Question 1

You have been asked to organize a patient and family education program as part of a discharge plan for a patient requiring home ventilatory support. Which of the following areas would you be sure to cover?
1) Equipment operation and disinfection
2) Patient assessment and monitoring
3) Airway management and clearance
4) Emergency procedures

Accepted Answer

All four areas should be covered in a patient and family education program for a patient requiring home ventilatory support. Equipment operation and disinfection are important for the safety of the patient and to prevent infections. Patient assessment and monitoring are crucial to ensure that the therapy is effective and to detect any problems. Airway management and clearance are important for preventing complications such as infection, pneumonia, or lung collapse. Emergency procedures should also be covered in case of any unexpected events or emergencies.

Question 2

Which of the following would indicate that a patient is not sufficiently stable for home mechanical ventilation?
1) Severe dyspnea while breathing on the ventilator
2) Airway secretions cleared only by suctioning
3) Frequent premature ventricular contractions
4) Use of a cuffed oral endotracheal tube

Accepted Answer

1) Severe dyspnea while on the ventilator indicates inadequate ventilation or underlying pathology not well controlled, making the patient unstable for home ventilation. 3) Frequent premature ventricular contractions can signify underlying cardiac issues that need to be addressed before considering home ventilation. 4) A cuffed oral endotracheal tube is typically used for acute care settings and suggests the patient requires a more secure airway management than what is usually manageable at home, indicating instability for home care.

Question 3

Which of the following strategies would you recommend for a cooperative patient with an intact upper airway who requires home ventilatory support?

Accepted Answer

For patients with an intact upper airway, a device capable of noninvasive positive pressure ventilation is the first choice.

Question 4

Patient parameters that lay caregivers of home mechanical ventilation should assess regularly include which of the following?
1) Vital signs
2) Skin color or diaphoresis
3) Chest excursions
4) Breath sounds

Accepted Answer

Lay caregivers of home mechanical ventilation should regularly assess vital signs, skin color or diaphoresis, and chest excursions to monitor the patient's condition and ensure the effectiveness of the ventilation. These parameters can provide important clues about the patient's respiratory status and overall health.

Question 5

According to the AARC, which of the following standards should be met when considering ventilatory support outside the acute care hospital?
1) Services must be based on the attending physician's prescription.
2) Those providing the support should be appropriately trained.
3) Appropriate recording and reporting mechanisms should exist.
4) Safe, effective, and appropriate equipment must be provided.

Accepted Answer

All four standards listed should be met when considering ventilatory support outside the acute care hospital, according to the AARC. Services must be based on the attending physician's prescription, those providing the support should be appropriately trained, appropriate recording and reporting mechanisms should exist, and safe, effective, and appropriate equipment must be provided.

Question 6

Which of the following can benefit most from intermittent use of noninvasive ventilation?

Accepted Answer

Type 2 patients generally require only intermittent or nocturnal support. Examples of patients in this category include those with chronic neuromuscular and chest wall diseases, such as muscular dystrophy and kyphoscoliosis.

Question 7

Emergency situations that home mechanical ventilation caregivers must be trained to recognize and manage include all of the following except:

Accepted Answer

Emergency situations that caregivers must be trained to recognize and properly deal with include ventilator or power failure, ventilator circuit problems, airway emergencies, and cardiac arrest.

Question 8

Mechanical ventilation in the home setting can be provided by which of the following methods?
1) Positive pressure through an oral endotracheal tube
2) Positive pressure through an intact upper airway
3) Intermittent abdominal displacement methods
4) Negative pressure through an intact upper airway

Accepted Answer

Mechanical ventilation in the home setting can be provided through various methods, including positive pressure ventilation through an intact upper airway (e.g., using masks), intermittent abdominal displacement methods, and negative pressure ventilation through an intact upper airway (e.g., using a chest cuirass or iron lung). Positive pressure through an oral endotracheal tube is typically used in acute care settings rather than at home.

Question 9

In addition to a ventilator, which of the following equipment or supplies would you recommend for a home care patient receiving long-term invasive positive pressure ventilation?
1) Self-inflating bag-valve-mask
2) Portable suction system
3) Portable DC defibrillator
4) Tracheal tubes and care kits
5) Disposable circuits and catheters

Accepted Answer

1) Self-inflating bag-valve-mask - Not necessary for a patient on long-term invasive positive pressure ventilation.
2) Portable suction system - Important for clearing secretions from the airway.
3) Portable DC defibrillator - Not necessary for a patient on long-term invasive positive pressure ventilation.
4) Tracheal tubes and care kits - Important for maintaining and replacing the tracheal tube.
5) Disposable circuits and catheters - Important for preventing infection and maintaining hygiene.

