RT 123 Final

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RT 123 Final
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2010-09-14 10:30:59
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RT 123 Final
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  1. 1. Pneumatic ventilators may incorporate which of the following components for operation?
    I. Pistons
    II. Air entrainers
    III. Flexible Diaphragms
    IV. Internal direct current batteries
    A. I and II
    B. I and IV
    C. III and IV
    D. II and III
    D. II and III
    (this multiple choice question has been scrambled)
  2. 2. An iron lung is which type of ventilator
    A. Fluidic
    B. Positive pressure
    C. Negative Pressure
    D. Positive/negative pressure
    C. Negative Pressure
    (this multiple choice question has been scrambled)
  3. 3. Which type of ventilator creates a sineusodial pressure waveform pattern of positive and negative pressures?
    A. combined pressure
    B. Positive-pressure
    C. Fluidic
    D. Pneumatic
    A. combined pressure
    (this multiple choice question has been scrambled)
  4. 4. A closed system can be described as which of the following
    I. Feedback
    II. Hierarchical
    III. Unintelligent
    IV. Servo-Controlled
    A. I
    B. II and IV
    C. I and IV
    D. II and IV
    C. I and IV
    (this multiple choice question has been scrambled)
  5. 5. Which of the following is a flow waveform created by a linear-drive piston?
    A. Ascending ramp
    B. Sinusodial
    C. Rectangular
    D. Descending ramp
    C. Rectangular
    (this multiple choice question has been scrambled)
  6. 6. The funnction of the exhalation valve following?
    A. Inflate during inspiration to prevent leaks in the inspiratory circuit
    B. Inflate during expiration to allow the patient to exhale throught the expiratory line
    C. Deflate during inspiration to allow the gas to go to the patient
    D. inflate during inspiration and to divert gas coming from the ventilator into the patient
    D. inflate during inspiration and to divert gas coming from the ventilator into the patient
    (this multiple choice question has been scrambled)
  7. 7. Which of the following flow-controlled electromagnetism?
    A. Propotional selenoid
    B. Poppet
    C. Stepper motor
    D. Microprossesor operated
    A. Propotional selenoid
    (this multiple choice question has been scrambled)
  8. 8. A patient receiving CPAP of 7.5 via a mask and freestanding system appears to be in distress. The patient is using accessory muscles and is diaphoretic the manometer is fluctuating between -5 and 7.5 the most appearant cause of the distress is
    A. Obstruction of the threshold
    B. Inadequate Flow
    C. Leak in the system
    D. Improper mask fitting
    B. Inadequate Flow
    (this multiple choice question has been scrambled)
  9. 9. The set tidal volume is 500 mL. During the first breath the exhaled volume measures 390 mL, with a peak pressures of 18. The second breath returns 460 mL, with 20 cm The third breath has peak pressure of 22 an exhaled volume of 500 mL. This can be described as what type of system
    A. closed loop system
    B. Open-loop
    C. Double-circuit
    D. Single-circuit
    A. closed loop system
    (this multiple choice question has been scrambled)
  10. 10. The gas that enters the ventilator from high-pressure sources goes directly to the system. This is what type of system
    A. single circuit
    B. Pneumatic circuit
    C. Double-circuit
    D. Power transmission
    A. single circuit
    (this multiple choice question has been scrambled)
  11. 11. Which of the following is a devic that uses a flow resistor to create expiratoi pressure?
    A. Fluidic devices
    B. Downs CPAP generator
    C. Positive expiratory pressure mask
    D. Modern ventilators
    C. Positive expiratory pressure mask
    (this multiple choice question has been scrambled)
  12. 12, Who has attempted to establish a ewer classification system to describe how ventilators work?
    A. Pilbeam
    B. Mushin
    C. Egan
    D. Chatburn
    D. Chatburn
    (this multiple choice question has been scrambled)
  13. 13. The most common type of ICU ventilators today are:
    A. Fluidic controlled pneumatically powered
    B. Negative-pressure
    C. pneumatically powered and microprocessor controlled.
    D. Pneumatically powered, Piston-driven, double circuit system
    C. pneumatically powered and microprocessor controlled.
    (this multiple choice question has been scrambled)
  14. 14. Internal expiratory valves have which of the following characteristics?
    I. high resistance
    II. low resistance
    III. large diameter opening
    IV. Flexible plastic diaphragms
    V. spring-loaded
    A. I, III, V
    B. II, III, IV
    C. I, V
    D. II III V
    B. II, III, IV
    (this multiple choice question has been scrambled)
  15. 15. PEEP is accomplished by which of the following methods?
    I. Flow resistance
    II. Passive resistance
    III. Threshold resistance
    A. I, III
    B. II, III
    C. I, II
    D. I only
    A. I, III
    (this multiple choice question has been scrambled)
  16. 16. The main parameter that the ventilator manipulates for any given breath is referred to as which of the following?
