Mechanical Ventilation Test Bank - 684 Verified Questions

Mechanical Ventilation Test Bank

Course Introduction

Mechanical Ventilation is a critical care course designed to provide students with a comprehensive understanding of the principles, indications, and management strategies for artificial respiratory support. The course covers the physiological basis of ventilation, types of ventilatory support, ventilator modes and settings, and monitoring techniques. Students learn to assess and respond to a variety of clinical scenarios involving acute and chronic respiratory failure, troubleshooting common complications, and weaning patients safely from mechanical ventilation. Emphasis is placed on evidence-based practices, the interpretation of arterial blood gases, patient-ventilator interactions, and interdisciplinary collaboration in intensive care settings.

Recommended Textbook

Pilbeams Mechanical Ventilation Physiological and Clinical Applications 5th Edition by J M Cairo

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23 Chapters

684 Verified Questions

684 Flashcards

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Chapter 1: Basic Terms and Concepts of Mechanical Ventilation

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35 Verified Questions

35 Flashcards

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Sample Questions

Q1) Calculate the effective static compliance (C_s)given the following information about a patient receiving mechanical ventilation: peak inspiratory pressure (PIP)is 56 cm H₂O,plateau pressure (P_plateau)is 40 cm H₂O,exhaled tidal volume (V_T)is 650 mL,and positive-end expiratory pressure (PEEP)is 10 cm H₂O.

A) 14.1 mL/cm H₂O

B) 16.3 mL/ cm H₂O

C) 21.7 mL/cm H₂O

D) 40.6 mL/cm H₂O

Answer: C

Q2) Calculate the static compliance (C_S),in mL/cm H₂O,when PIP is 47 cm H₂O,plateau pressure (P_plateau)is 27 cm H₂O,baseline pressure is 10 cm H₂O,and exhaled tidal volume (V_T)is 725 mL.

A) 43 C_S

B) 36 C_S

C) 20 C_S

D) 0.065 C_S

Answer: A

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Chapter 2: How Ventilators Work

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Sample Questions

Q1) The power transmission and conversion system of a ventilator is defined as which of the following?

A) A mechanical device that produces gas flow to the patient

B) An electrical motor that is connected by a special gearing mechanism

C) The system that interprets the settings and produces or regulates the desired output

D) Internal hardware that changes electrical or pneumatic energy into mechanical energy

Answer: D

Q2) Modern intensive care units' (ICU)ventilators regulate gas flow to the patient by using which of the following?

A) Rotary drive pistons

B) Linear drive pistons

C) Proportional solenoids

D) Spring-loaded bellows

Answer: C

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4

Chapter 3: How a Breath Is Delivered

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Sample Questions

Q1) The inspiratory and expiratory flow sensors are reading a base flow of 5 liters per minute (L/min).The flow trigger is set to 2 L/min.The expiratory flow sensor must read what flow to trigger inspiration?

A) 1 L/min

B) 2 L/min

C) 3 L/min

D) 4 L/min

Answer: C

Q2) When the maximum pressure limit is reached during volume ventilation,which of the following occurs?

1)Inspiratory time is decreased.

2)Volume delivered is decreased.

3)Inspiration continues until volume is delivered.

4)Pressure is held and the breath is volume cycled.

A) 3 only

B) 4 only

C) 1 and 2 only

D) 2 and 4 only

Answer: C

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Chapter 4: Establishing the Need for Mechanical Ventilation

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Sample Questions

Q1) A 55-year-old male with acute dyspnea is admitted to the hospital.He is alert and oriented.His physical examination reveals: heart rate (HR)120 and regular,blood pressure (BP)146/88,temperature 38° C,respiratory rate (RR)28 shallow and labored.Breath sounds are decreased throughout with fine late crackles on inspiration,chest expansion is decreased in both bases.The patient is not coughing.The arterial blood gas (ABG)on room air is: pH 7.52,partial pressure of carbon dioxide (PaCO₂)30 mm Hg,partial pressure of oxygen (PaO₂)42 mm Hg,Hb-O₂ 80%,bicarbonate (HCO₃^-)24 mEq/L.This patient is retired after working in a steel factory for 38 years and he has a 50 pack-year history of smoking.The most appropriate action for the respiratory therapist to take is which of the following?

