tidal volume ratio (VD/VT)

In which of the following patients is positive end expiratory pressure (PEEP) most indicated? FiO2 PaO2

Volume-controlled (VC) modes of mechanical ventilation include which of the following? 1) VC continuous mandatory ventilation 2) VC intermittent mandatory ventilation 3) Volume-assured, pressure-controlled 4) Bilevel positive airway pressure

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

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

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 are considered safe settings for a recruitment maneuver? 1) Pressures up to 50 cm H₂O 2) Pressures up to 35 cm H₂O 3) Pressures applied for 5 to 10 min 4) Pressures applied for 1 to 3 min

Detrimental effects of positive end expiratory pressure (PEEP) include which of the following? 1) Increased incidence of barotrauma 2) Decreased venous return or cardiac output 3) Increased pulmonary vascular resistance 4) Increased C_L

Compared with a square wave flow pattern, a decelerating flow waveform has which of the following potential benefits? 1) Reduced peak pressure 2) Improved cardiac output 3) Less inspiratory work 4) Decreased volume of dead space-to-tidal volume ratio (V_D/V_T)

In which of the following patients is positive end expiratory pressure (PEEP) most indicated? FiO₂ PaO₂