During pressure-controlled continuous mandatory ventilation, when the patient's lung compliance incrases, which of ther following will occur?
A.
beneficial physiological effects of positive end expiratory pressure (PEEP) include which of the following?
1. increased PaO2 for given FiO2
2. Increased lung compliance (CL)
3. Decreased shunt factor
4. increased functional residual capacity
D.
The volume delivered by a pressure-limited ventilator will decrease under which of the following conditions?
1. The patient's lung or thoracic (chest wall) compliance falls.
2. Airway resistance rises (Inspiratory time <3 times the time constant).
3. the patient tenses the respiratory muscles during inspiration.
4. airway resistance rises (Inspiratory time >3 time the time constant).
A.
In which of the following types of ventilation can pleural pressure become positive during inspiration?
Positive-pressure ventilation (PPV) can reduce urinary output by how much?
A.
Which of the following strategies are useful in the management of shunt?
1. Positive end expiratory pressure
2. Permissive hypercapnia
3. control of membrane permeability
D.
In which of the following modes of ventilatory support would the patient's wok of breathing be least?
A.
During volume assured pressure-supported ventilation, if the desired VT is not reached or exceeded at teh preset pressure support level, what happens?
B.
Which of the following is considered a normal spontaneous tidal volume?
D.
Physiological effects of the adding a volume-limited inflation hold to mandatory breaths include which of the following?
1. Decreased PaCO2
2. Increased inspiratory time
3. Decreased VD/VT
4. Longer expiratory times
A.
Which level of FiO2 and what time of exposure has been associated with oxygen toxicity?
1. FiO2 of 0.5
2. FiO2 of 0.7
3. FiO2 of 0.6
4. 24 to 48 hr
B.
Which of the following gastrointestinal conditions are commonly associated with long-term positive-pressure ventilation (PPV)?
1. Bleeding
2. Ulceration
3. Diarrhea
D.
What are some key causes of patient-ventilator
asynchrony and increased work of breathing during pressure-triggered volume-controlled continuous mandatory ventilation?
During volume-assured pressure-supported ventilation, the breath will be pressure-limited under what conditions?
A.
What spontaneous pressure-controlled breath mode allows separate regulation of the inspiratory and expiratory pressures?
D.
Which of the following variables determine the level of support achieved with adaptive support ventilation?
1. patient effort
2. flow
3. time constant
B.
During volume-controlled continuous mandatory ventilation, should either compliance decrease or airway resistance (Raw) increase, what will happen?
D.
To prevent muscle fatigue or atrophy, the level of the PSV should be adjusted to achieved what work load?
D.
Administration of positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) is associated with which of the following benefits?
1. Helps maintain open alveoli.
2. Helps with alveoli stability.
3. Helps maintain fluid-filled alveoli open
4. ensures surfactant-depleted alveoli remain closed.
C.
Which level of plateau pressure increases the likelihood of causing lung injury?
B.
What are some primary uses for pressure-supported ventilation (PSV)?
1. recruiting collapsed alveoli and improving oxygenation
2. Augmenting patient's spontaneous VT
3. Overcoming the imposed work of breathing
d 1, 2, and 3
C.
Detrimental effects of positive end expiratory pressure (PEEP) include which of the following?
1. Increased incidence of barotrauma
2. Decreased venous return or cardiac output
3. Increased pulmonary vascular resistance
4. Increased CL
D.
In which of the following modes of ventilatory support would the patient's work of breathing be greatest?
A.
What factor primarily determines the effect of positive-pressure ventilation (PPV) on the cardiac output?
B.
A patient receiving long-term positive-pressure ventilation support exhibits a progressive weight gain and a reduction in the hematocrit. Which of the following is the most likely cause of this problem?
A.
The increased work of breathing associated with auto-positive end expiratory pressure (PEEP) during mechanical ventilation is due to:
1. Hyperinflation or impaired contractility of the diaphragm
2. Large alveolar pressure drops required to rigger breaths
3. Increased volume of the intrathoracic airways
A.
Primary indications for using positive end expiratory pressure (PEEP) in conjunction with mechanical ventilation include which of the following?
1. When dynamic hyperinflation occurs in chronic obstructive pulmonary disease (COPD) patients.
2. When the imposed work of breathing is excessive
3. When acute lung injury causes refractory hypoxemia
D.
Which of the following conditions may require higher initial respiratory rates?
Which of the following lung units would be most prone to air-trapping?
B.
In which mode of ventilatory support does the patient breathe spontaneously at an elevated airway pressure, with short, intermittent decreases in pressure to a lower level?
D.
For patients with respiratory insufficiency, pressure-supported ventilation (PSV) has all of the following advantages over spontaneous breathing except:
B.
Which of the following is a benefit of high inspiratory flow during positive-pressure ventilation?
C.
Which of the following mechanisms explains the impaired renal function seen in patients receiving ventilatory support with positive pressure?
1. Decreased secretion of aldosterone
2. Decreased intravascular volume
3. increased secretion of vasopressin
A.
Which of the following are true about continuous positive airway pressure (CPAP)?
1. It maintains alveoli at greater inflation volumes.
2. It holds airway pressure essentially constant.
3. it provides the pressure gradient needed for ventilation
4. It has side effects similar to those of positive pressure ventilation
A.
What patients are at greatest risk for auto-PEEP?
1. Those supported by spontaneous breath modes
2. Those with high airway resistance
3. Those with high expiratory flow resistance
D.
Which of the following modes of support provides all of the patient's minute ventilation (VE) as mandatory volume-controlled (VC) breaths?
D.
Which of the following is the explination for the increased ratio when excessive positive end expiratory pressure (PEEP) is used?