A) Intubate and initiate positive pressure ventilation.

B) Initiate noninvasive positive pressure ventilation.

C) Administer oxygen via a high flow nasal cannula.

D) Initiate bronchodilator and mucolytic therapy.

Q2) Acute hypercapnic respiratory failure may be caused by which of the following?

A) Decrease fractional inspired oxygen (FIO₂)

B) Pulmonary shunt

C) Respiratory muscle fatigue

D) Perfusion/diffusion impairment

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Page 6

Chapter 5: Selecting the Ventilator and the Mode

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Sample Questions

Q1) A 68-year-old female admitted for congestive heart failure is in respiratory distress and is being seen by the hospital's medical emergency team in her regular room.The patient is in obvious respiratory distress and is immediately placed on a nonrebreathing mask.Physical assessment reveals: pulse 138 and thready;respiratory rate 30,shallow and labored;temperature 37° C;blood pressure 110/68.Breath sounds are bilaterally decreased with coarse crackles on inspiration.EKG shows normal sinus rhythm with widened cardiac output (QT)interval and an occasional irregular beat.No coughing is noted.The arterial blood gas on the nonrebreathing mask is: pH 7.34;PCO₂ 46 mm Hg;partial pressure of oxygen in the arteries (PO₂)is 52 mm Hg;oxygen saturation is 86%;bicarbonate (HCO₃^-)is 24

mEq/L.The patient is diaphoretic.The most appropriate ventilator mode to manage this patient initially is which of the following?

A) Noninvasive Positive Pressure Ventilation (NPPV)

B) Airway Pressure Release Ventilation (APRV)

C) Volume Controlled Synchronized Intermittent Mandatory Ventilation (VC-SIMV)

D) Pressure Controlled Synchronized Intermittent Mandatory Ventilation (PC-SIMV)

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Chapter 6: Initial Ventilator Settings

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Sample Questions

Q1) A 39-year-old,5'4",138 lb female patient requires intubation and mechanical ventilation.Her body temperature is 39° C.She has no history of lung disease.The appropriate initial minute ventilation for this patient is which of the following?

A) 5.7 L/min

B) 6.8 L/min

C) 7.6 L/min

D) 13.8 L/min

Q2) With which flow waveform pattern will the mean airway pressure be the highest?

A) Sine

B) Square

C) Ascending ramp

D) Descending ramp

Q3) Calculate the average tidal volume for a patient who has a minute ventilation of 10 L/min with a respiratory rate (RR)of 12 bpm.

A) 120 mL

B) 833 mL

C) 1000 mL

D) 1200 mL

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Chapter 7: Final Considerations in Ventilator Setup

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Sample Questions

Q1) What is the range for setting flow triggering?

A) 1 to 10 L/min

B) 10 to 15 L/min

C) 12 to 16 L/min

D) 20 to 30 L/min

Q2) The mechanical ventilator event that is considered potentially life-threatening or a level 2 event is which of the following?

A) Intrinsic positive-end-expiratory pressure (PEEP)

B) High respiratory rate

C) Humidifier malfunction

D) Exhalation valve failure

Q3) Calculate the humidity deficit when a heat moisture exchanger (HME)provided 14 mg/L of water to the set tidal volume.

A) 14 mg/L of water

B) 23 mg/L of water

C) 30 mg/L of water

D) 37 mg/L of water

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9

Chapter 8: Initial Patient Assessment

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Sample Questions

Q1) A 49-kg female patient intubated with a size 7 mm ID endotracheal tube is being mechanically ventilated in the volume-controlled continuous mandatory ventilation (VC-CMV)mode.During patient rounds,both the low pressure and low volume alarms are sounding persistently on the ventilator.Upon observation of the patient,the respiratory therapist hears murmuring from the patient,with audible sounds during inspiration.The cause of this condition is which of the following?

A) Circuit leak

B) Endotracheal tube (ET)cuff leak

C) Circuit disconnection

D) Incorrect ET tube size

Q2) A pathophysiologic condition that causes an increase in peal inspiratory pressure (PIP)while transairway pressure (P_TA)remains the same is which of the following?

A) Acute respiratory distress syndrome (ARDS)

B) Asthma

C) Emphysema

D) Chronic Bronchitis

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Chapter 9: Ventilator Graphics

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Sample Questions

Q1) The most important factor to affect the degree of resistance in the airways is which of the following?