    A. Cycle variable
    B. Phase variable
    C. Control variable
    D. Control circuit
    C. Control variable
    (this multiple choice question has been scrambled)
  17. 17. What variable begins the inspiratory phase of a ventilator?
    A. Control
    B. Trigger
    C. Cycle
    D. Limit
    B. Trigger
    (this multiple choice question has been scrambled)
  18. 18. What trigger variable is used during control ventilation?
    A. Volume
    B. Pressure
    C. Flow
    D. Time
    D. Time
    (this multiple choice question has been scrambled)
  19. 19. Which of the following variables en s the inspiratory phase?
    A. Limit
    B. Sensitivity
    C. Cycle
    D. Trigger
    C. Cycle
    (this multiple choice question has been scrambled)
  20. 20. Which of the following variables begins a mandatory breath?
    A. Volume
    B. F1ow
    C. Pressure
    D. Time
    D. Time
    (this multiple choice question has been scrambled)
  21. 21. The pressure maintained at the airway during exhalation is known as which of the following
    A. Sensitivity
    B. Proximal
    C. Mean airway
    D. Baseline
    D. Baseline
    (this multiple choice question has been scrambled)
  22. 22. Which two of the following patient triggers are most common?
    I. Flow
    II. Neural
    III. Volume
    IV. Pressure
    A. I and II
    B. III and IV
    C. II and III
    D. I and IV
    D. I and IV
    (this multiple choice question has been scrambled)
  23. 23. On a mechanical ventilator, pressure-triggering is usually set within which of the following ranges?
    A. 1.0 to3.0
    B. 0.5 to 2.0
    C. - 0.5 to – 1.5
    D. -2.0 to 0.5
    C. - 0.5 to – 1.5
    (this multiple choice question has been scrambled)
  24. 24. If the base flow is 8 L/min and the flow-trigger setting is 3 L/min, at what flow rate will the ventilator be triggered?
    A. 8 L/min
    B. 5 L/min
    C. 3 L/min
    D. 11 l/mm
    B. 5 L/min
    (this multiple choice question has been scrambled)
  25. 25. With a baseline pressure setting of 6 cm H20 and a sensitivity setting of .5 inspiration will begin at
    A. -4.5
    B. 4.5
    C. -1.5
    D. 1.5
    B. 4.5
    (this multiple choice question has been scrambled)
  26. 26. What is the flow rate if the set volume is 550 mL and the inspiratory time is 1.2
    second?
    A. 66 L/min \
    B. 45.8 L/min
    C. 55 L/min
    D. 27.5
    D. 27.5
    (this multiple choice question has been scrambled)
  27. 27. The maximum safety pressure sh be set at _____ cm H when the peak pressure reached during vo1ume-c ventilation is 25 cm H
    A. 30
    B. 35
    C. 40
    D. 45
    B. 35
    (this multiple choice question has been scrambled)
  28. 28. When the maximum safety pressure setting in a volume mode is reached, which ol the following occurs?
    A. Flow begins to decrease.
    B. Pressure is held until the target volume is delivered.
    C. Inspiration is triggered.
    D. Inspiration ends prematurely
    D. Inspiration ends prematurely
    (this multiple choice question has been scrambled)
  29. 29. When the maximum safety pressure on a volume ventilator is reached, which of the following occurs?
    A. Pressure is held until the tim cycle is reached.
    B. Pressure is held until the ver ilator volume time cycles.
    C. The flow rate begins to tape
    D. inspiration ends before the entire volume is delivered
    D. inspiration ends before the entire volume is delivered
    (this multiple choice question has been scrambled)
  30. 30. Which of the following represents the amount of time a pressure-targeted ventilator breath should be at the set pressure?
    a. Rise time
    b Inspiratory time
    c. Total cycle time
    d. Inspiratory hold
    b Inspiratory time
  31. 31. Improving lung compliance during pressure ventilation will cause which of the following?
    a, A decrease in peak pressure
    b. An increase in peak pressure
    c. An increase in volume delivery
    d. A decrease in volume delivery
    c. An increase in volume delivery
  32. 36. Improving lung compliance during volume-controlled ventilation will cause a(n)_____ in peak_____
    A. Decrease; pressure
    B. Increase; pressure
    C. Decrease; flow rate
    D. Increase; flow rate
    A. Decrease; pressure
    (this multiple choice question has been scrambled)
  33. 37. Worsening lung compliance during g volume-controlled ventilation will cause which of the following?
    A. an increase in peak pressure
    B. A decrease in volume delivery
    C. An increase in peak flow ate
    D. A decrease in peak pressure
    A. an increase in peak pressure
    (this multiple choice question has been scrambled)
  34. 38. Worsening lung compliance during pressure-controlled ventilation will cause which of the following?
    A. A decrease in volume delivery
    B. An increase in peak flow ate
    C. An increase in peak pressure
    D. A decrease in peak pressure
    A. A decrease in volume delivery
    (this multiple choice question has been scrambled)
  35. 39. What is the volume that will reach the patient when the volume setting is 700 mL, the circuit CT is 2 mL/cm, and the measured PIP is 35 cm H when the ventilator does not have tubing compliance compensation?
