Quizzes

Question 1

During volume control ventilation a patient’s airway resistance increases. This change will cause which of the following to occur?

Answer 1

increase in peak airway pressure

Question 2

The ventilator mode that allows the patient to breathe spontaneously between operator-selected time-triggered volume and pressure-targeted breaths is which of the following?

Answer 2

Intermittent mandatory ventilation (IMV)

Question 3

Calculate the expiratory time (TE) when the ventilator frequency is set to 25 breaths/min and the inspiratory time (TI) is 0.75 second.

Answer 3

1.65 second

Question 4

Acute hypercapnic respiratory failure may be caused by which of the following?

Answer 4

Respiratory muscle fatigue

Question 5

Calculate the inspiratory time (TI) when a ventilator is set at a tidal volume (VT) of 500 mL and a constant flow rate of 30 L/min.

Answer 5

1 second

Question 6

The underlying physiological process leading to pure hypercapnic respiratory failure is which of the following?

Answer 6

Alveolar hypoventilation

Question 7

Calculate the inspiratory time (TI) when a ventilator is set at a tidal volume (VT) of 800 mL and a constant flow rate of 40 L/min.

Answer 7

1.2 second

Question 8

Calculate the inspiratory to expiratory (I:E) ratio when the inspiratory time is 0.5 second and the respiratory rate is 30 breaths/min.

Answer 8

1:3

Question 9

Calculate the average tidal volume for a patient who has a minute ventilation of 10 L/min with a respiratory rate (RR) of 12 breaths/min.

Answer 9

833 mL

Question 10

The respiratory therapist is called to a patient’s room because the “alarms are ringing.” When the respiratory therapist arrives at the bedside, the high pressure limit, low exhaled tidal volume, and low exhaled minute volume alarms are active. The cause of these alarms is which of the following?

Answer 10

Airway resistance has increased.

Question 11

A patient with a drug overdose is unconscious and has the following ABG results on room air: pH 7.20; PaCO2 88; PaO2 42; HCO3- 25. What type of respiratory failure would describe this patient? What interventions would you recommend?

Answer 11

Acute Hypercapnic Respiratory Failure

Question 12

What is the range for setting flow triggering?

Answer 12

1-10

Question 13

A patient has a body temperature of 40° C. How should the initial minute ventilation setting be adjusted?

Answer 13

increase it by 30%

Question 14

A patient receiving 60% oxygen from an air entrainment mask has a partial pressure of oxygen (PaO2) of 45 mm Hg. The patient is being intubated and the ventilator set up. What is the appropriate fractional inspired oxygen (FIO2) to achieve a PaO2 of 60 mm Hg?

Answer 14

0.8

Question 15

A 63-year-old, 5’11”, 185 lb male patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital due to liver failure. Over the course of the 48 hours he has developed respiratory distress. The respiratory therapist performs a physical assessment and finds the following: heart rate 135 beats/min, respiratory rate 28 with accessory muscle use. Breath sounds are decreased bilaterally with coarse crackles in the right base. A chest X-ray from 24 hours ago shows bilateral lower lobe infiltrates. The patient has a nonproductive cough. The respiratory therapist draws an arterial blood gas that reveals: pH 7.31; partial pressure of carbon dioxide (PaCO2) 57 mm Hg; partial pressure of oxygen (PaO2) 58 mm Hg; arterial oxygen saturation (SaO2) 87%; bicarbonate (HCO3–) 27 mEq/L while receiving oxygen via nasal cannula 3 L/min. The respiratory therapist should recommend which of the following for this patient?

Answer 15

Use BiPAP with IPAP 10 cm H2O, EPAP 5 cm H2O, and bleed in 4 L/min oxygen.

Question 16

Following initiation of volume-controlled continuous mandatory ventilation (VC-CMV) ventilation, the patient’s average peak inspiratory pressure (PIP) is 23 cm H2O. The high pressure limit alarm should be set at which of the following?

Answer 16

33 cm H2O

Question 17

A 57-year-old, 5’3”, 165 lb female patient arrives in the open heart unit following coronary artery bypass surgery. The patient has a history of diabetes and no history of pulmonary disease. The most appropriate initial volume-controlled continuous mandatory ventilation (VC-CMV) settings are which of the following?

Answer 17

VT = 360 mL, rate = 15 breaths/min, PEEP = 5 cm H2O

Question 18

The respiratory therapist in the intensive care unit (ICU) responds to a patient’s room because the ventilator is alarming. The most appropriate immediate action is which of the following?

Answer 18

make sure the patient is being ventilated

Question 19

When changing the control variable from volume control (VC) to pressure control (PC), the initial inspiratory pressure should be set based on which of the following methods?

Answer 19

Plateau pressure measurement taken during VC ventilation

Question 20

During mechanical ventilation, a patient with a closed head injury develops the Cushing response. This may be immediately managed by using which of the following?

Answer 20

Iatrogenic hyperventilation

Question 21

The first step in the assessment and documentation of patient-ventilator interaction following placement of a patient on a mechanical ventilator is which of the following?

Answer 21

verify physicians orders

Question 22

The low-pressure and low-tidal volume alarms are sounding on a mechanically ventilated patient. Measurement of the cuff pressure reveals 18 cm H2O. What action should be taken?

Answer 22

Add air until a slight leak is heard while auscultating the larynx, then measure pressure.

Question 23

The pattern that has been shown to improve the distribution of gas in the lungs for an intubated patient on volume-controlled continuous mandatory ventilation (VC-CMV) is which of the following?

Answer 23

Descending ramp

Question 24

An increasing PIP may indicate which of the following?

Answer 24

decreasing lung compliance

Question 25

A high pressure ventilator alarm is sounding and you are unsure if ventilation is occurring. What action should you take first?

Answer 25

manually ventilate the patient

Question 26

An 87-kg male patient, orally intubated with a size 7.5 mm inner diameter (ID) endotracheal tube, is being mechanically ventilated in the pressure-controlled continuous mandatory ventilation (PC-CMV) mode. During patient rounds, both the low-pressure and low-volume alarms are sounding persistently on the ventilator. Upon observation of the patient, the respiratory therapist hears murmuring from the patient, with audible sounds during inspiration. The respiratory therapist notes the position of the endotracheal tube is 21 cm at the gum line, measures the cuff pressure, and adds 3 mL of air to the cuff. To make an appropriate seal, it requires 44 cm H2O. The respiratory therapist should do which of the following?

Answer 26

change to a larger endotracheal tube