RT 123 Final

  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



    C. II and III
  2. 2. An iron lung is which type of ventilator



    B. Negative Pressure
  3. 3. Which type of ventilator creates a sineusodial pressure waveform pattern of positive and negative pressures?



    C. combined pressure
  4. 4. A closed system can be described as which of the following
    I. Feedback
    II. Hierarchical
    III. Unintelligent
    IV. Servo-Controlled



    B. I and IV
  5. 5. Which of the following is a flow waveform created by a linear-drive piston?



    B. Rectangular
  6. 6. The funnction of the exhalation valve following?



    C. inflate during inspiration and to divert gas coming from the ventilator into the patient
  7. 7. Which of the following flow-controlled electromagnetism?



    A. Propotional selenoid
  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



    B. Inadequate Flow
  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



    C. closed loop system
  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
  11. 11. Which of the following is a devic that uses a flow resistor to create expiratoi pressure?



    A. Positive expiratory pressure mask
  12. 12, Who has attempted to establish a ewer classification system to describe how ventilators work?



    B. Chatburn
  13. 13. The most common type of ICU ventilators today are:



    B. pneumatically powered and microprocessor controlled.
  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. II, III, IV
  15. 15. PEEP is accomplished by which of the following methods?
    I. Flow resistance
    II. Passive resistance
    III. Threshold resistance



    C. I, III
  16. 16. The main parameter that the ventilator manipulates for any given breath is referred to as which of the following?



    B. Control variable
  17. 17. What variable begins the inspiratory phase of a ventilator?



    D. Trigger
  18. 18. What trigger variable is used during control ventilation?



    D. Time
  19. 19. Which of the following variables en s the inspiratory phase?



    D. Cycle
  20. 20. Which of the following variables begins a mandatory breath?



    B. Time
  21. 21. The pressure maintained at the airway during exhalation is known as which of the following



    A. Baseline
  22. 22. Which two of the following patient triggers are most common?
    I. Flow
    II. Neural
    III. Volume
    IV. Pressure



    A. I and IV
  23. 23. On a mechanical ventilator, pressure-triggering is usually set within which of the following ranges?



    B. - 0.5 to – 1.5
  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. 5 L/min
  25. 25. With a baseline pressure setting of 6 cm H20 and a sensitivity setting of .5 inspiration will begin at



    C. 4.5
  26. 26. What is the flow rate if the set volume is 550 mL and the inspiratory time is 1.2
    second?



    B. 27.5
  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



    B. 35
  28. 28. When the maximum safety pressure setting in a volume mode is reached, which ol the following occurs?



    A. Inspiration ends prematurely
  29. 29. When the maximum safety pressure on a volume ventilator is reached, which of the following occurs?



    C. inspiration ends before the entire volume is delivered
  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
  33. 37. Worsening lung compliance during g volume-controlled ventilation will cause which of the following?



    C. an increase in peak pressure
  34. 38. Worsening lung compliance during pressure-controlled ventilation will cause which of the following?



    B. A decrease in volume delivery
  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?



    B. 630 mL
  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?



    B. 120 mL
  37. 41. Pressure-support ventilation (PSV) is classified as:
    I. F1ow-cyc1ed
    II. Time triggered
    III. Volume targeted
    IV. Pressure targeted
    V. Patient-triggered



    D. I, IV, V
  38. 42. Plateau pressure may be obtained during volume ventilation by using which of the following?



    B. inspiratory pause
  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



    D. II and III
  40. 44. The transairway pressure (PTA) represents the pressure associated with which of the following?



    C. Airflow resistance
  41. 45. Which is the formula for transairway pressure (PTA)?



    D. PIP-Pplat
  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. I and IV
  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



    B. 0.02
  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
  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



    D. 46
  46. 51. Increasing the functional residual capacity (FRC) of a spontaneously breathing patient to improve oxygenation can e accomplished by which of the following?



    C. CPAP
  47. 52. What procedure is used to estimate the amount of air trapped in the patient’s lungs and in the patient circuit?



    A. End Expiratory pause
  48. 53. Auto-PEEP can be detected without the use of an expiratory pause on which of the following curves?



    D. flow-time
  49. 54. Which of the following is the technique that can actively remove gas from a ventilator circuit at the beginning of expiration?



    C. NEEP
  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?



    B. 35
  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



    B. II and III
  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



    D. I, II, III, and IV
  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



    C. II
  54. 4. Which of the following statements is false about positive-pressure ventilation (PPV)?



    B. During inspiration, pleural pressure decreases.
  55. 5. Which of following conditions is associated with a lack of response to increases FiO2 in patients receiving PPV?



