Mechanical Ventilation

Question 1

T/F: Lung compliance is typically reflected in lower airway pressures.

Answer 1

True

Question 2

Which of the following is an extrinsic factor that will affect resistance?

a) Airway diameter
b) Endotracheal tube size and length
c) Bronchospasms
d) Secretions

Answer 2

b) Endotracheal tube size and length

Question 3

Your patient is being mechanically ventilated. The patient receives a consistent 14 breaths per minute. This is an example of what type of mechanical ventilation?

Answer 3

Time triggered breath

Question 4

This ventilator mode delivers a preset pressure of gas to the lungs over a given amount of time.

Answer 4

Pressure Cycled aka Pressure Controlled

Question 5

What is a particularly important variable to monitor when a patient is being ventilated using volume cycled mode?

Answer 5

Plateau pressure. A high plateau pressure can result in barotrauma.

Question 6

What is a particularly important variable to monitor when a patient is being ventilated using pressure cycled mode

Answer 6

Tidal volume delivered or exhaled tidal volume since the tidal volume varies breath-to-breath.

Question 7

T/F: In pressure cycled mode, the tidal volume is set and does not vary breath-to-breath.

Answer 7

False

Question 8

What ventilator mode is best suited for long-term ventilatory support?

Answer 8

Volume mode

Question 9

T/F: CPAP is a true mode of ventilation because it provides additional pressure during inspiration.

Answer 9

False

Question 10

T/F: NIPPV typically reduces the need for sedation and medication assisted intubations.

Answer 10

True

Question 11

This ventilation mode delivers a preset volume or pressure at a preset rate. The patient may take additional breaths of any tidal volume without interference from the mandatory breaths.

Answer 11

Synchronized Intermittent Mandatory Ventilation (SIMV)

Question 12

This ventilation mode delivers a preset volume or preset pressure that is delivered at a preset rate. The patient has no active role in the ventilatory cycle and is “locked out” from triggering a breath.

Answer 12

Control (Controlled Mandatory Ventilation) aka CMV

Question 13

This ventilation mode applies a constant pressure throughout inspiration, and the ventilator makes pressure adjustments based on patient airway resistance and respiratory system compliance.

Answer 13

Pressure Regulated Volume Controlled (PRVC)

Question 14

This ventilation mode delivers a preset volume or pressure for the patient based on their inspiratory effort. If the patient fails to take a breath, the ventilator will administer a breath at a preset volume or pressure.

Answer 14

Assist Control (AC)

Question 15

If a patient is breathing spontaneously, should the Controlled Mandatory Ventilation mode be used on their ventilator?

Answer 15

No, it will cause patient discomfort as they “fight” the ventilator.

Question 16

In this ventilator mode, the ventilator can adjust pressure from breath-to-breath in order to deliver a preset tidal volume. (If the delivered volume was too low on the previous breath, the ventilator will increase the pressure for the next breath.)

Answer 16

Pressure Regulated Volume Controlled (PRVC)

Question 17

T/F: Spontaneous breaths will trigger a ventilator cycle in SIMV mode.

Answer 17

False

Question 18

What ventilator mode is typically best for weaning a patient off of the ventilator?

Answer 18

Synchronized Intermittent Mandatory Ventilation (SIMV)

Question 19

T/F: You are transporting a patient who is being ventilated with an inverse ratio ventilation (IRV). You would expect this patient to have decreased cardiac output.

Answer 19

True

Question 20

You have been asked to place a patient on 70% oxygen concentration. What is the correct FiO2 number?

Answer 20

0.7

Question 21

What is the typical weight-based range for tidal volume?

Answer 21

6 - 10 mL/kg

Question 22

What is the typical I:E ratio?

Answer 22

1:2

Question 23

On the ventilator, what setting helps prevent alveolar collapse and increases alveolar gas exchange?

Answer 23

PEEP

Question 24

What is the typical initial PEEP setting?

Answer 24

5 cmH2O

Question 25

You are setting the “sigh” function on the ventilator. This is a volume that is ________ times the inspired tidal volume.

Answer 25

1.5 - 2

Question 26

T/F: Positive-pressure ventilation van induce hypotension.

Answer 26

True

Question 27

What are the three classical signs and symptoms of oxygen toxicity?

Answer 27

1) V/Q mismatch
2) Diffuse pulmonary infiltrates on chest x-ray
3) Falling oxygen saturations

Question 28

What does the mnemonic “DOPE” (that is used to troubleshoot airway problems in an intubated patient) stand for?

Answer 28

Displaced ET-tube
Obstructions (secretions, biting the tube, etc.)
Pneumothorax
Equipment

Question 29

You are transporting a patient on a ventilator. You see an alarm indicating “circuit tube disconnect”. It appears the circuitry is hooked up appropriately, however the alarm continues. What should you do?

Answer 29

Ensure the circuitry is connected, and then increase the rate and volume.

Question 30

You observe a low pressure alarm on the ventilator. What is the most common cause of this alarm?

Answer 30

Patient was accidentally disconnected from the ventilator.

Question 31

What condition could develop that would cause a sudden increased peak airway pressure in a ventilated patient?

Answer 31

tension pneumothorax

Question 32

T/F: A displaced ET-tube could cause a decrease in peak airway pressures.

Answer 32

True

Question 33

T/F: Tidal volume is fixed in the pressure cycled ventilator mode.

Answer 33

False