Question 1

To prevent muscle fatigue or atrophy, the level of PSV should be adjusted to achieve what work load?

Accepted Answer

A)  0 J/L 
B)  0.6 to 0.8 J/L 
C)  0 to 0.5 J/L 
D)  Greater than 0.8 J/L 
A)  0 J/L 
B)  0.6 to 0.8 J/L 
C)  0 to 0.5 J/L 
D)  Greater than 0.8 J/L

Question 2

The respiratory therapist has been called to place a 70-kg male patient with ARDS on ventilatory support. The physician has requested a respiratory rate of 20/min. Which of the following would be an appropriate VT for this patient?

Accepted Answer

A)  140 ml 
B)  200 ml 
C)  350 ml 
D)  700 ml 
A)  140 ml 
B)  200 ml 
C)  350 ml 
D)  700 ml

Question 3

Which of the following modes of ventilatory support is used to help decrease airway and alveolar pressures?

Accepted Answer

A)  Pressure-controlled continuous mandatory ventilation 
B)  Pressure-controlled intermittent mandatory ventilation 
C)  Volume-controlled continuous mandatory ventilation 
D)  Volume-assured pressure-supported ventilation 
A)  Pressure-controlled continuous mandatory ventilation 
B)  Pressure-controlled intermittent mandatory ventilation 
C)  Volume-controlled continuous mandatory ventilation 
D)  Volume-assured pressure-supported ventilation

Question 4

What patients are at greatest risk for auto-PEEP?
1) Those supported by spontaneous breath modes
2) Those with high airway resistance
3) Those with high expiratory flow resistance

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 5

What are some primary uses for pressure-supported ventilation (PSV)?
1) Recruiting collapsed alveoli and improving oxygenation
2) Augmenting patient's spontaneous VT
3) Overcoming the imposed 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 6

Which of the following are potential effects of positive-pressure ventilation on the cardiovascular system?
1) Decreased venous return
2) Decreased cranial perfusion pressures
3) Increased pulmonary blood flow
4) Decreased ventricular stroke volume

Accepted Answer

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

Question 7

Which of the following is the best explanation for the decreased levels of atrial natriuretic hormone commonly observed among patients receiving positive-pressure ventilation?

Accepted Answer

A)  Stimulation of the pulmonary stretch receptors 
B)  Inhibition of posterior pituitary function 
C)  Inhibition of the cortex of the adrenal gland 
D)  Decreased right atrial transmural pressure 
A)  Stimulation of the pulmonary stretch receptors 
B)  Inhibition of posterior pituitary function 
C)  Inhibition of the cortex of the adrenal gland 
D)  Decreased right atrial transmural pressure

Question 8

What factor primarily determines the effect of positive-pressure ventilation (PPV) on the cardiac output?

Accepted Answer

A)  Peak airway pressure 
B)  Mean pleural pressure 
C)  CO2 
D)  Expiratory time 
A)  Peak airway pressure 
B)  Mean pleural pressure 
C)  CO2 
D)  Expiratory time

Question 9

What is traumatic injury to lung tissue caused by excessive pressure called?

Accepted Answer

A)  Pulmonary barotrauma 
B)  Pulmonary hemorrhage 
C)  Pulmonary infarction 
D)  Pulmonary embolism 
A)  Pulmonary barotrauma 
B)  Pulmonary hemorrhage 
C)  Pulmonary infarction 
D)  Pulmonary embolism

Question 10

During volume-assured pressure-supported ventilation, if the desired VT is not reached or exceeded at the preset pressure support level, what happens?

Accepted Answer

A)  Flow continues at a constant rate until the desired volume is achieved. 
B)  The breath terminates when a predetermined low flow is achieved. 
C)  Flow decreases exponentially until the desired volume is achieved. 
D)  Flow increases linearly until the desired volume is achieved. 
A)  Flow continues at a constant rate until the desired volume is achieved. 
B)  The breath terminates when a predetermined low flow is achieved. 
C)  Flow decreases exponentially until the desired volume is achieved. 
D)  Flow increases linearly until the desired volume is achieved.

