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100 Cards in this Set
- Front
- Back
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Which of the following is/are chemical properties of nitric oxide?
a. Lipophilic b. Highly reactive c. unstable free radical d. All of the above |
d. All of the above
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Which chemical is most associated with smooth muscle contractility?
a. Iron b. Calcium c. Citric Acid d. I- Arginine |
b. Calcium
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Inhaled nitric oxide reduces shunt by:
a. Vasodilating only pulmonary capillaries adjacent to atelectic lung units b. Decreasing pulmonary vascular resistance c. Increasing systemic oxygenation d. Vasodilating only pulmonary capillaries adjacent to functioning lung units |
d. Vasodilating only pulmonary capillaries adjacent to functioning lung units
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Which of the following are useful properties of helium when used to treat patients in status asthmaticus?
I. Lower density II.Lower viscosity III. Higher viscosity IV. Low thermal conductivity a. I and II b. I and III c. I, II, and IV d. I, III, and IV |
b. I and III
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All of the following are effects of heliox on mechanical ventilation except:
a. Measured flow is falsely low when using a defferential pneumotachometer b. Nebulizer output is decreased c. Actual flow from the flowmeter is lower than indicated d. Measured flow is falsely high when using a hotwire anemometer |
c. Actual flow from the flowmeter is lower than indicated
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Hypoxic and hypercarbic gas mixtures
a. increase pulmonary blood flow b. are useful in patients with pulmonary hypertension c. decrease pulmonary blood flow d. increase systemic blood flow |
c. decrease pulmonary blood flow
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Which of the following is not an inhaled anesthetic agent used to treat status asthmaticus?
a. Halothane b. Sevoflurane c. Enflurane d. Nitrous oxide |
d. Nitrous oxide
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Which of the following inhaled anesthetic agents are best tolerated by the patient when breathing spontaneously from a mast?
a.Isoflurane and enflurane b. Halothane and sevoflurane c. Enflurane and sevoflurane d. Isuflurane, halothane, and sevoflurane |
b. Halothane and sevoflurane
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What IA should not be used in patients receiving catecholamines?
a. Enflurane b. Isuflurane c. Sevoflurane d. Halothane |
d. Halothane
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Which of the following are potential side effects of iNO administration?
a. Nitrous oxide formation in the ventilator circuit b. Fetal hemoglobin formation c. decrease in guanylyl cyclase in the sarcoplasmic reticulum d. Methemoglobin formation |
d. Methemoglobin formation
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High frequency ventilation is defined in the US FDA by delivering more than
a. 150 breaths per minute b. 12 breaths per minute c. 120 breaths per minute d. 150 breaths per sec |
a. 150 breaths per minute
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High frequency jet ventilation delivers gas by:
a. Intermittently occluding a high flow of gas with a rotating vane b. Pulsing gas down the endotracheal tube at a high velocity c. Passing gas past the endotracheal tube and agitating it with a piston d. The same method as conventional ventilation, just at a higher frequency |
b. Pulsing gas down the endotracheal tube at a high velocity
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High frequency oscillatory ventilation delivers gas by:
a. The same method as conventional ventilation just at a higher frequency b. Pulsing gas down the endotracheal tube at a high velocity c. Alternating gas in and out via a rotating vane d. Passing gas past the endotracheal tube and agitating it with a piston |
d. Passing gas past the endotracheal tube and agitating it with a piston
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The exhalation phase of HFOV differs from other forms of high frequency ventilation because:
a. exhaled gas is actively pulled out via the patient as the piston moves back b. Exhalation is passive whereas on the HFV gas is pulled out via a venturi effect c. Exhalation is active during HFOV due to a separate vacuum assist device d. Exhaled gases passively exit the patient due to passive chest recoil |
a. exhaled gas is actively pulled out via the patient as the piston moves back
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Which of the following most accurately describes the relationship of lung volume and PAW?
