\

As I’m sure you already know, Mechanical Ventilation is definitely one of the most difficult subjects and courses that you will take in Respiratory Therapy school. It’s the course that most student struggle with. With that being said, it’s arguably the most important as well. 

Knowing the ins and outs of Mechanical Ventilation is crucial for anyone who wants to be a successful Respiratory Therapist. This is why it’s so important to truly learn and understand the concepts now, as a student, so that they will carry over in every part of your career. 

To help with that, we put together this Mechanical Ventilation final exam study guide that has some of the best practice questions that will help you learn everything you need to know in order to ace your exams in school and pass the TMC Exam whenever that time comes. So are you ready to get started? Good, let’s dive in. 

Mechanical Ventilation Final Exal Practice Questions:

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
Question 1

A patient is being mechanically ventilated at an FiO2 of 100%. As a precautionary measure, you would monitor and limit its use to ___________ as lung damage can occur with prolonged exposure.

  1. 6-12 hours
  2. 12-24 hours
  3. 24-48 hours
  4. 48-72 hours

 

Question 2

For adult patients during HFOV, the power is initially set at _____ and rapidly increased to achieve chest wiggle. Chest wiggle is defined as visible vibration from __________________.

  1. 4; shoulder to belly area
  2. 4; shoulder to mid-thigh area
  3. 6; shoulder to belly area
  4. 6; shoulder to mid-thigh area

 

Question 3

While monitoring the ventilator, you notice that the pressure gauge goes from 0 cm H2O and then goes up and stays at 8 cm H2O throughout the expiratory phase. Since PEEP is not in use, this observation is called:

  1. CPAP
  2. air leak
  3. auto-PEEP
  4. COPD

 

Question 4

An intubated patient is being treated with a broad-spectrum antibiotic. The physician would like to do a C&S sputum test. Since the patient’s cough is not strong enough to expectorate the retained secretions, you would collect the sputum sample in a _________________.

  1. laryngeal mask airway
  2. esophageal obturator
  3. suction catheter
  4. Lukens trap

 

Question 5

Alveolar hyperventilation is usually accompanied by a PaCO2 reading of _____________
and this may be managed by ________________ the mechanical VT or RR.

  1. > 45 mm Hg; increasing
  2. > 45 mm Hg; decreasing
  3. < 35 mm Hg; increasing
  4. < 35 mm Hg; decreasing

 

Question 6

Upon entering Mr. Pendleton’s room you notice that the high pressure alarm has been triggered since your last visit. It is no longer alarming. You should consider which of the following as the most likely cause?

  1. Atelectasis
  2. Bronchospasm
  3. Coughing
  4. Mucus plug

 

Question 7

You are reviewing the chart of a patient who has been admitted to the ICU for severe malnutrition and dehydration. Which of the following urine output measurements may be used to determine if the patient has a fluid deficit?

  1. Urinary output below 20 mL/hour
  2. Urinary output
  3. Urinary output
  4. All of the above

 

Question 8

A patient is being mechanically ventilated. Among other settings, PEEP-10 cm H2O and FiO2-70% are used. After determining the patient has met the weaning criteria, you would begin the weaning process by decreasing the:

  1. FiO2 gradually to 40%
  2. FiO2 gradually while simultaneously increasing the PEEP
  3. PEEP gradually to 3 cm H2O
  4. PEEP gradually while simultaneously increasing the FiO2

 

Question 9

A medical resident asks you to explain the difference between CPAP and PEEP. You would describe that CPAP provides an end-expiratory pressure to patients who are:

  1. on pressure control mode
  2. breathing spontaneously with mechanical breaths
  3. on SIMV mode
  4. breathing spontaneously without mechanical breaths

 

Question 10

Airway resistance imposed by the ventilator circuit and ETT can be minimized or overcome during spontaneous breathing by:

  1. adding deadspace
  2. increasing inspiratory flow
  3. using PSV
  4. All of the above

 

Question 11

Among the conditions below, auto-PEEP is most likely caused by _______________ while on the ventilator.

  1. air trapping
  2. excessive inspiratory flow
  3. insufficient tidal volume
  4. low frequency

 

Question 12

Mrs. McFarland, a patient with a history of COPD, has been admitted for elective surgery. Her preoperative ABGs on room air would most likely show:

  1. pH = 7.16, PaCO2 = 34 mm Hg, PaO2 = 64 mm Hg
  2. pH = 7.45, PaCO2 = 44 mm Hg, PaO2 = 65 mm Hg
  3. pH = 7.37, PaCO2 = 54 mm Hg, PaO2 = 60 mm Hg
  4. pH = 7.48, PaCO2 = 54 mm Hg, PaO2 = 58 mm Hg

 

Question 13

The initial frequency during HFOV is set at _______ Hz and may be ___________ if using amplitude alone fails to control the PaCO2.

