rt103 final

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rt103 final
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rt103 final
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  1. 1. The definition of “syllabus” is:
    A. A part of a word which c stands for a complete thought
    B. A summary for a course of study
    C. The first part of a professional lexicon
    D. A form of reasoning fror+ which a logical conclusion can be drawn
    B. A summary for a course of study
    (this multiple choice question has been scrambled)
  2. 2. T or F The first Student Learning Outcome (SLO) revolves around the principles, indications, hazards, and monitoring of negative pressure ventilation.
    False
  3. 3. T or F The Student Learning Outcome(SLO) for this class includes an introduction to in monitoring of cardiac functions
    True
  4. 4. T or F The Mid Term and Final constitute approximately 40% of the grade for this class.
    True
  5. 5. According to the institutional classroom Standards, if you are going to be absent you are to
    A. contact the instructor by SJVC email prior to your absence
    B. Bring a note from your physician
    C. Call Mr. Tom Serrano by phone prior to your absence
    A. contact the instructor by SJVC email prior to your absence
    (this multiple choice question has been scrambled)
  6. 6. Missing deadline for homework and projects may result in
    I. a 10% reduction in points
    II no credit
    III void the need for turning in the project
    A. I
    B. I or II or at the instructors discretion
    C. II or III
    B. I or II or at the instructors discretion
    (this multiple choice question has been scrambled)
  7. 7. Missed quizzes, including “pop” quizzes
    A. Can be taken late in accordance with college policies
    B. May not be taken later; you will get a zero for that quiz
    B. May not be taken later; you will get a zero for that quiz
  8. 8. To F It is okay to have coffee or soda in the classroom during lectures
    False
  9. 9. In the article “Competencies Needed by Graduate Respiratory Therapist in 2015 and Beyond” how many competencies were identified and agreed upon as being needed by both new grads and existing work force
    A. 77
    B. 69
    C. 7
    D. 49
    B. 69
    (this multiple choice question has been scrambled)
  10. 10. All of the following competencies were identified as being needed except
    A. Therapists must have a broad understanding of pharmacology for all organ systems and detailed knowledge of drugs delivered via intervenous methods
    B. Graduate therapists must be able to fully operate ICU Ventilators and discuss all commonly used modes of ventilation as well as their indications and limitations
    C. They must be able to provide ventilator care based on protocol
    D. They must fully understand the tenets of evidence based medicine including the ability to critically read and critique the medical literature and discuss the meaning of stastical anaylsis
    D. They must fully understand the tenets of evidence based medicine including the ability to critically read and critique the medical literature and discuss the meaning of stastical anaylsis
    (this multiple choice question has been scrambled)
  11. 11. In Table 12, the responders evaluated the relative importance of the following categories of skills, which did they indicate most important
    A. Physical examination — patient assesments
    B. Diagnostic invasive procedures
    C. Emergency care
    D. Critical care
    D. Critical care
    (this multiple choice question has been scrambled)
  12. 12. The importance of documenting competence and quality of care by administering national board speciality certifications examinations was first identified by other professions as early as
    A. 1929
    B. 1941
    C. 1948
    D. 1917
    D. 1917
    (this multiple choice question has been scrambled)
  13. 13. Which of the following participant groups identified that ther is a perfect storm of healthcare issues in our society, and that the respiratory care prefession is in a good position to assume new or expanding roles
    A. Hospital Administrators
    B. NBRC leaders
    C. Critical Care Physicians
    D. AARC leaders
    A. Hospital Administrators
    (this multiple choice question has been scrambled)
  14. 14. Based on your reading of this article do you think that the ability to research apply and adapt to respiratory care patient care protols to specific patients needs will be of value
    A. Very useful — because it’s at the bedside where the real issue of patiend safety and treatment efficacy are most important
    B. Moderately useful — the dept management will do the heavy work
    C. Rarely — we’ll leave it up to the physicians to tell us everything we need to do
    A. Very useful — because it’s at the bedside where the real issue of patiend safety and treatment efficacy are most important
    (this multiple choice question has been scrambled)
  15. 15. “RTs in 2015 must assume greater responsibility for ______ in order to reduce the cost of healthcare.”
    A. establishing vascular access for invasive hemodynamic monitoring
    B. acute and chronic disease management
    C. education of other healthcare workers in RT procedures
    D. evidence-based medicine
    C. education of other healthcare workers in RT procedures
    (this multiple choice question has been scrambled)
  16. 1. A diagnosis of respiratory failure can be made if which of the following are present
    I. PaO2 of 55, FiO2 .21 Pb 760
    II. PaCO2 57, FiO2 .21 Pb 760
    III. P(A-a) O2 45, FiO2 1.0 Pb 760
    IV. PaO2/FiO2 400 Pb 750
    A. I and II
    B. III and IV
    C. I, III, and IV
    D. I, II, III, and IV
    A. I and II
    (this multiple choice question has been scrambled)
  17. 2. What is respiratory failure due to inadequate ventilation?
    A. chronic
    B. hypercapnic
    C. hypoxemic
    D. compensated
    B. hypercapnic
    (this multiple choice question has been scrambled)
  18. 3. Hypercapnic (type II) respiratory fail terms?
    A. shunt
    B. V/Q mismatching
    C. diffusion impairment
    D. ventilatory failure
    D. ventilatory failure
    (this multiple choice question has been scrambled)
  19. 4. Hypoxemia can be caused by which of the following
    I. diffusion impairment
    II. alveolar hypoventilation
    III. V/Q mismatch
    IV. Intrapulmonary shunting
    A. I, II, and III
    B. I, II, III, and IV
    C. I, III, and IV
    D. II III and IV
    B. I, II, III, and IV
    (this multiple choice question has been scrambled)
  20. 5. Which of the following best describes t e difference between V/Q mismatch and shunt when supplemental oxygen is administered?
    A. Neither will respond to the administration of supplemental oxygen.
    B. V/Q mismatch will not respond but shunt will respond well.
    C. Both will respond equally well.
    D. V/Q mismatch will respond well but shunt will not.
    D. V/Q mismatch will respond well but shunt will not.
    (this multiple choice question has been scrambled)
  21. 6. Which of the following clinical signs is most often associated with hypoxemia due to shunt?
    • a. diffuse wheezing
    • b. “white” chest radiograph
    • c. stridor
    • d. loud P2
    • b. “white” chest radiograph
  22. 7. A patient with interstitial lung disease ho presents with hypoxemia due to diffusion def have which of the following clinical signs?
    I. fine bibasilar crackles
    II. clubbing of the finger nail beds
    III. jugular venous distention
    IV. increased P2
    A. I, II, III, and IV
    B. I, III, and IV
    C. III and IV
    D. I and II
    A. I, II, III, and IV
    (this multiple choice question has been scrambled)
  23. 8. What type of disease is associated with perfusion/diffusion impairment?
    A. vascular disease
    B. renal disease
    C. neuromuscular disease
    D. pancreatic disease
    A. vascular disease
    (this multiple choice question has been scrambled)
  24. 9. What is the most common cause of low mixed venous oxygen?