    A. 698 mL
    B. 630 mL
    C. 770 mL
    D. 665 mL
    B. 630 mL
    (this multiple choice question has been scrambled)
  36. 40. How much volume is lost in the ventilator circuit when the volume is Set at 500 mL, the PIP is 40 cm H and the circuit CT is 3 mL/cm H when the ventilator does not have tubing compliance compensation?
    A. 120 mL
    B. 280 mL
    C. 380mL
    D. l50 mL
    A. 120 mL
    (this multiple choice question has been scrambled)
  37. 41. Pressure-support ventilation (PSV) is classified as:
    I. F1ow-cyc1ed
    II. Time triggered
    III. Volume targeted
    IV. Pressure targeted
    V. Patient-triggered
    A. I, IV, V
    B. II and III
    C. IV and V
    D. I, II, and III
    A. I, IV, V
    (this multiple choice question has been scrambled)
  38. 42. Plateau pressure may be obtained during volume ventilation by using which of the following?
    A. Expiratory pause
    B. inspiratory pause
    C. Increased inspiratory time
    D. End-expiratory pressure
    B. inspiratory pause
    (this multiple choice question has been scrambled)
  39. 43. During volume ventilation, PIP is the pressure needed to overcome which two of
    the following factors?
    I. Muscle pressure
    II Airflow resistance
    III. Elastic recoil pressure
    IV. Transthoracic pressure
    A. III and IV
    B. I and III
    C. II and III
    D. I and II
    C. II and III
    (this multiple choice question has been scrambled)
  40. 44. The transairway pressure (PTA) represents the pressure associated with which of the following?
    A. Tubing compressibility
    B. End pressure
    C. Airflow resistance
    D. Elastic recoil
    C. Airflow resistance
    (this multiple choice question has been scrambled)
  41. 45. Which is the formula for transairway pressure (PTA)?
    A. Positive end pressure (PEEP) — Pplat
    B. PIP-Pplat
    C. PIP-PEEP
    D. Pplat-PIP
    B. PIP-Pplat
    (this multiple choice question has been scrambled)
  42. 46. Increased Pta is associated with which two of the following changes?
    I. Increased airway resistance
    II Decreased airway resistance
    III. Increased static compliance
    IV Decreased static compliance
    A. III and IV
    B. II and IV
    C. I and III
    D. I and IV
    D. I and IV
    (this multiple choice question has been scrambled)
  43. 48, What is the static lung compliance (Cs) when the returned tidal volume is 500 ml, baseline pressure is zero, and the Pplat reading is 25
    A. 2.0
    B. 0.2
    C. 0.02
    D. 2.0
    C. 0.02
    (this multiple choice question has been scrambled)
  44. 49. What is the Cs when the returned tidal volume is 700 ml the PEEP is 10 the PIP is 45cm and the Pplat is 35cm?
    A. 0.028
    B. 0.020
    C. 0.160
    D. 0.735
    A. 0.028
    (this multiple choice question has been scrambled)
  45. 50. What is the Cs when the returned tida1 volume is 460 mL, the PEEP is 8 cm the PIP is 27 cm H and the Pplat 18
    A. 20
    B. 51
    C. 46
    D. 26
    C. 46
    (this multiple choice question has been scrambled)
  46. 51. Increasing the functional residual capacity (FRC) of a spontaneously breathing patient to improve oxygenation can e accomplished by which of the following?
    A. Negative end-expiratory pressure (NEEP)
    B. PSV
    C. CPAP
    D. Inspiratory plateau
    C. CPAP
    (this multiple choice question has been scrambled)
  47. 52. What procedure is used to estimate the amount of air trapped in the patient’s lungs and in the patient circuit?
    A. Pressure-release ventilation
    B. End Expiratory pause
    C. Inspiratory pause
    D. Pressure-control ventilation
    B. End Expiratory pause
    (this multiple choice question has been scrambled)
  48. 53. Auto-PEEP can be detected without the use of an expiratory pause on which of the following curves?
    A. Pressure-time
    B. Pressure-volume
    C. flow-time
    D. Volume-time
    C. flow-time
    (this multiple choice question has been scrambled)
  49. 54. Which of the following is the technique that can actively remove gas from a ventilator circuit at the beginning of expiration?
    A. NEEP
    B. Inspiratory pause
    C. PEEP
    D. Expiratory pause
    A. NEEP
    (this multiple choice question has been scrambled)
  50. 55. What is the airflow resistance (Raw) hen the PIP is 50 cm H the Pplat is 1 5 cm H and the set ventilator gas flow ate is 60 L/min?
    A. 1
    B. 58
    C. 35
    D. 17
    C. 35
    (this multiple choice question has been scrambled)
  51. 1. In which of the following types of ventilation is alveolar expansion during inspiration due to a decrease in pleural pressure
    I. positive-pressure ventilation
    II. negative-pressure ventilation
    III. spontaneous ventilation
    A. I and II
    B. I and III
    C. I, II, and III
    D. II and III
    D. II and III
    (this multiple choice question has been scrambled)
  52. 2. Which of the following statements are true about negative pressure ventilation (NPV)?