D.
Bilevel positive airway pressure (BIPAP) is used for which of the following purposes?
1. Nocturnal ventilatory support of chronic disease patients
2. Preventing intubation of patients with acute exacerbations of obstructive pulmonary disease (COPD)
3. Treatment of obstructive sleep apnea (OSA) in the home
4. providing ventilatory support
A.
What are some physiological advantages of volume-assured pressure-supported ventilation?
1. improved patent-ventilator synchrony
2. Increased pressure-time
3. decreased work of breathing
A.
Ventilatory support strategies likely to result in auto-positive end expiratory pressure (PEEP) include which of the following?
Ventricular dysfunction occurs in patients receiving positive-pressure ventilation for which of the following reasons?
1. Hypovolemia
2. Excessive tidal volume
3. Receiving more than optimal positive end expiratory pressure (PEEP)
4. Hypervolemia
C.
Which of the following is the consequence of the decreased resistance or compliance
A.
Moderate rises in pleural pressure during positive-pressure ventilation have a minimal effect on cardiac output in normal subjects. What are some reasons for this lack of effect?
1. Compensatory dilation of the large arteries
2. Compensatory increase in venomotor tone
3. Compensatory increase in the cardiac rate
a. 2 and 3 only
b. 1 and 2 only
c 1, 2 and 3
d. 1 and 3 only
a
Which of the following are considered safe settings for a recruitment maneuver?
1. Pressures up to 50 cmH2O
2. Pressures up to 35 cmH2O
3. Pressures applied for 5 to 10 minutes
4. Pressures applied for 1 to 3 minutes
D.
Mean airway pressures can be increased by which of the following factors?
1. Increasing the inspiratory time
2. Increasing compliance
3. Increasing level of PEEP
4. Changing from a square to a decelerating ramp waveform
B.
In which of the following types of ventilation is alveolar expansion during inspiration due to a decrease in pleural pressure?
Which of the following modes of ventilatory support would result in the highest mean airway pressure?
A.
Which of the following occur with positive-pressure ventilation(PPV)?
1. During inspiration, pleural pressure decreases.
2. During inspiration, pressure in the alveoli increases.
3. the pressure gradients of normal breathing are reversed.
4. During inspiration, alveolar pressure exceeds pleural pressure.
C.
Which of the following modes of ventilatory support is used to help decrease airway and alveolar pressures?
C.
Which of the following terms describes the lung injury associated with the release of prostanoids?
C.
Which of the following is the recommended tidal volume for mechanical ventilation in a patient acutely requiring mechanical ventilation?
B.
Which of the following modes of ventilatory support combines the advantages of pressure-controlled and volume-controlled ventilation?
C.
Detrimental effects of auto-positive end expiratory pressure (PEEP) include which of the following?
1. Increased work of breathing
2. Increased pulmonary barotrauma
3. Decreased pulmonary vascular resistance
4. Increased venous return
D.
A patient switched from pressure-controlled continuous mandatory ventilation (CMV) with positive end expiratory pressure (PEEP) to pressure-controlled inverse ratio ventilation (PC-IRV) shows a good improvement in PaO2 but a decrease i tissue oxygenation. Which of the following best explains this observation?
B.
Which of the following variables determine the level of support achieved with proportional assist ventilation?
1. Patient effort
2. Elastance
3. Resistance
C.
What does pressure-supported ventilation consist of?
A.
Compared with a square wave flow pattern, a decelerating flow waveform has which of the following potential benefits?
1. Reduced peak pressure
2. Improved cardiac output
3. Less inspiratory work
4. Decreased volume of dead space-to-tidal volume ratio(VD/VT)
A.
Which of the following are potential effects of positive-pressure ventilation on the cardiovascular system?
Which of the following statements are true about negative-pressure ventilation(NPV)?
1. NPV is similar to spontaneous breathing
2. Airway (mouth) pressure during NPV is zero
3. Expiration during NPV is by passive recoil.
4. NPV decreases pressure at the body surface
D.
Which of the following conitions is associated with a lack of response to increased FiO2 in patients receiving positive-pressure ventilation?
A.
Which of the following variables determine the level of support achieved with adaptive support ventilation?
1. patient effort.
2. elastance
3. Resistance of the endotracheal tube
C.
Physical assessment indicating the presence of a tension pneumothorax includes which of the following?
Which of the following occur in pressure-limited modes of ventilation?
1. the volume delivered at a given pressure must decrease as compliance falls
2. the inspiratory flow varies with patient effort and lung mechanics
3. active effort by the patient against inspiration will decrease delivered volume.
4. the volume delivered at a given pressure must increase as Raw
d 2, 3 and 4 only
A.
In which of the following types of ventilation is alveolar expansion during inspiration due to an increase in alveolar pressure?
which of the following terms describe the lung injury associated with the use of low tidal volumes?
C.
The volume gas actually delivered to a patient by most positive-pressure ventilation is always less than that expelled from the machine. which of the following factors help to explain this finding?
1. Gas compression under pressure
2. Presence of built-in leaks
3. Expansion of the ventilator circuitry
C.
Which of the following is the best explanation for the decreased levels of atrial natriuretic hormone commonly observed among patients receiving positive-pressure ventilation?
B.
When bedside work of breathing measures are unavailable, you should adjust the level of pressure- supported ventilation (PPV) to which of the following breathing patterns?
A.
Assuming a constant rate of breathing, which of the following inspiratory-to-expiratory (I:E) ratio would tend to most greatly impair a patient's systemic diastolic pressure?
B.
What mode of pressure-controlled ventilation is designed to prevent alveoli with short-time constants from collapsing, thereby improving oxygenation?