Question 11

Hyperventilation should generally be avoided during mechanical ventilatory support. Exceptions to this rule include:
1) Trying to calm an agitated patient.
2) Failure of other methods to reduce intracranial pressure.
3) Hypokalemia causing cardiac arrhythmias.

Accepted Answer

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

Question 12

Contraindications for using positive end expiratory pressure (PEEP) in conjunction with mechanical ventilation include which of the following?
1) Untreated bronchopleural fistula
2) Chronic airway obstruction
3) Untreated pneumothorax

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 13

Which of the following variables determine the level of support achieved with adaptive support ventilation?
1) Patient effort
2) Elastance
3) Resistance of the endotracheal tube

Accepted Answer

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

Question 14

Which of the following mechanisms explains the hepatic dysfunction in patients receiving positive-pressure ventilation (PPV)?

Accepted Answer

A)  Decreased hepatic blood flow 
B)  Increased portal venous pressure 
C)  Hepatic congestion 
D)  Increased bilirubin conjugation 
A)  Decreased hepatic blood flow 
B)  Increased portal venous pressure 
C)  Hepatic congestion 
D)  Increased bilirubin conjugation

Question 15

What spontaneous pressure-controlled breath mode allows separate regulation of the inspiratory and expiratory pressures?

Accepted Answer

A)  Bilevel positive airway pressure 
B)  Continuous positive airway pressure 
C)  Pressure-supported ventilation 
D)  Pressure-controlled intermittent mandatory ventilation 
A)  Bilevel positive airway pressure 
B)  Continuous positive airway pressure 
C)  Pressure-supported ventilation 
D)  Pressure-controlled intermittent mandatory ventilation

Question 16

When bedside work of breathing measures are unavailable, you should adjust the level of pressure-supported ventilation (PSV) to which of the following breathing patterns? Spontaneous Rate VT

Accepted Answer

A)  20 breaths/min 6 ml/kg 
B)  27 breaths/min 9 ml/kg 
C)  22 breaths/min 4 ml/kg 
D)  10 breaths/min 9 ml/kg 
A)  20 breaths/min 6 ml/kg 
B)  27 breaths/min 9 ml/kg 
C)  22 breaths/min 4 ml/kg 
D)  10 breaths/min 9 ml/kg

Question 17

What mode of pressure-controlled ventilation is designed to prevent alveoli with short-time constants from collapsing, thereby improving oxygenation?

Accepted Answer

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

Question 18

A patient switched from pressure-controlled continuous mandatory ventilation (CMV) with positive end expiratory pressure (PEEP) to pressure-controlled inverse ratio ventilation (PC-IRV) shows a good improvement in PaO2 but a decrease in tissue oxygenation. Which of the following best explains this observation?

Accepted Answer

A)  High mean pressures caused by PC-IRV decreased pulmonary blood flow. 
B)  Intrinsic PEEP caused by PC-IRV resulted in increased alveolar recruitment. 
C)  High mean pressures caused by PC-IRV decreased cardiac output. 
D)  Intrinsic PEEP caused by PC-IRV compressed the pulmonary capillaries. 
A)  High mean pressures caused by PC-IRV decreased pulmonary blood flow. 
B)  Intrinsic PEEP caused by PC-IRV resulted in increased alveolar recruitment. 
C)  High mean pressures caused by PC-IRV decreased cardiac output. 
D)  Intrinsic PEEP caused by PC-IRV compressed the pulmonary capillaries.

Question 19

Ventilatory support strategies likely to result in auto-positive end expiratory pressure (PEEP) include which of the following?
1) Continuous mandatory ventilation (CMV) assist-control
2) Inverse ratio ventilation (IRV)
3) Low-rate intermittent mandatory ventilation
4) Low inspiratory flows

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 20

Which of the following modes of support provides all of the patient's minute ventilation (VE) as mandatory volume-controlled (VC) breaths?

