Adult Vent

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  1. A  45 YO with sepsis is developing ARDS. She weighs 64 kg (141 lbs) and has a ventilator tidal volume of 450ml, rate of 13 and 10cm PEEP. Her ABGs are accceptable but her CL is decreasing and plateau pressure is now 35cm. What should be recommended to the physician?

    A) increase PEEP to 15 cm
    B) Vt of 300 and rate of 20
    C) continue to monitor patient's condidition
    D) Vt of 600ml and rate of 10
    B) Vt of 300 and rate of 20
    (this multiple choice question has been scrambled)
  2. An unconscious apneic adult male patient with a drug OD has been admitted through the ED. He will be placed on a ventilator that cannot compensate for compressed volume. His ideal body weight is 80kg (176 lbs). The most appropriate uncorrected Ct would be?

    A) 450 ml
    B) 800 ml
    C) 950 ml
    D) 550 ml
    B) 800 ml
    (this multiple choice question has been scrambled)
  3. A patient with ARDS is receiving mechanical ventilation in the PC, A/C mode with a Vt of 400ml, rate of 24, 60%O2 and 15cm PEEP. after performing a lung recruitment maneuver, the therapist determines the lower inflection point at 20cm and the upper inflection point at 35cm. Where should the PEEP level be set?

    A) between 20 and 35cm
    B) 15 cm
    C) >15 cm
    D) >35cm
    A) between 20 and 35cm
    (this multiple choice question has been scrambled)
  4. An adult male patient is on the PC, A/C SIMV mode with a Vt of 600ml and a backup rate of 10. His total rate is 18. The physician would like to evaluate the patient's readiness to wean from the ventilator. Which of the following parameters indicate that the ventilator can be D/C'd?

    A) spontaneous Vt of 5ml/kg & vd/Vt ratio of 0.4
    B) apontaneous Vt of 5ml/kg & Vd/Vt ratio 0.4 & intrapulmonary shunt of 10%
    C) intrapulmonary shunt of 10% & VC of 9ml/kg & MIP of -15cm
    D) Vd/Vt ratio of 0.4 & intrapulmonary shunt of 10% & VC of 9ml/kg & MIP of -15cm
    B) apontaneous Vt of 5ml/kg & Vd/Vt ratio 0.4 & intrapulmonary shunt of 10%
    (this multiple choice question has been scrambled)
  5. The physician asks the therapist about which weaning methods would be most successful in the patient with weaning parameters listed in question 4. The spontaneous Vt is 400ml. Which of the following methods should be recommended?

    A) PCV
    B) T-piece and extubation in 15 minutes
    C) intermittent ventilator discontinuance
    D) SIMV weaning
    D) SIMV weaning
    (this multiple choice question has been scrambled)
  6. A 25 YO female postop patient is receiving mechanical ventilation. She is alert with a spontaneous Vt of 200ml and the desire to breathe on her own. Because of the emergency nature of her surgery, she has a smaller than normal ETT. Her PaO2 is 93 torr on 40% O2. What ventilator mode should be recommended for her?

    A) SIMV with PS
    B) SIMV with PS and PEEP
    C) PS with PEEP
    D) MMV
    A) SIMV with PS
    (this multiple choice question has been scrambled)
  7. An adult patient is recovering from ARDS. The ventilator is providing CPAP at 10cm and 40% O2 during a spontaneous breathing trial. In evaluating the patient after 1 hour, you note the following: SpO2 has dropped from 95% to 90%, rate has increased from 14 to 23 and the patient c/o tiredness. What should be done first?

    A) raise the CPAP level to 13 cm
    B) continue to monitor patient's condidition
    C) continue for another hour & reevaluate
    D) decrease the CPAP to 7 because the patient is tired
    C) continue for another hour & reevaluate
    (this multiple choice question has been scrambled)
  8. A patient has an HME in place for humidification. The therapist notices that the peak pressure has increased by 10 cm in the past hour. The nurse reports that the patient has thick secretions when last suctioned. What should be done in this situation?