I. Increasing PAW increases lung volume and improves ventilation-perfusion matching II. Increasing PAW increases the pressure gradient allowing more oxygen to coss the alveolar capillary membrane III. Increasing PAW improves the efficiency of the jet or piston IV at very high and very low lung volumes ventilation perfusion matching is impaired a. I b. II c. I, III, IV d. I and IV |
c. I, III, IV
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The goal in treating atelectasis prone is
a. High lung volume to recruit alveolar lung units b. Low lung volumes to reduce the chance of barotrauma c. High lung volumes to recruit the lung and large tidal volumes to aid ventilation d. Low tidal volumes combined with high lung volumes |
a. High lung volume to recruit alveolar lung units
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A neonate is progressing satisfactoryly on HFOV with a MAP of 15 cm H2O. The physician consults the respiratory clinician to determine in what increments the PAW should be weaned. What should the respiratory therapist recommend?
a. 4-6 cm H2O b. 3-4 cm H20 c. 1-2 cm H20 d. no increments |
c. 1-2 cm H20
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A clinician prepares to sxn a pt undergoing HFV. What is the most likely consequence of sxning?
a. hypoxia, requiring a temporary increasing in PAW b. Pulmonary hemorrage, requiring ETT epinephrine c. Negative pressure pulmonary edema requiring a temporary increasing in PAW to resolve d. none of the above |
A clinician prepares to sxn a pt undergoing HFV. What is the most likely consequence of sxning?
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An infant has just been place on HFJ. What trending monitor should be recommended?
a. In line blood gas analyzer b. pulse oximetery c. Transcutaneous monitoring d. B and C |
d. B and C
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The goal in treating infants with pulmonary interstitial emphysema or active air leak is
a. high lung volume to recruit alveolar lung units b. low lung volume to reduce the chance of creating or worsening an air leak c. High lung volume to recurit the lung and large tidal volumes to aid ventilation d. low tidal volumes combined with high lung volumes |
b. low lung volume to reduce the chance of creating or worsening an air leak
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Which of the following PaO2/FiO2 values define acute respiratory distress syndrome (ARDS)?
a. <100 b. <200 c. <250 d. <300 |
b. <200
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Oxygenation Index (OI) is defined as:
a. (Mean airway pressure x FIO2)/PaO2 x100 b. (Peak inspiratory pressure x FIO2) /PAO2 x100 c. (Mean airway pressure x PaO2)/FIO2 x 100 d. PAO2/FIO2 |
a. (Mean airway pressure x FIO2)/PaO2 x100
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Which of the following is not one of three pathologic stages of ARDS?
a. exudative stage b. proliferative stage c. Fibrotic stage d. Edematous Stage |
d. Edematous Stage
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Which of the following treatment strategies for acute lung injury in adult patients has been demonstrated to improve mortality?
a. prone positioning b. inhaled nitric oxide c. Low positive end expiratory pressure d. Low tidal volume ventilation |
d. Low tidal volume ventilation
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The overall goals in treatment of ARDS include:
a. Treatment of the underlying disease b. Achieve adequate tissue oxygenation c. minimize ventilator induced lung injury d. All of the above |
d. All of the above
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The criteria used to define ARDS include
a. hypoxemia b. bilateral pulmonary infiltrates c. abscess of left heart failure d. all of the above |
d. all of the above
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Which of the following adjunct therapies has been associated with a decrease in mortality in pediatric patients with acute lung injurt?
a. Permissive hypercapnia b. permissive hypoxemia c. exogenous surfactant administration d. low tidal volume ventilation |
c. exogenous surfactant administration
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Which of the following characteristics of infants and young children causes this population to be particularly prone to respiratory failure?
a. small caliber airways b. increased chest wall compliance c. greater propensity for rapid fatigue of respiratory muscles d. all of the above |
d. all of the above
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The most common immediate cause of death in patients with ARDS is:
a. failure of gas exchange b. multiorgan system failure c. renal failure d. cardiac failure |
b. multiorgan system failure
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Which of the following is generally the latest clinical findings in patients with ARDS:
a. hypoxemia b. decreased pulmonary compliance c. increased WOB d. hypercapnia |
d. hypercapnia
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Normal transition to extrauterine life depends on the pulmonary vascular system:
a. remaining in a steady state of balance with the hepatic blood flow b. changing from a low pulmonary vascular resistance to a high pulmonary vascular resistance c. changing from a high pulmonary vascular resistance to a low pulmonary vascular resistance d. maintaining a PDA |
c. changing from a high pulmonary vascular resistance to a low pulmonary vascular resistance
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Which of the following affects PVR?