    I. NPV is similar to spont
    II. Airway (mouth) pressure during NPV is zero
    III. Expiration during NPV is by passive recoil
    IV. NPV decreases pressure at the body surface
    A. III and IV
    B.II and IV
    C. I, II, III, and IV
    D. I, III, and IV
    C. I, II, III, and IV
    (this multiple choice question has been scrambled)
  53. 3. In which of the following types of ventilation is alveolar expansion during inspiration due to an increase in alveolar pressure
    I. negative-pressure ventilation
    II. positive-pressure ventilation
    III. spontaneous ventilation
    A. II and III
    B. II
    C. I, II, and III
    D. I and II
    B. II
    (this multiple choice question has been scrambled)
  54. 4. Which of the following statements is false about positive-pressure ventilation (PPV)?
    A. During inspiration, pleural pressure decreases.
    B. During inspiration, alveolar pressure exceeds pleural pressure.
    C. The pressure gradients of normal breathing are reversed.
    D. During inspiration, pressure in the alveoli increases
    A. During inspiration, pleural pressure decreases.
    (this multiple choice question has been scrambled)
  55. 5. Which of following conditions is associated with a lack of response to increases FiO2 in patients receiving PPV?
    A. hypoventilation
    B. hypoxemia
    C. dead space
    D. shunt
    D. shunt
    (this multiple choice question has been scrambled)
  56. 6. Administration of PEEP or CPAP is associated with all of the following benefits except maintaining:
    A. alveoli open
    B alveoli stable
    C. fluid-filled alveoli open
    D. surfactant-depleted alveoli closed
    D. surfactant-depleted alveoli closed
  57. 7. Which of the following is considered a normal spontaneous tidal volume?
    A. 10 to 12 mL/kg
    B. 5 to 7 mL/kg
    C.7 to 9 mL/kg
    D. 3 to 5 mL/kg
    B. 5 to 7 mL/kg
    (this multiple choice question has been scrambled)
  58. 8. Which of the following conditions do not require high mechanical respiratory rates?
    A. metabolic acidosis
    B. metabolic alkalosis
    C. increased intracranial pressure
    D. ARDS
    B. metabolic alkalosis
    (this multiple choice question has been scrambled)
  59. 9. Which of the following is the explanation positive end-expiratory pressure (PEEP
    A. shunt-like effect
    B. hyperexpansion
    C. diversion of blood from hypoventilated alveoli to ventilated alveoli
    D. diversion of blood from ventilated to hypoventilated areas
    D. diversion of blood from ventilated to hypoventilated areas
    (this multiple choice question has been scrambled)
  60. 10. Which of the following is the conseque:
    A. It takes less time to fill and more til
    B. It takes less time to fill and empty f
    C. It takes more time to empty the alv
    D. It takes more time to fill the alveoli
    B. It takes less time to fill and empty f
    (this multiple choice question has been scrambled)
  61. 11. Mean airway pressure may be increased by all of the following except increasing the:
    A. frequency
    B. FiO2
    C. positive end-expiratory pressure
    D. inspiratory time
    B. FiO2
    (this multiple choice question has been scrambled)
  62. 12. On what does volume delivered depend during pressure targeted modes of ventilatory support?
    1. set pressure limit
    II. patient lung mechanics
    III. patient effort
    A. II and III
    B. I and III
    C. I and II
    D. I, II, and III
    C. I and II
    (this multiple choice question has been scrambled)
  63. l3. Which of the following is FALSE about pressure limited modes of ventilation?
    A. Active effort by the patient against inspiration will decrease delivered volume
    B. The inspiratory flow varies with patient effort and lung mechanics
    C. The volume delivered at a given pressure must decreases as Raw rises
    D. The volume delivered at a given pressure must decrease as compliance falls
    C. The volume delivered at a given pressure must decreases as Raw rises
    (this multiple choice question has been scrambled)
  64. 14. The volume delivered by a pressure limited ventilator will decrease under all of the following conditions except:
    A. airway resistances rises
    B. the patient’s lung or thoracic compliance falls
    C. the patient tenses the respiratory muscles during inspiration
    D. airway resistances rises
    D. airway resistances rises
    (this multiple choice question has been scrambled)
  65. 15. Which of the following are considered safe settings for a recruitment maneuver
    I. pressures up to 50
    II. pressures up to 35
    III. pressures applied for 5 to 10 min
    IV. pressures applied for 1 to 2 min
    A. I and IV
    B. I and III
    C. II and III
    D. II and IV
    A. I and IV
    (this multiple choice question has been scrambled)
  66. 16. The magnitude of WOB depends on which of the following?
