Question 1

An increase in peak pressure without a corresponding increase in plateau pressure signals which of the following?

Accepted Answer

Increased airway resistance occurs when there is an increase in peak pressure without a corresponding increase in plateau pressure.

Question 2

Calculate the static compliance given the following information: P_peak 42 cm H₂O, P_plat 37 cm H₂O, V_T 550 mL, PEEP +10 cm H₂O, F_IO₂ 1.0, rate 22.

Accepted Answer

D

Question 3

Graphical analysis shows a spike at the beginning of the pressure scalar. Adjustment of which setting will eliminate the overshoot?

Accepted Answer

Increasing the rise time will slow down the delivery of the breath, reducing the initial spike or overshoot in pressure.

Question 4

A patient in the assist-control mode has a set rate of 15 with a total rate of 26. The inspiratory volume is 450 mL and the expiratory tidal volume is 375 mL with a PEEP of +6 cm H₂O and an F_IO₂ of 0.65. The inspiratory time is set on 1.25 seconds. Which of the following is most likely to be noted upon assessment when performing ventilator monitoring?

Accepted Answer

The total rate is higher than the set rate, indicating the patient is triggering additional breaths, which can lead to incomplete exhalation and auto-PEEP.

Question 5

The goal of mechanical ventilation is to:

Accepted Answer

The primary goal of mechanical ventilation is to ensure adequate gas exchange, which includes normalizing the pH by managing CO2 levels and oxygenation.

Question 6

A patient on mechanical ventilation with a fever has an acidotic pH with a CO₂ production of 300 mL/min. Normal CO₂ production is 200 mL/min. Which of the following should occur physiologically as CO₂ production increases?

Accepted Answer

As CO2 production increases, the body responds by increasing minute ventilation to expel more CO2 and maintain acid-base balance.

Question 7

A 5 foot, 2 inch female patient on mechanical ventilation has an ABG that shows a pH 7.52, PaCO₂ 30 mm Hg, PaO₂ 147 mm Hg, and HCO₃⁻ 23 mEq/L on assist-control ventilation with a rate of 18/min, V_T 500 mL, F_IO₂ 0.40, and PEEP +8 cm H₂O. The total rate is 22/min. Which change will help normalize the pH?

Accepted Answer

The answer of A 5 foot, 2 inch female patient...

Question 8

ABGs on a patient show a pH 7.28, PaCO₂ 31 mm Hg, HCO₃⁻17 mEq/L, and PaO₂ 47 mm Hg on a nonrebreather mask. Blood sugar is 105 mg/dL and the anion gap is 16. The most likely cause of the acidosis is:

Accepted Answer

The answer of ABGs on a patient show a pH...

Question 9

A patient receiving mechanical ventilation who was initially responsive now shows no response to stimuli. The intracranial pressure is 22 mm Hg. What is the consequence of the intracranial pressure?

Accepted Answer

When intracranial pressure is elevated, it can lead to decreased cerebral perfusion, resulting in brain anoxia (lack of oxygen to the brain), which can cause the patient to become unresponsive.

Question 10

What hormone is released with low cardiac output that may exacerbate kidney dysfunction by decreasing urine output further?

Accepted Answer

ADH (antidiuretic hormone) is released with low cardiac output and can exacerbate kidney dysfunction by decreasing urine output further.

Question 11

What is the greatest concern if mechanical ventilation causes liver dysfunction?

Accepted Answer

Decreased drug metabolism is the greatest concern if mechanical ventilation causes liver dysfunction because it can lead to drug toxicity.

Question 12

If the caloric needs of a patient are not met, what is the body's protein source?

Accepted Answer

When caloric needs are not met, the body breaks down skeletal muscle to use its protein as an energy source.

Question 13

End-tidal capnometry following an intubation attempt is 5%. The best interpretation of this data is that the:

Accepted Answer

The answer of End-tidal capnometry following an intubation attempt is...

Question 14

What is the expected capnography waveform if a beta-agonist medication has successfully reversed an airway obstruction?

Accepted Answer

A successful reversal of airway obstruction by a beta-agonist would result in a return to a normal capnography waveform, indicating effective ventilation and gas exchange.

Question 15

A patient in the cardiovascular recovery unit has an initial capnometry reading of 22 mm Hg. Two hours later, on the same ventilator settings, the capnometer readout has increased to 38 mm Hg. What is the significance of this change?

Accepted Answer

The answer of A patient in the cardiovascular recovery unit...

Question 16

The balloon has ruptured on a pulmonary artery catheter. Which of the following can be used to estimate the left ventricular end diastolic pressure?

Accepted Answer

The pulmonary artery diastolic pressure can be used to estimate the left ventricular end diastolic pressure when the balloon of a pulmonary artery catheter is ruptured, as it reflects the pressure in the left atrium and indirectly the left ventricle during diastole.

Question 17

A patient on the ventilator remains hypoxemic despite the application of PEEP and a high F_IO₂. Which assessment finding would you expect if a hemodynamic profile were performed?

Accepted Answer

The answer of A patient on the ventilator remains hypoxemic...

Quiz 6: Monitoring in Mechanical Ventilation