    A. neuromuscular disease
    B. peripheral vascular disease
    C. liver disease
    D. cardiac disease, with low cardiac output
    D. cardiac disease, with low cardiac output
    (this multiple choice question has been scrambled)
  25. 10. What is the normal P (A—a) 02 range while breathing room air?
    A. greater than 25 mmHg
    B. less than 10 mmHg
    C. l0 mmHg to 25 mmHg
    D. 25 mmHg to 50 mmHg
    C. l0 mmHg to 25 mmHg
    (this multiple choice question has been scrambled)
  26. 11. What is the normal P (A—a) 02 with V/Q mismatch and shunt?
    A. decreases with both V/Q mismatch and shunt
    B. it does not change
    C. increases with V/Q mismatch and decreases with shunt
    D. increases with both V/Q mismatch and shunt
    D. increases with both V/Q mismatch and shunt
    (this multiple choice question has been scrambled)
  27. 12. What is the optimal treatment of intrapulmonary shunt?
    A. surgery
    B. increase the FiO2
    C. alveolar recruitment
    D. decrease the FiO2
    C. alveolar recruitment
    (this multiple choice question has been scrambled)
  28. 13. A patient with an opiate drug overdose blood gas results breathing room air: pH 7.19, PCO2 89, HCO3 27, PO2 48
    Which of the following best describe the patient’s condition?
    A. acute hypoxemic respiratory failure
    B. chronic hypersonic respiratory failure
    C. acute hypersonic respiratory failure
    D. chronic hypoxemic respiratory failure
    C. acute hypersonic respiratory failure
    (this multiple choice question has been scrambled)
  29. 4. All of the following would tend to cause hypersonic respiratory failure except
    A. smoke inhalation
    B. hypothyroidism
    C. chronic obstructive pulmonary disease
    D. opiate drug overdose
    A. smoke inhalation
    (this multiple choice question has been scrambled)
  30. 15. Which of the following are associate with hypercapnic respiratory failure due to decreased ventilatory drive?
    I. brainstem lesions
    II. encephalitis
    III. hypothyroidism
    IV. asthma
    A. I, II, III, and IV
    B. III and IV
    C. I, II, and III
    D. II and IV
    C. I, II, and III
    (this multiple choice question has been scrambled)
  31. 16. All of the following are associated with respiratory muscle weakness or fatigue
    A. amyotrophic lateral sclerosis
    B. myasthenia gravis
    C. hyperthyroidism
    D. Guillian Barre syndrome
    C. hyperthyroidism
    (this multiple choice question has been scrambled)
  32. 17. Which of the following is a feature of Guillian Barre
    A. descending muscle weakness
    B. limited to trunk
    C. ascending muscle weakness
    D. limited to lower extremities
    C. ascending muscle weakness
    (this multiple choice question has been scrambled)
  33. 18. All of the following are associated with increased work of breathing except:
    A. kyphoscoliosis
    B. myasthenia gravis
    C. obesity
    D. asthma
    B. myasthenia gravis
    (this multiple choice question has been scrambled)
  34. 19. Which of the following information be respiratory failure from acute hypercapnea
    A. long-standing dyspnea that worsen
    B. forced expiratory volume in I second of forced vital capacity ratio is less than 75% predicted
    C. kidneys retaining bicarbonate to elevate the blood pH
    D. physical signs of hypoxemia, such as cyanosis and clubbing
    C. kidneys retaining bicarbonate to elevate the blood pH
    (this multiple choice question has been scrambled)
  35. 20. Which of the following is the cardinal sign of increased work of breathing
    A. retractions
    B. tachypnea
    C. hyperventilation
    D. bradycardia
    B. tachypnea
    (this multiple choice question has been scrambled)
  36. 21. In patients suffering from acute respiratory failure below what pH level is intubation and ventilatory support generally considered
    A. 7.30
    B. 7.15
    C. 7.20
    D. 7.26
    C. 7.20
    (this multiple choice question has been scrambled)
  37. 22. Which of the following patients has the most serious problem with the adequacy of oxygenation?
    A. 0.70 90
    B. 0.40 95
    C. 1.00 85
    D. 0.28 65
    C. 1.00 85
    (this multiple choice question has been scrambled)
  38. 23. A need for some form of ventilatory support is usually indicated when an adult’s rate
    of breathing rises above what level?
    A. 30/mm
    B. 25/mm
    C. 20/mm
    D. 35/mm
    D. 35/mm
    (this multiple choice question has been scrambled)
  39. 24. Which of the following measures is useful indicators in assessing the adequacy of a patient’s oxygenation?
    I. PAO2 – PaO2
    II. PaO2 to FiO2 ratio
    III. VD/VT
    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)
  40. 25. Which of the following measures taken on adult patients indicate unacceptably high demands or work of breathing?
    A. breathing rate of 22/mm
    B. MIP of -40 cm H
    C. VE of 17 L/min
    D. VD/VT of 0.45
    C. VE of 17 L/min
    (this multiple choice question has been scrambled)
  41. 26. Ventilatory support may be indicated when the VC falls below what level?
    A. 30m1/kg
    B. 65m1/kg
    C. 45 ml/kg
    D. 10ml/Ikg
    D. 10ml/kg
    (this multiple choice question has been scrambled)
  42. 27. What is the normal range of maximum inspiratory pressure, or MIP (also called negative inspiratory force, or NIF), generated by adults?
    A -80 to –l00
    B. -50 to -80
    C. -30 to -50
    D. -20 to -30
    A -80 to –l00
  43. 8. Which of the following MIP measure taken on an adult patient indicates inadequate
    respiratory muscle strength?
    A. -40
    B. -90
    C. -70
    D. –l5
    D. –l5
    (this multiple choice question has been scrambled)
  44. 29. Common bedside measures used to assess the adequacy of lung expansion include all of the following except
    A. VC
    B. respiratory rate
    C. VD/VT
    D. VT
    C. VD/VT
    (this multiple choice question has been scrambled)
  45. 30. You determine that an acutely ill patient can generate an MIP of -18. Based on this information, what might you conclude?
    A. The patient has an excessive work of breathing.
    B. The patient has inadequate alveolar ventilation.
    C. The patient has an unstable or irregular ventilatory drive.
    D. The patient has inadequate respiratory muscle strength.
    D. The patient has inadequate respiratory muscle strength.
    (this multiple choice question has been scrambled)
  46. 31. Breathing 100% 02, a patient has a PA 2 of 60mm Hg. Based on this information, what might you conclude?
    A. The patient has acceptable oxygenation.
    B. The patient has inadequate ventilation.
    C. The patient has an excessive work of breathing.
    D. The patient has severe hypoxemia.
    A. The patient has acceptable oxygenation.
    (this multiple choice question has been scrambled)
  47. 32. What is the normal range for Pa02?