    A) turn up the temperature on the HME
    B) instill normal saline before suctioning
    C) switch to a heated wick type humidifier
    D) switch to a cool, pass-over humidifier
    C) switch to a heated wick type humidifier
    (this multiple choice question has been scrambled)
  9. A ventilated female patient with pulmonary edema has the following ABGs on 40% O2: pH 7.43  PaCO2  35  PaO2  75. She is on VC, A/C mode with a backup rate of 10 and is assisting for a total rate of 18. Her peak airway pressure is 50cm and her plateau is 40. She developed a pneumothorax and had a chest tube inserted. What should be suggested to her physician?

    A) switch her to the PC, A/C mode
    B) switch her to CPAP
    C) sedate her so she does not assist
    D) switch her to the APRV mode
    A) switch her to the PC, A/C mode
    (this multiple choice question has been scrambled)
  10. The therapist has started a patient on the A/C mode and will be using pressure sensitivity breath triggering. What should the sensitivity control be set at?

    A) 0 cm
    B) -1 to -2 cm
    C) 1-2 cm
    D) -5 cm
    B) -1 to -2 cm
    (this multiple choice question has been scrambled)
  11. In preparing for a mode change from A/C to SIMV, the following must be done:

    A) inform the patient & add 5 cm PEEP & remove any deadspace
    B) turn off the sigh & add 5cm PEEP
    C) inform the patient & turn off the sigh & remove any mechanical deadspace
    D) turn the senitivity control off & turn off the sigh & add 5 cm PEEP
    C) inform the patient & turn off the sigh & remove any mechanical deadspace
    (this multiple choice question has been scrambled)
  12. Which of the following indicates that the patient is not tolerating PEEP?

    A) decreased Cst, increased intrapulmonary shunt & decreasing BP
    B) decreased Cst & increased intrapulmonary shunt
    C) increased intrapulmonary shunt & decreasing dead space
    D) increased Cst & increased intrapulmonary shunt & decreasing BP
    A) decreased Cst, increased intrapulmonary shunt & decreasing BP
    (this multiple choice question has been scrambled)
  13. An adult ventilated patient has had a trach tube placed in the ICU. When the patient coughs vigorously, about 10cm of blood is coughed into the ventilator circuit. What should be done?

    A) flush the blood out of the circuit with normal saline
    B) replace the circuit with a new one
    C) sedate the patient to prevent more coughing
    D) nebulize a local anesthetic to reduce the surgical pain
    B) replace the circuit with a new one
    (this multiple choice question has been scrambled)
  14. A patient with pneumonia is receiving ventilation and an HME is being used for humidification. After receiving an aerosolized BD rx, the patient coughs secretions into the HME. The high pressure alarm begins to sound. What should be done?

    A) suction the patient
    B) stop the BD rx
    C) replace the HME
    D) reset the high pressure alarm
    C) replace the HME
    (this multiple choice question has been scrambled)
  15. A patient's breathing is being supported by a ventilator with a circuit with an external exhalation valve. The nurse calls the therapist to evaluate the patient because the alarm is going off. Upon arrival, the therapist notices that the patient's chest is barely moving during a control breath, the peak pressure does not rise above 3 cm and the exhaled Vt spirometer show the set Vt when the control breath is delivered. The most likely cause of these findings is:

    A) the spirometer is out of calibration
    B) the inspiratory and expiratory limbs of the circuit are reversed
    C) the tubing to the exhalation valve is disconnected
    D) the machine is self cycling
    C) the tubing to the exhalation valve is disconnected
    (this multiple choice question has been scrambled)
  16. Expiratory retard would be indicated in a pateint with?

    A) air trapping
    B) pleural effusion
    C) pneumothorax
    D) pulmonary edema
    A) air trapping
    (this multiple choice question has been scrambled)
  17. All of the following parameters indicate the need for intubation and mechanical ventilation EXCEPT:

    A) MIP of less than -15cm
    B) Vd/Vt Ratio of 0.7
    C) VC of less than 10ml/hg
    D) P(A-a)O2 on 100% of 40 torr
    D) P(A-a)O2 on 100% of 40 torr
    (this multiple choice question has been scrambled)
  18. A patient with post polio syndrome is being ventilated with NPPV and has an IPAP of 15 cm and an EPAP of 5 cm. The patient c/o being SOB. The therapist checks the Vt and finds that it has dropped. How should the Vt be restored?

