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. An iron lung is which type of ventilator
C. Negative Pressure
3. Which type of ventilator creates a sineusodial pressure waveform pattern of positive and negative pressures?
B. combined pressure
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. Which of the following is a flow waveform created by a linear-drive piston?
A. Rectangular
6. The funnction of the exhalation valve following?
B. inflate during inspiration and to divert gas coming from the ventilator into the patient
7. Which of the following flow-controlled electromagnetism?
B. Propotional selenoid
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
A. Inadequate Flow
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
D. closed loop system
10. The gas that enters the ventilator from high-pressure sources goes directly to the system. This is what type of system
B. single circuit
11. Which of the following is a devic that uses a flow resistor to create expiratoi pressure?
A. Positive expiratory pressure mask
12, Who has attempted to establish a ewer classification system to describe how ventilators work?
C. Chatburn
13. The most common type of ICU ventilators today are:
A. pneumatically powered and microprocessor controlled.
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
B. II, III, IV
15. PEEP is accomplished by which of the following methods?
I. Flow resistance
II. Passive resistance
III. Threshold resistance
B. I, III
16. The main parameter that the ventilator manipulates for any given breath is referred to as which of the following?
C. Control variable
17. What variable begins the inspiratory phase of a ventilator?
C. Trigger
18. What trigger variable is used during control ventilation?
B. Time
19. Which of the following variables en s the inspiratory phase?
D. Cycle
20. Which of the following variables begins a mandatory breath?
D. Time
21. The pressure maintained at the airway during exhalation is known as which of the following
B. Baseline
22. Which two of the following patient triggers are most common?
I. Flow
II. Neural
III. Volume
IV. Pressure
B. I and IV
23. On a mechanical ventilator, pressure-triggering is usually set within which of the following ranges?
B. - 0.5 to – 1.5
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?
C. 5 L/min
25. With a baseline pressure setting of 6 cm H20 and a sensitivity setting of .5 inspiration will begin at
D. 4.5
26. What is the flow rate if the set volume is 550 mL and the inspiratory time is 1.2
second?
D. 27.5
27. The maximum safety pressure sh be set at _____ cm H when the peak pressure reached during vo1ume-c ventilation is 25 cm H
D. 35
28. When the maximum safety pressure setting in a volume mode is reached, which ol the following occurs?
B. Inspiration ends prematurely
29. When the maximum safety pressure on a volume ventilator is reached, which of the following occurs?
A. inspiration ends before the entire volume is delivered
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. 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
36. Improving lung compliance during volume-controlled ventilation will cause a(n)_____ in peak_____
A. Decrease; pressure
37. Worsening lung compliance during g volume-controlled ventilation will cause which of the following?
D. an increase in peak pressure
38. Worsening lung compliance during pressure-controlled ventilation will cause which of the following?
B. A decrease in volume delivery
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?
C. 630 mL
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?
A. 120 mL
41. Pressure-support ventilation (PSV) is classified as:
I. F1ow-cyc1ed
II. Time triggered
III. Volume targeted
IV. Pressure targeted
V. Patient-triggered
C. I, IV, V
42. Plateau pressure may be obtained during volume ventilation by using which of the following?
C. inspiratory pause
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
44. The transairway pressure (PTA) represents the pressure associated with which of the following?
D. Airflow resistance
45. Which is the formula for transairway pressure (PTA)?
B. PIP-Pplat
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
D. I and IV
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
D. 0.02
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?
C. 0.028
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
B. 46
51. Increasing the functional residual capacity (FRC) of a spontaneously breathing patient to improve oxygenation can e accomplished by which of the following?
A. CPAP
52. What procedure is used to estimate the amount of air trapped in the patient’s lungs and in the patient circuit?
B. End Expiratory pause
53. Auto-PEEP can be detected without the use of an expiratory pause on which of the following curves?
B. flow-time
54. Which of the following is the technique that can actively remove gas from a ventilator circuit at the beginning of expiration?
A. NEEP
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?
A. 35
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
A. II and III
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
C. I, II, III, and IV
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
4. Which of the following statements is false about positive-pressure ventilation (PPV)?
C. During inspiration, pleural pressure decreases.
5. Which of following conditions is associated with a lack of response to increases FiO2 in patients receiving PPV?
C. shunt
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
7. Which of the following is considered a normal spontaneous tidal volume?
C. 5 to 7 mL/kg
8. Which of the following conditions do not require high mechanical respiratory rates?
B. metabolic alkalosis
9. Which of the following is the explanation positive end-expiratory pressure (PEEP
B. diversion of blood from ventilated to hypoventilated areas
10. Which of the following is the conseque:
D. It takes less time to fill and empty f
11. Mean airway pressure may be increased by all of the following except increasing the:
D. FiO2
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
l3. Which of the following is FALSE about pressure limited modes of ventilation?
