Intensive Care Nursing Test Bank
Course Introduction
Intensive Care Nursing is a specialized course designed to equip nursing students and practicing nurses with advanced knowledge and clinical skills necessary for the care of critically ill patients. The course focuses on comprehensive assessment, monitoring, and management of patients in intensive care settings, including the utilization of complex technology and life-support systems. Students will explore pathophysiology of critical illnesses, prioritize interventions in emergencies, and apply evidence-based practices for improving patient outcomes. Emphasis is placed on interdisciplinary collaboration, ethical decision-making, communication with patients families, and the psychological impact of critical illness, preparing nurses to function effectively in high-stress, fast-paced environments essential for saving lives.
Recommended Textbook
Pilbeams Mechanical Ventilation Physiological and Clinical Applications 6th Edition by J M Cairo
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23 Chapters
707 Verified Questions
707 Flashcards
Source URL: https://quizplus.com/study-set/887 Page 2
Chapter 1: Basic Terms and Concepts of Mechanical
Ventilation
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/17519
Sample Questions
Q1) Calculate the inspiratory time necessary to ensure 98% of the volume is delivered to a patient with a Cs = 40 mL/cm H O and the R = 1 cm H O/(L/sec).
A) 0.04 second
B) 0.16 second
C) 1.6 second
D) 4.0 seconds
Answer: B
Q2) The respiratory therapist should expect which of the following findings while ventilating a patient with acute respiratory distress syndrome (ARDS)?
A) An elevated plateau pressure (P )
B) A decreased elastic resistance
C) A low peak inspiratory pressure (PIP)
D) A large transairway pressure (P ) gradient
Answer: A
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Chapter 2: How Ventilators Work
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/17520
Sample Questions
Q1) A patient being transferred from a hospital to a skilled nursing facility requires mechanical ventilation with a fractional inspired oxygen (F O )of 0.21.The skilled nursing facility has no piped in gases.Which of the following ventilators will be able to function in the skilled nursing facility without any extra equipment?
A) Servoi
B) LTV 1000
C) Bird Mark 7
D) Bio-Med MVP-10
Answer: B
Q2) The respiratory therapist enters modes and parameters into the ventilator with which of the following?
A) Control logic
B) Input power
C) User interface
D) Drive mechanism
Answer: C
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Chapter 3: How a Breath Is Delivered
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/17521
Sample Questions
Q1) The equation of motion describes the relationships between which of the following?
A) Pressure and flow during a mechanical breath
B) Pressure and volume during a spontaneous breath
C) Flow and volume during a mechanical or spontaneous breath
D) Flow, volume, and pressure during a spontaneous or mechanical breath
Answer: D
Q2) During pressure-targeted ventilation the patient's airway resistance decreases to normal due to medication delivery.The ventilator will respond with which of the following changes?
1)Altered flow waveform
2)Increased pressure
3)Increased volume
4)Decrease volume
A) 1 and 3 only
B) 2 and 4 only
C) 1 and 4 only
D) 1, 2, and 3 only
Answer: A
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5
Chapter 4: Establishing the Need for Mechanical Ventilation
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) A 14-year-old boy who had previously been diagnosed with mild persistent asthma has a PEFR of 100 L/min.This indicates which of the following?
A) Increased airway resistance
B) Heart failure
C) Increased lung compliance
D) Inability to take in a deep breath and cough
Q2) The underlying physiological process leading to pure hypercapnic respiratory failure is which of the following?
A) Ventilation/perfusion mismatch
B) Intrapulmonary shunting
C) Diffusion impairment
D) Alveolar hypoventilation
Q3) Hypercapnic respiratory failure due to increased work of breathing will be caused by which of the following?
A) Drug overdose
B) Myasthenia gravis
C) Asthma exacerbation
D) Pulmonary embolism
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6
Chapter 5: Selecting the Ventilator and the Mode
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32 Verified Questions
32 Flashcards
Source URL: https://quizplus.com/quiz/17523
Sample Questions
Q1) A breath that is triggered,limited,and cycled by the mechanical ventilator is which of the following?
