Deck 26: Advanced Modes of Mechanical Ventilation

Question 1

Application of dual control with breathing modes of ventilation is used ____________

A) to simplify the ventilation strategy.
B) to reduce the number of health care providers needed to deliver care.
C) to reduce the work of breathing while maintaining minute volume and tidal volume.
D) prior to implementing high frequency ventilation

Answer 1

to reduce the work of breathing while maintaining minute volume and tidal volume.

Question 2

Intermittent Mandatory Ventilation is _______________________

A) spontaneous breathing between machine breaths.
B) periodic pressure breathing in between volume breaths.
C) the same as control ventilation.
D) used to improve arterial oxygenation.

Answer 2

spontaneous breathing between machine breaths.

Question 3

The goal of inverse ratio ventilation is to ____________________

A) decrease carbon dioxide by over inflation of the alveoli.
B) increase mean airway pressure to improve oxygenation in ARDS.
C) hyperextend alveoli to increase pulmonary vascular resistance.
D) increase air trapping by lengthening inspiration

Answer 3

increase mean airway pressure to improve oxygenation in ARDS.

Question 4

Which of the following statements are true regarding RSBI?
I.Less than 105 indicates increasing work of breathing.
II.Respiratory rate divided by tidal volume in liters
III.Increasing RSBI indicates a patient may become fatigued.

A) I, II and III
B) I and II
C) II and III
D) II only

Question 5

APRV is which of the following?

A) Airway Pressure Release Ventilation
B) Continuous Positive Airway Pressure with two pressure levels
C) Time triggered, pressure limited, time cycled with spontaneous breathing
D) All of the above

Question 6

Benefits of APRV are which of the following?

A) Increased secretion mobilization
B) Improved gas exchange, reduced dead space, less sedation
C) Reduction of ventilating pressures
D) Reversal of bronchospasm

Question 7

Mandatory minute volume is described by which of the following?

A) It is a totally assist mode used to wean a patient from the ventilator.
B) If patient does not breathe target minute volume ventilator will make up difference.
C) It is a control mode that requires the patient to breathe a target minute volume.
D) It uses set mandatory breaths with spontaneous tidal volume breaths.

Question 8

The practitioner wants to improve the gas exchange and reduce sedation for a patient on pressure control ventilation.The therapist should consider ________________

A) decreasing plateau pressure.
B) switching to volume assist control ventilation.
C) changing to APRV.
D) increasing the PEEP.

Question 9

What is the key indicator of ventilation?

A) Tidal volume
B) RSBI
C) PaCO₂
D) PaO₂

Question 10

Current guidelines for use of inverse ratio ventilation recommend which of the following?

A) Hypoinflation of the alveoli should be managed with 300 mL tidal volume
B) Do not use more than 50% O₂ to avoid hyperoxygenation
C) Keep PIP less than 30 cmH2O to avoid ventilator induced lung injury
D) Avoid respiratory rates above 20 bpm to allow reduction of PIP

Question 11

Rapid shallow breathing index is used _______________________

A) to measure effectiveness of oxygenation.
B) to identify the settings used in high frequency ventilation.
C) in assessment of neonates and infants.
D) to quantify the relationship between tidal volume and respiratory rate.

Question 12

A practitioner decreases the oxygenation setting on the mechanical ventilator,which results in an increase in heart rate.This is _____________________

A) a first sign of hypoxemia.
B) an expected cardiovascular change.
C) typical with normal healthy patients.
D) an indication that the patient needs suctioning.

Question 13

Dual control is which of the following?

A) Switching from pressure to volume control
B) Shared responsibility for ventilator changes between RTs and RNs
C) When one knob adjusts two parameters like rate and flow
D) Is also known as differential lung ventilation

Question 14

A practitioner wants to use volume support but is concerned that the patient might have periods of apnea.What should be used to ensure that the patient will have a backup ventilation mode?

A) Automode
B) Automatic tube compensation
C) Mandatory minute ventilation
D) Proportional assist ventilation

Question 15

Tidal volume delivery during APRV is __________________

A) affected by lung compliance.
B) affected by airway resistance.
C) affected by Phigh and Plow.
D) all of the above.

Question 16

Inverse ratio ventilation is __________________

A) where the expiratory phase is longer than inspiration.
B) best described a expiratory retard.
C) when inspiration is longer than expiration.
D) is an I:E of 1:1.1

Question 17

Which of the following is true of THIGH with APRV?

A) It is the same as IPAP in BiPAP.
B) It keeps the alveoli recruited and inflated.
C) Time on Thigh is short than TLOW.
D) It is the same as plateau pressure in volume ventilation.

Question 18

Which primary control variable will result in flow and pressure being variable in the presence of changing airway resistance or lung compliance?

A) Pressure
B) Volume
C) Flow
D) Time

Question 19

The oxygenation goal for most mechanically ventilated patients is ___________________

A) SpO₂ 95-100%, PaO₂ 100-105 mm Hg.
B) SpO₂ 88-90%, PaO₂ 60+ mm Hg.
C) SpO₂ 93-98%, PaO₂ 75 mm Hg.
D) PaO₂ 80-100 mm Hg.

Question 20

A respiratory care practitioner identifies that a patient is having breathing difficulties because the endotracheal tube is one size smaller than optimal.The practitioner should consider which of the follow modes to overcome the airway resistance from a small tube?

A) Mandatory Minute Ventilation
B) Proportional Assist Ventilation
C) Automatic tube compensation
D) Automode

Question 21

A patient needs to have a lower mean airway pressure and improved oxygenation.The respiratory care practitioner should consider _________________

A) SIMV.
B) PRVC.
C) automode with volume support ventilation.
D) inverse ratio ventilation.

Question 22

What is the auto-set-point control?

Question 23

What are the purposes of ventilator alarms and backup modes?

Question 24

What is proportional assist ventilation?

Question 25

Volume ventilation is causing high pressures for a patient with ARDS.The practitioner would like to use a pressure mode but is concerned about the changing compliance.Which of the following should be considered for this purpose?

A) SIMV
B) PRVC
C) Automode with volume support ventilation
D) Inverse ratio ventilation

Question 26

What are three problems that mandatory minute ventilation cannot prevent?

Question 27

A respiratory care practitioner may use which of the following to eliminate the airway resistance caused by an artificial airway?

A) APRV
B) Automatic tube compensation
C) Inverse ratio ventilation
D) Automode

Question 28

Time cycled breath control _______________

A) identifies periods of apnea.
B) is adjusted in increments of 1-3 mm Hg.
C) adjusts the end of inspiration after a specified time.
D) increases pressure to a set value.

Question 29

The Nellcor Puritan Bennett 840 recommends an operational check of the BDU,sensors,resistance and compliance of the circuit prior to use.This is called ________________

A) tubing compliance.
B) The short self test.
C) the power on self test
D) the user verification test

Question 30

BiLevel with the Nellcor Puritan Bennett 840 allows adjustment of High PEEP,Low PEEP,Time High and Time Low.These controls are also seen in _________________

A) SIMV
B) PRVC
C) APRV
D) VSV

Question 31

Which of the following will occur after 12 seconds in the VSV Automode?

A) The ventilator will flash a visible apnea alarm.
B) The ventilator will switch to pressure support.
C) The ventilator will switch to PRVC.
D) The ventilator will volume assist ventilation.

Question 32

How does a respiratory care practitioner assess the patient's work of breathing?

Question 33

Proportional assist ventilation will do which of the following?

A) Provide better ventilator synchrony and application of pressure
B) Adjust pressure support with changes in the patient's efforts
C) Proportionally assist a patient's spontaneous ventilation
D) All of the above