Respiratory Therapy - Vent 2 Flashcards

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Terms Definitions
Intermittent mandatory ventilation might be used in which of the following situations:
a. to wean a patient from mechanical ventilation
b. to improve ventilation
c. to improve oxygenation
d. to alter the I-E ratio
e. to decrease the work of breath
Calculate the effective static compliance given tidal volume 800 ml, plateau pressure 42 cm/H20, peak inspiratory pressure 50 cm H2O and a PEEP of 10 cm H2O

a.18 ml/cm H2O
b. 22
c. 7 25
d. 28
e. 30
Vesicular breath sounds during mechanical ventilation are most compatible with:

a. normal respiration b. pneumothorax
c. atelectasis
d. consolidation
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
Increasing the inspiratory time during continuous mechanical ventilation will:
 a. decrease the venous return­
b. decrease the peak airway pressure
c. increase the cardiac output
d. increase the blood pressure
e. not effect the cardiovascular s
Major disadvantages of the common ventilators used to deliver IPPB therapy include:
I.          inadequate pressure for severely non-compliant patients
II.       inadequate flow rates
III.      inability to control volume delivered
Which of the following patient conditions will have the most significant adverse cardiovascular response to continuous mechanical ventilation with high pressure?
a. pneumonia
b. asthma
c. tuberculosis
d. emphysema
e. pneumoconiosis
For a spontaneously breathing patient, which of the following will provide the therapeutic effects of PEEP?
b. SIMV 
d. Inspiratory hold
A 65-year-old woman in congestive heart failure is receiving 10 cm H2O CPAP and 70% oxygen. Her arterial blood gas results are below.
PH 7.41      PaC02  40 torr       HC03 25 mEq/liter     Pa02     150 torr
Based on these findings,
Dead space is defined as:
a. ventilation greater than perfusion
b. ventilation greater than diffusion
c. perfusion greater than ventilation
d. perfusion greater than diffusion
e. no ventilation or perfusion
When applying an inflation hold pressure plateau maneuver the following would be true:
I.          the inspiratory time would become longer
II.        expiratory time would become longer
III.         during this maneuver the exh
Calculate the inspiratory time given the following tidal volume 850 ml, peak pressure 50 cm H2O, plateau pressure 40 cm H2O, PEEP 10 cm H2O and a peak flow rate of 50 L/min?
a. 0.5 sec
b. 1.0
c. 1.4
d. 1.8
e. 2.2
The physiological parameter defined as volume change per unit pressure change is called:
a. compliance
b. resistance
c. elastance
d. surface tension
e. conductance
While you are administering chromolyn sodium to a patient the patient complains of dyspnea. You should consider adding:

a. albuterol
b. atrovent
c. aerobid
d. asteroid
A patient with respiratory failure caused by which one of the following could have normal lungs:
a. emphysema
b. bronchopneumonia
c. asthma
d. pulmonary fibrosis
e. barbituate overdose
Optimum PEEP often correlates best with the maximum:
a. respiratory rate
b. peak inspiratory pressure
c. dynamic compliance
d. end-expiratory pressure 
e. airway resistance
A patient while being mechanically ventilated has a reduced chest excursion and reduced breath sounds. You would consider adding:
2) Mechanical Vd
3) Tidal volume
4) Peak flow

a. 1 and 2         b. 1 and 3       c. 4 only  

Which of the following are indications for Incentive spirometry?
I. presence of pulmonary atelectasis
II. upper-abdominal surgery
III. thoracic surgery
IV. surgery in patients with chronic obstructive pulmonary disease (COPD)
V. presence of a r
While doing equipment rounds, the respiratory therapist hears a high-pitched whistling sound coming from the bubble humidifier connected to the patient's 24% air­entrainment mask. The 02 flowmeter is set at 10 L/min. What should be done?
I. Add water to
While performing an IPPB treatment, the patient suddenly complains of right sided chest pain and becomes very short of breath. Upon assessing the patient you note decreased breath sounds on the right side, with tracheal deviation towards the left side. Wh
Incentive spirometry is designed to mimic which aspect of the normal respiratory pattern?

A. grunting
B. sighing
C. coughing
D. breath holding
A stable patient is receiving mechanical ventilation with 21 % oxygen while in the postanesthesia recovery room. An ABG sample is drawn with these results:
pH 7.41              PaC02 38 torr           Pa02 185 torr   
HC03 26
An adult patient is receiving volume-cycled ventilation with the following settings:
Vt         800 mL
Set rate 14
PEEP   10 cm water
Peak pressure   45 cm water
Plateau pressure           30 cm H2O
Pressure support      
A neonate is being mechanically ventilated on the IMV mode. During the last 2 hours, the patient's Pa02 has decreased from 60 to 45 mm Hg. The physician orders an increase in the mean airway pressure. Which of the following would you recommend to accompli
Which of the following ventilator graphic curves are most commonly used to detect auto-PEEP?