a. Changes in PaO2 b. Changes in PaCO2 c. Changes in pH d. all of the above c. none of the above |
d. all of the above
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What are the two categories that have typically been used to classify congenital cardiac defects?
a. right sided versus left sided b. atrial versus ventricular c. What are the two categories that have typically been used to classify congenital cardiac defects? a. right-sided versus left sided b. atrial versus ventricular c. cyanotic versus acyontic d. simple versus complex e. above versus below the diaphragm |
c. cyanotic versus acyontic
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The PDA connects which two vessels?
a. Superior vena cava and the pulmonary artery b. Aorta the pulmonary artery c. Pulmonary artery and the pulmonary vein d. Coronary arteries and aortic arch c. Ductus venosus to the right atrium |
b. Aorta the pulmonary artery
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What is the therapeutic goal of subambient oxygen therapy?
a. increase the PVR b. Balance blood flow between the vena cava and right atrium c. decrease the PVR d. Increase the diastolic blood pressure |
a. increase the PVR
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The purpose of managing PVR in the presence of cardiac defects is to ensure the desired balance between systemic and pulmonary blood flow:
a. true b. false |
a. true
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Tetralogy of Fallot consists of which four concomitant conditions:
I. truncus arteriousus II. Left Ventricular Hypertrophy III. Right ventricular hypertrophy IV. Overriding aorta V. Interrupted aortic arch VI. Pulmonary Stenosis VII. Ventricular Septal defect VIII. Right ventricular outlfow tract obstruction a. I, II, III, V b. III, IV, VI, VII c. V, VI, VII, VIII |
b. III, IV, VI, VII
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In complete transposition of the great arteries, the aorta and pulmonary circulation run in series.
a. True b. False |
b. False
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For which condition is a ventilator strategy utilizing larger tidal volumes, lower rates, and a shorter I-Time typically used?
a. unrepaired truncus arteriousus b. total anomalous venous return c. situs inversus d. bidirectional glenn |
d. bidirectional glenn
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Increasing gradients between ETCO2 and PACO2 in patients with congentital cardiac defects are often the result of:
a. loss of calibration b. ventilation perfusion mismatching c. equipment malfunction |
b. ventilation perfusion mismatching
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How is chronic lung disease defined in an infant?
a. Persistant infiltrates and emphysema like changes on chest x-ray b. requiring oxygen and any form of positive pressure support on discharge c. high levels of vitamin E and A as markers of CLD and greater than 1 liter of oxygen at 40 weeks d. Requiring oxygen or mechanical ventilation and continuing to require oxygen at 36 weeks gestational age |
d. Requiring oxygen or mechanical ventilation and continuing to require oxygen at 36 weeks gestational age
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Which of the following statements are true about the cause of CLD in the newborn?
a. results from oxygen use during the newborn period b. Results from the positive pressure ventilation during the newborn period c. depends on the severity of the surfactant dysfunction d. A and B c. A, B, and C |
c. A, B, and C
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What is an important component to preventing oxidative stress in the treatment of CLD in the newborn?
a. administering high dose of beta carotene b. resuscitating with a minimum FIO2 at birth c. Includes administration of Vitamin E d. B and C e. A, B, and C |
d. B and C
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Which of the following are true about the development of CLD of the newborn?
I. Oxidative stress and mechanical ventilation lead to inflammation II. Neutrophils are prevelent in infants with RDS but decrease as RDS resolves III. neutrophil degranulation prevents surfactant production IV. Neutrophils are prevalent despite the resolution of RDS V. Vitamin E enhances the protective of lamellar bodies a. I, III, IV b. II, III, V c. I, II, IV d. II, III, IV, V |
d. II, III, IV, V
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Which of the following may be used to reduce mortality and morbidity associated with RDS leading to chronic lung disease?