    A. 150 to 250
    B. >400
    C. 75 to 150
    D.250 to 350
    B. >400
    (this multiple choice question has been scrambled)
  48. 33. Which of the following measures should be used in assessing the adequacy of a patient’s alveolar ventilation?
    1. Pa02
    II. arterial pH
    III. PaC0
    A. I and II
    B. I and III
    C. II and III
    D. I, II and III
    • C. II and III
  49. 34. A patient with a 10-year history of chronic bronchitis for, with an acute viral pneumonia for the last 3 days now exhibits the following blood gas pH= 7.22; PCO =67; HCO= 26 PCO2 = 60 which of the following best describes the patient’s condition?
    A. acute hypercapnic respiratory failure
    B. chronic hypercapnic respiratory failure
    C. chronic hypoxemic respiratory failure
    D. acute hypoxemic respiratory failure
    A. acute hypercapnic respiratory failure
    (this multiple choice question has been scrambled)
  50. 35. cause an elevated PaCO2 increases ventilatory drive in normal subjects , the clinical presence of hypercapnia indicates which of the following?
    I. inability of the stimulus to get to the muscles
    II. weak or missing central nervous system
    III. pulmonary muscle fatigue
    A. II and III
    B. I or III
    C. I and II
    D. I, or II, or III
    D. I, or II, or III
    (this multiple choice question has been scrambled)
  51. 36. Which of the following indicators are useful in assessing respiratory muscle strength
    I. maximum voluntary ventilation (MVV)
    II. forced vital capacity (FVC)
    III. dead space to tidal volume ratio (VD/VT)
    IV. Maximum inspiratory pressure (MIP)
    A. I and III
    B. I, II, and IV
    C. III and IV
    D. II and IV
    B. I, II, and IV
    (this multiple choice question has been scrambled)
  52. 37. A reversible impairment in the response of an overload best describes which of the following
    A. contractile respiratory muscle fatigue
    B. transmission respiratory muscle fatigue
    C. chronic respiratory muscle fatigue
    D. central respiratory muscle fatigue
    A. contractile respiratory muscle fatigue
    (this multiple choice question has been scrambled)
  53. 38. Which of the following modes of ventilatory support would you recommend for a mild hypoxemic patient from congestive heart
    A. high-level pressure support ventilation
    B. intermittent mandatory ventilation
    C. continuous positive airway pressure
    D. inverse-ratio pressure control ventilation
    C. continuous positive airway pressure
    (this multiple choice question has been scrambled)
  54. 39. Which of the following patients are at greatest risk for developing auto PEEP during mechanical ventilation?
    A. those with acute lung injury
    B. those with congestive heart failure
    C. those with COPD
    D. those with bilateral pneumonia
    C. those with COPD
    (this multiple choice question has been scrambled)
  55. 40. What are some causes of dynamic hyperinflation.
    I. increased expiratory time
    II. increased airway resistance
    III. decreased expiratory flow rate
    A. I, II, and III
    B. I and III
    C. II and III
    D. II and II
    C. II and III
    (this multiple choice question has been scrambled)
  56. 26. It is important to monitor ventilatory parameters in addition to arterial blood gases because:
    A. it is easier and more cost-effective to monitor ventilatory parameters.
    B. monitoring of ventilatory parameters can be done without a physician’s order, whereas arterial blood gas monitoring requires a physician’s order.
    C. monitoring of the ventilatory parameters does not require specialized equipment and can be done more quickly.
    D. changes will occur in ventilator parameters before they are seen in arterial blood gases.
    D. changes will occur in ventilator parameters before they are seen in arterial blood gases.
    (this multiple choice question has been scrambled)
  57. 27.Ventilatory measurements routinely monitored at the bedside include all of the following except:
    A. airway pressures.
    B. lung volumes and flows.
    C. oxygen consumption and carbon dioxide production.
    D. fractional gas concentrations.
    C. oxygen consumption and carbon dioxide production.
    (this multiple choice question has been scrambled)
  58. 28. It is important to monitor lung volumes in patients on ventilators because they:
    a affect gas exchange in the lung.
    b. reflect changes in the patient’s clinical status.
    c. indicate response to therapy and any problems that may arise.
    d. All of the above
    c. indicate response to therapy and any problems that may arise.
  59. 29. Which of the following is/are true about the tidal volume?
    A. It is made up of two components: alveolar volume and dead space volume.
    B. It is usually 10 to 15 mLlkg ideal body weight.
    C. It is usually about 25% to 30% of total lung capacity.
    d. All of the above
    A. It is made up of two components: alveolar volume and dead space volume.
    (this multiple choice question has been scrambled)
  60. 30. In healthy, spontaneously breathing patients, an occasional increase in tidal volume to three or four times the normal level, which normally occurs about six to ten times each hour is the defnition of a:
    A. sigh.
    B. sneeze.
    C. forced vital capacity.
    D. cough.
    A. sigh.
    (this multiple choice question has been scrambled)
  61. 31. If intubated and mechanically ventilated patients are given shallow tidal volumes without sighs, which of the following is most likely to occur?
    A. Atelectasis
    B. Coughing
    C. Increase in secretion production
    D. Respiratory arrest
    A. Atelectasis
    (this multiple choice question has been scrambled)
  62. 32. In mechanically ventilated patients, normal tidal volumes are not usually used without positive end-expiratory pressure (PEEP) because they will cause:
    a. an increase in intrapulmonary shunting.
    b. a reduction in functional residual capacity.
    c. a decrease in the partial pressure of arterial oxygen (Pa0
    d. All of the above
    d. All of the above
  63. 33. The “stacking” of breaths, often seen in mechanically ventilated patients with severe obstruction, can be caused by:
    A. ventilator malfunction.
    B. an insufficient expiratory time.
    C. a low-measured tidal volume.
    D. a respiratory rate that is too low.
    B. an insufficient expiratory time.
    (this multiple choice question has been scrambled)
  64. 34. The amount of force needed to maintain a mechanical tidal volume breath in the patient’s lungs is known as:
    A. continuous positive airway pressure.
    B. positive end-expiratory pressure.
    C. static pressure.
    D. peak pressure.
    C. static pressure.
    (this multiple choice question has been scrambled)
  65. 35. Compliance is defined as:
    A. Both a and b
    B. elasticity.
    C. pressure change per unit of volume.
    D. volume change per unit of pressure.
    D. volume change per unit of pressure.
    (this multiple choice question has been scrambled)
  66. 36. ARDS, pneumonia, and pulmonary edema are likely to cause a decrease in lung compliance. This is evidenced in a mechanically ventilated patient by:
    A. an increase in static pressure.
    B. an increase in dynamic pressure.
    C. an increase in expiratory time.
    D. an increase in inspiratory time.
    A. an increase in static pressure.
    (this multiple choice question has been scrambled)
  67. 37. If auto-PEEP is present, it is most likely to be detected if the expiratory limb of th patient circuit is occluded at what point in the cycle?
    a. At the end of exhalation
    b. In the middle of inhalation
    c. In maximal inhalation
    d. All of the above
  68. 38. In the ICU, the airway resistance (Raw) of a mechanically ventilated patient can b easily estimated by which of the following formulas?