A) Flow rate of the gas

B) Viscosity of the gas

C) Length of the airways

D) Diameter of the airways

Q2) Delayed termination during pressure support ventilation (PSV)can be avoided with patients who have chronic obstructive pulmonary disease (COPD)by doing which of the following?

A) Increase inspiratory time.

B) Increase flow-cycle percent.

C) Change the flow pattern.

D) Decrease peak inspiratory pressure.

Q3) An increase in airway resistance during pressure ventilation will result in which of the following?

A) Plateau pressure (P_Plateau)will increase.

B) Volume curve will resemble an igloo.

C) Inspiration will end prior to flow tapering to zero.

D) Pressure curve will become concave on inspiration.

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Page 11

Chapter 10: Assessment of Respiratory Function

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Sample Questions

Q1) While trying to use a finger probe to assess a patient's oxygenation status,the respiratory therapist finds that the pulse rate and the ECG monitor heart rate are not consistent and the oxygen saturation measured by pulse oximeter (S_pO₂)reading is blank.The patient is awake,alert,and in no obvious respiratory distress.The respiratory therapist should first take which of the following actions?

1)Change the probe site.

2)Draw an arterial blood gas.

3)Adjust the probe position on the finger.

4)Remove probe,perform a capillary refill test.

A) 1 and 2 only

B) 2 and 3 only

C) 3 and 4 only

D) 1 and 4 only

Q2) How often should the respiratory therapist reposition the sensor of a transcutaneous monitor?

A) 30 minutes to 1 hour

B) 1 to 3 hours

C) 4 to 6 hours

D) 7 to 9 hours

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Page 12

Chapter 11: Hemodynamic Monitoring

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Sample Questions

Q1) The hemodynamic values for a patient in the cardiovascular care unit are: blood pressure (BP)96/60 mm Hg,pulmonary artery pressure (PAP)29 mm Hg,pulmonary capillary wedge pressure (PCWP)14 mm Hg,stroke volume (SV)50 mL.The patient has a body surface area of 1.6 m².Calculate the patient's left ventricular stroke work (LVSW).

A) 12.3 g-m/m²

B) 30.6 g-m/m²

C) 33.2 g-m/m²

D) 49 g-m/m²

Q2) The vessels that often require a surgical cut down when used for pulmonary artery catheter access include which of the following?

1)Femoral vein

2)Subclavian vein

3)Internal jugular vein

4)Antecubital vein

A) 1 and 2 only

B) 1 and 4 only

C) 2 and 4 only

D) 2 and 3 only

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Chapter 12: Methods to Improve Ventilation in Patient-Ventilator Management

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Sample Questions

Q1) An invasively ventilated patient with ARDS is on PC-CMV,PIP = 30 cm H₂O,PEEP = 12 cm H₂O,F_IO₂ = 1.0.The patient's returned V_T is 320 mL.The ABG results on these settings are: pH 7.3,PaCO₂ 53 mm Hg,PaO₂ 62 mm Hg.The patient is placed in the prone position,and after 1 hour,ABG results show: pH 7.38,PaCO₂ 46mm Hg,PaO₂ 83 mm Hg.The respiratory therapist should do which of the following?

A) Keep the patient in the prone position.

B) Place the patient in the supine position.

C) Keep the patient in the prone position and decrease the F_IO₂.

D) Place the patient in the supine position and decrease PEEP.

Q2) A mechanically ventilated patient continues to have rhonchi after deep suctioning.The respiratory therapist should recommend which of the following?

A) Prone position

B) Vest Airway Clearance System

C) Prone position with the foot of the bed elevated 12 inches

D) Supine position with the foot of the bed elevated 18 inches

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Chapter 13: Improving Oxygenation and Management of Ards

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Sample Questions

Q1) Despite the risk,it is still important to use PEEP,because it can prevent alveolar collapse during exhalation and reopening,even when a low V_T is used.It now is theorized that it is important to use the pressure-volume loop to set PEEP _____________________.

A) at the upper inflection point detected during inflation of the lung

B) above the upper inflection point detected during deflation of the lung

C) at the lower inflection point detected during inflation of the lung

D) at the peak inspiration point detected during inflation of the lung

Q2) Regardless of the procedure used to establish an appropriate PEEP level,ventilating pressures should not be allowed to exceed which of the following?

