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30 Cards in this Set
- Front
- Back
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The most likely complication of manual resuscitation (bagging) of the
non-intubated patient is: A. vagal stimulation B. bradycardia C. pneumothorax D. gastric distension E. bronchospasm |
D. gastric distension
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A patient has a -15 cm water pressure negative inspiratory pressure (NIF) . What can you conclude from this result?
I. The patient has weak inspiratory muscles. II. The patient meets extubation criteria III. The patient has obstructive airways disease. A. I B. II C. I, II D. I, III |
A. I
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During manual resuscitation cardiac output can be decreased. This is due to:
A. higher airway resistance B. lower lung compliance C. higher intrathoracic pressures in the chest D. lack of passive exhalation |
C. higher intrathoracic pressures in the chest
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During normal negative pressure breathing there is bulk movement of air into an out of the lungs. If we define P1 as atmospheric pressure and P2 as alveolar pressure, which of the following is correct during inhalation?
I. P2 < P1 II. P1 < P2 III. Boyle's Law causes P2 to decrease in relation to P1 IV. P1 = P2 V. Boyle's Law causes P2 to increase in relation to P1 A. IV B. II, V C. I, V D. I, III E. II, III |
D. I, III
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During manual resuscitation (bagging) cardiac output can be decreased.
This is due to: A. higher airway resistance B. lower lung compliance C. positive pressure in the chest D. lack of passive exhalation |
C. positive pressure in the chest
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What is the best "sequence of events" when intubating the trachea?
A. insert the laryngoscope; position the head; preoxygenate; insert the tube through the vocal chords; inflate the cuff; listen for breath sounds; attach resuscitator bag and hand ventilate B. position the head; preoxygenate; insert the laryngoscope; insert the tube through the vocal chords; inflate the cuff; attach resuscitator bag and hand ventilate; listen for breath sounds C. position the head; preoxygenate; insert the laryngoscope; inflate the cuff; insert the tube through the vocal chords; attach resuscitator bag and hand ventilate; listen for breath sounds D. preoxygenate; position the head; insert the laryngoscope; insert the tube through the vocal chords; attach resuscitator bag and hand ventilate; listen for breath sounds; inflate the cuff |
B. position the head; preoxygenate; insert the laryngoscope; insert the tube through
the vocal chords; inflate the cuff; attach resuscitator bag and hand ventilate; listen for breath sounds |
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. A patient on a ventilator has a peak pressure of 30 cmH2O, a plateau pressure of 20 cmH2O measured.
What is the airway resistance (RAW) with a flowrate of 60 L/M? A. .5 cmH2O/L/S B. .33 cmH2O/L/S C. 10 cmH2O/L/S D. 30 cmH2O/L/S E. 10 cc/L/M |
C. 10 cmH2O/L/S
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The FRC acts as a reservoir for gas exchange during exhalation. What is the expected effect of PEEP on FRC ?
A. FRC will decrease B. FRC will be maintained at present level whatever that level is C. FRC will increase to just below the upper inflection point D. FRC will increase to just above the lower inflection point to prevent alveolar collapse |
D. FRC will increase to just above the lower inflection point to prevent alveolar collapse
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A patient on a ventilator has a peak pressure of 30 cmH2O, a plateau pressure of
20 cmH2O measured with an inspiratory hold of 1 second. The baseline pressure is zero (no PEEP). The tidal volume delivered to the patient is 600 cc. What is the static compliance? A. 12 L cmH2O B. 30 cc/cmH2O C. .033 cmH2O/cc D. 600 cc/sec E. 20 cc/cmH20 |
B. 30 cc/cmH2O
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A chest X-ray following intubation:
A. provide absolute proof the ETT is in the trachea B. confirm the position of the tube once in the trachea C. must be done immediately following intubation for initial assessment D. is not accurate because it is an AP film E. a and c |
B. confirm the position of the tube once in the trachea
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Which of the following is NOT an reason for mechanical ventilation?
A. Apnea B. Ventilatory Failure C. Special Procedure D. Profound Hypoxemia E. Pneumonia |
E. Pneumonia
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Which of the following lists the steps required for an extubation in the correct order?
i. deflate cuff ii untape tube iii suction down the tube iv suction the pharynx v remove the tube A. iii, iv, i, ii, v B. ii, i, iv, iii, v C. iii, iv, ii, i, v D. iii, i, ii, v, iv E. iv, ii, i, iii, v |
C. iii, iv, ii, i, v
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Vital Capacity (VC) is an extubation parameter. What is the minimal acceptable value for this parameter that predicts a successful extubation?
A. 50-70-cc/Kg B. 2 X the Vt C. 10cc/Kg D. 5cc/Kg |
C. 10cc/Kg
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Which of the following is the minimal negative inspiratory force (NIF) when assessing ventilatory performance and muscle strength in the patient who is to be weaned.