    A. shunt
  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?



    D. 5 to 7 mL/kg
  58. 8. Which of the following conditions do not require high mechanical respiratory rates?



    B. metabolic alkalosis
  59. 9. Which of the following is the explanation positive end-expiratory pressure (PEEP



    D. diversion of blood from ventilated to hypoventilated areas
  60. 10. Which of the following is the conseque:



    A. It takes less time to fill and empty f
  61. 11. Mean airway pressure may be increased by all of the following except increasing the:



    A. FiO2
  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



    C. I and II
  63. l3. Which of the following is FALSE about pressure limited modes of ventilation?



    B. The volume delivered at a given pressure must decreases as Raw rises
  64. 14. The volume delivered by a pressure limited ventilator will decrease under all of the following conditions except:



    A. airway resistances rises
  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



    C. I and IV
  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



    C. I, II, III, IV, and V
  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)
  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
  70. 20. Which level of plateau pressure increases the likelihood of causing lung injury?



    D doesn’t matter as long as positive inspiratory pressure is less than 50
    C. >30
  71. 21. All of the following factors would tend o increase mean airway pressure except:



    A. short inspiratory times
  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. I, II, III, and IV
  73. 23. Detrimental effects of positive end-expiratory pressure (PEEP) include all of the following except:



    B. increased CL
  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



    C. I and III
  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
  76. 26. Which of the following is a benefit of high inspiratory flows during positive-pressure ventilation?



    C. reduced air trapping
  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



    C. I, II, and III
  78. 28. In which of the following modes does the patient’s ventilatory pattern have most control over PaO2, PaCO2, and acid base balance



    C. volume-controlled continuous mandatory ventilation
  79. 29. Which of the following modes of ventilatory support would result in the highest mean airway pressure?



    A. volume-controlled continuous mandatory ventilation
  80. 30. In which of the following modes of ventilatory support is muscle atrophy most likely to occure



    B. volume-controlled continuous mandatory ventilation
  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



    C. I and II
  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.
  83. 33. During volume-controled continous mandatory ventilation should either compliance decrease or airway resistance increases



    B. The peak airway pressure will increase
  84. 34. Which of the following is FALSE about permissive hypercapnia if allowed to increase slowly?



    B. It increases pulmonary vascular resistance
  85. 35. What mode of pressure-controlled ventilation is designed to prevent alveoli with short time constants from collapsing there by improving oxygenation



    A. pressure-controlled inverse ratio
  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?



    C. High mean pressures caused by PC-IRV decreased cardiac output
  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



    D. I and III
  88. 38. What factor primarily determines the effect of positive-pressure ventilation (PPV) on the cardiac output?



    C. mean pleural pressure
  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. II and III
  90. 40. Positive-pressure ventilation (PPV) can reduce urinary output by how much?



    A. 30% to 50%
  91. 41. Detrimental effects of auto positive end -expiratory pressure (PEEP) include all of the following except:



    A. pulmonary vascular resistance
  92. 42. Which of the following gastrointestinal contitions are commonly associated with long-term positive-pre ventilation
    I. bleeding
    II. ulceration
    III. diarrhea



    D. I and II
  93. 43. Which of the following terms describe the lung injury associated with low tidal volumes?



    C. atelectrauma
  94. 44. Which of the following lung units would be most prone to air trapping



    A. one with high resistance and high compliance
  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



    B. I and II
  96. 1. What is the name of the point in the respiratory tract where inspired gas reaches body
    temperature, ambient pressure, saturated (BTPS) conditions?



    C. isothermic saturation boundary
  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. maintain normal physiologic conditions
  99. 4. Which of the following inspired conditions should be maintained when delivering medical gases to the nose or mouth?



    B. 50% relative humidity (RH) at 20 to 22° C
  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?



    D. 100% RH at 32°to35°C
  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



    C. I, II, III, and IV
  102. 7. The greater the temperature of the gas, the:



    C. more water vapor it can hold
  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?



    B. wick
  104. 9. Advantages of passover humidifiers include all of the following except:



    C. They do not require heating to maintain body temperature, ambient pressure, saturated (BTPS) conditions.
  105. 10. Which type of humidifier “traps” the patient’s body heat and expired water vapor to
    raise the humidity of inspired gas?



    B. heat-moisture exchanger
  106. 11. Which of the following are types of heat-moisture exchangers (HMEs)?
    I. simple condenser
    II. hygroscopic condenser
    III. hydrophobic condenser



    C. I, II, and III
  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%
  109. 14. All of the following are features of an ideal heat-moisture exchanger (HME) except:



    C. high compliance
  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



    C. I and II
  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:



    C. The unit reservoir is refilled with sterile water.
  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 inspiratory limb of the circuit, near but not at the “wye”
  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



    D. I, II, and III
  115. 20. All of the following are contraindications for heat-moisture exchangers except:



    B. when a patient is suffering from hyperpyrexia
  116. 21. All of the following are potential hazards of using a heated humidifier during mechanical ventilation except:



    A. hypoventilation due to increased dead space
  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 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?



    B. Switch the patient to a large-volume heated humidifier.
  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?



    C. temperature of 33 ± 2°C, with a minimum of 30 mgL of water vapor
Author
noah.aisner
ID
34648
Card Set
RT 123 Final
Description
RT 123 Final
Updated