I. Nasal CPAP therapy II. Surfactant replacement therapy III. Corticosteroid therapy IV iNO V ECMO a. II, IV b. II, IV, V c. I, III, V d. III, IV, V e. I, II, IV |
e. I, II, IV
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What does the diagnosis of retinopathy of prematurity include?
a. Staging of the retinal vascular change b. Timing the rate of vascular change in clock hours c. A description of the location and extent of the retinal vascular change d. A, B, and C e. A and C |
e. A and C
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Treatment to reverse the effects of ROP consists of
a. Lasar ablation of the affected vascular area b. administration of vitamin E and limiting light exposure c. supplemental O2 d. none of the above e. A, B, C |
d. none of the above
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What is the most important cause IVH?
a.Positive pressure ventilation b. hypoxemia and respiratory failure c. lack of auto-regulation and resulting fluctuations in cerebral blood flow d. Intravascular administration of glucose and other nutrients e. administration of medications used to close a PDA |
c. lack of auto-regulation and resulting fluctuations in cerebral blood flow
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What procedure is performed to diagnose IVH?
a. an echocardiogram b. a pericardiocentesis c. a spinal tap d. a head ultrasound |
d. a head ultrasound
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A 30 week GA newborn has been on the ventilator for 9 weeks with PaCO2 values around 60 and PaO2 values around 60 despite increased ventilator settings. Chest xray reveal atelectasis, hyperlucencies, cystic changes, hyperinflation, and mild cardiomegaly. The most likely diagnosis is which of the following?
a. CF b. BPD c. Bacterial pneumonitis d. Pulmonary interstitial emphysema e. MAS |
B. BPD
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An infant brought to the NICU presents with cyanosis and upper airway obstruction relieved by crying and improvement in color. Suspecting choanal atresia the best action is to
a. insert an 8 french sxn catheter to verify the diagnosis b. insert an oral airway c. start nasal CPAP d. provide heated humidity |
b. insert an oral airway
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Complications related to chronic upper airway obstruction from anatomic malformations results in which of the following?
I. chronic hypoxia and CO2 retention II. Pulmonary hypertension and cor pulmonale III. hyperventilation and acidosis IV. failure to thrive V. CHF a. I, III b. I, II, IV c. I, II, III, V d. II, III, IV e. II, IV, V |
b. I, II, IV
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The most common tracheoesophageal fistula and esophageal atresia lesion is classified as which type?
a. Esophageal atresia with a long gap b. Esophageal atresia with a distal treachoesophageal fistula c. h-type tracheoesophageal fistula d. esophageal atresia with proximal fistula |
b. Esophageal atresia with a distal treachoesophageal fistula
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A drooling newborn infant with polyhydramnios in utero and suspected kidney and cardiac anomalies is admitted into the NICU and presents with coughing, respiratory distress, and cyanosis during feedings. The most likely diagnosis is:
a. Gastoschisis b. tetralogy of fallot c. pulmonary sequestration d. esophageal atresia with treacheoesophageal fistula e. choanal atresia |
d. esophageal atresia with treacheoesophageal fistula
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Which of the following are true concerning a congenital diaphragmatic hernia?
I. pulmonary hypoplasia is present in both lungs II. PPHN is the main complication III. Surgical correction results in complete reversal of the respiratory distress IV. CDH formation is a defect that occurs very early in gestational age V. The right lung is not usually affected a. I, II, IV b. I, III, IV, V c. I, IV, V d. II, III, IV, V e. II, III, V |
a. I, II, IV
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A 3200g term infant male is born to a healthy mother. Apgar scores are 7 and 5 with the infant gasping and heart rate decreasing to 90. Physical exam reveals cyanosis, a scaphoid abdomen, and visible tracheal deviation to the right. Considering this informatino the ONLY appropriate action would be to
a. get a blood gas b. bag mask ventilate c. sxn and stimulate vigorously d. Insert an oral sxn catheter to vent the stomach |
d. Insert an oral sxn catheter to vent the stomach
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Considering the likely diagnosis of congenital diaphragmatic hernia, which would be appropriate decision concerning ventilator strategy?
a. hypoxic gases b. rapid rate and low pressures c. high pressure and long inflation times d. slow rate and short i times e. low pressure with high peep |
b. rapid rate and low pressures
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A female infant was born with a large gastoschisis anomaly. The reduction surgery will most likely affect the respiratory system by causing
a. an increase in RAW b. a decrease in pulmonary compliance c. a decrease in transpulmonary pressure d. an increase in respiratory time constant e. B and D |
b. a decrease in pulmonary compliance
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When comparing gastroschisis and omphalocele, which of the following is true?