    A) raise the IPAP level
    B) raise the EPAP level
    C) lower the EPAP level
    D) lower the IPAP level
    A) raise the IPAP level
    (this multiple choice question has been scrambled)
  19. A therapist is working with a patient with obstructive sleep apnea who is receiving bilevel NPV through a nasal mask. During a sleep period, it is noticed that he is snoring. Which of the following adjustments should be made?

    A) increase the lower pressure level
    B) loosen the nasal mask
    C) increase the rate
    D) increase the upper pressure level
    A) increase the lower pressure level
    (this multiple choice question has been scrambled)
  20. A theapist is working with an 80kg (175 lbs) patient who is apnic after abdominal surgery. The patient is being ventilated and has the following parameters: MV 5.6
    l, rate 10, I:E Ratio 1:3, FiO2 35%, mechanical dead space 100ml. The ABGs show: pH 7.31  PaCO2 50  PaO2 70 BE 0 Sat 95%. Which of the following should be recommended?

    A) change the I:E Ratio to 1:2
    B) decrease the MV
    C) add 5cm PEEP
    D) remove the deadspace
    D) remove the deadspace
    (this multiple choice question has been scrambled)
  21. It is noticed that a patient's peak pressure has increased from 20 to 40cm without a change in static pressure. Possible causes of this include which of the following:

    A) retained secretions & bronchospasm
    B) retained secretions & pleural effusion
    C) bronchospasm & pulmonary edema
    D) pleural effusion & pulmonary edema
    A) retained secretions & bronchospasm
    (this multiple choice question has been scrambled)
  22. Which of the following will have the greatest impact on increasing the mean airway pressure?

    A) increasing the inspiratory flow
    B) increasing the expiratory time by 0.25 second
    C) adding 5 cm PEEP
    D) removing 0.5 second of inflation hold
    C) adding 5 cm PEEP
    (this multiple choice question has been scrambled)
  23. If a ventilator dependent patient has a large amount of thick tracheal secretions, it is best to:

    A) nebulize saline every 2-4 hours
    B) use a cascade type humidifier
    C) use an HME for her humidity needs
    D) use no humidification system so that secretions will dry
    B) use a cascade type humidifier
    (this multiple choice question has been scrambled)
  24. All of the following are needed to assemble a free standing CPAP system EXCEPT:

    A) water traps
    B) disconnect alarm
    C) exhaled volume spirometer
    D) CPAP pressure device
    C) exhaled volume spirometer
    (this multiple choice question has been scrambled)
  25. A pediatric patient is receiving VC ventilation with a Vt of 250ml. The patient's breath sounds are clear, but the expiratory flow is seen on the monitor to not return to baseline before the next breath. How could this be interpreted?

    A) decreasing Clt
    B) decreasing Raw
    C) too small a Vt
    D) presence of autoPEEP
    D) presence of autoPEEP
    (this multiple choice question has been scrambled)
  26. The following are found on an adult patient receiving VC ventilation with A/C mode: Vt 500ml, Peakflow 45 lpm, Peak Pressure 40cm, Plateau 20cm, PEEP 5cm. Calculate the patient's Raw.

    A) 800
    B) 0.4
    C) 15
    D) 27
    D) 27
    (this multiple choice question has been scrambled)
  27. Raw Calculation
    Raw = (Peak-Plateau)/Flow in lps
  28. A 16 YO patient with severe asthma has been receiving nebulized albuterol treatments through the ventilator system over the past 12 hours. What can the therapist recommend to best evaluate the patient's response?

    A) check airway resistance changes
    B) breath sounds
    C) CXR
    D) check Clt changes
    A) check airway resistance changes
    (this multiple choice question has been scrambled)
  29. A 75 YO male with CHF has been receiving ventilation over the past 24 hours. The diuretic drug furosemide has been given several times. What is the best way to evaluate how the patient's lung function is responding?

    A) Compare Clt measurements at the start of therapy and now
    B) evaluate breath sounds
    C) compare admission weight versus current
    D) compare airway resistance changes
    A) Compare Clt measurements at the start of therapy and now
    (this multiple choice question has been scrambled)
  30. After open heart surgery, a patient is receiving ventilation. The patient needs to have a pacer inserted in the cath lab. It is expected the patient will be back in the ICU in an hour or two. How should ventilatory support be provided during this time?