    A. (peak pressure - static pressure)/2
    B. (ET tube diameter - static pressure)/peak airway pressure
    C. (peak pressure - static pressure)/flow
    D. (flow - inspiratory time)/60
    C. (peak pressure - static pressure)/flow
    (this multiple choice question has been scrambled)
  69. 39. All of the following are likely to increase the mean airway pressure (MAP) except
    a. an increase in flow rate.
    b. an increase in PEEP levels.
    c. an increase in peak pressure.
    d. an increase in expiratory time.
  70. 40. When a patient’s mechanical ventilator has a graphic display screen, which of the following waveforms could be used to determine whether there is any leak in the
    system and the amount of the leak?
    A. Pressure/time
    B. Volume/time
    C. Pressure/flow
    D. Flow/time
    B. Volume/time
    (this multiple choice question has been scrambled)
  71. 41. A pre-use check on the Servo i contains which of the following:
    a. Circuit leak check
    b. Measurement of compressible volume factor
    c. 02 cell check
    d. All of the above are correct
    e. The Servo I does not have a pre use check
    d. All of the above are correct
  72. 42. How long will the Oxygen Breath button deliver 100% 02 on the Servo i?
    A. 1 minute
    B. 5 minutes
    C. 2 minutes
    d Until you turn it off
    C. 2 minutes
    (this multiple choice question has been scrambled)
  73. 43. The Servo i has the option of compensating for circuit compressible volume (aka. Tube Compliance Factor, TCF).
    a. True
    b. False
    a. True
  74. 44. Which of the following is NOT controlled by a direct access knob on the user interface in Volume Control mode:
    a. Fi02
    b. Respiratory Rate
    c Inspiratory Time
    d. PEEP
    e. All of the above can be directly controlled in Volume Control mode.
    c Inspiratory Time
  75. 45. When the Automode is activated it will allow the patient to increase the inspiratory flow rate above the set flow rate, and shorten the Ti.
    a. True
    b. False
    a. True
  76. 46. The criteria for the clinical diagnosis of brain death includes all of the following except:
    a. Doll’s eyes
    b. no cough response to deep tracheal suction
    c .intact spinal reflexes
    d. persistent apnea after 7-10 minutes
    c .intact spinal reflexes
  77. 47. For the end results of the APNEA TEST to be valid, the PaCO2 must be greatei than:
    a. 30torr
    b. 40torr
    c. 50torr
    d 60torr
    d 60torr
  78. 48. Apnea Test “exclusion criteria” to rule out potentially reversible causes of coma thai mimic brain death, include all of the following except:
    A. Hypertension
    B. Sedative drugs
    C. NMBs
    D. Hypothermia
    A. Hypertension
    (this multiple choice question has been scrambled)
  79. 49. Acute dyspnea can be caused by which of the following ventilator setting:
    I. High pressure control setting
    II. Setting the tidal volume low enough that the peak airway pressure is kept <30 cm H20
    III The assist-control back-up rate is set so that the patient must trigger th ventilator
    IV. A long inspiratory time
    A. I, II, IV
    B. I, II, III
    C. I, III, IV
    d. All of the above can cause dyspnea
    A. I, II, IV
    (this multiple choice question has been scrambled)
  80. 50. True or False
    Ventilator settings that “exercise” the patient can cause patient-ventilator dys synchrony.
    True
  81. 51. pH 7.46 PCO 25 HCO 17
    A. Acute Metabolic Acidosis
    B. Combined Respiratory & Metabolic Acidosis
    C. Chronic Respiratory Alkalosis
    D. Mixed Metabolic & Respiratory Alkalosis
    E. Chronic Respiratory Acidosis
    C. Chronic Respiratory Alkalosis
    (this multiple choice question has been scrambled)
  82. 52. pH 7.33 PCO 70 HCO 36
    A. Mixed Metabolic & Respiratory Alkalosis
    B. Acute Metabolic Acidosis
    C. Chronic Respiratory Alkalosis
    D. Combined Respiratory & Metabolic Acidosis
    E. Chronic Respiratory Acidosis
    E. Chronic Respiratory Acidosis
    (this multiple choice question has been scrambled)
  83. 53. pH 7.11 PCO 16 HCO 5
    a. Chronic Respiratory Alkalosis
    b. Mixed Metabolic & Respiratory Alkalosis
    c. Acute Metabolic Acidosis
    d. Chronic Respiratory Acidosis
    e. Combined Respiratory & Metabolic Acidosis
    • c. Acute Metabolic Acidosis
    • 54. pH 7.55 PCO 35 HCO 33
    • a. Chronic Respiratory Alkalosis
    • b. Mixed Metabolic & Respiratory Alkalosis
    • c. Acute Metabolic Acidosis
    • d. Chronic Respiratory Acidosis
    • e. Combined Respiratory & Metabolic Acidosis
    • b. Mixed Metabolic & Respiratory Alkalosis
  84. 55. pH 7.15 PCO 50 HCO 17
    A. Chronic Respiratory Alkalosis
    B. Combined Respiratory & Metabolic Acidosis
    C. Chronic Respiratory Acidosis
    D. Acute Metabolic Acidosis
    E. Mixed Metabolic & Respiratory Alkalosis
    E. Mixed Metabolic & Respiratory Alkalosis
    (this multiple choice question has been scrambled)
  85. 56. pH 7.61 PCO 33 HCO 29
    A. Combined Respiratory & Metabolic Acidosis
    B. Normal Acid Base balance
    C. Respiratory Alkalosis correcting Metabolic Acidosis
    D. Combined Metabolic & Respiratory Alkalosis
    E. Chronic Respiratory Acidosis
    A. Combined Respiratory & Metabolic Acidosis
    (this multiple choice question has been scrambled)
  86. 57. pH 7.35 PCO 20 HCO 12
    A. Chronic Respiratory Acidosis
    B. Combined Respiratory & Metabolic Acidosis
    C. Normal Acid Base balance
    D. Respiratory Alkalosis correcting Metabolic Acidosis
    E. Combined Metabolic & Respiratory Alkalosis
    D. Respiratory Alkalosis correcting Metabolic Acidosis
    (this multiple choice question has been scrambled)
  87. 58. pH7.30 PCO31 HCO15
    A. Respiratory Alkalosis correcting Metabolic Acidosis
    B. Combined Respiratory & Metabolic Acidosis
    C. Combined Metabolic & Respiratory Alkalosis
    D. Chronic Respiratory Acidosis
    E. Normal Acid Base balance
    C. Combined Metabolic & Respiratory Alkalosis
    (this multiple choice question has been scrambled)
  88. 59. pH 7.40 PCO 33 HCO 50
    A. Normal Acid Base balance
    B. Respiratory Alkalosis correcting Metabolic Acidosis
    C. Combined Respiratory & Metabolic Acidosis
    D. Chronic Respiratory Acidosis
    E. Combined Metabolic & Respiratory Alkalosis
    B. Respiratory Alkalosis correcting Metabolic Acidosis
    (this multiple choice question has been scrambled)
  89. 60. pH 7.26 PCO 50 HCO 22
    A. Combined Respiratory & Metabolic Acidosis
    B. Chronic Respiratory Acidosis
    C. Respiratory Alkalosis correcting Metabolic Acidosis
    D. Combined Metabolic & Respiratory Alkalosis
    E. Normal Acid Base balance
    A. Combined Respiratory & Metabolic Acidosis
    (this multiple choice question has been scrambled)
  90. 61. While monitoring patients, signals, or values are susceptible to variability due to all of the following, except
    A. artifacts
    B. fictitious events
    C. seasonal variation
    D. instrument drift
    C. seasonal variation
    (this multiple choice question has been scrambled)
  91. 62. Temporary variation in pulmonary artery pressure readings due to movement of the hemodynamic monitoring line is an example of what type of variability?
