Question 1

Which of the following therapies should be considered as first line of therapy in patients with exacerbation of chronic obstructive pulmonary disease (COPD)?

Accepted Answer

A)  Noninvasive ventilation (NIV) 
B)  Mechanical ventilation 
C)  High-flow nasal cannula 
D)  Systemic steroids 
A)  Noninvasive ventilation (NIV) 
B)  Mechanical ventilation 
C)  High-flow nasal cannula 
D)  Systemic steroids A

Question 2

Which of the following interfaces appear to be more efficient to improve ventilation?
1) Nasal pillows
2) Full-face mask
3) Nasal mask
4) Oral mask

Accepted Answer

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

Question 3

How does noninvasive ventilation (NIV) benefit the patient with restrictive thoracic disease?
1) It rests the respiratory muscles.
2) It lowers the PaCO2.
3) It improves lung compliance.
4) It improves pulmonary function testing.

Accepted Answer

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

Question 4

Your patient is being ventilated with a nasal mask to relieve dyspnea. He has a long history of chronic obstructive pulmonary disease and hypercarbia. What is the goal of noninvasive ventilation in this setting with regard to the ABGs?

Accepted Answer

A)  Return the PaCO2 to 40 to 45 mm Hg. 
B)  Return the pH to near normal. 
C)  Return the PaCO2 to less than 60 mm Hg. 
D)  Return the bicarbonate level to near normal. 
A)  Return the PaCO2 to 40 to 45 mm Hg. 
B)  Return the pH to near normal. 
C)  Return the PaCO2 to less than 60 mm Hg. 
D)  Return the bicarbonate level to near normal.

Question 5

What is the best option for the patient in respiratory failure who continues to deteriorate 30 min after the initiation of noninvasive ventilation?

Accepted Answer

A)  Wait another 30 min and monitor the patient. 
B)  Begin continuous positive airway pressure. 
C)  Intubate and begin mechanical ventilation. 
D)  Ventilate the patient using a bag-valve-mask. 
A)  Wait another 30 min and monitor the patient. 
B)  Begin continuous positive airway pressure. 
C)  Intubate and begin mechanical ventilation. 
D)  Ventilate the patient using a bag-valve-mask.

Question 6

Which of the following is/are the minimum performing characteristics of most noninvasive ventilators?
1) Mandatory rate of 50 breaths/min or less
2) Inspiratory pressure of 30 cm H2O or less
3) PEEP of 15 cm H2O or less
4) Inspiratory flow of 180 L/min or less at 20 cm H2O

Accepted Answer

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

Question 7

Initiating noninvasive ventilation (NIV) can be done in which of the following settings?
1) Emergency department
2) Intensive care unit
3) Hospital ward
4) Nursing home

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 8

Your patient has acute pulmonary edema from left heart failure. Which therapy should be tried first?

Accepted Answer

A)  Noninvasive ventilation (NIV) 
B)  Continuous positive airway pressure (CPAP) 
C)  Mechanical ventilation 
D)  Positive end-expiratory pressure 
A)  Noninvasive ventilation (NIV) 
B)  Continuous positive airway pressure (CPAP) 
C)  Mechanical ventilation 
D)  Positive end-expiratory pressure

Question 9

Which of the following is likely to occur when decreasing the expiratory positive airway pressure in the patient being ventilated using noninvasive ventilation?

Accepted Answer

A)  Improved PaO2 
B)  Increased functional residual capacity 
C)  Increased tidal volume 
D)  Increased inspiratory positive airway pressure 
A)  Improved PaO2 
B)  Increased functional residual capacity 
C)  Increased tidal volume 
D)  Increased inspiratory positive airway pressure

Question 10

Which of the following is required for noninvasive ventilators to work properly?

Accepted Answer

A)  Exhalation valve 
B)  Pressure alarm 
C)  Leak 
D)  Blender 
A)  Exhalation valve 
B)  Pressure alarm 
C)  Leak 
D)  Blender

Question 11

Which of the following findings are exclusion criteria for using noninvasive ventilation (NIV) in the patient with acute respiratory failure?
1) Apnea
2) Hemodynamic or cardiac instability
3) Low risk of aspiration
4) Lack of cooperation by the patient

Accepted Answer

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

Question 12

What physiologic effect will raising the expiratory positive airway pressure have in the patient receiving noninvasive ventilation?

Accepted Answer

A)  Increase the functional residual capacity. 
B)  Increase the tidal volume. 
C)  Decrease the PCO2. 
D)  Lower the mean airway pressure. 
A)  Increase the functional residual capacity. 
B)  Increase the tidal volume. 
C)  Decrease the PCO2. 
D)  Lower the mean airway pressure.

Question 13

Which of the following is the most important advantage of noninvasive ventilators over other types of ventilators?

Accepted Answer

A)  Cost 
B)  Ability to trigger and cycle appropriately when small-to-moderate air leaks are present 
C)  Ability to remove CO2 
D)  Ability to oxygenate 
A)  Cost 
B)  Ability to trigger and cycle appropriately when small-to-moderate air leaks are present 
C)  Ability to remove CO2 
D)  Ability to oxygenate

Question 14

Which of the following indications for noninvasive ventilation (NIV) is where the greatest controversy exists?

Accepted Answer

A)  Chronic obstructive pulmonary disease 
B)  Pneumonia 
C)  Hypoxemic respiratory failure 
D)  Nocturnal hypoventilation 
A)  Chronic obstructive pulmonary disease 
B)  Pneumonia 
C)  Hypoxemic respiratory failure 
D)  Nocturnal hypoventilation

Question 15

Which of the following define successful application of noninvasive ventilation (NIV)?
1) Overall improvement of patient's blood gas
2) Normal blood gas
3) PaO2 increased
4) PaCO2 decreased

Accepted Answer

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

Question 16

Which of the following devices is considered to be the first electrically powered negative-pressure ventilator?