    A) manual ventilation with resuscitation bag
    B) Pressure cycled transport ventilator
    C) microporcessor type ventilator
    D) NIV
    B) Pressure cycled transport ventilator
    (this multiple choice question has been scrambled)
  31. A patient with emphysema is receiving ventilation with the following settings: Mode VC A/C, Vt 600ml, Set Rate 12, Total Rate 12, FiO2 0.30, I:E Ratio 1:2. During a ventilator check, you measure the patient's exhaled Vt at 500ml. What can be done to help the patient exhale more completely?

    A) change to PC Mode
    B) change to a larger ETT
    C) decrease the inspiratory time
    D) increase the expiratory time
    D) increase the expiratory time
    (this multiple choice question has been scrambled)
  32. After abdominal surgery, a female patient is awakening gradually from anesthesia. Her ventilator settings are as follows: Mode VC SIMV, Vt 550, Spontaneous Vt 400 when awake, Set Rate 12, Total Rate 16, FiO2 0.30, Inspiratory Flow 40 lpm. When awake, she uses accessory muscles and her breathing is not synchonized. What can be done to improve synchrony?

    A) increase the inspiratory flow to 50 lpm
    B) give her pain medications
    C) give her more oxygen
    D) decrease the set Vt
    A) increase the inspiratory flow to 50 lpm
    (this multiple choice question has been scrambled)
  33. An adult patient with myasthenia gravis is receiving ventilation with these settings: Mode PC A/C, Set Vt 450,ml, Set rate 10. Total rate 15, FiO2 0.40, Inspiratory Flow 60lpm. The patient's ABGs are all within the normal range. You notice the patient is making 24 breathing efforts per minute and using accessory muscles. What should be done?

    A) increase the flow sensitivity
    B) increase the set rate to 15
    C) increasing the inspiratory flow
    D) increase the O2
    A) increase the flow sensitivity
    (this multiple choice question has been scrambled)
  34. An unconscious adult patient has been received in the ED after suffering a stroke. The only ventilator available is an older volume cycled unit. The physician asks the therapist for a recommendation on the initial ventilator Vt to use with this patient who weighs 73kg (160 lbs). What should be recommended?

    A) 500 ml
    B) 320 ml
    C) 1000 ml
    D) 700ml
    D) 700ml
    (this multiple choice question has been scrambled)
  35. A 6 YO patient will be started on ventilation. What should the initial respiratory rate be?

    A) 80 bpm
    B) 20 bpm
    C) 14 bpm
    D) 50 bpm
    B) 20 bpm
    (this multiple choice question has been scrambled)
  36. A 50 YO, 75kg (165 lbs) male patient has just returned from open heart surgery adn has been placed on a microprocessor ventilator with the following settings: Mode Vc A/C, Set Vt 500ml, Set Rate 12, Total rate 12. FiO2 0.50, I:E Ratio 1:2. After 45 minutes, the ABGs are pH 7.50  pCO2 30, PaO2 115 HCO3 22 BE -2. What should be done in this situation?

    A) decrease the rate to 10 bpm
    B) decrease the FiO2 to 0.40
    C) decrease the Vt to 400ml
    D) increase the rate to 14 bpm
    A) decrease the rate to 10 bpm
    (this multiple choice question has been scrambled)
  37. A patient with bilateral pneumonia is receiving ventilation with the following settings: Mode PC SIMV, Set Vt 650ml, Set Rate 14, FiO2 0.50, I:E Ratio 1:2, PEEP 10 cm. The nurse is concerned that the patient's SpO2 value drops from 94% to 85% when suctioned. How can this be prevented?