a. they are both full thickness defects of the abdominal wall b. they are both commonly associated with other anomalies c. omphalocele is a midline defect while a gastrochisis is a lateral wall defect d. an omphalocele is covered by epidermal tissue e. gastroschiss is requires surgical reductions that frequently must be performed in several stages while omphalocele is completed in a single surgery |
c. omphalocele is a midline defect while a gastrochisis is a lateral wall defect
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Although the lung bud anomalies have different histopathology, clinical presentation usually:
a. becomes obvious in the early newborn period and is manifested by respiratory distress b. becomes obvious in the early newborn period and is manifested by recurrent pulmonary infections c. Develops later in childhood and is characterized by severe respiratory distress d. Remains undetected until adolescence or early adulthood e. Presents as severe respiratory distress requiring mechanical ventilation |
a. becomes obvious in the early newborn period and is manifested by respiratory distress
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A 25 week GA newborn appears cyanotic with an ABG indicating hypoxia and hypercarbia. The infant has severe chest wall retractions with inspiratory effort. The amniotic fluid appeared normal at birth. What is most likely the cause of respiratory distress?
a. Surfactant defiency b. MAS c. Pneumonia d. BPD |
a. Surfactant defiency
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An infant diagnosed with RDS subsequent to lung prematurity is receiving oxygen therapy with an FIO2 of 0.8 and NCPAP set at 10cm H20. The infant is experiencing progressive hypercarbia and apneic episodes are appearing prolonged. The next logical course of action is to:
a. increase the FIO2 by 0.1 and look for improvements in ABG parameters b. Start iNOtherapy to improve the lung V:Q ratio c. Increase NCPAP to 12 cmH2O and refit the nasal prongs d. Intubate the infant and begin mechanical ventilation |
d. Intubate the infant and begin mechanical ventilation
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A full term infant is delivered via c-section and demonstrates mild symptoms of RDS including cyanosis, tachypnea, and nasal flaring. APGAR scores are good and chest radiographs show hyperexpansion and perihilar streaking. Which situation most likely fits this case?
a. This infant is in the "honeymoon" stage and is expected to develop more serious RDS b. This infant has TTN and will likely recover in 72 hrs c. This infant is int he early stages of pneumonia and should be started on broad spectrum antibiotics d. This infant likely has elevated PVR and a hyper-oxia test should be performed to confirm PPHN |
b. This infant has TTN and will likely recover in 72 hrs
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A 4-day old infant, born at 27 weeks gestation develops recurrent symptoms of RDS. The infant had been removed from mechanical ventilation and extubated at day 3, and was receiving NCPAP with an FIO2 of .04 when lung function acutely worsened. Chest radiograph show a widespread diffuse granular pattern and analysis of ABG samples from UAC demonstrates that O2 sat is refractory to increase the FIO2. The most likely cause for these recurrent symptoms of RDS is:
a. Progressive periods of apnea b. PDA c. MAS d. Postnatal pneumonia |
d. Postnatal pneumonia
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A Newborn infant begins to develop symptoms of respiratory distress at 5 days of life. A cerebrospinal fluid culture tests positive for Strep B infection. Which mode of transmission is most likely to cause the infection?
a. Transplacental or perinatal b. Transplacental only c. Perinatal or postnatal d. Postnatal only |
c. Perinatal or postnatal
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Which condition would would be most critical in leading the caregiver to anticipate MAS?
a. Desaturation refractory to oxygen therapy. b. Yellowish-green colored amniotic fluid c. Distinct chest wall retractions with inspiratory efforts |
b. Yellowish-green colored amniotic fluid
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Which fetal assessments may suggest that when born an infant will be at risk for MAS?
a.Fetal oligohydramnios b. abnormal fetal heart tracings c. both a and b d. neither a and b |
c. both a and b
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PPHN can be associated with which underlying pulmonary disorders?
a. MAS b. RDS c. None (idiopathic) d. All of the above |
d. All of the above
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A full term infant diagnosed with PPHN is refractory to oxygen therapy and mechanical ventilation. Which would be the next logical therapy to try?
a. HFV b. Volume therapy c. iNO therapy d. All would have potential benefits |
c. iNO therapy
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A newborn at 34 weeks gestation is experiencing brief periods of apnea, which results in bradycardia and cyanosis. Blood and cerebrospinal fluid cultures test negative for infection. Which interventions can help reduce the incidence of apneic episodes?
