Question 1

Which of the following would likely delay the start weaning a patient from mechanical ventilation?

Accepted Answer

Frequent dysrhythmias, severe acidosis, and ventilator failure are all significant issues that would likely delay the weaning process from mechanical ventilation.

Question 2

Which of the following values would be satisfactory for considering a ventilator weaning attempt on a 38-year-old patient with no history of chronic lung disease?

Accepted Answer

A spontaneous tidal volume (V_T) of 6 mL/kg predicted body weight (PBW) is generally considered satisfactory for weaning attempts, as it indicates adequate lung function and respiratory effort.

Question 3

The oxygenation status of a 29-year-old postoperative patient shows: PaO₂= 58 mm Hg, SaO₂ = 85%, Qs/Qt = 25%, PaO₂/F_IO₂ = 105 mm Hg, F_IO₂ = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

Accepted Answer

None of the measurements (PaO2, SaO2, Qs/Qt, PaO2/FIO2) are within the recommended thresholds for weaning, indicating poor oxygenation status.

Question 4

Which of the following sets of pulmonary measurements suggest readiness for a weaning attempt?

Accepted Answer

The combination of V_D /V_T = 44%, static compliance = 36 mL/cm H₂O, and f/V_T = 80 breaths/min/L suggests readiness for weaning, as these values indicate adequate ventilation efficiency, lung compliance, and respiratory muscle strength.

Question 5

A mechanically ventilated patient has the following oxygen content measurements: CcO₂ = 19.8 vol%, CaO₂ = 17.9 vol %, CvO₂ = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

Accepted Answer

The shunt fraction is calculated as (CcO2 - CaO2) / (CcO2 - CvO2) = (19.8 - 17.9) / (19.8 - 13.7) = 0.31 or 31%. This indicates a severe shunt.

Question 6

The PaO₂ of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO₂ is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

Accepted Answer

The answer of The PaO₂ of a mechanically ventilated patient...

Question 7

A mechanically ventilated patient has a PaO₂ of 77 mm Hg on 30% oxygen. What is the PaO₂/F_IO₂ (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

Accepted Answer

The P/F ratio is calculated by dividing the PaO2 by the FIO2 (expressed as a decimal). Here, 77 mm Hg / 0.30 = 256. A P/F ratio of 256 is generally considered acceptable for ventilator weaning, as it indicates relatively adequate oxygenation.

Question 8

The following patients were recorded from a patient receiving mechanical ventilation: corrected tidal volume = 520 mL, peak inspiratory pressure = 42 cm H₂O, plateau pressure = 29 cm H₂O, PEEP = 10 cm H₂O. What is the calculated static compliance, and is it acceptable based on the criteria for weaning?

Accepted Answer

Static compliance is calculated as tidal volume divided by (plateau pressure - PEEP). Here, it is 520 mL / (29 - 10) cm H₂O = 27 mL/cm H₂O. This value is generally considered low and unacceptable for weaning.

Question 9

Rapid shallow breathing would most likely cause:

Accepted Answer

Rapid shallow breathing increases the dead space to tidal volume ratio (V_D/V_T) because a larger proportion of each breath is wasted in the conducting airways, not participating in gas exchange.

Question 10

What would be the calculated RSBI (f/V_T) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

Accepted Answer

The answer of What would be the calculated RSBI (f/V_T)...

Question 11

An RSBI of 91 breaths/min/L would best be interpreted by which of the following?

Accepted Answer

An RSBI (Rapid Shallow Breathing Index) of 91 breaths/min/L is below the typical threshold of 105 breaths/min/L, indicating that the patient is likely ready for weaning from mechanical ventilation.

Question 12

Which of the following options would be able to provide "partial" ventilatory support via providing part of a patient's minute volume requirement?

Accepted Answer

The answer of Which of the following options would be...

Question 13

A diagnostic spontaneous breathing trial should be at least _____ in duration but may go as long as ______, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.

Accepted Answer

A diagnostic spontaneous breathing trial (SBT) should be at least 30 minutes in duration but may go as long as 120 minutes, depending on the patient's tolerance and the clinician's assessment.

Question 14

Which of the following trends may be used as indicators of weaning failure?

Accepted Answer

The answer of Which of the following trends may be...

Question 15

Terminal weaning is best defined as withholding of mechanical ventilation:

Accepted Answer

Terminal weaning refers to the process of gradually withdrawing mechanical ventilation in patients for whom continued life support is considered futile, and it is expected to result in the patient's death.

Question 16

Which of the following is the best definition of success for discontinuing mechanical ventilation?

Accepted Answer

A successful spontaneous breathing trial (SBT) followed by extubation for at least 48 hours is considered a standard measure of successful weaning from mechanical ventilation.

Question 17

Which of the following best describes prolonged weaning from mechanical ventilation?

Accepted Answer

Prolonged weaning is characterized by patients who fail at least three spontaneous breathing trials (SBTs) and require a more gradual approach to weaning from mechanical ventilation.

Question 18

All of the following are important actions to consider when preparing patients for a successful weaning outcome. What is the first item to consider when assessing for readiness to start the weaning process?

Accepted Answer

The first item to consider when assessing readiness for weaning is ensuring that the underlying reason for initiating mechanical ventilation has been adequately resolved, as this is crucial for a successful weaning process.

Question 19

Which of the following would be options to consider to reduce the risk for reintubation during the weaning process for COPD patients and others at greater risk?

