Question 1

Which of the following is an indicator of weaning failure?

  1. decreasing VD/VT
  2. increasing MIP
  3. increasing f/VT
  4. decreasing f

 

Question 2

Based on the weaning protocol described in the textbook, all of the following conditions must be met for consideration of a weaning attempt except:

  1. hemodynamic stability.
  2. little or no sedation required.
  3. PaO2/FIO2
  4. presence of inspiratory effort.

 

Question 3

Terminal weaning is defined as _______________ of mechanical ventilation that results in the ______________ of a patient.

  1. withdrawal; death
  2. withholding; death
  3. withdrawal; vegetative state
  4. withholding; vegetative state

 

Question 4

Other causes of increased airflow resistance during mechanical ventilation include all of the following conditions except:

  1. kinking of the ET tube.
  2. secretions in ET tube.
  3. use of a humidifier.
  4. use of an HME.

 

Question 5

All of the following pulmonary measurements suggest readiness for weaning attempt except:

  1. maximal inspiratory pressure = -12 cm H2O
  2. VD/VT = 40%
  3. static compliance = 32 mL/cm H2O
  4. f/VT = 80 breaths/min/L

 

Question 6

If pulse oximetry is used to monitor a patient’s oxygenation status, the pulse oximetry O2 saturation (SpO2) should be kept in the mid-80s for allowance of machine inaccuracies.

  1. True
  2. False

 

Question 7

The ____ is measured by dividing the patient’s tidal volume (measured at the airway opening) by the difference in the plateau pressure and the PEEP.

  1. airway resistance
  2. static lung compliance
  3. deadspace to tidal volume ratio
  4. dynamic lung compliance

 

Question 8

Patients who fail the SBT often do so within the first 10 minutes of the trial.

  1. True
  2. False

 

Question 9

____ is an indicator of weaning failure.

  1. Increasing PaO2
  2. Increasing PaCO2
  3. Increasing SpO2
  4. Increasing PaO2/FIO2

 

Question 10

Patients who fail the spontaneous breathing trial (SBT) may exhibit which of the following clinical signs and symptoms:

  1. agitation.
  2. bradycardia
  3. cyanosis.
  4. diaphoresis.

 

Question 11

____ remains an effective tool in altering the degree of partial ventilatory support during continuous mechanical ventilation.

  1. ATC
  2. CPAP
  3. PS
  4. SIMV

 

Question 12

Generally accepted ventilatory weaning criteria includes a ____.

  1. vital capacity of greater than 5 mL/kg
  2. minute ventilation of less than 15 L with satisfactory blood gases
  3. spontaneous VT of greater than 5 mL/kg
  4. PaCO2 of less than 65 mm Hg with normal pH

 

Question 13

For a successful weaning outcome, ____.

  1. the PaO2 should be > 75 mm Hg
  2. the P(A-a)O2 should be < 450 mm Hg while on 100% O2.
  3. the PaO2/FIO2 should be 150 mm Hg
  4. the QS/QT should be < 45%

 

Question 14

Weaning criteria are used to evaluate the:

  1. Likelihood of weaning success.
  2. Readiness for extubation.
  3. Readiness of a patient to begin the weaning trial.

 

Question 15

The ____ is used to estimate how much pulmonary perfusion is wasted.

  1. P/F index
  2. QS/QT ratio
  3. P(A-a)O2 gradient
  4. CaO2 content

 

Question 16

Which of the following patient conditions is the least importantconsideration prior to weaning a patient from mechanical ventilation?

  1. frequent arrhythmias
  2. severe acidosis
  3. ventilatory failure
  4. use of PEEP

 

Question 17

The blood gases and related parameters of a patient are as follows: pH = 7.43, PaCO2 = 40 mm Hg, PaO2 = 80 mm Hg, PECO2 = 30 mm Hg. What portion of the tidal volume is considered wasted (deadspace) ventilation?

  1. 15%
  2. 25%
  3. 50%
  4. 75%

 

Question 18

A patient has the following oxygen content measurements: CcO2 = 20 vol%, CaO2 = 18 vol%, CvO2 = 13 vol%. The claculated QS/QT is about _________ and it reflects ___________ shunting.

  1. 19%; mild
  2. 29%; significant
  3. 39%; severe
  4. 55%; severe

 

Question 19

____ is defined as an absence of ventilatory support 48 hours following an extubation.

  1. Weaning success
  2. Weaning in progress
  3. Weaning failure
  4. Spontaneous breathing trial

 

Question 20

Which of the following are included in a weaning protocol:

  1. the detailed process of weaning.
  2. the evaluation of weaning outcomes.
  3. the patient condition in which weaning may be attempted.

 

Question 21

Automatic tube compensation (ATC) allows the patient to have a breathing pattern as if breathing spontaneously without an artifcial airway.

  1. True
  2. False


Question 22

When the RSBI or f/VT ratio becomes greater than 100 breaths/min/L, it correlates with weaning failure.

  1. True
  2. False

 

Question 23

____ is a clinical condition that decreases static compliance.

  1. Kinking of ET tube
  2. Bronchospasm
  3. Airway obstruction
  4. Tension pneumothorax

 

Question 24

____ is a clinical condition that decreases dynamic compliance.

  1. Atelectasis
  2. ARDS
  3. Retained secretions in the airways
  4. Retained secretions in the lungs

 

Question 25

____ = PAO2 – PaO2

  1. QS/QT
  2. P(A-a)O2
  3. CaO2
  4. PaCO2

 

Question 26

A patient has the following measurements while receiving mechanical ventilation: exhaled VT = 480 mL, PIP = 45 cm H2O, plateau pressure = 30 cm H2O, PEEP = 8 cm H2O. What is the calculated static compliance? Is it normal based on the pulmonary measurement criteria for weaning?

  1. 11 mL/cm H2O; normal
  2. 11 mL/cm H2O; abnormal
  3. 22 mL/cm H2O; normal
  4. 22 mL/cm H2O; abnormal

 

Question 27

Respiratory muscle dysfunction may be due to all of the following conditions except:

  1. electrolyte imbalance.
  2. excessive nutritional intake.
  3. low oxygen delivery.
  4. respiratory muscle atrophy due to muscle disuse.

 

Question 28

Patients who fail an SBT often exhibit the following objective clinical signs: tachypnea, ____, hypertension, hypotension, hypoxemia or acidosis, arrhythmias.

  1. bradycardia
  2. tachycardi
  3. atrial fibrillation
  4. ventricular fibrillatio

 

Question 29

Termination criteria for weaning from mechanical ventilation includes a ____.

  1. SpO2 < 80%
  2. heart rate >120/min
  3. systolic pressure >180 mm Hg
  4. systolic pressure < 75 mm Hg

 

Question 30

Sometimes SIMV and ____ are used together in patients who have failed the spontaneous breathing trial.

  1. PSV
  2. VS
  3. VAPS
  4. APRV

 

Question 31

In ____, the pressure support level is adjusted automatically to achieve the target tidal volume.

  1. VS
  2. VAPS
  3. MMV
  4. APRV

 

Question 32

For a successful weaning outcome, the patient should have a ____.

  1. static lung compliance
  2. VC
  3. VD/VT ratio should be >60%
  4. MIP of at least –30 cm H2O