    A) perform suctioning only once per hour
    B) give 100% O2 before suctioning
    C) increase the PEEP level before suctioning
    D) use the largest suction catheter possible
    B) give 100% O2 before suctioning
    (this multiple choice question has been scrambled)
  38. A 40 YO, 60kg (132 lbs) female patient is recovering from ARDS. Her current settings are as follows: Mode VC A/C, Set Vt 400ml, Set Rate 12, Total Rate 18, FiO2 0.40 and I:E Ratio 1:3. She has the following ABGs:  ph 7.42 PaCO2 37, PaO2 85 HCO3 25 BE +1. She has no complications and is
  39. An adult male is recovering from flail chest injury and the physician wants to wean him from the ventilator. The patient is intubated with a 7.0 ETT and is breathing with the support of the SIMV mode. When the set rate was decreased for 8 to 6npm, the patient becomes tired. How can the patient's WOB be decreased?

    A) nebulize a BD med
    B) add automatic tube compensation
    C) maintain the set rate at 8
    D) increase the flow through the ventilator during SIMV breaths
    B) add automatic tube compensation
    (this multiple choice question has been scrambled)
  40. A 65 YO male, 70kg(155 lbs) males patient who suffered a heart attack is receiving ventilation with the following settings: Mode PC,SIMV, Set Vt 500ml, Set Rate 12, Total Rate 18, FiO2 0.70. The physician is concerned that the patient may be developing pulmonary edema. These ABGs were recorded while the patient was on the ventilator:  pH 7.43  PaCO2 35  PaO2 50  HCO3 22 BE -2. What should be done to help this patient?

    A) increase the set rate to 18
    B) add 5 cm PEEP
    C) add mechanical dead space
    D) increase the O2 to 100%
    B) add 5 cm PEEP
    (this multiple choice question has been scrambled)
  41. A 42 YO patient was accidentally given an OD or morphine for pain after surgery. Because the drug caused hypoventilation, the patient was intubated and started on ventilation in the Vc A/C mode. THe morphine has now been reversed and the patient is awake. The patient has the following beside spirometry values: RR 16bpm, VC 2300  Vt 400ml  MIP -55cm H2O. What should be done at this time?

    A) change to the SIMV mode
    B) reassess the patient in 4 hours
    C) remove the ETT
    D) spontaneous breathing trial on a T-piece
    D) spontaneous breathing trial on a T-piece
    (this multiple choice question has been scrambled)
  42. The PCIRV mode is indicated in which of the following conditions:

    A) ARDS
    B) chronic bronchitis
    C) asthma
    D) pulmonary contusion
    A) ARDS
    (this multiple choice question has been scrambled)
  43. A patient is receing CPAP at 10 cm with 40% O2 and a flow of 6lpm. THe nurse calls the therapist because the low pressure alarm is periodically sounding. The therapist finds the patient to be alert and breathing comfortably. The pressure gauge shows the CPAP fluctuating between 10 and 6 cm H2O. The low pressure alarm is set at 8 cm with a delay of 5 seconds. What should be done about this situation?

    A) increase the alarm delay to 10 seconds
    B) increase the flow
    C) sedate the patient
    D) set the low pressure alarm at 5 cm
    B) increase the flow
    (this multiple choice question has been scrambled)
  44. Which of the following clinical conditions could result in a decreased Clt and increasing pressure plateau?

    A) pulmonary edema & pneumonia & emphysema & ARDS
    B) pneumonia & emphysema
    C) pulmonary edema & pneumonia
    D) pulmonary edema & pneumonia & ARDS
    D) pulmonary edema & pneumonia & ARDS
    (this multiple choice question has been scrambled)
  45. MMV Ventilation

    A) is similar to the VC A/C mode
    B) is similar to the VC A/C mode & is a substitute for CPAP
    C) is indicated when a patient has an unstable respiratory drive & ensures a minimum minute volume
    D) ensures a safe minimum minute volume
    A) is similar to the VC A/C mode
    (this multiple choice question has been scrambled)
  46. High frequency ventilation would be indicated for all of the following situations EXCEPT:

    A) near drowning
    B) bronchopleural fistula
    C) bronchoscopy
    D) laryngoscopy
    A) near drowning
    (this multiple choice question has been scrambled)
  47. A patient undergoing a spontaneous breathing trial for weaning should be carefully assessed. Weaning should be terminated when:

    A) pulmonary edema
    B) decrease the MV
    C) the patient's rapid/shallow breathing index is 120 & the patient's PaCO2 is 60
    D) increase PEEP to 15 cm
    C) the patient's rapid/shallow breathing index is 120 & the patient's PaCO2 is 60
    (this multiple choice question has been scrambled)
  48. Indications for ventilatory support:
    • rapid/shallow breathing index of 105 or more
    • a PaCO2 of >55 torr
    • cardiac dysrhythmias occur
  49. An adult patient was receiving a Vt of 500ml on the ventilator before going to the OR for a left pneumonectomy. How should the patient's breathing be supported after surgery?