    A. artifact
    B. fictitious event
    C. instrument drift
    D. physiologic variation
    A. artifact
    (this multiple choice question has been scrambled)
  92. 63. Which of the following are the reasons monitors are needed?
    I. continuous assessment
    II. analysis of vital signs
    III. measurement of values that caregivers cannot detect
    A. I and III
    B. I only
    C. I and II
    D. I, II, and III
    A. I and III
    (this multiple choice question has been scrambled)
  93. 64. Which of the following parameters is NOT a major factor in determining tissu oxygenation?
    A. R/Q ratio
    B. oxygen uptake
    C. tissue perfusion
    D. arterial oxygenation
    A. R/Q ratio
    (this multiple choice question has been scrambled)
  94. 65. In low-perfusion patients, what site would be best for monitoring Sp0
    A. forehead
    B. earlobe
    C. nose
    D. finger
    D. finger
    (this multiple choice question has been scrambled)
  95. 66 The setting of the alarm threshold for the minute ventilation (Ve) may be too high if it allows the natient to double their current Ve.
    A. True
    B. False
    A. True
  96. 67. Which of the following is NOT likely to cause errors in SpO2 readings?
    A. significant tachycardia
    B. deeply pigmented skin
    C. anemia
    D. motion due to shivering
    A. significant tachycardia
    (this multiple choice question has been scrambled)
  97. 68. What is the normal approximate value for oxygen consumption?
    A. 300 ml/min
    B. 150 ml/mm
    C. 200 ml/mm
    D. 250 ml/mm
    D. 250 ml/mm
    (this multiple choice question has been scrambled)
  98. 69. What method(s) is/are used to measure oxygen consumption?
    I. Fick method
    II. analysis of inspired and expired gases
    III. V/Q scans
    A. I only
    B. I and III
    C. I, II, and III
    D. I and II
    D. I and II
    (this multiple choice question has been scrambled)
  99. 70. What is the best measure of the efficiency of gas exchange in the lung?
    A. PaCO
    B. PaCO
    C. VD/VT
    D. end-tidal PCO
    C. VD/VT
    (this multiple choice question has been scrambled)
  100. 71. In which of the following disorders would an increased VD/VT ratio be likely?
    A. pulmonary embolism
    B. hypothalamus tumor
    C. acute lung injury
    D. congestive heart failure
    B. hypothalamus tumor
    (this multiple choice question has been scrambled)
  101. 72. What is the normal range for lung compliance?
    A. 100 to 120
    B. 40 to 60
    C. 60 to 100
    D. 80 to 120
    C. 60 to 100
    (this multiple choice question has been scrambled)
  102. 73. Which of the following conditions is associated with an increased lung compliance measurement?
    A. pneumonia
    B. bronchial intubation
    C. emphysema
    D. atelectasis .
    C. emphysema
    (this multiple choice question has been scrambled)
  103. 74. Which of the following is NOT a cause of increased airway resistance?
    A. high gas flow
    B. suctiomng
    C. small endotracheal tube
    D. increased secretions
    B. suctiomng
    (this multiple choice question has been scrambled)
  104. 75. What is the upper limit for plateau airway pressure that is recommended during mechanical ventilation?
    A. 40 to 50
    B. depends on the patient
    C. less than 30
    D. 60 to 80
    C. less than 30
    (this multiple choice question has been scrambled)
  105. 76. Which of the following factors is not associated with an increased risk for auto-PEEP
    A. mechanical ventilation of a patient with obstructive lung disease
    B. high minute volume during mechanical ventilation
    C. acute respiratory distress syndrome (ARDS) patients
    D pulmonary fibrosis
    D pulmonary fibrosis
  106. 77. Which of the following is NOT associated with auto-PEEP?
    A. hemodynamic compromise
    B. erroneous calculation of static lung compliance
    C. barotraumas
    D. effective trigger sensitivity
    D. effective trigger sensitivity
    (this multiple choice question has been scrambled)
  107. 78. What is the normal range for the percent of oxygen consumption consumed by the , muscles?
    A 2% to 5%
    B. 5%tolO%
    C. l0%tol5%
    D. 20%to25%
    A 2% to 5%
  108. 79. Which of the following breathing patterns suggests respiratory muscle decompensation?
    A. slow and deep breaths
    B. slow and shallow breaths
    C. rapid and shallow breaths
    D. rapid and deep breaths
    C. rapid and shallow breaths
    (this multiple choice question has been scrambled)
  109. 80. Which of the following is NOT a common purpose of using ventilator graphics?
    A. to determine patient ventilator synchrony
    B. to assess effects of bronchodilators
    C. to detect auto-PEEP
    D. to determine best FIO
    D. to determine best FIO
    (this multiple choice question has been scrambled)
  110. 81. What medication is associated with dilated and fixed pupils in the intensive care unit patient?
    A. atropine
    B. vanceril
    C. aminophylline
    D. lidocaine
    A. atropine
    (this multiple choice question has been scrambled)
  111. 82. At what level of intracranial pressure will venous drainage be impeded and cerebral edema develop in uninjured tissue?
    A. 30 to 35mmHg
    B. l0 to l5mmHg
    C. 20 to 30 mm Hg
    D. 40 to 45mmHg
    A. 30 to 35mmHg
    (this multiple choice question has been scrambled)
  112. 83. What is the Glasgow Coma Scale (GCS) score that requires intracranial
    pressure monitoring?
    A less than 8
    B. less than 9
    C. less than l0
    D. less than 11
    A less than 8
  113. 84. Which of the following should be considered if medical and mechanical problems have been e and the patient continues to fight the ventilator or exhibit high levels of agitation or distress?
    A. paralytics
    B. sedatives
    C. narcotics
    D. anesthetics
    B. sedatives
    (this multiple choice question has been scrambled)
  114. 85. What type of internal compressor is used by the Cardinal AVEA ventilator?
    A. Scroll pump
    B. Diaphragm
    C. Piston
    D. Rotary
    A. Scroll pump
    (this multiple choice question has been scrambled)
  115. 86. On the Cardinal AVEA, the pressure-support ventilation (PSV) Tmax setting provides which of the following?