A) Upper inflation point on the inspiratory limb (UIPi)

B) 2 to 3 cm H₂O above the UIPi

C) 30 cm H₂O

D) Lower inflection point on the inspiratory limb

Q3) Patients with which of the following clinical disorders may benefit from PEEP?

A) COPD

B) Asthma

C) ARDS

D) Cystic fibrosis

Page 15

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Chapter 14: Ventilator-Associated Pneumonia

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Sample Questions

Q1) Effective treatment of ventilator-associated pneumonia can be ensured by diagnosis based on findings from which of the following?

A) Chest radiographs

B) Hematological studies

C) Bronchial alveolar lavage

D) Patient signs and symptoms

Q2) The type of organism that most often causes ventilator-acquired pneumonia is which of the following?

A) Fungi

B) Bacteria

C) Viruses

D) Protozoa

Q3) The mortality rate for VAP associated with prolonged hospital stays is which of the following?

A) 5% to 25%

B) 15% to 40%

C) 25% to 50%

D) 45% to 75%

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16

Chapter 15: Sedatives,Analgesics,and Paralytics

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Sample Questions

Q1) A patient with hypovolemic shock secondary to widespread second- and third-degree burns is being mechanically ventilated.The patient appears agitated,and the respiratory therapist is unable to synchronize the ventilator to the patient.Which drug can the respiratory therapist suggest to the ICU team to sedate this patient and synchronize ventilation?

A) Fentanyl

B) Morphine

C) Propofol

D) Succinylcholine

Q2) A patient who is receiving mechanical ventilation in the ICU is found to be wildly agitated.The most appropriate drug to control this delirium is which of the following?

A) Propofol

B) Fentanyl

C) Haloperidol

D) Lorazepam

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Chapter 16: Extrapulmonary Effects of Mechanical

Ventilation

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Sample Questions

Q1) Which of the following ventilator parameters would result in the highest mean airway pressure?

A) PIP = 30 cm H₂O;PEEP = 10 cm H₂O;T_I = 0.5

sec;TCT = 5 sec

B) PIP = 50 cm H₂O;PEEP = 10 cm H₂O;T_I = 0.5

sec;TCT = 5 sec

C) PIP = 30 cm H₂O;PEEP = 15 cm H₂O;T_I = 0.5

sec;TCT = 5 sec

D) PIP = 50 cm H₂O;PEEP = 10 cm H₂O;T_I = 0.5

sec;TCT = 5 sec..

Q2) Calculate the cerebral perfusion pressure when the mean arterial blood pressure is 120 mm Hg and the ICP is 14 mm Hg.

A) 134 mm Hg

B) 106 mm Hg

C) 120/14 mm Hg

D) 134/106 mm Hg

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Chapter 17: Effects of Positive Pressure Ventilation on the

Pulmonary System

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Sample Questions

Q1) Alveolar tissue and pulmonary capillary injury is caused by which of the following?

A) Barotrauma

B) Biotrauma

C) Shear stress

D) Overdistention

Q2) Preservation of spontaneous breathing during mechanical ventilation favors the distribution of gas to which areas of the lung?

A) Peribronchial area

B) Upper airway

C) Lung periphery

D) Central airways

Q3) Which of the following mechanically ventilated patients shows clinical signs of hypoventilation?

A) A patient who is cool to the touch and has negative T waves on the ECG.

B) A patient who has twitchy extremities and also atrial flutter on the ECG.

C) A patient who is anxious and hypertensive and has elevated T waves on the ECG.

D) A patient who has cool,twitchy extremities and also low,rounded T waves on the ECG.

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Page 19

Chapter 18: Troubleshooting and Problem Solving

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Sample Questions

Q1) The respiratory therapist enters the room of an intubated and mechanically ventilated patient to find the low pressure,low exhaled volume,and low V_E alarms active.The ventilator circuit is connected to the patient's endotracheal tube.This situation could be caused by which of the following?

A) Improper flow rate and flow pattern.

B) Poorly responsive internal demand valve.

C) Migration of the ET tube into the upper airway.

D) The patient is continuing to actively inhale.

Q2) An increased arterial-to-end-tidal partial pressure CO₂ gradient can help identify which of the following?