    A) the same Vt as before surgery
    B) Vt less than before surgery
    C) a larger Vt than before surgery
    D) CPAP should be used
    B) Vt less than before surgery
    (this multiple choice question has been scrambled)
  50. A negative pressure ventilator is indicated for the following types of patients EXCEPT:

    A) COPD in acute failure
    B) neuromuscular defects
    C) kyphoscoliosis
    D) ARDS
    D) ARDS
    (this multiple choice question has been scrambled)
  51. An adult patient with an active lung injury has had an optimal PEEP study performed. Which of the following parameters found during the study would help determine the best PEEP setting?

    A) pulmonsry compliance improves & PaO2 increases & shunt perentage decreases & pulmonary vascular resistance decreases
    B) pulmonary compliance increases & PaO2 increases & shunt percentage decreases & PVR increases
    C) PaO2 increases & PVR increases & PVR decreases & BP decreases and HR increases
    D) PaO2 increases & PVR increases & BP decreases and HR increases
    A) pulmonsry compliance improves & PaO2 increases & shunt perentage decreases & pulmonary vascular resistance decreases
    (this multiple choice question has been scrambled)
  52. A patient with pulmonary edema is receiving VC A/C with the following clinical data: Vt set 700ml, Corrected Vt 600ml, Peak pressure 65cm, Plateau 48cm. PEEP 12 cm. Calculate the patient's static compliance,

    A) 13 ml/cm
    B) 15 ml/cm
    C) 17ml/cm
    D) 19ml/cm
    C) 17ml/cm
    (this multiple choice question has been scrambled)
  53. Static compliance calculation =
    Cst = (Exhaled Vt - Compressed volume)/ (Plateau - PEEP)
  54. A mechanically ventilated patient has an exhaled Vt of 700ml. Because of refractory hypoxemia, 6 cm of PEEP is started. The peak pressure is 35cm and the plateau is 25cm. The compliance factor has been determined to be 4ml/cm. Calculate the Cst for this patient.

    A) 24 ml/cm
    B) 32ml/cm
    C) 19 ml/cm
    D) 28 ml/cm
    B) 32ml/cm
    (this multiple choice question has been scrambled)
  55. A mechanically ventilated patient has an exhaled Vt of 700ml. Because of refractory hypoxemia, 6 cm of PEEP is started. The peak pressure is 35cm and the plateau is 25cm. The compliance factor has been determined to be 4ml/cm. Calculate the Cdyn for this patient.

    A) 19ml/cm
    B) 24 ml/cm
    C) 32 ml/cm
    D) 16 ml/cm
    A) 19ml/cm
    (this multiple choice question has been scrambled)
  56. When preparing to ventilate a patient with HFJV, it is necessary to have all of the following EXCEPT:

    A) jet injector line
    B) spirometer to measure the Vt
    C) humidifier
    D) high pressure O2 source
    B) spirometer to measure the Vt
    (this multiple choice question has been scrambled)
  57. Over the course of an 8 hour shift, the therapist notices that a patient receiving constant volume ventilation has had a increase in peak pressure from 25 to 40 cm H2O. What could have caused this change?

    A) Raw increased & Clt decreased
    B) Raw decreased & Clt increased
    C) Raw increased
    D) CLt decreased
    A) Raw increased & Clt decreased
    (this multiple choice question has been scrambled)
  58. A 45 YO patient has developed pulmonary edema. Thy physician asks the RT for the best ventilator adjustment to adjust the patient's intrapulmonary  shunting. The therapist should recommend?

    A) decreasing the respiratory rate
    B) increasing the sigh volume
    C) increasing the PEEP
    D) increasing the inspiratory time
    C) increasing the PEEP
    (this multiple choice question has been scrambled)
  59. A trauma patient has a pleural tube to the left lung. A microprocessor ventilator is delivering an inspiratory Vt of 800ml. The expiratory Vt is shown to be 600ml. What could best explain the volume difference?