    A. Maximum pressure support level during airway pressure-release ventilation
    B. Time-cycling for spontaneous breaths
    C. Pressure-limit setting for PSV mode
    D. Maximum flow setting for flow-cycling
    (APRV)
    B. Time-cycling for spontaneous breaths
    (this multiple choice question has been scrambled)
  116. 87. Which of the following represent the neonatal modes of ventilation available
    on the Cardinal AVEA?
    I. Pressure-regulated volume control (PRVC) A/C
    II. Time-cycled, pressure-limited (TCPL) SIMV
    III. APRV/BiPhasic
    IV. CPAP PSV
    A. I and III
    B. II and IV
    C. III and IV
    D. I and II
    B. II and IV
    (this multiple choice question has been scrambled)
  117. 88. The Cardinal AVEA can deliver which of the following gases to a patient?
    I. Room air
    II. Nitrous oxide
    III. 70/30 heliox
    IV. 80/20 heliox
    A. II and III
    B. I and IV
    C. I and III
    D. II and IV
    B. I and IV
    (this multiple choice question has been scrambled)
  118. 89. The respiratory mechanics maneuver on the Cardinal AVEA ventilator that is used to determine a patient’s work of breathing is:
    A. Pflex
    B. Esophageal pressure
    C. P100
    D. MIP
    B. Esophageal pressure
    (this multiple choice question has been scrambled)
  119. 90. To achieve the set volume in the PRVC mode, the Cardinal AVEA will increase or decrease the pressure by ____ cm H
    a. 1
    b. 2
    c. 3
    d. 4
    • c. 3
    • 1. When transporting a patient on a transport ventilator it isn’t necessary to bring a self-inflating bag and mask of appropriate size.
    • A. True
    • B. False
    • B. False
  120. 2. Transport ventilators have not been shown to provide a more constant minute ventilation than manual ventilation during short term in-house patient transports.
    A. True
    B. False
    B. False
  121. 3. Contraindications to in-house transports include:
    I. inability to provide adequate oxygenation
    II. inability to maintain acceptable hemodynamic performance during transport
    III. inability to adequately monitor patient cardiopulmonary status during transport,
    IV. inability to maintain artificial airway control
    A. I, II, III, IV
    B.I
    C. I, II
    D. I, II, III
    A. I, II, III, IV
    (this multiple choice question has been scrambled)
  122. 4. Loss of the artrncial airway is potential risk during in-hospital transport.
    A. True
    B. False
    A. True
  123. 5. In one major study regarding in-hospital transport, approximately 70% of the in-hospital transports caused significant physiologic events lasting at least 5 minutes.
    A. True
    B. False
    A. True
  124. 1. PRVC uses what flow pattern to deliver a breath?
    A. Constant flow
    B. Decelerating wave
    C. Sine wave
    D. Square wave
    e. None of the above
    B. Decelerating wave
    (this multiple choice question has been scrambled)
  125. 2. A pre-use check on the Servo i contains which of the following:
    a. Circuit leak check
    b. Measurenicnt of compressible volume factor
    c. 02 cell check
    d. All of the above are correct
    e. The Servo I does not have a preuse cheek
    d. All of the above are correct
  126. 3. How long will the Oxygen Breath button deliver 100% 02 on the Servo I?
    A. 1 minute
    B. 2 minutes
    C. 5 minutes
    d Until you turn it off
    B. 2 minutes
    (this multiple choice question has been scrambled)
  127. 4 The Servo i has the option of compensating for circuit compressible volume (aka. Tube Compliance Factor, TCP).
    A. True
    B. False
    A. True
  128. 5. Which of the following is NOT controlled by a direct access knob on the user interface in Volume Control mode:
    A. Respiratory Rate
    B. Inspiratory Time
    C. Fi02
    D. PEEP
    e. All of the above can be directly controlled in volume Control mode.
    B. Inspiratory Time
    (this multiple choice question has been scrambled)
  129. 6. Which of the following statements is true about the Servo I?
    A. The ventilator cannot freeze (save) pressure volume loops
    B. The ventilator can be used for transport with gas cylinder attached
    C. The ventilator can on be used on adult patients
    D. The ventilator has a backup battery power source for its compressor
    B. The ventilator can be used for transport with gas cylinder attached
    (this multiple choice question has been scrambled)
  130. 7. Which mode of ventilation on the Servo i adjusts the pressure support level automatically for the spontaneously breathing patient?
    A. Volume Support
    B. Volume Control
    C. Pressure Regulated Volume Control
    D. Pressure Support
    C. Pressure Regulated Volume Control
    (this multiple choice question has been scrambled)
  131. 8. The Servo i has the option for monitoring the end-tidal PCO2 (PetCO2), and calculating the VCO2, which is half of the respiratory quotient.
    A. True
    B. False
    A. True
  132. 9. When the Automode is activated it will allow the patient to increase the inspiratory flow rate above the set flow rate, and shorten the Ti.
    A. True
    B. False
    A. True
  133. 10. The default flow pattern in all volume modes is a decelerating waveform;
    A. True
    B. False
    B. False
  134. 1. What was the initial stated purpose for using Adaptive Pressure Control mode of ventilation?
    A. To support ARDS patients, and protect from excessive pressures
    B. To be used as an Auto-wean mode in the post-OP population
    C. To replace PSV because it over ventilated too many patients
    D. To support COPD patients, and reduce their work of breathing
    B. To be used as an Auto-wean mode in the post-OP population
    (this multiple choice question has been scrambled)
  135. 2. Which of the following ventilators dropped to Ojoules of support as the patient’s work of breathing increased?
    a PB 840 VC+
    b. Drager Auto Flow
    c. Hamilton Galileo
    d. Servo-i
    d. Servo-i
  136. 3. From this, and other, articles we now know the following:
    A. Most ventilators work about the same in APC mode
    B. If the ventilator shows a measured Vt higher than the set Vt, the patient is not receiving much (if any) pressure support, and may be inspiratory flow starved.
    C. This mode of ventilation always meets the patient’s inspiratory flow demand.
    B. If the ventilator shows a measured Vt higher than the set Vt, the patient is not receiving much (if any) pressure support, and may be inspiratory flow starved.
    (this multiple choice question has been scrambled)
  137. 4. According to another article quoted, which of the following modes was the least comfortable for spontaneous breathing normal patients?
    A. Volume control
    B. Pressure support
    C. APC
    C. APC
    (this multiple choice question has been scrambled)
  138. 5. Among ARDS patients, which of the following modes of ventilation supported the patient’s WOB best?
    A. Volume control
    B. Pressure support
    C. APC
    A. Volume control
    (this multiple choice question has been scrambled)
  139. 1. List 3 medical conditions which have been confirmed to have an association with obstructive sleep apnea.