Question 10

In which of the following situations would you recommend that more than one ventilator be provided for a home care patient?
1) If the patient cannot maintain spontaneous ventilation for at least 1 hr
2) If the patient's care plan requires mechanical ventilation during mobility
3) If a replacement ventilator cannot be secured within 2 hr

Accepted Answer

Providing more than one ventilator for a home care patient would be necessary in situations where the patient's care plan requires mechanical ventilation during mobility (option 2) and if a replacement ventilator cannot be secured within 2 hours (option 3). It is not necessary to provide more than one ventilator if the patient cannot maintain spontaneous ventilation for at least 1 hr (option 1).

Question 11

For which of the following groups would you recommend long-term negative pressure ventilation in an alternative setting?
1) Patients who cannot or will not use noninvasive positive pressure ventilation
2) Patients who need frequent airway access for suctioning
3) Patients with severe nasal congestion or obstruction

Accepted Answer

The answer of For which of the following groups would...

Question 12

What equipment function should lay caregivers of home mechanical ventilation assess regularly? 1) Cleanliness and function of bag-valve-mask 2) Internal and external battery power levels 3) Cleanliness of filters and alarm functions 4) Accuracy of ventilator tidal volume (V_T) output

Accepted Answer

Lay caregivers of home mechanical ventilation should regularly assess cleanliness and function of bag-valve-mask, internal and external battery power levels, cleanliness of filters and alarm functions. Accuracy of ventilator tidal volume (V_T) output is not a function that lay caregivers can accurately assess and should be left to medical professionals.

Question 13

Which of the following are prerequisites to successful home-based mechanical ventilation?
1) Presence of adequate professional support
2) Willingness of family to accept responsibility
3) Patient's condition, especially stability
4) Overall viability of the home care plan

Accepted Answer

Successful home-based mechanical ventilation requires adequate professional support to ensure proper care and management, willingness of the family to accept responsibility for the patient's care, a stable condition of the patient to facilitate home care, and an overall viable home care plan that addresses the patient's needs and ensures safety.

Question 14

Absolute contraindications for using noninvasive positive pressure ventilation include which of the following?
1) Hemodynamic instability
2) Uncooperative patient
3) Copious secretions
4) Need for airway protection

Accepted Answer

Hemodynamic instability can be worsened by noninvasive positive pressure ventilation, and patients who are uncooperative or require airway protection may not be able to tolerate the treatment. Copious secretions can also be a challenge for noninvasive positive pressure ventilation, but this is not an absolute contraindication and can often be managed with appropriate suctioning and airway clearance techniques.

Question 15

Which of the following strategies would you recommend for a hemodynamically unstable patient with an intact upper airway who requires home ventilatory support?

Accepted Answer

In patients with an intact upper airway for whom noninvasive positive pressure ventilation is contraindicated or unsuccessful, a negative pressure ventilator should be considered.

Question 16

Which of the following strategies would you recommend for a patient with a tracheotomy who requires home ventilatory support?

Accepted Answer

If invasive ventilation by tracheostomy is the selected approach, the best choice is a positive pressure ventilator.

Question 17

Relative contraindications for using noninvasive ventilation (NIV) include all of the following except:

Accepted Answer

Relative contraindications to NIV include severe upper airway dysfunction, copious secretions that cannot be cleared by spontaneous or assisted cough, or O₂ concentration requirements exceeding 40%.

Question 18

Which of the following conditions is an indication for application of noninvasive ventilation (NIV)?

Accepted Answer

The answer of Which of the following conditions is an...

Question 19

You have been asked to organize a patient and family education program as part of a discharge plan for a patient requiring home ventilatory support. Which of the following methods would be best for training the family in the operation of the ventilator chosen?

Accepted Answer

Ideally, the patient should have a trial period on the actual home ventilator before discharge.

Question 20

In the early stages after a patient requiring mechanical ventilation is discharged to the home, how often should patient follow-up by a respiratory care practitioner occur?

Accepted Answer

In the early stages after discharge, patient follow-up by a respiratory therapist will likely occur every day.

