Respiratory Therapy - Vent Flashcards

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Intermittent mandatory ventilation might be used in which of the following situations?
a. to allow a chronic lung patient to "find" his own PC02
b. to improve ventilation
c. to improve oxygenation
d. to alter the I-E ratio
e. to decrease the work
A
Intermittent mandatory ventilator (IMV) means:
a. volume and rate of all breaths are preset
b. patient breathes preset volumes at his/her own rate
c. positive pressure is maintained throughout the respiratory cycle
d. only part of the inspired breath
D
When observing your mechanically ventilated patient at the bedside, you notice that the patient appears to be trying to continue to exhale when the next ventilator breath begins. You suspect that auto-PEEP is occurring. Which of the following would NOT be
C
A transcutaneous oxygen monitor (Ptc02) is set to operate at body temperature. The probe is placed on the patient's right upper chest. The monitor shows a reading of 50 torr. An ABG sample shows these results:
pH 7.39      PaC02  43 torn     
A
If a patient's lung compliance decreases while on pressure control ventilation, which of the following actions should be taken to maintain adequate minute ventilation?
a. sigh the patient
b. increase the flow rate
c.  increase the cycling pressure
C
Your patient is on mechanical ventilation. The blood gas results show a Respiratory acidosis. You should consider
a.         increasing the peak flow rate
b.         adding mechanical deadspace
c.       increasing the minute venti
C
A patient is receiving mechanical ventilation with the following parameters:  Mode SIMV Mandatory rate 6   Mandatory Vt 800 mL
Total rate  3 0        Spontaneous Vt     180 mL
The physician asks the respiratory therapist to recommend and
A
The patient position that usually produces the best Pa02 is:
a. prone
b. upright
c. supine
d. left lateral
e. right lateral
A
A constant flow generator would exhibit which of the following characteristics?
I.          the inspired flow would remain constant throughout inspiration
II.        the ventilator is not influenced by the patients lung characteristics
B
When using the expiratory retard option during mechanical ventilation you would expect the possibility of:

a. the inspiratory flow rate to increase
b. the expiratory flow rate to increase
c. patient-ventilator asynchrony
d. auto-peep
D
If, during suctioning, while on mechanical ventilation you notice the patient' secretions are thick and tenacious you could suggest:

a. mucolytic      
b. bronchodilator
c. albuterol       
d. atrovent
A
A patient is being mechanically ventilated via an endotracheal tube. The patient seems to be in distress,the "first" thing that you should do is:

a. check the volume of the cuff
b. manually ventilate
c. suction the airway
d. extubate the patient
B
A patient is breathing spontaneously on a 60% aerosol mask with the following   arterial blood gas results:
pH - 7.36           v PC02 - 43 torr HC03 - 24 mEq/L P02 - 48 torr   11-11
Based on this information, the respiratory care practiti
A
If a patients lung compliance decreases while on mechanical ventilation while on a Seimens 9000 ventilator, you would expect:

a. peak pressure would decrease
b. peak pressure would increase
c. peak flow would decrease
d. peak flow would increase
B
A mechanically ventilated patient has the following values:
Peak pressure 56 Plateau pressure 22 PEEP 5 cm/h2o Peak flow 801pm Tidal volume 1000m1
What is the static compliance in cc/cmH20 in this case?
a. 30
b. 40
c. 50
d. 60
D
A patient diagnosed with Pseudomonas pneumonia is having her respiratory care equipment changed. Her nondisposable large-volume nebulizer must be disinfected. What is the best way to do this?

A send it to autoclave
B wipe it down with 70% alcohol
C w
D
Your patient has adult respiratory distress syndrome (ARDS) and is being managed on a volume ventilator. What is the best way to reduce the patient's intrapulmonary shunting?

A increase the peep level to the therapeutic range 
B increase the tidal vo
A
A patient is receiving Pressure Controlled ventilation. The physician asks the respiratory therapist to interpret the following patient information:
10 AM   2 PM
Exhaled tidal volume 800 mL     650 mL
Respiratory rate 12/min  12/min
Peak pressu
C
A 35-year-old, 300-pound patient with obstructive sleep apnea is being managed with a bilevel CPAP while on mechanical ventilation delivered through a nasal mask (or non invasive His arterial blood gases show a PaC02 of 50 mm Hg. When sleeping, he still h
C
The best means of determining the adequacy of continuous mechanical ventilation is through the use of:
a. chest x-ray studies
b. arterial blood gas monitoring
c. ventilator monitoring
d. physical assessment of the patient
e. spontaneous ventilato
B
A patient's minute volume is 7.5 liters and the respiratory rate is 15. What is the tidal volume?
a. 250 cc
b. 300
c. 500
d. 520
e. 600
C
You are caring for a mechanically ventilated patient on SIMV 4 / min, Vt - 10 ml/Kg, PEEP 5, inspiratory time 2 sec, FI02 0.40. The patient's spontaneous rate is 35 / min and labored. You would now recommend:
a. increasing the rate to 8 / min
b. incre
B
The adequacy of ventilation is best assessed by looking at the:

a. tidal volume
b. VA
c. pH
d  PaCO2
e. Pa02
D
A volume ventilator that you are monitoring experiences a low exhaled volume alarm situation. Which of the following could cause this occurrence?
I. an increase in lung compliance
II. a decrease in lung compliance
Ill. a change in the sensitivity se
A
CPAP is appropriate treatment to use on a patient with which of the following?
a. apnea
b. spontaneous respirations with intrapulmonary shunting
c. patients being mechanically ventilated
d. drug overdose patients
e. patients in the assist control
A
While adjusting the sensitivity on a mechanical ventilator you are adjusting the:

a. Inspiratory time
b. inspiratory threshold
c. expiratory time
d. peak flow rate
B
CPAP would be most appropriate to treat hypoxia due to which of the following?
a. pulmonary shunting
b. dead space ventilation
c. low cardiac output
d. cyanide poisoning
A
If a patient is receiving an excessively high amount of CPAP, the result will be a decrease in the patient's:

a.blood pressure
b. respiratory rate
c. PaC02
d. Residual volume
A
Which of the following would most likely violate the high pressure limit on a mechanical ventilator?
I.          increase in minute ventilation
II.          decrease in lung compliance
III.         endo tracheal tube occlusion
C
If a patient becomes disconnected from a mechanical ventilator which of the following alarms should alert the practitioner:
1 high pressure
2 low pressure
3 low FI02
4 low exhaled volume
 
a. 2 only           b. 1,2,3 and 4      c.
C
In which ventilator mode would the most work be contributed by the patient:

a. CPAP  
b. Assist/Control
c. SIMV           
d. Pressure Support Control
A
A postoperative patient who is awake and alert has just been removed from mechanical ventilation. The patient has the following values:
tidal volume 350 ml: respiratory rate of 16 vital capacity of 2.6 L
You would suggest:
a. CPT
b. CMV 
c.  IS

C
Tidal volume would be best defined as:

a. Peak flow divided by I time
b. Minute ventilation divided by peak flow
c. Minute ventilation times respiratory rate
d.Inspiratory time times peak flow
 
D
Humidity for an intubated patient who is breathing spontaneously would be best provided by:

a. cool aerosol
b. heated ultrasonic nebulizer
c. high humidity diffuser 
d. heated large reservoir jet nebulizer
C
Peep is used to:
1. decrease the QS/QT
2. decrease venous return
3. increase the Pa02
4. increase the FRC
5. increase the tidal volume

a. 1,2,4 and 5      b. 1 and 2        c. 1,2 and 4        d. 1,3 and 4
D
Which of the following best describes the Coanda effect?
a. The parallel flow of a gas through a tube owing to its laminar characteristics
b. The movement of a gas through a tube owing to negative pressure
c. The increase in gas velocity owing to an i
E
The Pressure Control mode is being used to mechanically ventilate a 60-kg (132-1b) patient. The following are noticed during a routine ventilator check:     Set respiratory rate        12/min
Actual respiratory rate    25/min
Exhaled tidal
C
When a pulmonary function test is performed on an adult patient, the following results are found:
Tidal volume     500 mL,
IRV       1800 mL
FRC      4000 mL
ERV     1200 mL
Based on this information, what is the patient's total lu
D
A patient with status asthmaticus will be given an 80%/20% heliox mix to a nonrebreather mask. A standard oxygen flowmeter will be used to set the gas flow. The physician has ordered an initial heliox flow of 12 L/min. What should be set on the oxygen flo
A
It is noticed that a mechanically ventilated patient's Sp02 value decreases from 94% to 87% when she is disconnected from the ventilator during suctioning. Currently the patient's ventilator settings are as follows: tidal volume, 750 mL; rate, 14; 60% oxy
C
For incentive spirometry to be most effective, the following should be done:
A. The patient should exhale maximally and hold it for several seconds B. The patient should inhale and hold a vital capacity for 10 seconds
C. A maximum inspiratory capacity
C
Your patient is having a difficult time keeping a tight seal around the mouthpiece. He complains that the breath is too long and takes the mouthpiece out. To help the PR-II cycle off, you would adjust which of the following?
A. air mix
B. flow
C. sens
B
A decrease in lung compliance will cause:
 