Accepted Answer

A)  The Bird 
B)  The iron lung 
C)  The chest cuirass 
D)  The rocking bed 
A)  The Bird 
B)  The iron lung 
C)  The chest cuirass 
D)  The rocking bed

Question 17

Which of the following are indications to use noninvasive ventilation (NIV) in patients who have chronic obstructive pulmonary disease (COPD) with nocturnal hypoventilation?
1) PaCO2 greater than 55 mm Hg
2) More than two hospitalizations related to hypercapnic respiratory failure
3) PaCO2 greater than 65 mm Hg
4) PaCO2 between 50 and 54 mm Hg with nocturnal desaturation

Accepted Answer

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

Question 18

Which of the following groups of patients with nocturnal hypoventilation respond to noninvasive ventilation (NIV)?

Accepted Answer

A)  Hypoxic 
B)  Hypercapnic 
C)  Acidotic 
D)  Hypocapnic 
A)  Hypoxic 
B)  Hypercapnic 
C)  Acidotic 
D)  Hypocapnic

Question 19

Which of the following are contraindications for the use of noninvasive ventilation (NIV)?
1) Nonsupportive family
2) Lack of financial resources
3) Copious amounts of secretions
4) Uncooperative behavior on the part of the patient

Accepted Answer

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

Question 20

What strategy should be used when the patient complains of nasal congestion during the use of a nasal mask for noninvasive ventilation (NIV)?

Accepted Answer

A)  Switch to an oral mask. 
B)  Switch to a face mask. 
C)  Add a heated humidifier. 
D)  Reduce the inspiratory flow. 
A)  Switch to an oral mask. 
B)  Switch to a face mask. 
C)  Add a heated humidifier. 
D)  Reduce the inspiratory flow.

Exam 49: Noninvasive Ventilation

Which of the following therapies should be considered as first line of therapy in patients with exacerbation of chronic obstructive pulmonary disease (COPD)?

Which of the following interfaces appear to be more efficient to improve ventilation? 1) Nasal pillows 2) Full-face mask 3) Nasal mask 4) Oral mask

How does noninvasive ventilation (NIV) benefit the patient with restrictive thoracic disease? 1) It rests the respiratory muscles. 2) It lowers the PaCO2. 3) It improves lung compliance. 4) It improves pulmonary function testing.

Your patient is being ventilated with a nasal mask to relieve dyspnea. He has a long history of chronic obstructive pulmonary disease and hypercarbia. What is the goal of noninvasive ventilation in this setting with regard to the ABGs?

What is the best option for the patient in respiratory failure who continues to deteriorate 30 min after the initiation of noninvasive ventilation?

Which of the following is/are the minimum performing characteristics of most noninvasive ventilators? 1) Mandatory rate of 50 breaths/min or less 2) Inspiratory pressure of 30 cm H2O or less 3) PEEP of 15 cm H2O or less 4) Inspiratory flow of 180 L/min or less at 20 cm H2O

Initiating noninvasive ventilation (NIV) can be done in which of the following settings? 1) Emergency department 2) Intensive care unit 3) Hospital ward 4) Nursing home

Your patient has acute pulmonary edema from left heart failure. Which therapy should be tried first?

Which of the following is likely to occur when decreasing the expiratory positive airway pressure in the patient being ventilated using noninvasive ventilation?

Which of the following is required for noninvasive ventilators to work properly?

Which of the following findings are exclusion criteria for using noninvasive ventilation (NIV) in the patient with acute respiratory failure? 1) Apnea 2) Hemodynamic or cardiac instability 3) Low risk of aspiration 4) Lack of cooperation by the patient

What physiologic effect will raising the expiratory positive airway pressure have in the patient receiving noninvasive ventilation?

Which of the following is the most important advantage of noninvasive ventilators over other types of ventilators?

Which of the following indications for noninvasive ventilation (NIV) is where the greatest controversy exists?

Which of the following define successful application of noninvasive ventilation (NIV)? 1) Overall improvement of patient's blood gas 2) Normal blood gas 3) PaO2 increased 4) PaCO2 decreased

Which of the following devices is considered to be the first electrically powered negative-pressure ventilator?

Which of the following groups of patients with nocturnal hypoventilation respond to noninvasive ventilation (NIV)?

Which of the following are contraindications for the use of noninvasive ventilation (NIV)? 1) Nonsupportive family 2) Lack of financial resources 3) Copious amounts of secretions 4) Uncooperative behavior on the part of the patient

What strategy should be used when the patient complains of nasal congestion during the use of a nasal mask for noninvasive ventilation (NIV)?

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

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

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

How does noninvasive ventilation (NIV) benefit the patient with restrictive thoracic disease? 1) It rests the respiratory muscles. 2) It lowers the PaCO_2. 3) It improves lung compliance. 4) It improves pulmonary function testing.

Which of the following is/are the minimum performing characteristics of most noninvasive ventilators? 1) Mandatory rate of 50 breaths/min or less 2) Inspiratory pressure of 30 cm H₂O or less 3) PEEP of 15 cm H₂O or less 4) Inspiratory flow of 180 L/min or less at 20 cm H₂O

Which of the following define successful application of noninvasive ventilation (NIV)? 1) Overall improvement of patient's blood gas 2) Normal blood gas 3) PaO₂ increased 4) PaCO₂ decreased