I. volume-time II. pressure-time III. flow-volume IV. pressure-volume

A. I and II only    B. I and III only    C. II and IV only    D. III and IV
A decrease in compliance will tend to:
a. increase total lung capacity
b. increase airway resistance
c. decrease vital capacity
d. increase residual volume
e. increase functional residual capacity
Which of the following controls when adjusted independently will change the length of the expiratory phase of a volume ventilator incorporating a rate control?
I. volume      II. respiratory rate    III. flow rate
a. I only
b. II only
The most popular method of adjusting the low inspired pressure alarm is to:

a. set the alarm 10 cm/H20 above the peak inspiratory pressure
b. set the alarm 10 cm/H20 below the peak inspiratory pressure
c. set the alarm 15 cm/H20 below the peak ins
If a tubing leak occurs during controlled ventilation with a 7200, which of the following will occur?
I.          the exhaled tidal volume will remain unchanged
II.          the peak airway pressure will decrease
Which of the following factors affect the volume delivered by ventilators used for IPPB treatments?
I.  patient lung compliance
II. patient airway resistance
III. ventilator pressure setting %
IV.  ventilator power source
a. I and II only   
The circuit of a mechanical ventilator does all of the following except:

a. allow gas to flow from the ventilator to the patient.
b. adds to the compressible volume of the circuit
c. decreases the actual tidal volume delivered to the patient 
A patient has the following blood gas:
Ph 7.53
PC02 42 mm/hg HC03 34 meq/1 f nt v­P02 102 mm/hg ?
This would suggest:

a. metabolic alkalosis               b. metabolic acidosis
c. respiratory alkalosis             d.
An increase in airway resistance 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
While taking an IPPB treatment with Albuterol medication, the patient starts to complain of feeling dizzy, lightheaded, with tingling in the fingers. What action should the therapist take to correct this problem?
A. tell the patient to breath deeper
After assembling the circuit to the Bird Mark VII ventilator, you are unable to make the machine cycle off when occluding the mouthpiece. Which of the following is the most likely cause?
A the gas inlet is plugged
B. there is a leak in the circuit
To increase the set I -in BiPap should increase

A the Pa02
B the expiratory time
C the tidal volume 
D the FRC
After a successful CPR effort, an adult patient requires mechanical ventilation. He is apneic, 183 cm (6 ft.) tall, and weighs 73 kg (160 lb). The physician requests that you select the ventilator settings. Which of the following should be used?
Because of facial trauma, a 77-kg (170-1b) adult patient was given an emergency tracheostomy and had a 6-mm ID tracheostomy tube placed. Mechanical ventilation was started with a tidal volume of 800 mL because of apnea. The respiratory therapist notices t
If the inspiratory flow of a mechanical ventilator in the pressure control mode is set too high, which ventilation parameter will be adversely affected?
A. Tidal volume
B. Peak inspiratory pressure
C. Mean airway pressure
 D. Trigger sensitivity
The most effective way to increase a patient's alveolar ventilation while on a ventilator in the control mode would be to increase the:

a. inspiratory flow rate
b. ventilator rate
c. tidal volume
d. sensitivity
A patient is struggling to initiate a breath on a Bird Mark 7 ventilator. The settings are:
Flow control - 10    Pressure - 15    Sensitivity -5    Air mix - 0
You should adjust the:
a. sensitivity - 2
b. control pressure - 20
c. flow contro
A check valve phenomenon in a distal airway during mechanical ventilation will results in which of the following?
a. atelectasis
b. air trapping
c. collateral ventilation
d. secretion evacuation
e. wheezing
When a ventilator is operating in the control mode, an inadequate inspiratory flow setting would be indicated by which of the following alarms?
a. temperature
b. pressure
c. I:E
d. low pressure
e. oxygen
Which of the following would be a hazard of PEEP?
a. oxygen toxicity
b. absorption atelectasis
c. hypotension
d. hypercarbia
When receiving a new IPPB order, the respiratory therapist should first:

a. prepare the medication
b. start the treatment with low pressure
c. explain the treatment to the patient
d. review the patient's chart
While on mechanical ventilation assist control mode rate of 12, tidal volume 850 ml, F102 70%. You notice a total rate of 18. The blood gases are:
Ph 7.51
PC02 29 mm/hg    P02 76 mm/hg      Sat 94% '
You would suggest:
a add deadspace
b. decre
A  (B?, D?)
If during an arterial blood gas you notice the patient has practically no reflex this could be defined as:
a. confused
b. stuperous
c. comatose
d. asleep
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
A patient is admitted to the emergency room in respiratory distress with respiratory rate = 40/min., Vt = 280ml, PaCO2 = 50, Pa02 = 45, F102 = 0.21. You would recommend:

a. mask CPAP
b. mechanical ventilation
c. oxygen therapy
d. bronchodilator the
An elderly patient has been given a diuretic to help treat her congestive heart failure. It is noticed on her ECG monitor that she is having occasional premature ventricular contractions. It is most important to monitor which of the following electrolyte
A patient with an 8-mm ID fenestrated tracheostomy tube is to receive IPPB treatments for unresolved atelectasis. After the patient initiates a breath, it is found that the machine does not cycle off to allow exhalation. After manually stopping the delive
A patient with ARDS has had a flow-directed balloon-tipped catheter inserted to evaluate her cardiovascular status. To confirm that it is properly positioned, a chest radiograph could show the catheter tip in the:
I. Left atrium
II. Left pulmonary art
Which of the following should not be turned on when setting up the Bird Mark 7 for IPPB therapy?

A. flowrate control
B. sensitivity control
C. inspiratory pressure control
D. expiratory timing device
You have placed an unconscious 80 kg (176-1b) postoperative thoracotomy patient on the ventilator with these settings:
Mode SIMV Rate 12/min Oxygen 40% Tidal volume        1100 mL
Arterial blood gases after 20 minutes show:
Pa02     93 torr
When starting a new IPPB treatment on a patient, you notice that at first the manometer needle on the Bird Mark 7 is in the negative range. It moves into the positive range later during inspiration just before the machine cycles off. What would you do to
For which of the following patients is hyperinflation therapy best indicated for?
A. a patient with severe COPD
B. a patient in (CHF) congestive heart failure
C. a patient recovering from a drug overdose
D. a post-op patient recovering from upper ab
An adult patient has an 8-mm ID tracheostomy tube in place. What is the largest suction catheter that should be used to remove secretions?

A 18 fr
B 12 fr
C 10 fr
D  8 fr
Which of the following is a correct definition of (IPPB) intermittent positive pressure breathing therapy?
A. long-term breathing treatment using above atmospheric pressures with a volume­limited ventilator
B. short-term breathing treatment using sub-a
If a patient's tidal volume is 650 ml and the pressure measured while maintaining the volume is 15 cm H2O, which is the compliance?
a. .043 liter/cm H2O
b. .097 liter/cm H2O
c. 2.3 liters/cm H2O
d. 40 liters/cm H2O
e. 57 liters/cm H2O
The minimum I -E ratio that should be maintained while ventilating adult patients is:
a. 3-1
b. 2-1.5
c. 1-1.5
d. 1-2
e. 1-3
You obtained blood gases on a child on nasal CPAP of 5 cm/hg. The F102 is set at 50%. The gas had the following results:
Ph - 7.32 PC02 - 32 P02 - 40 Sao2 - 75%
Which of the following should you consider?
a. increase the CPAP to 10 cm/hg
b. increase
What Pa02 would you expect from a 42 year old patient breathing 40% oxygen while on mechanical ventilation:

a. 100 mm/hg 
b. 200 mm/hg
c. 300 mm/hg
d. 400 mm/hg
A volume ventilator is set to cycle on at a respiratory rate of 12 BPM. The LE ratio is 1:1.5. Which of the following inspiratory and expiratory times are correct?
Inspiratory                 Expiratory
a. 1.0 seconds        2.5 s
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
A 70 kg (154-1b) patient with advanced emphysema is being cared for on a volume ventilator. The following settings and blood gases have been recorded:
                         10:00 am           11:00 am
Tidal volume 
C (?)
If the peak flow is increased to 55 1 /min in the situation above with all other variables remaining constant, what is the I-E ratio now?
a. 1-1
b. 1-3 
c. 1-4
d. 1-5
An 80 kg patient has a tidal volume of 1250 cc and a respiratory rate of 8.ABG's show: PH 7.53, PC02 27, HC03 22 and P02 92. You would suggest:

a. decrease the respiratory rate  
b. decrease the tidal volume
c. decrease the peep    
d. decrea
A patient who weighs 80 kg (180 lb) is receiving volume-cycled ventilation in the SIMV mode with the following parameters:
Set Vt   800 mL      Set rate 12
PEEP   10 cm water
Pressure support           4 cm water
Spontaneous rate 
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