    I. compliance
    II. resistance
    III. ventilatory drive
    IV. trigger sensitivity
    V. peak flow
    A. I, II, and V
    B. I and III
    C. I, II and III
    D. I, II, III, IV, and V
    D. I, II, III, IV, and V
    (this multiple choice question has been scrambled)
  67. 17. In which of the following modes of ventilator would the patient’s work of breathing be greatest?
    A. continuous positive airway pressur (CPAP)
    B. continuous mandatory ventilation (CMV)
    C. intermittent mandatory ventilation (IMV)
    D. pressure-supported ventilation (PSV)
    A. continuous positive airway pressur (CPAP)
    (this multiple choice question has been scrambled)
  68. 18. In which of the following modes of ventilatory support would the patient’s work of breathing be least?
    A continuous positive airway pressure (CPAP)
    B. pressure-supported ventilation (PS )
    C. intermittent mandatory ventilation (IMV)
    D. continuous mandatory ventilation (CMV)
    D. continuous mandatory ventilation (CMV)
  69. 19. When bedside work of breathing measures are unavailable, you should adjust the level of pressure-supported ventilation (PSV) to which of the following breathing patterns?
    Spontaneous Rate VT
    A. 5 to 25 l/min 5 to 8 ml/kg
    B. 20 to 30 l/min 3 to 5ml/kg
    C. l0 to l5 l/min 3 to5ml/kg
    D. l5 to 25 l/min 8 to l0ml/kg
    A. 5 to 25 l/min 5 to 8 ml/kg
    (this multiple choice question has been scrambled)
  70. 20. Which level of plateau pressure increases the likelihood of causing lung injury?
    A. >25
    B. >30
    C. >15
    D doesn’t matter as long as positive inspiratory pressure is less than 50
    B. >30
    (this multiple choice question has been scrambled)
  71. 21. All of the following factors would tend o increase mean airway pressure except:
    A. increased levels of positive inspiratory pressure (PIP)
    B. T1 increased levels of positive end-expiratory pressure (PEEP)
    C. short inspiratory times
    D. increased mandatory breaths
    C. short inspiratory times
    (this multiple choice question has been scrambled)
  72. 22. Beneficial physiological effects of positive end-expiratory pressure (PEEP) include which of the following?
    I. increased PaO2 for given FiO2
    II. increased lung compliance (CL)
    III. decreased shunt fraction
    IV. increased functional residual capacity
    A. II, III, and IV
    B. I, II, III, and IV
    C. III and IV
    D. II and IV
    B. I, II, III, and IV
    (this multiple choice question has been scrambled)
  73. 23. Detrimental effects of positive end-expiratory pressure (PEEP) include all of the following except:
    A. increased incidence of barotrauma
    B. decreased venous return or cardiac output
    C. increased CL
    D. pulmonary vascular resistance
    C. increased CL
    (this multiple choice question has been scrambled)
  74. 24. Contraindications for using positive end-expiratory pressure (PEEP) in conjunction
    with mechanical ventilation include which of the following?
    I. untreated bronchopleural fistula
    II. chronic airway obstruction
    III. untreated pneumothorax
    A. II and III
    B. I, II, and III
    C. I and III
    D. I and II
    C. I and III
    (this multiple choice question has been scrambled)
  75. 25. Compared with a square wave flow pattern, a decelerating flow waveform has all of the following potential benefits except
    A. improved cardiac output
    B. less inspiratory work
    C. decreased volume of dead space to—tidal volume ratio (VD/VT)
    D. reduced peak pressure
    A. improved cardiac output
    (this multiple choice question has been scrambled)
  76. 26. Which of the following is a benefit of high inspiratory flows during positive-pressure ventilation?
    A. reduced air trapping
    B. higher work of breathing
    C. improved gas exchange
    D. higher peak pressures
    A. reduced air trapping
    (this multiple choice question has been scrambled)
  77. 27. Physiological effects of adding a volume include which of the following?
    I. decreased PaCO2
    II. increased inspiratory time
    III. decreased VD/VT
    IV. Longer expiratory times
    A. I, II, III, and IV
    B. II and IV
    C. III and IV
    D. I, II, and III
    D. I, II, and III
    (this multiple choice question has been scrambled)
  78. 28. In which of the following modes does the patient’s ventilatory pattern have most control over PaO2, PaCO2, and acid base balance
    A. volume-controlled intermittent mandatory ventilation
    B. volume-controlled continuous mandatory ventilation
    C. pressure-controlled inspiratory reserve volume
    D. pressure-supported ventilation
    B. volume-controlled continuous mandatory ventilation
    (this multiple choice question has been scrambled)
  79. 29. Which of the following modes of ventilatory support would result in the highest mean airway pressure?
