-20 cm H2O - ANSWERS-A patient is considered to have sufficient respiratory
muscle strength to maintain adequate ventilation and prevent secretion retention
when the maximum inspiratory pressure (MIP; NIF) is more negative than which
of the following?
dietary habits - ANSWERS-Which of the following selections in a patient's medical
history would be least important to consider in evaluating their pulmonary
condition?
the spirometer is performing within acceptable limits - ANSWERS-A normal 5-foot
4-inch tall staff member serves as a biologic control for the PFT lab. Her
established FVC is 3.81 L with a SD of ±0.13 L. During quality control testing of a
spirometer, she produces the following FVC results: FVC #1 = 3.73 L, FVC #2 = 3.88
L, FVC #3 = 3.71 L. You should conclude that the
tighten the regulator connection - ANSWERS-After opening the valve on an E
cylinder which has a regulator attached, you hear a hissing noise. The
flowmeter/gauge is turned off. Which of the following corrective actions should
you take?
SIMV allows graded levels of support - ANSWERS-Which of the following is an
advantage of SIMV over assist/control ventilation?
,lower the PEEP back to 10 cm H2O - ANSWERS-The physician orders an increase in
PEEP from 10 to 14 cm H2O for a patient receiving mechanical ventilation. After
you adjust the PEEP setting, you note a rapid drop in the patient's blood pressure
and a significant rise in heart rate. Which of the following actions would be
appropriate?
pulmonary barotrauma - ANSWERS-What is the major hazard associated with the
use of bag-valve resuscitator?
discarded the sample and obtain a new one - ANSWERS-While analyzing an ABG
sample you obtained from a patient breathing room air, you obtain the following
values: pH 7.44 PaCO2 46 torr PaO2 163 torr The patient's blood gas results
should be:
check/adjust ET tube cuff pressure - ANSWERS-You are using a portable pressure-
cycled ventilator with a heated humidifier and IPPB circuit to temporarily
ventilate a post-operative patient who is regaining consciousness in the recovery
room. After checking the patient and ventilator, you notice that the inspiratory
time is prolonged and the machine does not cycle off without active patient
effort. What should you do in order to correct the problem?
either the patient's inspiratory efforts or a timing mechanism - ANSWERS-A
ventilator that is being used in the assist/control mode will trigger on in response
to which of the following?
Exacerbation of COPD - ANSWERS-A 62-year-old male patient with a history of
COPD and CHF have arrived in the ER with a complaint of difficulty breathing. To
help with the differential diagnosis, the doctor orders the patient's blood to be
, tested for bacteremia, CK-MB, cTnI, cTnT, and BNP. All results are negative. What
is the most likely cause of the patient's dyspnea?
pneumonia - ANSWERS-If you were to hear bronchial breath sounds over the
patient's right middle lobe, what condition would you suspect is probably
present?
cheyne-stokes respiration - ANSWERS-You are called to evaluate a patient's
breathing pattern. You see that the patient's tidal volumes go from small to large
to small and then stop for 10 seconds before starting again and it repeats itself.
Which of the following would best describe this breathing pattern?
maintain the endotracheal tube in place - ANSWERS-A trauma patient has been
receiving volume controlled SIMV via an endotracheal tube for the past three
days. The attending surgeon anticipates that the patient will likely be on the
ventilator for another 4 to 5 days. Which of the following actions would you
recommend?
maintain the current settings - ANSWERS-You are monitoring a mechanically
ventilated patient 36 hours post-craniotomy who has an ICP of 20 mmHg but is
otherwise stable. The latest ABG results are as follows: pH 7.39 PaCO2 43 mm Hg
HCO3 24 mEq/L BE 0 PaO2 88 mm Hg SaO2 95% Based on this information, which
of the following is the most acceptable action?
decrease stroke volume during positive pressure - ANSWERS-While assessing a
patient who is receiving ventilatory support, you note significant weakening of
the pulse during the inspiration of machine-given breaths. Which of the following
is the most likely cause of this finding?
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