A) Pulmonary embolism

B) Dynamic hyperinflation

C) Cardiogenic pulmonary edema

D) Noncardiogenic pulmonary edema

Q3) An apnea alarm may be activated by which of the following?

A) Secretions

B) Auto PEEP

C) Loss of PEEP

D) Active inhalation

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Page 20

Chapter 19: Basic Concepts of Noninvasive Positive

Pressure Ventilation

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Sample Questions

Q1) Negative pressure ventilators cause air to enter the lungs by increasing ______________ pressure.

A) transairway

B) transpulmonary

C) transrespiratory

D) transthoracic

Q2) The leading cause of patient discomfort and noncompliance with NPPV is which of the following?

A) Drying of nasal mucosa

B) Mask type and fit

C) Type of PTV

D) Lack of an oxygen blender

Q3) A patient with central sleep apnea uses a nasal mask with NPPV at night.The patient complains of nasal congestion.What action should the respiratory therapist take?

A) Reduce the EPAP.

B) Add a heated humidifier.

C) Switch to a mouthpiece.

D) Add a heat/moisture exchanger.

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Chapter 20: Discontinuation and Weaning From Mechanical Ventilation

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Sample Questions

Q1) At what pressure is pressure support not high enough to contribute significantly to ventilatory support but is sufficient to overcome the work imposed by the ventilator system?

A) 2 cm H₂O

B) 5 cm H₂O

C) 8 cm H₂O

D) 10 cm H₂O

Q2) Which mode of ventilation delivers the exact amount of pressure required to overcome the resistive load imposed by the ET tube for the flow measured at the time?

A) Automode

B) Volume-targeted PSV

C) Pressure support ventilation

D) Automatic tube compensation

Q3) Which parameter is used as the primary index of the drive to breathe?

A) Airway occlusion pressure

B) CROP index

C) Maximum inspiratory pressure

D) Rapid shallow breathing index

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Chapter 21: Long Term Ventilation

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Sample Questions

Q1) A VAI patient with a TT is having a trial of cuff deflation to allow for speech.The patient's voice is "weak," and he can speak only two or three words with each exhalation.The respiratory therapist could adjust which ventilator settings to improve the patient's speech?

1)Expiratory time

2)Inspiratory time

3)Volume

4)PEEP

A) 1 and 3

B) 2 and 4

C) 1 and 4

D) 2 and 3

Q2) The appropriate power source for a wheelchair-mounted ventilator is which of the following?

A) AC current

B) Pneumatic

C) Internal DC battery

D) External DC battery

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23

Chapter 22: Neonatal and Pediatric Ventilation

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Sample Questions

Q1) A newborn with which of the following clinical manifestations should receive nasal CPAP?

A) Substernal retractions,PaCO₂= 65 mm Hg,PaO₂ = 48 mm Hg,F_IO₂ = 0.4.

B) Tachypnea,nasal flaring,PaCO₂ = 50 mm Hg,PaO₂ = 50 mm Hg,F_IO₂ = 0.6.

C) Grunting,substernal retractions,pH = 7.20,PaCO₂ = 70 mm Hg,PaO₂ = 40 mm Hg,F_IO₂ = 0.7.

D) Tachypnea,pale skin,pH = 7.32,PaCO₂ = 45 mm Hg,PaO₂ = 75 mm Hg,F_IO₂ = 0.21.

Q2) Respiratory failure is imminent in infants who demonstrate which of the following?

A) Substernal retractions

B) Tachypnea

C) Grunting

D) Nasal flaring

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24

Chapter 23: Special Techniques in Ventilatory Support

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Sample Questions

Q1) Weaning from APRV includes which of the following?

A) Increasing the P_high and decreasing the T_high

B) Decreasing the P_high and increasing the T_high

C) Increasing the P_low and decreasing the T_low

D) Decreasing the P_low and increasing the T_low

Q2) When T_highis set at 5.5 seconds,and the T_low is set at 0.5 seconds;what is the set ventilator rate?

A) 8

B) 10

C) 14

D) 16

Q3) The chest radiograph of a patient just placed on HFOV shows the diaphragm at the level of the seventh rib.Which of the following parameters should be adjusted?

A) mP_aw

B) Power

C) Bias flow

D) Amplitude

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