Deck 11: Respiratory Insufficiency, Respiratory Failure and Ventilatory Management Protocols

Question 1

Which of the following are contraindications for noninvasive ventilation?
1) Facial and head trauma
2) Community-acquired pneumonia
3) Copious, viscous sputum
4) Severe upper GI bleeding

A)1
B)2, 3
C)2, 3, 4
D)1, 3, 4

Answer 1

1, 3, 4

Question 2

What is the primary pathophysiologic mechanism in alveolar hypoventilation?

A) Decreased minute ventilation
B) Increased ventilation/perfusion ratio
C) Decreased venous admixture
D) Decreased inspired oxygen pressure

Answer 2

Decreased minute ventilation

Question 3

Which of the following are causes of hypercapnic respiratory?
1) Impending ventilatory failure
2) Apnea
3) Severe refractory hypoxemia
4) Acute ventilatory failure

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Answer 3

1, 2, 4

Question 4

What V_D/V_T ratio range would you expect to see in a patient receiving mechanical ventilation?

A) 20% and 40%
B) 30% and 50%
C) 40% and 60%
D) 50% and 70%

Question 5

You are the respiratory therapist managing an adult male patient receiving mechanical ventilation as a result of hypoxemic respiratory failure. The patient has a pressure time index of 0.16, and rapid shallow breath index of 95, and the cuff-leak test demonstrated the patient could breathe when it was deflated. What would your recommendations to the physician be regarding weaning this patient based on this data?

A) Do not attempt to wean.
B) Attempt to wean.
C) Reattempt a spontaneous breathing trial to see if RSBI improves before weaning.
D) Cannot determine.

Question 6

What effect would a pulmonary embolism have on the V_D/V_T and the ratios?

A) The V_D/V_T would increase and the would decrease.
B) The V_D/V_T would decrease and the would increase.
C) The V_D/V_T and the ratios would both increase.
D) The V_D/V_T and the ratios would both decrease.

Question 7

Which of the following are clinical indicators of type I respiratory failure?
1) Decreased PaO₂
2) Increased P(A-a)O₂
3) Decreased PaO₂/FIO₂
4) Decreased

A)1, 2
B)2, 4
C)1, 2, 3
D)2, 3, 4

Question 8

Which of the following is a critical value for the key clinical indicators in hypercapnic respiratory failure in an adult?
1) pH 7.19
2) Ventilatory rate 35 breaths/min
3) MIP 80 cm H₂O
4) V_D/V_T 35%

A)1, 4
B)2, 3
C)1, 2
D)3, 4

Question 9

Which of the following values is the V_D/V_T value if the PaCO₂ is 40 mm Hg and the is 30 mm Hg?

A) 0.25 or 25%.
B) 0.33 or 33%.
C) 0.4 or 40%.
D) Need more information to determine the value.

Question 10

Which of the following are abnormal causes of anatomic shunt?
1) Bronchial venous drainage
2) Congenital heart disease
3) Intrapulmonary fistula
4) Vascular lung tumors

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3