A) Assisted breath
B) Mandatory breath
C) Spontaneous breath
D) Breath
Q2) A breath that is patient triggered,pressure targeted,and time cycled is which of the following?
A) Assisted breath
B) Mandatory breath
C) Spontaneous breath
D) Breath
Q3) If flow or sensitivity is set incorrectly,which of the following is most likely to occur during the continuous mandatory ventilation (CMV)mode?
A) Muscle atrophy
B) Respiratory alkalosis
C) Ventilator dyssynchrony
D) Increase in mean airway pressure
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Chapter 6: Initial Ventilator Settings
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) A 57-year-old,5'3",165 lb female patient arrives in the open heart unit following coronary artery bypass surgery.The patient has a history of diabetes and no history of pulmonary disease.The most appropriate initial volume-controlled continuous mandatory ventilation (VC-CMV)settings are which of the following?
A) V = 220 mL, rate = 25 breaths/min, PEEP = 10 cm H O
B) V = 360 mL, rate = 15 breaths/min, PEEP = 5 cm H O
C) V = 550 mL, rate = 12 breaths/min, PEEP = 12 cm H O
D) V = 750 mL, rate = 10 breaths/min, PEEP = 8 cm H O
Q2) A patient having an acute,severe asthma exacerbation is intubated and set up on volume-controlled continuous mandatory ventilation (VC-CMV).To ensure volume delivery at the lowest peak pressure while providing for better air distribution,which flow waveform should be used?
A) Sine
B) Constant
C) Ascending ramp
D) Descending ramp
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Chapter 7: Final Considerations in Ventilator Setup
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/17525
Sample Questions
Q1) A patient is intubated due to an acute exacerbation of chronic obstructive pulmonary disease (COPD).The patient is now breathing with pressure support ventilation 5 cm H O and continuous positive airway pressure (CPAP)5 cm H O.The patient is unable to flow trigger every inspiration.Unintended positive end-expiratory pressure (auto-PEEP)is measured at 10 cm H O.The most appropriate action to take is which of the following?
A) Decrease the CPAP to 3 cm H O.
B) Increase the CPAP to 8 cm H O.
C) Increase pressure support to 10 cm H O.
D) Change the flow trigger setting to 1 L/min.
Q2) The goal of selecting a specific oxygen concentration is to try to achieve clinically acceptable arterial oxygen tensions within which of the following ranges?
A) 40 5 mm Hg
B) 50-60 mm Hg
C) 60-100 mm Hg
D) 100-120 mm Hg
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Chapter 8: Initial Patient Assessment
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37 Verified Questions
37 Flashcards
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Sample Questions
Q1) An 87-kg male patient,orally intubated with a size 7.5 mm inner diameter (ID)endotracheal tube,is being mechanically ventilated in the pressure-controlled continuous mandatory ventilation (PC-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 respiratory therapist notes the position of the endotracheal tube is 21 cm at the gum line,measures the cuff pressure,and adds 3 mL of air to the cuff.To make an appropriate seal,it requires 44 cm
H O.The respiratory therapist should do which of the following?
A) Change to a larger size endotracheal tube.
B) Add air to the cuff and clamp the pilot tube.
C) Check the position of the endotracheal tube.
D) Reposition the endotracheal tube in the mouth.
Q2) How long after beginning mechanical ventilation on a patient should an arterial blood gas sample be drawn?
A) 5 minutes
B) 10 minutes
C) 15 minutes
D) 20 minutes
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Chapter 9: Ventilator Graphics
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32 Verified Questions
32 Flashcards
Source URL: https://quizplus.com/quiz/17527
Sample Questions
Q1) The type of flow curve produced by volume ventilation with constant flow is which of the following?
A) Sinusoidal
B) Rectangular
C) Descending ramp
D) Exponential decay
Q2) An increase in airway resistance during pressure ventilation will result in which of the following?