Quiz 56: Respiratory Care in Alternative Settings

Which of the following strategies would you recommend for a cooperative patient with an intact upper airway who requires home ventilatory support?

Patient parameters that lay caregivers of home mechanical ventilation should assess regularly include which of the following? 1) Vital signs 2) Skin color or diaphoresis 3) Chest excursions 4) Breath sounds

Which of the following can benefit most from intermittent use of noninvasive ventilation?

Emergency situations that home mechanical ventilation caregivers must be trained to recognize and manage include all of the following except:

Mechanical ventilation in the home setting can be provided by which of the following methods? 1) Positive pressure through an oral endotracheal tube 2) Positive pressure through an intact upper airway 3) Intermittent abdominal displacement methods 4) Negative pressure through an intact upper airway

What equipment function should lay caregivers of home mechanical ventilation assess regularly? 1) Cleanliness and function of bag-valve-mask 2) Internal and external battery power levels 3) Cleanliness of filters and alarm functions 4) Accuracy of ventilator tidal volume (V_T) output

Which of the following are prerequisites to successful home-based mechanical ventilation? 1) Presence of adequate professional support 2) Willingness of family to accept responsibility 3) Patient's condition, especially stability 4) Overall viability of the home care plan

Absolute contraindications for using noninvasive positive pressure ventilation include which of the following? 1) Hemodynamic instability 2) Uncooperative patient 3) Copious secretions 4) Need for airway protection

Which of the following strategies would you recommend for a hemodynamically unstable patient with an intact upper airway who requires home ventilatory support?

Which of the following strategies would you recommend for a patient with a tracheotomy who requires home ventilatory support?

Relative contraindications for using noninvasive ventilation (NIV) include all of the following except:

Which of the following conditions is an indication for application of noninvasive ventilation (NIV) ?

You have been asked to organize a patient and family education program as part of a discharge plan for a patient requiring home ventilatory support. Which of the following methods would be best for training the family in the operation of the ventilator chosen?

In the early stages after a patient requiring mechanical ventilation is discharged to the home, how often should patient follow-up by a respiratory care practitioner occur?

Quiz 56: Respiratory Care in Alternative Settings

Which of the following strategies would you recommend for a cooperative patient with an intact upper airway who requires home ventilatory support?

Patient parameters that lay caregivers of home mechanical ventilation should assess regularly include which of the following? 1) Vital signs 2) Skin color or diaphoresis 3) Chest excursions 4) Breath sounds

Which of the following can benefit most from intermittent use of noninvasive ventilation?

Emergency situations that home mechanical ventilation caregivers must be trained to recognize and manage include all of the following except:

Mechanical ventilation in the home setting can be provided by which of the following methods? 1) Positive pressure through an oral endotracheal tube 2) Positive pressure through an intact upper airway 3) Intermittent abdominal displacement methods 4) Negative pressure through an intact upper airway

What equipment function should lay caregivers of home mechanical ventilation assess regularly? 1) Cleanliness and function of bag-valve-mask 2) Internal and external battery power levels 3) Cleanliness of filters and alarm functions 4) Accuracy of ventilator tidal volume (VT) output

Which of the following are prerequisites to successful home-based mechanical ventilation? 1) Presence of adequate professional support 2) Willingness of family to accept responsibility 3) Patient's condition, especially stability 4) Overall viability of the home care plan

Absolute contraindications for using noninvasive positive pressure ventilation include which of the following? 1) Hemodynamic instability 2) Uncooperative patient 3) Copious secretions 4) Need for airway protection

Which of the following strategies would you recommend for a hemodynamically unstable patient with an intact upper airway who requires home ventilatory support?

Which of the following strategies would you recommend for a patient with a tracheotomy who requires home ventilatory support?

Relative contraindications for using noninvasive ventilation (NIV) include all of the following except:

Which of the following conditions is an indication for application of noninvasive ventilation (NIV) ?

You have been asked to organize a patient and family education program as part of a discharge plan for a patient requiring home ventilatory support. Which of the following methods would be best for training the family in the operation of the ventilator chosen?

In the early stages after a patient requiring mechanical ventilation is discharged to the home, how often should patient follow-up by a respiratory care practitioner occur?

What equipment function should lay caregivers of home mechanical ventilation assess regularly? 1) Cleanliness and function of bag-valve-mask 2) Internal and external battery power levels 3) Cleanliness of filters and alarm functions 4) Accuracy of ventilator tidal volume (V_T) output