Chapter 44 Initiating and Adjusting Ventilatory Support

Chapter 44  Initiating and Adjusting Ventilatory Support

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which of the following is the LEAST frequent cause of acute respiratory failure needing mechanical ventilation?
a.
sepsis
b.
postoperative respiratory failure
c.
heart failure
d.
aspiration

ANS: D
The most common causes of acute respiratory failure that necessitate mechanical ventilation are listed in Table 44-2.

DIF: Recall REF: p. 1090 OBJ: 1

2. Which of the following clinical findings is LEAST likely to be seen in a patient with acute hypoxic respiratory failure?
a.
confusion
b.
tachycardia
c.
hypotension
d.
dyspnea

ANS: C
Clinical manifestations of acute hypoxemia and acute ventilatory failure are listed in Table 44-6.

DIF: Recall REF: p. 1109 OBJ: 1

3. Which of the following findings would you expect to see in a patient who has acute ventilatory failure with severe hypercapnia?
a.
jugular vein distension
b.
pale, dry skin
c.
bradycardia
d.
hyperresponsiveness and dilated pupils

ANS: C
Clinical manifestations of acute hypoxemia and acute ventilatory failure are listed in Table 44-6.

DIF: Recall REF: p. 1109 OBJ: 2

4. Physiological goals of artificial ventilatory support include which of the following?
1. support or manipulate gas exchange
2. reduce or manipulate the work of breathing
3. increase lung volume
a.
1 and 2
b.
2 and 3
c.
1 and 3
d.
1, 2, and 3

ANS: D
The goals of mechanical ventilatory support are to maintain adequate alveolar ventilation and oxygen delivery, restore acid-base balance, and reduce the work of breathing with minimum harmful side effects and complications.

DIF: Application REF: p. 1089 OBJ: 2

5. After starting volume-cycled mechanical ventilation on a patient in respiratory failure with a VT of 10 ml/kg, you measure and obtain a plateau pressure of 45 cm H2O. Which of the following actions would you recommend to the patient’s physician?
a.
Decrease the inspiratory flow.
b.
Lower the delivered VT.
c.
Administer a bronchodilator.
d.
Add PEEP.

ANS: B
Plateau pressure (Pplat) during mechanical ventilation reflects alveolar pressure, the best bedside clinical reflection of transalveolar pressure. Limiting Pplat reduces the likelihood of ventilator-induced lung injury, although patients with decreased thoracic compliance may require plateau pressures greater than 30 cm H2O without resulting overdistention.

DIF: Application REF: p. 1089 OBJ: 2