Accepted Answer

High-flow nasal cannula and noninvasive ventilation are both effective strategies to support patients during the weaning process and reduce the risk of reintubation, especially in COPD patients.

Question 20

Of the choices provided, which one is the leading cause of failure for attempts to liberate patients from mechanical ventilation?

Accepted Answer

Respiratory muscle weakness is a common reason why patients fail to wean off mechanical ventilation, as the muscles may not be strong enough to support independent breathing.

Quiz 11: Weaning From Mechanical Ventilation

Which of the following would likely delay the start weaning a patient from mechanical ventilation?

Which of the following values would be satisfactory for considering a ventilator weaning attempt on a 38-year-old patient with no history of chronic lung disease?

The oxygenation status of a 29-year-old postoperative patient shows: PaO₂= 58 mm Hg, SaO₂ = 85%, Qs/Qt = 25%, PaO₂/F_IO₂ = 105 mm Hg, F_IO₂ = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

Which of the following sets of pulmonary measurements suggest readiness for a weaning attempt?

A mechanically ventilated patient has the following oxygen content measurements: CcO₂ = 19.8 vol%, CaO₂ = 17.9 vol %, CvO₂ = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

The PaO₂ of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO₂ is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

A mechanically ventilated patient has a PaO₂ of 77 mm Hg on 30% oxygen. What is the PaO₂/F_IO₂ (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

Rapid shallow breathing would most likely cause:

What would be the calculated RSBI (f/V_T) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

An RSBI of 91 breaths/min/L would best be interpreted by which of the following?

Which of the following options would be able to provide "partial" ventilatory support via providing part of a patient's minute volume requirement?

A diagnostic spontaneous breathing trial should be at least _ in duration but may go as long as __, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.

Which of the following trends may be used as indicators of weaning failure?

Terminal weaning is best defined as withholding of mechanical ventilation:

Which of the following is the best definition of success for discontinuing mechanical ventilation?

Which of the following best describes prolonged weaning from mechanical ventilation?

All of the following are important actions to consider when preparing patients for a successful weaning outcome. What is the first item to consider when assessing for readiness to start the weaning process?

Which of the following would be options to consider to reduce the risk for reintubation during the weaning process for COPD patients and others at greater risk?

Of the choices provided, which one is the leading cause of failure for attempts to liberate patients from mechanical ventilation?

Quiz 11: Weaning From Mechanical Ventilation

Which of the following would likely delay the start weaning a patient from mechanical ventilation?

Which of the following values would be satisfactory for considering a ventilator weaning attempt on a 38-year-old patient with no history of chronic lung disease?

The oxygenation status of a 29-year-old postoperative patient shows: PaO2= 58 mm Hg, SaO2 = 85%, Qs/Qt = 25%, PaO2/FIO2 = 105 mm Hg, FIO2 = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

Which of the following sets of pulmonary measurements suggest readiness for a weaning attempt?

A mechanically ventilated patient has the following oxygen content measurements: CcO2 = 19.8 vol%, CaO2 = 17.9 vol %, CvO2 = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

The PaO2 of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO2 is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

A mechanically ventilated patient has a PaO2 of 77 mm Hg on 30% oxygen. What is the PaO2/FIO2 (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

Rapid shallow breathing would most likely cause:

What would be the calculated RSBI (f/VT) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

An RSBI of 91 breaths/min/L would best be interpreted by which of the following?

Which of the following options would be able to provide "partial" ventilatory support via providing part of a patient's minute volume requirement?

A diagnostic spontaneous breathing trial should be at least _____ in duration but may go as long as ______, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.

Which of the following trends may be used as indicators of weaning failure?

Terminal weaning is best defined as withholding of mechanical ventilation:

Which of the following is the best definition of success for discontinuing mechanical ventilation?

Which of the following best describes prolonged weaning from mechanical ventilation?

All of the following are important actions to consider when preparing patients for a successful weaning outcome. What is the first item to consider when assessing for readiness to start the weaning process?

Which of the following would be options to consider to reduce the risk for reintubation during the weaning process for COPD patients and others at greater risk?

Of the choices provided, which one is the leading cause of failure for attempts to liberate patients from mechanical ventilation?

The oxygenation status of a 29-year-old postoperative patient shows: PaO₂= 58 mm Hg, SaO₂ = 85%, Qs/Qt = 25%, PaO₂/F_IO₂ = 105 mm Hg, F_IO₂ = 0.55. Based on these data, the therapist should recommend to the physician that weaning:

A mechanically ventilated patient has the following oxygen content measurements: CcO₂ = 19.8 vol%, CaO₂ = 17.9 vol %, CvO₂ = 13.7 vol%. Which one of the following is the best description of the calculated shunt?

The PaO₂ of a mechanically ventilated patient is 150 mm Hg on 100% oxygen. If the PAO₂ is 675 mm Hg, what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference approximates 2% shunt?

A mechanically ventilated patient has a PaO₂ of 77 mm Hg on 30% oxygen. What is the PaO₂/F_IO₂ (P/F) ratio value for this patient, and is it acceptable or unacceptable for the oxygenation criteria for ventilator weaning?

What would be the calculated RSBI (f/V_T) for a patient who has an average spontaneous frequency of 23/min and tidal volume of 380 mL?

A diagnostic spontaneous breathing trial should be at least _ in duration but may go as long as __, and this is largely determined by the clinician's evaluation of how well the patient is tolerating the SBT using objective and subjective assessments.