A. -5 cmH2O B. -10 cmH2O C. -20 cmH2O D. -40 cmH2O E. 40 L/M |
C. -20 cmH2O
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The manometer used with a flow inflating resuscitator bag allow you to monitor:
A. PIP and PEEP B. tidal volume C. FIO2 D. plateau pressure E. respiratory rate |
A. PIP and PEEP
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What is the expected FIO2 of a self inflating resuscitator bag that does not have a reservoir, but is connected to an oxygen flow meter set at maximum flow?
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40%
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26. Regarding "flow inflating" (flow-dependent) manual resuscitators,
which of the following is false? A. .they must be connected to a gas source in order for them to operate B. they can be used on intubated or non-intubated patients C. their use can cause a decrease in cardiac output D. they have a diaphragm, spring and disk (or ball), or duck bill valve E. none of the above |
C. their use can cause a decrease in cardiac output
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27.
Which is true of resuscitator bags? I. the spring and ball valve still functions best when contaminated with blood or vomit II. a reservoir can increase FIO2 to 100% oxygen III. a resuscitator bag without a reservoir provides approximately 40% 02 IV. a self inflation bag provides the best "feel" for the patient's lung compliance A. I, II B. II, III C. I, IV D. II, III, V E. all of the above |
B. II, III
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28. A positive pressure mechanical ventilator has a preset tidal volume or a preset inspiratory pressure. A preset inspiratory pressure ventilator will deliver a:
A. a constant volume and a variable pressure B. a constant pressure and a variable volume C. a constant volume and a constant pressure D. a variable pressure and a variable volume |
B. a constant pressure and a variable volume
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When the chest wall becomes more difficult to expand; which of the following best reflects this effect?
A. increased RAW B. decreased static compliance C. increased Vt during pressure targeted ventilation D. increased dynamic compliance |
B. decreased static compliance
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During positive pressure breathing there is bulk movement of air into an out of the lungs. If we define P1 as pressure applied to the airway and P2 as alveolar
pressure, which of the following is correct during inhalation? A. P1 < P2 B. P1 > P2 C. Boyle's Law causes P2 to increase while P1 decreases D. P1 = P2 |
B. P1 > P2
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A 75Kg COPD patient has the following extubation parameters:
NIF = 14 cmH2O MV = 15 L/M RR = 32 BPM VC = .6L Vt = 3cc/Kg Based on this information only what is the next step for this patient? A. extubate immediately B. place the patient back on the ventilator C. leave the patient on a T piece until the F/Vt ratio increases then repeat the parameters D. draw a blood gas after 30" on a T piece, then if the ABG values are normal for the patient; extubate |
B. place the patient back on the ventilator
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Which of the following are factors that will increase airway resistance?
i ETT size too small ii ARDS iii Bronchospasm iv fibrosis v pulmonary edema A. i, iii B. i, iii, iv C. ii, iv, v D. i, ii, iv, v |
A. i, iii
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A patient on a ventilator has a peak pressure of 30 cmH2O, a plateau pressure of
20 cmH2O measured with an inspiratory hold of 1 second. The baseline pressure is zero (no PEEP). The tidal volume delivered to the patient is 600 cc. What is the static compliance? A. 12 L cmH2O B. 30 cc/cmH2O C. .033 cmH2O/cc D. 600 cc/sec E. 20 cc/cmH20 |
A. 12 L cmH2O
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You are ventilating now because you are:
A. pulling the air in B. pushing the air in C. neither pulling or pushing ventilation occurs by diffusion D. just by keeping your FRC at the optimum level |
A. pulling the air in
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The single most predictive factor of successful extubation of the following is:
A. VC B. Vt C. Rapid shallow breathing index D. MVV |
C. Rapid shallow breathing index
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With volume oriented positive pressure ventilation the peak pressure needed to push in the Vt represents a combination of two forces. These two forces can be isolated by performing a plateau pressure. The difference between peak and plateau pressures represent___________ , while the plateau pressure itself represents _____________.
A. airway resistance....... elastic or compliance factors B. static compliance...... dynamic compliance C. inspiratory time........ expiratory time D. PSV........ flowby |
A. airway resistance....... elastic or compliance factors
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37. A 70 kg (154 lb) man is being mechanically ventilated. Which of the following data obtained during spontaneous breathing would support a decision to continue ventilatory support?
I.vital capacity of 1.15 L II. maximum inspiratory pressure (MIP) of –25 cm H2O III. rapid shallow breathing index 266 IV. tidal volume of 150 ml V. respiratory rate of 40/min. A. I and II only B. I and III only C. II and III only D. I, II, and III E. III, IV, V |
E. III, IV, V
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A mechanically ventilated asthmatic patient has become more bronchospastic over several hours. Which of the following changes would you expect to see during that time?
i. decreasing PIP ii. increasing PIP iii. increasing plateau iv. decreasing plateau v. no change in plateau A. i, iv B. ii, iii C. i, v D. ii, v |
D. ii, v
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9.A 75Kg COPD patient has the following extubation parameters:
NIF = -14 cmH2O MV = 15 L/M RR = 32 BPM VC = .6L Vt = 3cc/Kg Calculate the value for the Rapid Shallow Breathing Index A. 142 B. 7 C. 225 D. 30 |
A. 142
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