Question 1

Hypoventilation is a condition that results in a(n):

Accepted Answer

A)   decrease in pH.
B)   decrease in PaO2.
C)   increase in PaCO2.
D)   increase in cardiac output. C

Question 2

Refractory hypoxemia is usually caused by:

Accepted Answer

A)   intrapulmonary shunting.
B)   hypoventilation.
C)   cardiac arrest.
D)   dead space ventilation. A

Question 3

Conditions leading to mechanical ventilation may include all of the following except:

Accepted Answer

A)   excessive ventilatory workload.
B)   gas exchange abnormalities.
C)   eucapnic respiratory drive.
D)   failure of the ventilatory pump. C

Question 4

During mechanical ventilation, one method to evaluate compliance change is to use the:

Accepted Answer

A)   volume-time waveform.
B)   pressure-time waveform.
C)   pressure-volume waveform.
D)   flow-volume waveform.

Question 5

Ventilatory failure develops when the patient's minute alveolar ventilation cannot keep up with the:

Accepted Answer

A)   oxygen consumption.
B)   carbon dioxide production.
C)   acid-base balance.
D)   pulmonary perfusion.

Question 6

A higher than normal lung compliance is often seen in patients with:

Accepted Answer

A)   tension pneumothorax.
B)   acute respiratory distress syndrome.
C)   emphysema.
D)   atelectasis.

Question 7

Gas exchange abnormalities may be caused by which of the following conditions?

Accepted Answer

A)   V̇/Q̇ mismatch, diffusion defects, shunting
B)   V̇/Q̇ mismatch, hypoventilation, diffusion defects, shunting
C)   Hypoventilation, diffusion defects, shunting
D)   V̇/Q̇ mismatch, hypoventilation, shunting

Question 8

Which of the following pressure changes is consistent with atelectasis?

Accepted Answer

A)   Increase in Pplat, increase in PIP
B)   Decrease in Pplat, decrease in PIP
C)   No change in Pplat, increase in PIP
D)   No change in Pplat, decrease in PIP

Question 9

During mechanical ventilation, the flow is paused momentarily at end inspiration. This maneuver is done to:

Accepted Answer

A)   evaluate a patient's lung compliance.
B)   evaluate a patient's airway resistance.
C)   obtain the peak inspiratory pressure.
D)   obtain the dynamic compliance.

Question 10

For mechanically ventilated patients, pressure support ventilation (PSV) is useful to compensate for the increased work of breathing due to:

Accepted Answer

A)   airflow resistance.
B)   compliance.
C)   respiratory muscle fatigue.
D)   ventilation/perfusion mismatch.

Question 11

A decrease of the peak inspiratory pressure-plateau pressure (PIP-Pplat) gradient implies that the

Accepted Answer

A)   airflow resistance has increased.
B)   airflow resistance has decreased.
C)   total compliance has increased.
D)   total compliance has decreased.

Question 12

What does the pressure gradient (ΔP) represent in the compliance (C = ∆V/∆P) and airway resistance (R = ΔP/V̇) equations?

Accepted Answer

A)   Peak inspiratory pressure
B)   Oxygen consumption
C)   Work of breathing
D)   Metabolic rate

Question 13

A rapid shallow breathing pattern leads to V̇/Q̇ mismatch due to a(n):

Accepted Answer

A)   decrease in lung compliance.
B)   increase in airflow resistance.
C)   decrease in cardiac output.
D)   increase in dead space ventilation.

Question 14

The equation corrected tidal volume/(peak inspiratory pressure − PEEP) is used to calculate the patient's:

Accepted Answer

A)   static compliance.
B)   dynamic compliance.
C)   airway resistance.
D)   transpulmonary pressure.

Question 15

A mechanically ventilated patient has shown significant clinical improvement. The lung consolidation and bronchospasm are almost completely resolved. Which of the following demonstrates the patient's improvement?

Accepted Answer

A)   Decrease in Pplat, large decrease in PIP
B)   No change in Pplat, decrease in PIP
C)   Increase in Pplat, large increase in PIP
D)   Decrease in Pplat, increase in PIP

Question 16

Airway resistance is an important concept in mechanical ventilation, because when the airway radius is reduced by 50% airflow resistance increases by:

Accepted Answer

A)   2 times.
B)   4 times.
C)   8 times.
D)   16 times.

Question 17

During volume-controlled ventilation, a patient's peak inspiratory pressure has been increasing over the past 8 hours. What is the cause of this change?

Accepted Answer

A)   Increasing airflow resistance or decreasing compliance
B)   Decreasing airflow resistance or increasing compliance
C)   Increasing airflow resistance
D)   Decreasing compliance

Question 18

Which of the following factors at the alveolocapillary membrane affect the gas diffusion rate?

Accepted Answer

A)   Capillary flow, surface area, gas pressure gradient
B)   Thickness, capillary flow, surface area
C)   Thickness, surface area, gas pressure gradient
D)   Thickness, capillary flow, surface area, gas pressure gradient

Question 19

A patient arrives at the emergency department with complaint of shortness of breath. She also shows cyanosis, diminished sensorium, bradycardia, and hypotension. Based on this information, the patient is most likely to have:

Accepted Answer

A)   a mental disorder.
B)   hypoxia.
C)   hyperventilation.
D)   COPD.

Question 20

During volume-controlled ventilation, a patient's plateau pressure has been increasing over the past 3 hours. This is indicative of:

Accepted Answer

A)   increasing airflow resistance.
B)   decreasing airflow resistance.
C)   increasing compliance.
D)   decreasing compliance.

Exam 1: Principles of Mechanical Ventilation

Hypoventilation is a condition that results in a(n) :