    A) air leak through the chest tube
    B) deflated ETT cuff
    C) bronchospasm & autoPEEP
    D) miscalibrated spirometer
    A) air leak through the chest tube
    (this multiple choice question has been scrambled)
  60. Ina patient with ARDS, the indication to switch from VC to PC is:

    A) Clt < 30ml/cm
    B) peak pressure & plateau pressure total >30cm H2O
    C) Plateau pressures of >30cm H2O
    D) peak pressures of 30 cm of H2O
    C) Plateau pressures of >30cm H2O
    (this multiple choice question has been scrambled)
  61. A 70 kg (154 lbs) patient with a stroke and increasing ICP is being mechanically ventilated in the A/C mode with the following settings: MV 6.0L, I:E Ratio 1:2, FiO2 0.35, Rate 12. The patients ABGs are: pH 7.39  PaCO2 43  PaO2 107 BE 0 Sat 100%. On the basis of this information, it would be most appropriate to recommend:

    A) increase the rate
    B) increase the expiratory time
    C) decrease nthe MV
    D) decrease the FiO2
    A) increase the rate
    (this multiple choice question has been scrambled)
  62. Indications for increasing the expiratory time
    air trapping or autoPEEP
  63. The CXR of a patient receiving ventilation indicates atlectasis in both bases. In addition, the breath sounds are diminished bilaterally and she has a low grade fever. Which of the following ventilator adjustments should the therapist recommend?

    A) increase the flow rate
    B) increase the ventilatory frequency
    C) increase the expiratory time
    D) increase the sigh volume
    D) increase the sigh volume
    (this multiple choice question has been scrambled)
  64. A patient with ARDS is receiving a smaller than normal Vt with resulting hypercarbia. What guidelines should be followed with permissive hypercarbia?

    A) the CO2 level is allowed to increase & the pH should be kept > 7.25
    B) bivarb may be given to increase the pH & the CO2 is allowed to increase & the pH should be kept > 7.25
    C) the pH should be kept between 7.35 and 7.45 & the PaCO2 should be kept between 40 & 50 torr
    D) the CO2 is allowed to increase & the PaCO2 should be kept between 40 and 50 torr
    B) bivarb may be given to increase the pH & the CO2 is allowed to increase & the pH should be kept > 7.25
    (this multiple choice question has been scrambled)
  65. An adult female has the desire to breathe spontaneously and has a Vt that is 4 ml/kg. Because of her facial trauma from an MVA, she has a 6.5 ETT. he also has lung contusions in the MVA. Her PaO2 is 63 on 55% O2. What ventilator mode should be recommended for her?

    A) SIMV with low level pressure support and PEEP
    B) Low level PS Ventilation with PEEP
    C) SIMV with high level pressure support (PSVmax)
    D) A/C with flow sensitvity for triggering
    A) SIMV with low level pressure support and PEEP
    (this multiple choice question has been scrambled)
  66. An apneic 60kg (132lbs) patient si being ventilated in the PC A/C mode. The patient's settings are: Vt 400ml, RR 10, O2 100%, Mech Ds 100ml. His ABG's show:  pH 7.32  PaCO2 55  PaO2 66 HCO3 28 BE +4. Considering all of the above, all of the following ventilator adjustments would improve upon the ABGs EXCEPT:

    A) Change to SIMV with a rate of 10
    B) increase the rate to 14
    C) remove the deadspace
    D) increase the Vt to 500
    A) Change to SIMV with a rate of 10
    (this multiple choice question has been scrambled)
  67. Indications that the patient is tolerating SIMV include all of the following EXCEPT:

    A) RR has increased
    B) HR is stable
    C) ABGs are stable
    D) accessory muscles are not being used
    A) RR has increased
    (this multiple choice question has been scrambled)
  68. A 55kg (120 lbs) female pateint is being vetnilated with the PC SIMV mode and a rate of 10, Vt 400, PEEP 10 and 35% O2. She has an 8.0 trach tube. Her spontaneous Vt is 300ml with a rate of 10. The most recent ABGs: pH 7.40  PaCO2 41  PaO2 95 HCO# 24 BE 0. What should be recommended?