A) Plateau pressure (P<sub>plateau</sub>) 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.
Q3) 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
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Page 11
Chapter 10: Assessment of Respiratory Function
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55 Verified Questions
55 Flashcards
Source URL: https://quizplus.com/quiz/17528
Sample Questions
Q1) An energy expenditure (EE)of 20 kcal/hr/m² for an adult is indicative of which of the following conditions?
A) Pregnancy
B) Starvation
C) Hyperthyroidism
D) Stimulant drugs
Q2) The energy required to move gas through the airways and expand the thorax is known as which of the following?
A) Airway resistance
B) Dynamic compliance
C) Intrinsic work of breathing
D) Extrinsic work of breathing
Q3) An arterial blood gas should be done to confirm pulse oximetry findings less than a minimum of _____________.
A) 60%
B) 70%
C) 80%
D) 90%
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12
Chapter 11: Hemodynamic Monitoring
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56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/17529
Sample Questions
Q1) Advancing a pulmonary artery catheter into a smaller artery may cause which of the following complications?
A) Pneumothorax
B) Air embolism
C) Pulmonary infarction
D) Ventricular fibrillation
Q2) Which of the following disorders can cause an increase in systemic vascular resistance?
A) Lung collapse
B) Hypervolemia
C) Chronic bronchitis
D) Cardiogenic pulmonary edema
Q3) Ventricular contractility can be estimated by which of the following?
A) Systemic vascular resistance
B) Ejection fraction
C) Pulmonary vascular resistance
D) Left ventricular stroke work
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Chapter 12: Methods to Improve Ventilation in Patient-Ventilator Management
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) An invasively ventilated patient with ARDS is on PC-CMV,PIP = 30 cm H O,PEEP = 12 cm H O,F O = 1.0.The patient's returned V is 320 mL.The ABG results on these settings are: pH 7.3,P CO 53 mm Hg,P O 62 mm Hg.The patient is placed in the prone position,and after 1 hour,ABG results show: pH 7.38,P CO 46 mm Hg,P O 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 O .
D) Place the patient in the supine position and decrease PEEP.
Q2) During mechanical ventilation of a patient with COPD,the P CO = 58 mm Hg and the minute ventilation = 5.5 L/min.The desired P CO for this patient is 45 mm Hg.To what should the minute ventilation be changed?
A) 4.3 L/min
B) 4.8 L/min
C) 6.6 L/min
D) 7.1 L/min
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Chapter 13: Improving Oxygenation and Management of ARDS
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32 Verified Questions
32 Flashcards
Source URL: https://quizplus.com/quiz/17531
Sample Questions
Q1) An invasively ventilated patient with ARDS is on PC-CMV,PIP = 30 cm H O,PEEP = 12 cm
H O,F O = 1.0.The patient's returned V is 320 mL.The ABG results on these settings are: pH 7.3,P CO 53 mm Hg,P O 62 mm Hg.The patient is placed in the prone position,and after 1 hour,ABG results show: pH 7.38,P CO 46 mm Hg,P O 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 O .
D) Place the patient in the supine position and decrease PEEP.
Q2) PEEP therapy is indicated for patients with which of the following?
A) P CO of 95 mm Hg while receiving an F O of 0.3
B) P CO of 100 mm Hg while receiving an F O of 0.8
C) Returned V of 600 mL with a P of 12 cm H O
D) Returned V of 800 mL with a P of 15 cm H O
Q3) The level of applied PEEP should be set at what point on the pressure-volume curve?
A) At the upper inflection point of the inflation curve.
B) Above the lower inflection point of the deflation curve.
C) At the peak inspiration point of the inflation curve.
D) Above the upper inflection point of the deflation curve.
Page 15
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Chapter 14: Ventilator-Associated Pneumonia
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The mortality rate for VAP associated with prolonged hospital stays is which of the following?