D. The volume delivered at a given pressure must decreases as Raw rises
14. The volume delivered by a pressure limited ventilator will decrease under all of the following conditions except:
A. airway resistances rises
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
D. I and IV
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
17. In which of the following modes of ventilator would the patient’s work of breathing be greatest?
A. continuous positive airway pressur (CPAP)
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)
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
D. 5 to 25 l/min 5 to 8 ml/kg
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
21. All of the following factors would tend o increase mean airway pressure except:
A. short inspiratory times
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
23. Detrimental effects of positive end-expiratory pressure (PEEP) include all of the following except:
B. increased CL
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
A. I and III
25. Compared with a square wave flow pattern, a decelerating flow waveform has all of the following potential benefits except
D. improved cardiac output
26. Which of the following is a benefit of high inspiratory flows during positive-pressure ventilation?
A. reduced air trapping
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
A. I, II, and III
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
29. Which of the following modes of ventilatory support would result in the highest mean airway pressure?
D. volume-controlled continuous mandatory ventilation
30. In which of the following modes of ventilatory support is muscle atrophy most likely to occure
B. volume-controlled continuous mandatory ventilation
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
D. I and II
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.
33. During volume-controled continous mandatory ventilation should either compliance decrease or airway resistance increases
B. The peak airway pressure will increase
34. Which of the following is FALSE about permissive hypercapnia if allowed to increase slowly?
D. It increases pulmonary vascular resistance
35. What mode of pressure-controlled ventilation is designed to prevent alveoli with short time constants from collapsing there by improving oxygenation
D. pressure-controlled inverse ratio
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?
A. High mean pressures caused by PC-IRV decreased cardiac output
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
38. What factor primarily determines the effect of positive-pressure ventilation (PPV) on the cardiac output?
A. mean pleural pressure
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)
C. II and III
40. Positive-pressure ventilation (PPV) can reduce urinary output by how much?
D. 30% to 50%
41. Detrimental effects of auto positive end -expiratory pressure (PEEP) include all of the following except:
C. pulmonary vascular resistance
42. Which of the following gastrointestinal contitions are commonly associated with long-term positive-pre ventilation
I. bleeding
II. ulceration
III. diarrhea
A. I and II
43. Which of the following terms describe the lung injury associated with low tidal volumes?
A. atelectrauma
44. Which of the following lung units would be most prone to air trapping
C. one with high resistance and high compliance
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
D. I and II
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
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
3. What is the primary goal of humidity therapy?
A. maintain normal physiologic conditions
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
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?
B. 100% RH at 32°to35°C
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
B. I, II, III, and IV
7. The greater the temperature of the gas, the:
A. more water vapor it can hold
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?
A. wick
9. Advantages of passover humidifiers include all of the following except:
B. They do not require heating to maintain body temperature, ambient pressure, saturated (BTPS) conditions.
10. Which type of humidifier “traps” the patient’s body heat and expired water vapor to
raise the humidity of inspired gas?
A. heat-moisture exchanger
11. Which of the following are types of heat-moisture exchangers (HMEs)?
I. simple condenser
II. hygroscopic condenser
III. hydrophobic condenser
A. I, II, and III
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
13. An ideal heat-moisture exchanger (RIME) should have an efficiency rating of at leasi
which of the following?
B. 90%
14. All of the following are features of an ideal heat-moisture exchanger (HME) except:
C. high compliance
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
A. I and II
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
17. Conditions that can cause temperature “overshoot” with servo-controlled heated
humidifiers include all of the following except:
B. The unit reservoir is refilled with sterile water.
18. Where should you place the thermistor probe for a servo-controlled heated humidifier being used on a patient receiving mechanical ventilation?
C. in the inspiratory limb of the circuit, near but not at the “wye”
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
B. I, II, and III
20. All of the following are contraindications for heat-moisture exchangers except:
C. when a patient is suffering from hyperpyrexia
21. All of the following are potential hazards of using a heated humidifier during mechanical ventilation except:
B. hypoventilation due to increased dead space
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.
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?
C. Switch the patient to a large-volume heated humidifier.
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
25. During routine use on an intubated patient, a heated humidifier should deliver inspired at which of the following?
A. temperature of 33 ± 2°C, with a minimum of 30 mgL of water vapor