    A. volume-controlled intermittent mandatory ventilation
    B. pressure controlled intermittent mandatory ventilation
    C. volume-controlled continuous mandatory ventilation
    D. volume-controlled intermittent mandatory ventilation
    C. volume-controlled continuous mandatory ventilation
    (this multiple choice question has been scrambled)
  80. 30. In which of the following modes of ventilatory support is muscle atrophy most likely to occure
    A. pressure-controlled intermittent mandatory ventilation
    B. volume-controlled continuous mandatory ventilation
    C. volume-controlled intermittent mandatory ventilation
    D. volume-controlled intermittent mandatory ventilation + pressure support
    B. volume-controlled continuous mandatory ventilation
    (this multiple choice question has been scrambled)
  81. 31. What are some key causes of patient-ventilator asynchrony and increased work of breathing during pressure-triggered you ventilation?
    I. improper trigger setting
    II. insufficient inspiratory flows
    III. high peak airway pressures
    A. I and II
    B. I and III
    C. I, II, and III
    D. II and III
    A. I and II
    (this multiple choice question has been scrambled)
  82. 32. Inspection of the airway pressure waveform of a patient receiving volume controlled continuous mandatory ventilation assist control with constant flow reveals a large dip or drop in pressure ONLY at the very beginning of inspiration which of the problems is most likely?
    A. The trigger setting is improper.
    B. The inspiratory flow is inadequate
    C. The pressure limit is too low.
    D. The set volume is too large.
    A. The trigger setting is improper.
    (this multiple choice question has been scrambled)
  83. 33. During volume-controled continous mandatory ventilation should either compliance decrease or airway resistance increases
    A. The peak airway pressure will increase
    B. The peak airway pressure will decrease
    C. The inspiratory flow will increase
    D. The inspiratory time will decrease
    A. The peak airway pressure will increase
    (this multiple choice question has been scrambled)
  84. 34. Which of the following is FALSE about permissive hypercapnia if allowed to increase slowly?
    A. It increases pulmonary vascular resistance
    B. It does not reduce systemic oxygenation
    C. It can reduce the incidence of barotrauma
    D. It lowers intrathoracic and alveolar pressures
    A. It increases pulmonary vascular resistance
    (this multiple choice question has been scrambled)
  85. 35. What mode of pressure-controlled ventilation is designed to prevent alveoli with short time constants from collapsing there by improving oxygenation
    A. bilevel positive airway pressure
    B. pressure-controlled intermittent mandatory ventilation
    C. volume-assured pressure-support
    D. pressure-controlled inverse ratio
    D. pressure-controlled inverse ratio
    (this multiple choice question has been scrambled)
  86. 36. A patient switched from pressure-control with positive end-expiratory pressure ventilation to pressure control inverse ratio ventilation (PC-IRV) shows a good improvement in oxygenation. Which of the following best explains this observation?
    A. Intrinsic PEEP caused by PC-IRV compressed pulmonary capillaries
    B. Intrinsic PEEP caused by PC-IRV resulted in increased alveolar recruitment
    C. High mean pressures caused by PC-IRV decreased pulmonary blood flow
    D. High mean pressures caused by PC-IRV decreased cardiac output
    D. High mean pressures caused by PC-IRV decreased cardiac output
    (this multiple choice question has been scrambled)
  87. 37. What are some physiological advantages of volume-assured pressure-supported ventilation?
    I. improved patient-ventilator synchrony
    II. increased pressure-time product
    III. decreased work of breathing
    A. I, II, and III
    B. I and II
    C. I and III
    D. II and III
    C. I and III
    (this multiple choice question has been scrambled)
  88. 38. What factor primarily determines the effect of positive-pressure ventilation (PPV) on the cardiac output?
    A. peak airway pressure
    B. CO2
    C. expiratory time
    D. mean pleural pressure
    D. mean pleural pressure
    (this multiple choice question has been scrambled)
  89. 39. Potential effects of hyperventilation on the central nervous system include which of the following?
    I. increased 02 consumption
    II. increased cerebral vascular resistance (CVR)
    III. increased intracranial pressure (ICP)
    A. I and II
    B. I, II, and III
    C. II and III
    D. I and III
    C. II and III
    (this multiple choice question has been scrambled)
  90. 40. Positive-pressure ventilation (PPV) can reduce urinary output by how much?
    A. 30% to 50%
    B. 80% to9O%
    C. 60% to7O%
    D. 10% to 2O%
    A. 30% to 50%
    (this multiple choice question has been scrambled)
  91. 41. Detrimental effects of auto positive end -expiratory pressure (PEEP) include all of the following except:
    A. decreased venous return
    B. increased work of breathing
    C. increased pulmonary barotrauma
    D. pulmonary vascular resistance
    D. pulmonary vascular resistance
    (this multiple choice question has been scrambled)
  92. 42. Which of the following gastrointestinal contitions are commonly associated with long-term positive-pre ventilation
    I. bleeding
    II. ulceration
    III. diarrhea
    A. II and III
    B. I, II, and III
    C. I and III
    D. I and II
    D. I and II
    (this multiple choice question has been scrambled)
  93. 43. Which of the following terms describe the lung injury associated with low tidal volumes?