a. Upright positioning b. Temp stability c. Low FIO2 of 0.23-0.25 d. all of the above |
d. all of the above
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A patient is being masked and ventilated. What is the term for a method of respiratory assistance that does not require an indwelling artificial airway?
a. noninvasive b. invasive c. Positive pressure d. negative pressure |
a. noninvasive
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What complications of NPPV can be specifically found in children?
a. apiration and/or reflux b. upper airway obstruction or large oral leak c. Agitation d. all of the above |
d. all of the above
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What pitfalls are associated with NPPV in the pediatric patient?
a. poor fit b. incorrect adjustments for inspiratory and expiratory pressures c. insufficient sensitivity for infants d. all of the above |
d. all of the above
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A 6 year old patient has just been placed on NPPV. What is not the objective?
a. To decrease the WOB b. to avoid intubation at all cost c. To increase alveolar ventilation d. to increase FRC |
d. to increase FRC
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Why is NPPV not attempted not attempted more often?
a. lack of pt interfaces for the majority of the population b. it is easier to sedate and mechanically ventilate patients via an ETT c. Lack of conclusive evidence showing benefit when compared when invasive mechanical ventilation d. A and C |
d. A and C
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Name an advantage of negative pressure ventilation
a. Carbon dioxide may be removed without the need for a trach b. it is more physiologic than positive pressure ventilation c. it is easily trasportable d. A and B |
d. A and B
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What is a relative contraindication to negative pressure ventilation?
a. hypoventilation b. thoracic trauma requiring an open would or chest tubes c. airway obstruction d. Chronic respiratory disease |
c. airway obstruction
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A pt is receiving ventilation at an IPAP setting of 10. What is IPAP?
a. Inspiratory positive airway pressure b. Inspiratory position airway posture c. Peak positive airway pressure d. none of the above |
a. Inspiratory positive airway pressure
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How should the IPAP be set?
a. To 5 cm H20 above EPAP b. Above EPAP to increase tidal volume and unload the respiratory muscles reducing the work of breathing c. Until an audible leak around the mask is heard, determining lung filling d. to 2 cm H2O for every year of age until the age of 10 |
b. Above EPAP to increase tidal volume and unload the respiratory muscles reducing the work of breathing
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A patient in the PICU undergoes respiratory failure and has just been placed on NPPV. How should this device be monitored?
a. as a piece of life support equipment b. it does not require monitoring c. alarms are not required d. PRN spot checks |
a. as a piece of life support equipment
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Which of the following issues would most likely explain why a newborn infant's measured RR would rise from 40-100 breaths /min on a ventilator after the patient was turned and an audible ETT leak was heard?
a. pneumothorax b. Autocycling c. Secretions d. Bradypnea |
b. Autocycling
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A !0-year-old child is intubated and receiving mechanical ventilation. The tidal volume is set at 280ml, the peak airway pressure is 38 cm H20, the plateau pressure is 20 cm H20, and the PEEP is 5 cm H20. The tubing compliance factor is 1.5 ml/cm H2O. What is delivered VT to this patient?
a. 255 ml b. 157 ml c. 230 ml d. 330 ml |
c. 230 ml
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A term infant is being ventilated with a microprocessor ventilator and the physician would like to wean the infant from the ventilator. The clinician has tried turning the patient's set rate on SIMV down to 10 breaths/min, but the infant immediately becomes tachypneic and desaturates to 85%. Which of the following should be done at this time?
a. Increase the PEEP b. Initiate pressure support ventilation c. Increase the inspiratory pressure d. place on nasal CPAP |
b. Initiate pressure support ventilation
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A 600g neonate is being mechanically ventilated in pressure control ventilation with the following ventilator settings:PIP 24 cm H2O, PEEP 4 cm H2O, FIO2 0.45, RR 40. Which of the inspiratory time should the clinician recommend?
a. 0.6 seconds b. 0.3 seconds c. 0.8 seconds d. 1.0 seconds |
b. 0.3 seconds
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The physician would like to begin dual control ventilation of a 500g infant. What would be the initial corrected volume target?