A. both the peak and plateau pressures to increase
B. both the peak and plateau pressure to decrease
C. peak pressure to increase and allow the plateau pressure to remain unchanged
D. peak pressure to de
A
Which of the following is a definite contraindication to IPPB administration?
a.         hypoxic drive
b.         bullous emphysema
c.         myocardial infarction
d.         staphylococcal infection
e.       
E
Which of the following would NOT be appropriate for the initial management of a child during an acute asthmatic attack?
a.         metaproterenol (Alupent)
b.         cromolyn sodium (Intal)
c.         isoproterenol (Isuprel)
B
You set the flowrate on a volume ventilator to 40 L/min and an Inspiratory time of 1 second. The tidal volume being delivered in this case would be:
a          400 ml
b.         550 ml
c.         660 ml
d.         730
C
SIMV refers to a mode of ventilation where:
a. a deeper than normal ventilator breath is delivered
b. the breath volume and the initiation of the breath are under the patients control
c. there are no mechanical breaths - all breaths are spontaneous
D
Which of the following makes up the Static Respiratory System Compliance measurement?
I.          lung compliance
II.          thorax compliance
III.         airway resistance

a. I, II and III      b. II only     c
C
When the 7200 ventilator is in the CPAP mode all the patient breaths are:
a. controlled     
b. spontaneous
c. assisted    
d. prolonged
e. sine wave contoured
B
Which of the following would be a hazard of PEEP?

a. oxygen toxicity
b. absorption atelectasis
c. hypotension     
d. hypercarbia
C
When using cidex to clean a non disposable ventilator circuit all of the following are true except:

a. It is cidal if soaked for 10 hours
b. it is cidal if heated to 60 degrees centigrade
c. the solution length of time should be monitored
d. equipm
B
Calculate the I:E ratio of a patient receiving 1000 ml volumes 10 times a minute at a peak inspiratory flow rate of 30 lpm: 
a. 1/1   
b. 1/2       
c. 1/3
d. 1/4   
e. 1/5
B
An RRT working in the adult, surgical ICU has been performing ventilator rounds and has charted the ventilator data in the following table from a postoperative laparotomy patient who is receiving mechanical ventilatory support via a microprocessor ventila
A
A Spirometer is reading 850 ml and represents the volume delivered from the ventilator. The ventilator compliance factor is 4.5 ml per cm H2O, and the peak pressure is 45 cm H2O. The approximate delivered volume to the patient is:
A. 850 ml
B. 750 ml
C
You are called to assist with the emergency delivery of a preterm infant. After the baby is born, the physician asks you to determine an APGAR score. The respiratory therapist evaluates all of the following except:
A heart rate
B muscle tone 
C breat
C
Serial peak flows are performed on an asthmatic patient. It is planed to give a bronchodialator to measure pre and post performance. The three consecutive peak flow measurements are as follows: 255 L/min, 265 L/min, and 285 L/min. Based on the ATS standar
B
Which of the following lung volumes is an IBE maneuver a measurement of?
A. inspiratory capacity
B. functional residual capacity
C. total lung capacity
D. tidal volume
E. peak flow
A
Which of the following is the correct maneuver for performing Incentive spirometry?

A. perform a peak inspiratory flow
B. perform a sustained maximal inspiration
C. perform a sustained maximal expiration
D. perform ten rapid and deep breaths
B
You obtained blood gases on a child on nasal CPI of 5 cm/hg. The FI02 is set at 50%. The gas had the following results:
Ph 7.32     PC02 58    P02 61    Sao2 89%
Which of the following should you consider?



a.         increase t
D
What would be the most common cause of a sudden absence of breath sounds on the left side during continuous mechanical ventilation?

a.         atelectasis has occurred on the left side
b.         a tension pneumothorax is present on th
D
The use of PEEP during mechanical ventilation should:
 
a. increase lung compliance
b. increase resistance
c. improve arterial blood gases
d. decrease blood pressure
D (A?, C?)
While using the Bird Mark VII for an intermittent positive pressure breathing treatment you notice the delivered tidal volume is not sufficient. What changes can you make to correct the problem?
a. increase the sensitivity
b. increase the pressure
c.
B
If the tidal volume is 900 ml, the respiratory rate is 1,2 and the peak flow is set at 60 Ipm. What is the I-E ratio? 

a. 1-2.2
b. 1-3.4
c. 1-4.5
d. 1-5.2
C
A 66 kg patient is on a ventilator with a tidal volume of 900 ml, respiratory rate of 8, an F102 of 80% and a peep of 5 cm/ H2O. ABG's show:
Ph7.31   PC02 54 mm/hg   HC03 26 meq/1   Pa02 51
You would suggest:
a. increase the tidal volume and inc
D
Which of the following is not a hazard or complication of Incentive spirometry?

A. barotrauma in emphysematous lungs
B. chest discomfort
C. hyperventilation
D. exacerbation of bronchospasms
E. hypoxia, if oxygen therapy is interrupted
D
If a patient on a ventilator is set up in such a way for the inverse I:E ratio alarm to be activated, what ventilator change could be made to correct this breathing pattern?
a. Decrease flowrate
b. Increase flowrate
c. Increase tidal volume
d. Increa
B
. If you are preparing to place a 50 year old 57 kg female patient onto mechanics' ventilation what tidal volume would you suggest.
a. 500 cc
b. 700 cc
c. 900cc
d. 1000 cc
A
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