    A. barotrauma
    B. atelectrauma
    C. biotrauma
    D. volutrauma
    B. atelectrauma
    (this multiple choice question has been scrambled)
  94. 44. Which of the following lung units would be most prone to air trapping
    A. one with low resistance and low compliance
    B. one with high resistance and high compliance
    C. one with high resistance an low compliance
    D. one with normal resistance and low compliance
    B. one with high resistance and high compliance
    (this multiple choice question has been scrambled)
  95. 45. The increased work of breathing associated with auto PEEP during mechanical ventilation is due to
    I. hyperinflation or impaired contractility of the diaphragm
    II. large alveolar pressure drops required triggere breaths
    III. increased volume of the intrathoracic airways
    A. I and III
    B. II and III
    C. I, II, and III
    D. I and II
    D. I and II
    (this multiple choice question has been scrambled)
  96. 1. What is the name of the point in the respiratory tract where inspired gas reaches body
    temperature, ambient pressure, saturated (BTPS) conditions?
    A. hygroscopic saturation boundary
    B. point of thermal equilibrium
    C. thermal inversion boundary
    D. isothermic saturation boundary
    D. isothermic saturation boundary
    (this multiple choice question has been scrambled)
  97. 2. Which of the following factors cause the isothermic saturation boundary (ISB) to shift farther down into the airways?
    I. decreased ambient temperature
    II. increased tidal volume
    III. endotracheal intubation
    A.I and II
    B. II and III
    C. I and III
    D I, II and III
    D I, II and III
  98. 3. What is the primary goal of humidity therapy?
    A. deliver drugs to the airway
    B. maintain normal physiologic conditions
    C. decrease airway reactivity to cold
    D. reduce upper airway inflammation
    B. maintain normal physiologic conditions
    (this multiple choice question has been scrambled)
  99. 4. Which of the following inspired conditions should be maintained when delivering medical gases to the nose or mouth?
    A. 50% relative humidity (RH) at 20 to 22° C
    B. 80% RH 28° to 32°C
    C. 100% RH at 32°to35°C
    D. l00% RH at 20°to22°C
    A. 50% relative humidity (RH) at 20 to 22° C
    (this multiple choice question has been scrambled)
  100. 5. Which of the following inspired conditions should be maintained when delivering medical gases directly into the trachea through an endotracheal tube or a tracheotomy tube?
    A. 95% RH 29° to 32°C
    B. 50% relative humidity (RH) at 20 to 22° C
    C. l00% RH at 20°to22°C
    D. 100% RH at 32°to35°C
    D. 100% RH at 32°to35°C
    (this multiple choice question has been scrambled)
  101. 6. Clinical indications for delivering cool humidified gas include which of the following?
    I. postextubation edema
    II. upper airway inflammation
    III. croup (laryngotracheal bronchitis)
    IV. epiglottitis
    A. II, III, and IV
    B. I, II, and III
    C. I, II, III, and IV
    D. II and III
    C. I, II, III, and IV
    (this multiple choice question has been scrambled)
  102. 7. The greater the temperature of the gas, the:
    A. more water vapor is lost
    B. less efficient the humidifier is
    C. more water vapor it can hold
    D. less water vapor it can hold
    C. more water vapor it can hold
    (this multiple choice question has been scrambled)
  103. 8. A design that increases surface area and enhances evaporation by incorporating an absorbent material partially submerged in a water reservoir that is surrounded by a heating element best describes what type of humidifier?
    A. hygroscopic
    B. wick
    C. bubble
    D. cascade
    B. wick
    (this multiple choice question has been scrambled)
  104. 9. Advantages of passover humidifiers include all of the following except:
    A. They add minimal flow resistance to breathing circuits.
    B. They do not require heating to maintain body temperature, ambient pressure, saturated (BTPS) conditions.
    C. They can maintain water vapor saturation at high flows.
    D. They do not generate any bacteria-spreading microaerosol.
    B. They do not require heating to maintain body temperature, ambient pressure, saturated (BTPS) conditions.
    (this multiple choice question has been scrambled)
  105. 10. Which type of humidifier “traps” the patient’s body heat and expired water vapor to
    raise the humidity of inspired gas?
    A. bubble
    B. passover
    C. membrane
    D. heat-moisture exchanger
    D. heat-moisture exchanger
    (this multiple choice question has been scrambled)
  106. 11. Which of the following are types of heat-moisture exchangers (HMEs)?
    I. simple condenser
    II. hygroscopic condenser
    III. hydrophobic condenser
    A. II and III
    B. III
    C. I and II
    D. I, II, and III
    D. I, II, and III
    (this multiple choice question has been scrambled)
  107. 12Which of the following best describes the performance of a typical hygroscopic
    condenser HME?
    A. 40 mg/L water vapor exhaled; 27 mg/L returned
    B. 40 mg/L water vapor exhaled; 20 mg/L returned
    C. 27 mg/L water vapor exhaled; 40 mg/L returned
    D. 44 mg/L water vapor exhaled; 37 mg/L returned
  108. 13. An ideal heat-moisture exchanger (RIME) should have an efficiency rating of at leasi
    which of the following?