    • Hypertension
    • Stroke
    • Nocturnal Angina
  140. 2. Compared with data of the general US population, patients with obstructive sleep apnea/hypopnea syndrome may have _______ as much hypertension, ______as much ischemic heart diease, and ______as much cerebrovascular disease.
    • 2x
    • 3x
    • 4x
  141. 3. Hypertrophy of the right and left ventricles of the heart tends to occur with obstructive sleep apnea. What is the suspected mechanism?
    Repeated hypoxemic events
  142. 4. Patients with obstructive breathing disorders are more prone to depression, anxiety, and sexual dysfunction.
    A. True
    B. False
    A. True
  143. 5. (Fill in the blank) Studies demonstrate excess mortality rates due to obstructive sleep apnea of ____ % over 5-8 years, with most deaths attributed to _________________
    • 6
    • Vascular Disease
    • 1. Our multidisciplinary goal is to maintain pam control at a level 5 or above on a Wong Baker scale (scale of 0 — 10).
    • A. True
    • B. False
    • B. False
  144. 2. Pleuritic chest pain is often sharp, localized pain, most often at the periphery of the chest, and increases with deep breathing, coughing, sneezing or movement. Musculoskeletal trauma would be a good example.
    A. True
    B. False
    A. True
  145. 3. Unrelieved pain has no relationship to the pulmonary signs of decreased flows and volumes, atelectasis, shunting & hypoxemia, decreased effectiveness of cough, or sputum retention.
    A. True
    B. False
    B. False
  146. 4. We should notify the physician or nurse if the initial, or subsequent, pain medication orders are inadequate or breakthrough pain occurs.
    A. True
    B. False
    A. True
  147. 5. FLACC scale (face-legs-activity-cry-consolability) can be used for children 0-5 years of age or children who cannot self-report pain.
    A. True
    B. False
    A. True
  148. 6. Morphine is often used to treat dyspnea, but it can depress the central respiratory center.
    A. True
    B. False
    A. True
  149. 7. Pain increases gastric and bowel motility.
    A. True
    B. False
    B. False
  150. 8. Aggressive Respiratory Care, in the form of frequent moving of the patient and encouraging coughing, should be avoided in chest trauma patients.
    A. True
    B. False
    B. False
  151. 9. Visceral chest pain often leads us to the conclusion that the pain is gastric in origin, even though the exact cause of this type of pain remains poorly understood.
    A. True
    B. False
    A. True
  152. 10. Morphine and fentanyl both can cause rigidity of the chest wall muscles at high doses.
    A. True
    B. False
    A. True
  153. What is the most common cause of pleural effusion in the clinical setting?
    a. acute renal failure
    b. congestive heart failure
    c, liver disease
    d. lungcancer
    b. congestive heart failure
  154. 2. The pleural effusions associated with heart failure are rarely drained.
    a. true
    b. false
    a. true
  155. 3. What is a common complication of pleurodynia (pleural pain)?
    A. insomnia
    B. atelectasis
    C. pneumothorax
    D. pneumonia
    B. atelectasis
    (this multiple choice question has been scrambled)
  156. 4. what is the most common cause of hemothorax?
    A. pulmonary embolism
    B. surgery
    C. malignancy
    D. chest trauma
    D. chest trauma
    (this multiple choice question has been scrambled)
  157. 5. what is a common clinical finding even with small pleural effusions?
    A. dyspnea
    B. air bronchograms
    C. tachycardia
    D. arrhythmias
    A. dyspnea
    (this multiple choice question has been scrambled)
  158. 6. What are the functions of a chest tube in a patient with chest trauma that causes bleeding and pneumothorax?
    I. to measure the rate of bleeding
    II. to improve ventilation
    III. to allow lung re-expansion
    A. I, II and III
    B. I and II
    C. II and III
    D. III only
    A. I, II and III
    (this multiple choice question has been scrambled)
  159. 7. Chest tubes should be directed toward the base of the lung to evacuate a pneumothorax.
    a. true
    b. false
    b. false
  160. 8. At what anatomic position should an 18-gauge IV catheter be placed to relieve a tension pneumothorax?
    A. just superior to the second rib
    B. just superior to the fourth rib
    C. just inferior to the third rib
    D. just inferior to the second rib
    A. just superior to the second rib
    (this multiple choice question has been scrambled)
  161. 9. A quick diagnosis based on clinical presentation can significantly improve the survival rates in patients with tension pneumothorax.
    a. true
    b. false
    a. true
  162. 10. What complication often occurs following rapid lung re-expansion due to the evacuation of air or fluid from the pleural space?
    A. systemic hypotension
    B. arrhythmias
    C. pulmonary emboli
    D. pulmonary edema
    D. pulmonary edema
    (this multiple choice question has been scrambled)
  163. 11. The administration of oxygen to a patient with a pneumothorax will speed the rate at which resolution occurs once the leak has stopped.
    a. true
    b. false
    a. true
  164. 12. What method of chest tube removal has been associated with the lowest level of pneumothorax recurrence?
    A. Clamp the chest tube for 4 hours; if chest radiograph is good, remove the tube.
    B. Clamp chest tube for 24 hours; if clinically stable, remove the tube.
    C. Remove the chest tube as soon as the air leak resolves.
    D. Remove the chest tube 48 hours after the air leak resolves.
    D. Remove the chest tube 48 hours after the air leak resolves.
    (this multiple choice question has been scrambled)
  165. 13. Which type of chest tube has the least complication rate?
    a. Small tubes
    b. Large tubes.
    b. Large tubes.
  166. 14. Which of the following complications is present both early and late in the clinical use of chest tubes?
    A. Laceration of the lung.
    B. Tube placement not in the pleural space.
    C. Nonfunctional tubes.
    D. Infections around the tube
    C. Nonfunctional tubes.
    (this multiple choice question has been scrambled)
  167. 15. Signs of broncho-pleural fistula may include which of the following?
    Loss of returned tidal volumes
    I Actively bubbling Pleur-evac device
    II Life-threatening respiratory acidosis
    IV Auto-cycling of the ventilator
    V Persistent atelectasis
    A. I, II, III, IV
    B. I, II, III,
    C. I,III,IV,V
    D. I, II, IV, V
    D. I, II, IV, V
    (this multiple choice question has been scrambled)
  168. 1. A patient-ventilator system check must include both the set and observed ventilator frequency, and the delivered tidal volume (either measured or calculated).
    a. true
    b. false
    a. true
  169. 2. All of the following complications are possible if you disconnect a patient, except
    A. Hypotension
    B. Hypoxemia
    C. Hyperventilation
    D. Bradycardia
    C. Hyperventilation
    (this multiple choice question has been scrambled)
  170. 3. When should you drain the ventilator tubing?
    A. Before the ventilator check so the condensation doesn’t influence the readings and calculations.
    B. During the ventilator check so you demonstrate the effects of removing the condensation.
    C. We don’t need to remove an condensation because it’s sterile.
    D. After the ventilator check so you demonstrate the effects of the condensation.
    A. Before the ventilator check so the condensation doesn’t influence the readings and calculations.
    (this multiple choice question has been scrambled)
  171. 4. What is the minimum time that it takes to begin to gel an accurate plateau pressure?
