Mechanical Ventilation practice questions 1

Mechanical Ventilation practice questions #1 25 studiers recently 5.0 (3 reviews) Students also studied Terms in this set (15) Science MedicinePulmonology Save NCLEX Mechanical Ventilation Ques...Teacher 6 terms emeltineRNPreview TMC Mechanical Ventilation Practic...35 terms macie_dugasPreview Mechanical Ventilation Quizzes and ...23 terms mpaylimPreview Respira Teacher dru Which of the following is NOT an indication for continuous mechanical ventilation?

• MIP -20 cmH2O
• acute ventilatory failure
• Vt < 5 mL/kg
• VC < 10 mL/kg

MIP -20 cmH2O Optium PEEP therapy can be identified by all of the

following EXCEPT:

• Inflection point of a volume-pressure loop graphic
• Acceptable oxygenation with no cardiovascular side

effects

• Increasing oxygenation with increasing plateau

pressures

• Increasing static compliance with acceptable

oxygenation Increasing oxygenation with increasing plateau pressures All of the following could be recommended to treat a patient with a severely decreased static compliance

problem, EXCEPT:

• inverse positive pressure ventilation
• optium PEEP therapy
• pressure control ventilation
• expiratory resistance

expiratory resistance

Which of the following is NOT a primary ventilation parameter measured and displayed to create airway graphics of continuous mechanical ventilation?

• Flow

B. PEEP

• Tidal volume
• Airway pressure

PEEP A "broken" flow/volume loop and/or volume/pressure

loop will occur with:

• airway resistance
• overdistension
• auto PEEP
• airway leak

airway leak A 32 year old female who weighs 100 kg (220 lbs.) and is 165 cm (5 ft. 6 inches) tall has chest trauma due to a motorcycle accident. The patient has just been intubated, sedated and paralyzed with morphine sulfate and pancuronium bromide. The physician asks for your immediate recommendation in ventilator settings for this

patient. You would recommend:

• A/C mode, rate 10, tidal volume 1000 ml
• SIMV mode, rate 8, tidal volume 900 ml
• IMV mode, rate 14, tidal volume 800 ml
• Control mode, rate 12, tidal volume 600 ml

Control mode, rate 12, tidal volume 600 ml A respiratory care practitioner reviews a ventilator parameter sheet and finds that the peak inspiratory pressure has been gradually rising for the past several hours. Which of the following could be the cause for this change?

• Bronchospasm

II. Increasing pulmonary compliance III. Accumulation of secretions IV. Increasing airway resistance

• III only
• I & III only
• I, III & IV
• I, II, III &IV

I, III & IV A 29 year old female post-operative mitral valve replacement patient is combative on a volume-cycled ventilator in the assist/control mode. The peak pressure alarm is sounding with each breath. The nurse practitioner has a STAT call into the cardiovascular surgeon. She asks for your immediate recommendation. You would recommend which of the following?

• Increase the peak pressure alarm limit
• Order a STAT chest x-ray
• Change to SIMV mode and evaluate the patient
• Order a STAT arterial blood gas

Change to SIMV mode and evaluate the patient

A 44 year old male patient is being mechanically ventilated with a volume cycled ventilator. You observe that there is insufficient time for the patient to exhale completely. You would now do which of the following to correct the problem?

• increase the flow
• decrease the minute volume
• add expiratory retard
• remove mechanical deadspace

increase the flow A 58 year old male patient is hypoxic on a volume cycled ventilator and is receiving 15 cmH2O of PEEP on an FIO2

0.60. Shortly after increasing the PEEP therapy to 18

cmH2O, the respiratory care practitioner notes the systemic blood pressure has fallen from 110/72 torr to 94/50 torr and the cardiac output has fallen from 4.3 L/min. to 2.5 L/min. The most appropriate action at this

time would be to:

• maintain the present therapy and re-evaluate the

patient in thirty minutes

• decrease the PEEP to 15 cmH2O and increase the FIO2

to 0.70

• decrease the PEEP to 12 cmH2O and maintain the FIO2

at 0.60

• discontinue the PEEP and increase the FIO2 to 0.80

decrease the PEEP to 15 cmH2O and increase the FIO2 to 0.70 A 80 kg (176 lb) post-operative hepatic turmor removal patient is being mechanically ventilated on a volume

cycled ventilator at the following settings:

Mode: A/C

Mandatory rate: 12 br/min

Total rate: 18 br/min

Tidal volume (set): 800 ml

Tidal volume (spontaneous): 0

FIO2: 0.50

Peak flow: 60 LPM

Arterial blood gas results:

pH: 7.34

PaCO2: 41 torr

PaO2: 94 torr

HCO3: 21 mEq/L

BE: -2

Which of the following should the respiratory care practitioner recommend at this time?

• increase the tidal volume to 900 ml
• increase the rate setting to 14 br/min
• maintain current ventilator settings
• add a pressure support of 10 cmH2O

maintain current ventilator settings

Which of the following clinical combinations would indicate that you have exceeded the optimum level of PEEP therapy and that you should reduce the PEEP and increase the FIO2?

• BP decreases, QT decreases, PWP increases and PAP

increases

• BP decreases, QT decreases, PWP decreases and PAP

decreases

• BP stable, QT stable, PWP decreases and PAP

decreases

• BP stable, QT increases, PWP stable and PAP stable

BP decreases, QT decreases, PWP increases and PAP increases A 74 year old female who weighs 65 kg (132 lbs) is being mechanically ventilated with a volume cycled ventilator following hip replacement surgery. Ventilator settings and

arterial blood gas results are as follows:

Ventilator settings

Mode: A/C

Set rate: 14 br/min

Total rate: 14 br.min

Tidal volume: 750 ml

Peak flow: 50 lpm

FIO2: 0.35

Arterial blood gas

pH: 7.50

PaCO2: 29 torr

PaO2: 118 torr

HCO3: 23 mEq/L

The respiratory care practitioner should do which of the following?

• decrease the peak flow setting
• decrease minute ventilation
• decrease the FIO2
• initiate pressure support therapy

decrease minute ventilation