    A. 90%
    B. 30%
    C. 50%
    D. 70%
    A. 90%
    (this multiple choice question has been scrambled)
  109. 14. All of the following are features of an ideal heat-moisture exchanger (HME) except:
    A. minimal flow resistance
    B. minimal dead space
    C. 70% or higher efficiency
    D. high compliance
    D. high compliance
    (this multiple choice question has been scrambled)
  110. 15. For which of the following patients would you select a heated humidifier?
    I. patient receiving oxygen through a bypassed upper airway
    II. patient receiving long-term mechanical ventilation
    III. patient receiving oxygen through an oronasal mask
    A. III
    B. II
    C. I and II
    D. II and III
    C. I and II
    (this multiple choice question has been scrambled)
  111. 16. A heated humidifier should trigger both auditory and visual alarms and interrupt power to the heater when the delivered temperature exceeds which of the following?
    A 25°C
    B 30°C
    C. 35°C
    D. 40° C
    D. 40° C
  112. 17. Conditions that can cause temperature “overshoot” with servo-controlled heated
    humidifiers include all of the following except:
    A. Flow is decreased during normal operation.
    B. The unit is allowed to warm up without flow.
    C. The unit reservoir is refilled with sterile water.
    D. The airway temperature probe becomes dislodged.
    C. The unit reservoir is refilled with sterile water.
    (this multiple choice question has been scrambled)
  113. 18. Where should you place the thermistor probe for a servo-controlled heated humidifier being used on a patient receiving mechanical ventilation?
    A. in the expiratory limb of the circuit, as close to the “wye” as possible
    B. in the inspiratory limb of the circuit, near but not at the “wye”
    C. in the expiratory limb of the circuit, near but not at the “wye”
    D. in the inspiratory limb of the circuit, as close to the “wye” as possible
    B. in the inspiratory limb of the circuit, near but not at the “wye”
    (this multiple choice question has been scrambled)
  114. 19. What are some potential problems with manually refilled heated humidifier reservoirs?
    I. cross-contamination and infection
    II. variable compliance or delivered volume
    III. delivery of dry andlor hot gases
    A. I and III
    B. I, II, and III
    C. I and II
    D. II and III
    B. I, II, and III
    (this multiple choice question has been scrambled)
  115. 20. All of the following are contraindications for heat-moisture exchangers except:
    A. presence of thick, copious, or bloody secretions
    B. presence of a large leak around artificial airway
    C. when a patient is suffering from hyperpyrexia
    D. when a patient’s minute ventilation exceeds 10 L/min
    C. when a patient is suffering from hyperpyrexia
    (this multiple choice question has been scrambled)
  116. 21. All of the following are potential hazards of using a heated humidifier during mechanical ventilation except:
    A. aerosolization of condensate during disconnection
    B. underhydration or impaction of secretions
    C. hypoventilation due to increased dead space
    D. unintended tracheal lavage from condensate
    C. hypoventilation due to increased dead space
    (this multiple choice question has been scrambled)
  117. 22. A patient receiving ventilatoiy support is being provided with humidification using a heat-moisture exchanger (HME). A physician orders a bronchodilator drug administered through a metered-dose inhaler (MDI) via the ventilator circuit. Which of the following must be performed to ensure delivery of the drug to the patient?
    A. The inspiratory flow setting of the ventilator should be increased.
    B. The HME must be removed from the circuit during MDI use.
    C. The VT setting of the ventilator should be decreased.
    D. A heated humidifier should replace the IIME when using the MDI.
    • B. The HME must be removed from the circuit during MDI use.
  118. 23. A patient has been supported by a mechanical ventilator using a heat-moisture exchanger for the last 3 days. Suctioning revealsan increase in the amount and tenacity of secretions. Which of the following actions is indicated?
    A. Replace the hygroscopic condenser humidifier with a new one.
    B. Reassess the patient’s secretions over the next 24 to 48 hours.
    C. Increase the hygroscopic condenser humidifier temperature.
    D. Switch the patient to a large-volume heated humidifier.
    D. Switch the patient to a large-volume heated humidifier.
    (this multiple choice question has been scrambled)
  119. 24. How often should heat-moisture exchangers be inspected and replaced?
    A. at least every shift
    B: when contaminated by secretions
    C. at least every day
    D. when condensate is visible
    B: when contaminated by secretions
  120. 25. During routine use on an intubated patient, a heated humidifier should deliver inspired at which of the following?
    A. temperature of 37 = 2° C, with a minimum of 44 mgfL of water vapor
    B. temperature of 30 ± 2° C, with a minimum of 24 mg/L of water vapor
    C. temperature of 33 ± 2°C, with a minimum of 30 mgL of water vapor
    D. temperature of 20 + 2° C, with a minimum of 10 mg/L of water vapor
    C. temperature of 33 ± 2°C, with a minimum of 30 mgL of water vapor
    (this multiple choice question has been scrambled)

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