A) 5-25%
B) 15-40%
C) 25 0%
D) 45-75%
Q2) Reasons for the shift in oropharyngeal flora in patients receiving invasive mechanical ventilation with endotracheal tubes include which of the following?
A) Lowered pH levels
B) Increase in mucus-producing cells
C) Decreased production of proteases
D) Decreased mucosal immunoglobulin A
Q3) The type of organism that most often causes ventilator-acquired pneumonia is which of the following?
A) Fungi
B) Bacteria
C) Viruses
D) Protozoa
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16
Chapter 15: Sedatives, Analgesics, and Paralytics
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) The group of drugs that interact with GABA receptor complex on neurons in the brain is which of the following?
A) Opioids
B) Paralytics
C) Benzodiazepines
D) Depolarizing agents
Q2) The drug of choice for sedating mechanically ventilated patients in the ICU for longer than 24 hours is which of the following?
A) Lorazepam (Ativan)
B) Midazolam (Versed)
C) Diazepam (Valium)
D) Propofol (Diprivan)
Q3) A patient with head trauma and an elevated ICP is being ventilated postoperatively and shows signs of asynchrony with the mechanical ventilator.The most appropriate medication to sedate this patient is which of the following?
A) Morphine
B) Propofol
C) Propofol and morphine
D) Fentanyl
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Chapter 16: Extrapulmonary Effects of Mechanical
Ventilation
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/17534
Sample Questions
Q1) 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
Q2) Positive pressure ventilation increases splanchnic resistance,decreases splanchnic venous outflow,and may contribute to gastric mucosal ischemia,which can contribute to which of the following?
A) Liver metastases
B) Gastric mucosal ischemia
C) Gastric ulcers
D) Increased portal blood flow
Q3) Normovolemic patients experience decreases in cardiac output above what level of PEEP?
A) 5 cm H O
B) 8 cm H O
C) 12 cm H O
D) 15 cm H O
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Chapter 17: Effects of Positive Pressure Ventilation on the
Pulmonary System
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) A patient receiving pressure controlled-continuous mandatory ventilation (PC-CMV)has initial arterial blood gas (ABG)findings as follows: P O of 101 mm Hg,partial pressure of carbon dioxide in the arteries (P CO )of 60 mm Hg,and pH of 7.30.The respiratory therapist should:
A) increase minute ventilation to this patient.
B) decrease pressure setting.
C) change the ventilation mode.
D) increase the minute ventilation to this patient very gradually over the next several days.
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
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19
Chapter 18: Troubleshooting and Problem Solving
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) An increased arterial-to-end-tidal partial pressure CO<sub>2</sub> gradient can help identify which of the following?
A) Pulmonary embolism
B) Dynamic hyperinflation
C) Cardiogenic pulmonary edema
D) Noncardiogenic pulmonary edema
Q2) The initial step in the management of patient-ventilator asynchrony is which of the following?
A) Lower the high pressure alarm setting.
B) Check the endotracheal tube cuff pressure.
C) Ventilate the patient with a manual resuscitator bag.
D) Check the low and high pressure alarm settings.
Q3) The flow-time curve shows small oscillations after the peak flow rate has been reached.The respiratory therapist can alleviate this by making which of the following ventilator adjustments?
A) Increase the set flow rate.
B) Increase the inspiratory time.
C) Decrease the inspiratory rise time.
D) Increase the inspiratory rise time.
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Page 20
Chapter 19: Basic Concepts of Noninvasive
Positive-Pressure Ventilation
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) A 61-year-old female was admitted last night with shortness of breath.She currently is alert and oriented but very anxious.Her latest arterial blood gas values,on a nasal cannula at 3 L/min,show: pH = 7.39; P CO = 41 mm Hg; P O = 40 mm Hg; S O = 74%; HCO 24 mEq/L.Breath sounds are decreased throughout with fine late crackles on inspiration.The current chest X-ray shows an enlarged heart with bilateral vascular congestion.The most appropriate therapy for this patient is _________.