Accepted Answer

A)  VC continuous mandatory ventilation 
B)  VC intermittent mandatory ventilation 
C)  Pressure-supported ventilation 
D)  Continuous positive airway pressure 
A)  VC continuous mandatory ventilation 
B)  VC intermittent mandatory ventilation 
C)  Pressure-supported ventilation 
D)  Continuous positive airway pressure

Exam 46: Physiology of Ventilatory Support

To prevent muscle fatigue or atrophy, the level of PSV should be adjusted to achieve what work load?

The respiratory therapist has been called to place a 70-kg male patient with ARDS on ventilatory support. The physician has requested a respiratory rate of 20/min. Which of the following would be an appropriate VT for this patient?

Which of the following modes of ventilatory support is used to help decrease airway and alveolar pressures?

What patients are at greatest risk for auto-PEEP? 1) Those supported by spontaneous breath modes 2) Those with high airway resistance 3) Those with high expiratory flow resistance

What are some primary uses for pressure-supported ventilation (PSV)? 1) Recruiting collapsed alveoli and improving oxygenation 2) Augmenting patient's spontaneous VT 3) Overcoming the imposed work of breathing

Which of the following are potential effects of positive-pressure ventilation on the cardiovascular system? 1) Decreased venous return 2) Decreased cranial perfusion pressures 3) Increased pulmonary blood flow 4) Decreased ventricular stroke volume

Which of the following is the best explanation for the decreased levels of atrial natriuretic hormone commonly observed among patients receiving positive-pressure ventilation?

What factor primarily determines the effect of positive-pressure ventilation (PPV) on the cardiac output?

What is traumatic injury to lung tissue caused by excessive pressure called?

During volume-assured pressure-supported ventilation, if the desired VT is not reached or exceeded at the preset pressure support level, what happens?

Hyperventilation should generally be avoided during mechanical ventilatory support. Exceptions to this rule include: 1) Trying to calm an agitated patient. 2) Failure of other methods to reduce intracranial pressure. 3) Hypokalemia causing cardiac arrhythmias.

Contraindications for using positive end expiratory pressure (PEEP) in conjunction with mechanical ventilation include which of the following? 1) Untreated bronchopleural fistula 2) Chronic airway obstruction 3) Untreated pneumothorax

Which of the following variables determine the level of support achieved with adaptive support ventilation? 1) Patient effort 2) Elastance 3) Resistance of the endotracheal tube

Which of the following mechanisms explains the hepatic dysfunction in patients receiving positive-pressure ventilation (PPV)?

What spontaneous pressure-controlled breath mode allows separate regulation of the inspiratory and expiratory pressures?

When bedside work of breathing measures are unavailable, you should adjust the level of pressure-supported ventilation (PSV) to which of the following breathing patterns? Spontaneous Rate VT

What mode of pressure-controlled ventilation is designed to prevent alveoli with short-time constants from collapsing, thereby improving oxygenation?

Ventilatory support strategies likely to result in auto-positive end expiratory pressure (PEEP) include which of the following? 1) Continuous mandatory ventilation (CMV) assist-control 2) Inverse ratio ventilation (IRV) 3) Low-rate intermittent mandatory ventilation 4) Low inspiratory flows

Which of the following modes of support provides all of the patient's minute ventilation (VE) as mandatory volume-controlled (VC) breaths?

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

What are some primary uses for pressure-supported ventilation (PSV)? 1) Recruiting collapsed alveoli and improving oxygenation 2) Augmenting patient's spontaneous V_T 3) Overcoming the imposed work of breathing

During volume-assured pressure-supported ventilation, if the desired V_T is not reached or exceeded at the preset pressure support level, what happens?

When bedside work of breathing measures are unavailable, you should adjust the level of pressure-supported ventilation (PSV) to which of the following breathing patterns? Spontaneous Rate V_T

Which of the following modes of support provides all of the patient's minute ventilation (V_E) as mandatory volume-controlled (VC) breaths?