Exam 52: Discontinuing Ventilatory Support

Common causes for weaning failure include which of the following? 1. Myocardial ischemia 2. Critical illness polyneuropathy 3. Psychological dependence 4. Secondary polycythemia

In considering a patient for extubation, which of the following would you recommend to minimize the risk of postextubation aspiration?

Which method of weaning may be useful to minimize auto-PEEP?

What are some advantages of mandatory minute ventilation (MMV) as a weaning tool? 1) It provides greater control over PaCO₂ than intermittent mandatory ventilation does. 2) It prevents acidemia with acute hypoventilation. 3) It eliminates concerns over depressant drugs. 4) It ensures an efficient pattern of ventilation.

Which of the following signs observed on a mechanically ventilated patient indicate that successful weaning is unlikely? 1) Palpable scalene muscle use during inspiration 2) Palpable abdominal tensing during expiration 3) Presence of an irregular breathing pattern 4) Patient unable to alter breathing pattern on command

You measure the spontaneous rate of breathing and V_T on four patients receiving ventilator support. For which one is successful weaning most likely? Breathing frequency V_T

In considering a patient for endotracheal tube extubation, which of the following procedures would you recommend to determine the risk of postextubation upper airway obstruction?

Ventilatory capacity is determined by which of the following? 1) Central nervous system (CNS) drive 2) Trigger level 3) Muscle strength 4) Muscle endurance

Which of the following is false about artificial tracheal airways and weaning?

A patient has an adequate ventilatory reserve if which of the following is true?

Which of the following weaning methods provides the best respiratory muscle strength conditioning?

Which of the following ventilator modes can ensure delivery of a preset V_T during spontaneous breathing? 1) Volume support 2) Volume-assured pressure support 3) Mandatory minute ventilation

Which of the following four adult patients receiving ventilatory support is the best candidate for weaning? VC V_E MVV MIF V_D/V_T

Advantages of adding continuous positive airway pressure (CPAP) to T tube weaning include which of the following? 1) Improved blood oxygenation 2) Decreased work of breathing 3) Compensation for auto-PEEP 4) Faster weaning or extubation

Which of the following patients exhibits an acceptable ventilatory demand? V_E PaCO₂

An alert patient receiving intermittent mandatory ventilation at a rate of 8/min and V_T of 600 ml has stable vital signs and satisfactory blood gases on an FiO₂ of 0.45. What would you do to initiate weaning for this patient?

While monitoring a patient during a T tube weaning trial, you notice the following: increased patient agitation; increased heart rate (from 90 to 118/min); increased respiratory rate (from 17 to 33/min with some paradoxical motion); and premature ventricular contractions (PVCs) increasing to an average of 5/min. Which of the following actions would be appropriate at this time?

In most weaning protocols, what minimum blood gas parameters are needed to start the process?

Which of the following factors can reduce a patient's ventilatory drive? 1) Respiratory alkalosis 2) Metabolic acidosis 3) Depressant drugs 4) Decreased metabolism

When is ventilator dependence likely to occur? 1) When ventilatory capacity exceeds demand 2) When arterial hypoxemia is present 3) When the patient is malnourished 4) When the cardiovascular system is unstable