    A) add 10cm of PS
    B) reduce PEEP to 7
    C) increase SIMV rate to 12
    D) reduce SIMV rate to 3
    D) reduce SIMV rate to 3
    (this multiple choice question has been scrambled)
  69. When working with a pateint who recently had a bowel resection and is receiving paralyzing meds to prevent fighting against the ventilator, it is important to

    A) give the patient meds for pain
    B) give the patient caffeine as a CNS stimulant
    C) add 5 cm PEEP
    D) give her pain medications
    A) give the patient meds for pain
    (this multiple choice question has been scrambled)
  70. A patient with a closed head injury and increased ICP is being ventilated in the VC A/C mode with an FiO2 of 0.5, Rate of 12 and Vt of 600ml.  The ABGs are: pH 7.43, PaCO2 35, PaO2 195 HCO3 22 BE -2 at 100%. The physician orders a PaCO2 of 25 for this patient. What should the therapist change on the ventilator to accomplish this?

    A) add deadspace
    B) decrease the rate
    C) increase the Vt
    D) decrease the FiO2
    C) increase the Vt
    (this multiple choice question has been scrambled)
  71. An 80kg (176 lbs) man with bilateral pneumonia is being ventilated in the PC A/C mode with set rate 12, total rate 16, exhaled Vt 800 and inspiratory pressure of 28. Four hours later, the total rate has increased to 26 and the exhaled Vt has decreased to 600. What is the most appropriate thing to do at this time?

    A) increase the rate
    B) add pressure support
    C) sedate the patient
    D) increase the inspiratory pressure
    D) increase the inspiratory pressure
    (this multiple choice question has been scrambled)
  72. A 17 YO female has been admitted with status asthmaticus and is place on a microprocessor ventilator. The physician wants to know if she has any autoPEEP. What is the best waveform to determine this?

    A) MVV tracing
    B) flow volume loop
    C) pressure time tracing
    D) flow time tracing
    D) flow time tracing
    (this multiple choice question has been scrambled)
  73. An adult female patient will be receiving NIV at night in her home for sleep apnea. THe nasal mask has been applied and these NIV parameters have been set: IPAP 15 cm EPAP 4 cm Rate 14  30% O2. after trying the NIV system for 10 minutes, the patient states she is not getting enough air. What is the first adjustment to make?

    A) increase the rate to 16
    B) increase her FiO2 to 0.4
    C) increase the IPAP to 20cm
    D) increase the EPAP to 8 cm
    C) increase the IPAP to 20cm
    (this multiple choice question has been scrambled)
  74. After suffering mutiple trauma in an MVA, a 43 YO male patient is recovering. Ventilation has been needed for 5 days and weaning is being tried for the first time. After breathing on a T-piece for 40 minutes, the patient has the following ABFs:  7.30  PaCO2 54  PaO2 65 HCO3 26  BE =2 St 91%. Bedside spirometry shows: Vc before 1100, after 700; Vt before 400, after 300; Rate before 14, rate after 28, MIP before -26, MIP after -15, Based on this information, what should be recommended?

    A) return to mechanical ventilation
    B) extubate and begin PEP therapy
    C) continue to monitor weaning trial
    D) extubate and give 50% O2
    A) return to mechanical ventilation
    (this multiple choice question has been scrambled)
  75. An adult patient with ARDS has developed a pneumothorax during VC mechanical ventilation. The physician has decided to change the patient to HFO. The HFO settings are: f4, Amplitude 20 cm H20, I:E Ratio 1:2; O2 60%, PEEP 8 cm.  After 50 minutes of HFO, gases were pH 7.31  PaCO2 52, PaO2 66 HCO3 37, BE +2  Sat 92%. What should be recommended?

    A) continue to moniotr patient
    B) increase the amplitude to 25 cm
    C) increase the PEEP to 15 cm
    D) change the I:E Ratio to 1:1
    B) increase the amplitude to 25 cm
    (this multiple choice question has been scrambled)
Author:
n1297f
ID:
316113
Card Set:
Adult Vent
Updated:
2016-02-20 17:34:51
Tags:
adult vent
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Description:
adult vent
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