a. 5ml/kg b. 10ml/kg c. 3ml/kg d. 8ml/kg |
a. 5ml/kg
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While observing a ventilator flow graphic for a 12 year old patient with asthma, the clinician noticies that the expiratory flow does not return to baseline and the patient's autopeep level is 6 cm H2O. Which ventilator manipulation might help this patient the most?
a. increase the RR by 8 breaths per minute b. Decrease the I time c. Decrease the Peak inspiratory flow d. Increase the PEEP |
b. Decrease the I time
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A NICU pt with RSV is receiving mechanical ventilation in the pressure control mode with the following current settings: PIP 14, PEEP of 5, FIO2 of 0.5, RR of 28. The patient has poor chest rise bilaterally, and breath sounds are uneraerated with faint wheezes bilaterally. You notice that the measured tidal volume 3ml/kg and the respiratory rate is 80 breaths/min. The patient has nasal flaring, retractions and head bobbing. What should be suggested at this time?
a. Placing the patient on a high frequency oscillator b. Sxn and then increase the PIP c. Decrease the RR d. Using the neuromusclar blocking agent |
b. Sxn and then increase the PIP
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TCPL is fundamentally different from PCV in that a ___ must be set:
a. Constant flow rate b. external PEEP resistor c. High pressure limit alarm d. Apnea alarm |
a. Constant flow rate
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Which nonconventional ventilator approach would be good for a 10-year-old boy with severe ARDS who is spontaneously breathing while undergoing ventilation?
a. TCPL b. APRV c. CPAP d. IRV |
b. APRV
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Which of the following factors does not affect the MAP?
a. PEEP b. I-time c. Time constant d. PIP |
c. Time constant
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The most common interface used to deliver CPAP to spontaneously breathing infants is:
a. infant hood b. nasal prongs c. nasopharyngeal endotracheal tube |
b. nasal prongs
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Physiologic effects of CPAP include all of the following except:
a. improved respiratory system compliance and resistance b. stabalization of the chest wall c. increased mucus production d. less lung injury than with mechanical ventilator |
c. increased mucus production
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CPAP is contraindicated in infants with which of the following congenital defects?
a. preoperative congenital diaphragmatic hernia b. postoperative heart surgery c. postoperative congenital diaphragmatic hernia |
a. preoperative congenital diaphragmatic hernia
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CPAP levels greater than 8 cm H2O are commonly associated with which of the following conditions?
a. gastric distention b. oropharyngeal leaks c. acute pulmonary edema d. Both a and b |
d. Both a and b
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Which of the following clinical indicators best describes methods for detecting early pneumothorax while monitoring infants receiving nasal CPAP?
a. Persistant coughing and nasal flaring b. widened pulse pressure c. an increased FIO2 over the first day of CPAP support d. a significant increase in respiratory distress e. diminished bilateral breath sounds |
c. an increased FIO2 over the first day of CPAP support
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The following factors are essential when constructing a B-CPAP system, except
a. a PEEP/exhalation valve b. hudson nasal prongs c. a blended gas source |
a. a PEEP/exhalation valve
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Early attempts to create a system to provide CPAP to spontaneously breathing infants were aimed at trying to mimic which of the following important physiologic factors that affect gas delivery to the lung?
a. nasal flaring b. chest rise c. work of breathing d. grunting |
d. grunting
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The most important aspect of CPAP that can impact the outcome and success of CPAP is
a. The device being used to generate CPAP b. Sxning and airway clearance c. Proper bedside care and level of experience of the clinicians using the CPAP device d. The physician writing the orders |
c. Proper bedside care and level of experience of the clinicians using the CPAP device
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The proper arrangement for any nasal CPAP system includes all of the following except:
a. The hat should be loose fitting, covering the nose, and extending to the base of the neck b. Lateral attachment should provide gentle tension on the nasal interface c.The prongs should be properly sized to eliminate migration from the nares d. The hat should be tight fitting, covering the ears and extending to the base of the neck |
a. The hat should be loose fitting, covering the nose, and extending to the base of the neck
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All of the following devices are considered acceptable for measuring and delivering nasal CPAP safely to infants except:
a. V-CPAP b. B-CPAP c. IF SiPAP d. High flow nasal cannula |
d. High flow nasal cannula
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