NIPPV REVIEW QUESTIONS

Question 1

NIV Has just been initiated on a patient in respiratory distress with an IPAP pressure of 12 cmH2O & an EPAP pressure of 5 cm H2O. Which of the following would indicate clinical improvement of the patient’s condition?
1. Increased respiratory rate
2. Synchronization with the ventilator
3. Decrease inspiratory muscle activity
4. Decreased SaO2

Answer 1

2. Synchronization with a Ventilator
3. Decrease inspiratory muscle activity

Question 2

Which of the following patients would not be a good candidate for nasal - mask NIV.

A. A patient with a pH of 7.34
B. A patient with stable COPD and OSA
C. A patient with an absent cough reflex
D. The patient requires nocturnal NIV only.

Answer 2

C. A patient with an absent cough reflex

Question 3

A patient has been on nasal- mask NIV for almost 24 hrs. The patient is now complaining of nasal congestion and a dry mouth. Which of the following would you recommend?
A. Reduce the inspiratory flow
B. Change to a full -face mask
C. Begin in line aerosol treatments
D. Add a heated humidifier

Answer 3

D. Add a heated humidifier

Question 4

The patient may benefit from the nocturnal application of NIV if which of the following symptoms is present?
1. Morning headaches
2. Daytime hypersomnolence
3. Aching and stiff joints
4. Nocturnal desaturation

Answer 4

1. Morning headaches
2. Daytime hypersomnolence
3. Nocturnal desaturation

Question 5

A patient has been on an IV with the nasal mask for the past hour. The patient is still experiencing significant leaking around the mask. Which of the following would be the most appropriate action to take at this time?
A. Change to a full-mask
B. Tighten ahead straps
C. Intubate and begin invasive mechanical ventilation
D. Add heated humidifier to the circuit

Answer 5

A. Change to a full-mask

Question 6

The best way to prevent aspiration during NIV is to:
A. Insert a nasogastric tube before NIV application
B. Use only a nasal mask for application
C. Adhere to proper selection guidelines
D. Use delivery pressures less than 10 cm H2O

Answer 6

C. Adhere to proper selection guidelines

Question 7

Which of the following are reported to be advantages using a portable pressure-target ventilator and the delivery of NIV?
1. Variable flow delivery capabilities
2. Leak compensation
3. Adjustable inspiratory and expiratory sensitivity
4. Sophisticated alarm systems

Answer 7

1. Variable flow delivery capabilities
2. Leak compensation
3. Adjustable inspiratory and expiratory sensitivity

Question 8

Which of the following will result in the lowest FiO2 during the administration of NIV when O2 is bled into the circuit of a portable pressure-target in a litter?
A. Bleeding 02 into the mask when the leak port is located in the mask
B. Bleeding O2 into the mask when the leak port is located in the circuit.
C. Bleeding O2 into the circuit when the leak port is located in the circuit.
D. Bleeding O2 into the circuit and sealing the leak.

Answer 8

A. Bleeding 02 into the mass when the leak port is located in the mask

Question 9

Which of the following ventilator settings with most likely result in re-breathing CO2?
A. EPAP levels > 6 cm H2O
B. EPAP levels < 4 cmH2O
C. IPAP levels > 6 cm H2O
D. CPAP levels > 6 cm H2O

Answer 9

B. EPAP levels < 4 cmH2O

Question 10

A patient is admitted to the corner I see you for a cute cardiogenic pulmonary edema. The physician wants to use noninvasive in the treatment of patient’s condition. Which of the following modes of Intel I’m sorry to part would be most appropriate for these at this time?
1. PSV
2. Bilevel NIV
3. CPAP
4. PSV & PEEP

Answer 10

2. Bilevel NIV
3. CPAP
4. PSV & PEEP

Question 11

The highest level of evidence supports the use of NIV as a standard of care in the treatment of:
A. Community-acquired pneumonia
B. Severe of a stable COPD
C. Acute asthma
D. Acute exacerbation of COPD

Answer 11

D. Acute exacerbation of COPD

Question 12

The physiological benefits of NIV include which of the following?

A. decrease in PaCO2 levels
B. decrease in PaO2 levels
C. decrease in HCO3- levels
D. increasing uses accessory muscles

Answer 12

A. Decrease in PaO2 levels

Question 13

A patient has been on NIV for 1 hour and the assist mode only. Ventilator settings include an IPAP at 8 cmH2O & EPAP at 4 cm H2O. O2 is being bled into the circuit at 4 L/ min. The patient’s ABGs after 1 hour reveal pH = 7.34, PaO2 = 62 mmHg, and PaO2 = 62 mm mercury. The patient’s respiratory rate is 27 breaths/ min and the SpO2 is 92%. There is a minimal leaking around the face mask. What would be the most appropriate ventilator changed to make it this time?
A. Increase EPAP level to 8 cmH2O
B. Decrease CPAP level 2 cmH2O
C. Increase IPAP level to 10 cmH2O
D. Decrease IPAP level to 6 cm H2O

Answer 13

C. Increase IPAP level to 10 cmH2O

Question 14

All of the following may increase CO2 rebreathing during an IV except:
A. Use of a full face mask
B. Low impact pressure levels
C. Patient Breathing pattern
D. High inspiratory flow rates

Answer 14

D. High inspiratory flow rates

Question 15

Clinical benefits of an IV in the Q care setting include which of the following?

1. Lower incidence of ventilator-associated pneumonia
2. Improve patient comfort
3. Reducing staff time in the care of patients with COPD
4. Lower intubation rate

Answer 15

1. Lower incidence of ventilator-associated pneumonia
2. Improve patient comfort
3. Lower intubation rate