    A. 5.0 seconds
    B. 0.2 seconds
    C. 0.5 seconds
    D. 2.0 seconds
    D. 2.0 seconds
    (this multiple choice question has been scrambled)
  172. 5. Which of the following are reasons to do a Patient-Ventilator Check?
    I. Routine — Q 2-4 hrs.
    II. Before each ABO.
    III. With ventilator orders/settings changes.
    IV. With any acute change in patient conditions
    V. Upon arrival back from a transport to MIRJ for 2 lirs.
    VI. Whenever the ventilator performance is questionable.
    A. I, II, III, IV, VI
    B. I, II, III only
    C. I, II, III, IV, V, VI
    D. I, II, III, IV only
    C. I, II, III, IV, V, VI
    (this multiple choice question has been scrambled)
  173. 6. Patient vital signs belong p in the Nursing Notes, not in our Patient-Ventilator Check charting.
    a. true
    b. false
    b. false
  174. 7. An ‘error of omission” in charting can be grounds for malpractice.
    a. true
    b. false
    a. true
  175. 8. Spelling errors and math errors have no effect on the perception of our professionalism; the other Healthcare Workers understand the complexities and time constraints.
    a. true
    b. false
    b. false
  176. 9. Brief narratives regarding the clinical observations of the patient’s response to the current mechanical ventilator settings are not necessary, according to the AARC — CPG on Patient- Ventilator Check.
    a. true
    b. false
    b. false
  177. 10. All of the following are direct complications of suctioning except:
    A. Infection (patient and/or caregiver)
    B. Cardiac dysrhythmias
    C. Bronchoconstrictionl/bronchospasm
    D. Mesenteric isehemia
    E. Cardiac-Respiratory arrest
    D. Mesenteric isehemia
    (this multiple choice question has been scrambled)
  178. 11. All of the following are considered evidence of effective suctioning, except:
    A. A narrowing of PIP - Pplateau
    B. Decreased peak inspiratory pressure (PIP)
    C. Decreased static compliance
    D. Increased dynamic compliance
    E. Increased tidal volume delivery during pressure-limited ventilation
    C. Decreased static compliance
    (this multiple choice question has been scrambled)
  179. 12. One of the stated reasons for doing a Patient-Ventilator Systems Check, according to the AARC CPG, is to verify and document that the ventilator alarms are appropriate and active.
    a. true
    b. false
    a. true
  180. 13. According to the AARC CPG, an acceptable order for mechanical ventilation cannot be solely based on the desired blood gas results or ranges, leaving you to manipulate the settings to obtain these desired results.
    a. true
    b. false
    b. false
  181. l4 According to the AARC CPG, the volume monitoring devices should have an accuracy of within ± 10% of the set Vt, and the oxygen analyzer accuracy should be within ±3% of actual concentrations.
    a. true
    b. false
    a. true
  182. 15. According to the AARC CPG, the routine patient-ventilator check should do which of the following?
    I. Prevent untoward incidents
    II. Warn of impending events
    III. Assure proper ventilator functioning
    IV. Match the physician’s orders
    A. I, II, III
    B. II, III, IV
    C. I, II, III, IV
    D. I, III, IV
    C. I, II, III, IV
    (this multiple choice question has been scrambled)
  183. 1. Acute dyspnea can be caused by which of the following ventilator setting:
    I. High pressure control setting
    II Setting the tidal volume low enough that the peak airway pressure is kept <30 cm H20
    III The assist-control back-up rate is set so that the patient must trigger the ventilator
    IV. A long inspiratory time
    a. I, II, IV
    b. I, II, III
    c. I, II IV
    d. all of the above can cause dyspnea
    d. all of the above can cause dyspnea
  184. 2. Venilator settings that “exercise” the patient can cause patient-ventilator dys-synchrony.
    a. true
    b. false
    a. true
  185. 3. The setting of the alarm threshold for the minute ventilation (ye) may be too high if it allows the patient to double their current ye.
    a. true
    b. false
    a. true
  186. 4. Delirium can cause patient distress sufficient to cause adverse patient- ventilator interactions.
    a. true
    b. false
    a. true
  187. 5. Ventilator alarm systems will always alert you to a ventilator malfunction.
    a. true
    b. false
    b. false
  188. 6. Malposition of the ETT down the mainstem bronchus will always trigger a high peak airway alarm.
    a. true
    b. false
    b. false
  189. 7. Slow cuff leaks most often lead to which of the following problems?
    I. Hypoventilation
    II. Hypoxemia
    III. Aspiration
    IV. High peak airway pressures
    A. I, II, III
    B. II, III, IV
    C. I, III
    D. I, II, III, IV
    A. I, II, III
    (this multiple choice question has been scrambled)
  190. 8. Assuming normal pulmonary compliance and resistance, and properly set alarms, a new onset of Kussmaul’s breathing while on a ventilator should cause a low minute ventilation alarm.
    a. true
    b. false
    b. false
  191. 9. One of the first steps in responding to high peak airway pressures alarms is to confirm that the artificial airway is not obstructed by trying to suction down the tube.
    a. true
    b. false
    a. true
  192. 10. The ventilator alarms will always alert us to increasing expiratory airway resistance due to HMEs.
    a. true
    b. false
    b. false
  193. 11. Which of the following is not a potential cause of dyspnea?
    A. hypercapnia
    B. central apnea
    C. acidemia
    D. hypoxemia
    B. central apnea
    (this multiple choice question has been scrambled)
  194. 12. Tachypnea (rapid breathing) is always a good indicator that the patient is dyspnic.
    a. true
    b. false
    b. false
  195. 13 Most patients’ can sense the magnitude of inspiratory effort neces5 to take a breath, which becomes the basis for their sense of breathlessness.
    a. true
    b. false
    a. true
  196. 14. Dyspnea is an objective sign, which is easy to measure and treat.
    a. true
    b. false
    b. false
  197. 15. Our “hypoxic drive” is mediated through our central chemoreceptors.
    a. true
    b. false
    b. false
  198. 16. Morphine is the drug of choice to treat a dyspnic emphysema patient.
    a. true
    b. false
    b. false
  199. 17 Paroxysmal nocturnal dyspnea (PND) is most often associated with congestive heart failure I pulmonary edema.
    a. true
    b. false
    a. true
  200. 18. In addition to history taking, it is often necessary to do both pulmonary function tests and a cardiac stress test to quantify the severity of dyspnea on exertion (DOE), particularly if the patient is seeking disability insurance.
    a. true
    b. false
    a. true
  201. 19. In patients with cardiogenic pulmonary edema (CPE), dyspnea is seldom a major symptom at the time of presentation in ER.
    a. true
    b. false
    b. false
  202. 20. Fanning air across the patient’s face is totally ineffective for the relief of dyspnea in COPD and cancer patients.
    a. true
    b. false
    b. false

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