A) NIPPV
B) mask CPAP
C) invasive ventilation
D) nonrebreather mask
Q2) A patient who was diagnosed 1 year ago with amyotrophic lateral sclerosis is being seen in his primary care physician's office.The patient is complaining of fatigue and inability to concentrate at work.The patient's FVC is 45% of predicted,the P CO is 47 mm Hg,and the MIP is 54 cm H O.Which of the following should be considered for this patient?
A) Continuation of current therapy
B) Supplemental home oxygen
C) Nocturnal CPAP
D) Nocturnal NIV
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Chapter 20: Weaning and Discontinuation from Mechanical Ventilation
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) Which of the following is considered a closed loop mode used for weaning from mechanical ventilation?
A) Pressure support ventilation
B) Adaptive support ventilation
C) Continuous positive airway pressure
D) Intermittent mandatory ventilation
Q2) A patient is extubated and placed on a cool,bland aerosol with 30% oxygen.Twenty minutes post extubation,the respiratory therapist is called to assess the patient,who has shortness of breath.The respiratory therapist observes intercostal retractions,accessory muscle use,and a respiratory rate of 38 breaths/min.Stridor can be heard without a stethoscope,and the S O has dropped from 97% to 85%.The patient is given an aerosolized racemic epinephrine treatment and reassessed.Accessory muscle use continues,intercostal retractions decrease slightly,and stridor is heard on auscultation.The patient's respiratory rate is 30 breaths/min and the S O is 88%.What should the respiratory therapist recommend?
A) Reintubation and mechanical ventilation
B) Heliox therapy and steroid administration
C) Increase the F O on the cool bland aerosol to 40%
D) Use a nonrebreather mask with 15 L/min oxygen.
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Chapter 21: Long-Term Ventilation
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) What bacteria is most often the cause of ventilator-associated pneumonia in VAIs?
A) Staphylococcus aureus
B) Enterobacter spp.
C) Burkholderia cepacia
D) Streptococcus pneumoniae
Q2) What pressure range may be necessary to achieve a sufficient V using a chest cuirass?
A) -10 to -20 cm H O
B) -25 to -50 cm H O
C) -35 to -60 cm H O
D) -50 to -75 cm H O
Q3) The preferred location for ventilator-dependent patients is ________________________.
A) a skilled nursing facility
B) a subacute care unit
C) their own homes
D) a long-term acute care hospital
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Chapter 22: Neonatal and Pediatric Ventilation
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40 Verified Questions
40 Flashcards
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Sample Questions
Q1) A mechanically ventilated pediatric patient in the process of being weaned is switched to PC-IMV with PS.The respiratory therapist notes that every PS breath is being time cycled.The most likely cause of this is which of the following?
A) The PS setting is too high.
B) The flow cycle setting is too low.
C) This is the normal cycle for PS.
D) A large leak is present around the cuffless ET tube.
Q2) The number of time constants for almost complete equilibration of alveolar pressure in a normal infant's lungs is___________.
A) 1-3
B) 2-4
C) 3-5
D) 4-7
Q3) The patient with which of the following conditions should be considered for HFV?
A) Status asthmaticus
B) Bronchopleural fistula
C) Meconium aspiration
D) Cystic fibrosis
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24
Chapter 23: Special Techniques in Ventilatory Support
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21 Flashcards
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Sample Questions
Q1) Compared with pressure-controlled inverse ratio ventilation,APRV does which of the following?
A) Decreases the cardiac index
B) Reduces the need for sedation
C) Increases the peak airway pressure
D) Increases the central venous pressure
Q2) An 80% He:20% O mixture is being delivered to an asthmatic patient by a nonrebreather mask through an oxygen flow meter set at 8 L/min.What is the actual flow delivered to the patient?
A) 10 L/min
B) 12 L/min
C) 14 L/min
D) 18 L/min
Q3) The NAVA mode can be used in which of the following situations?
A) Paralysis
B) Heavy sedation
C) Injury to the respiratory brain centers
D) Spontaneous breathing
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25