  1. 5-6; decreased
  2. 5-6; increased
  3. 10-15; decreased
  4. 10-15; increased

 

Question 14

Inverse ratio ventilation (IRV) is accomplished mainly by:

  1. decreasing the VT
  2. increasing the inspiratory flow rate
  3. extending the inspiratory time
  4. decreasing the PIP

 

Question 15

In HFOV, the mean airway pressure (mPaw) is affected by the ___________ and the initial mPaw should start at __________ the mPaw obtained during conventional mechanical ventilation.

  1. power setting; 5 cm H2O
  2. power setting; 15 cm H2O
  3. frequency; 5 cm H2O
  4. frequency; 15 cm H2O

 

Question 16

The physician asks you to assess a patient for excessive extracellular fluid. Among other signs, you would evaluate all of the following conditions except:

  1. bounding pulse
  2. increased cardiac output
  3. oliguria
  4. pulmonary edema

 

Question 17

Permissive hypercapnia is a strategy in which the ________ value is allowed to go beyond its normal limit and it is used to ____________________:

  1. PaO2; reduce intracranial pressure in patients with head injuries
  2. PaO2; reduce O2 toxicity
  3. PaCO2; minimize ventilator-related lung injuries
  4. PaCO2; compensate for metabolic alkalosis

 

Question 18

Mr. Jones, a patient who has been mechanically ventilated for 3 weeks, is now on a high calorie diet. Which of the following can be a potential problem associated with overfeeding during mechanical ventilation?

  1. Decreased O2 consumption
  2. Decreased work of breathing
  3. Increased CO2 production
  4. Increased fixed acid

 

Question 19

In HFOV, the power setting controls the amplitude of oscillation and thus the:

  1. frequency
  2. oxygenation level
  3. tidal volume
  4. A and B only

 

Question 20

Dr. Kao asks you to estimate a patient’s resting energy expenditure (REE) using the Harris Benedict equation. You would gather the following set of information:

  1. age, height, & weight
  2. height & weight
  3. sex, height, & weight
  4. sex, age, height, & weight

 

Question 21

The incidence of VAP may be reduced by employing all of the following procedures except:

  1. proper handwashing
  2. more frequent ventilator circuit change
  3. early microbiological exam and use of appropriate antibiotherapy
  4. closed suction system

 

Question 22

When an MDI is administered inline to a mechanically ventilated patient with a HME,

  1. MDI may not be used inline with a ventilator circuit
  2. the MDI must be placed between the patient and the HME
  3. the MDI must be placed between the ventilator and the HME
  4. the HME must be removed

 

Question 23

The degree of ventilation is best assessed by measuring the patient’s:

  1. PaCO2
  2. PaO2
  3. pH
  4. PvCO2

 

Question 24

In high frequency oscillatory ventilation (HFOV), hypoventilation may be managed by ___________ the amplitude or by ____________ frequency.

  1. increasing; increasing
  2. increasing; decreasing
  3. decreasing; increasing
  4. decreasing; decreasing
Question 25

In patients with normal cardiopulmonary status, increasing the ________ is the treatment of choice in improving the patient’s oxygenation.

  1. FiO2
  2. PEEP
  3. PSV
  4. VT

 

Question 26

In mechanical ventilation, the most common approach to improving minute ventilation is to increase the _________________. However it should not exceed __________ as auto-PEEP may occur.

  1. respiratory rate; 10/min
  2. respiratory rate; 20/min
  3. tidal volume; 600 mL
  4. tidal volume; 800 mL

 

Question 27

The major cation in the intracellular fluid (ICF) is:

  1. sodium
  2. calcium
  3. potassium
  4. magnesium

 

Question 28

An order has been written for initiating MV at a VT setting of 3 mL/kg. You would contact the physician and explain to her that the VT setting would be too _________ and it may lead to _______________.

  1. high; barotrauma
  2. high; alveolar hyperventilatio
  3. low; atelectasis
  4. low; bronchospasm

 

Question 29

You are reviewing ABG results of a 30-year-old, postoperative patient who has been on assist/control (a/c) ventilation and is currently awake and breathing spontaneously. The results are as follows: pH = 7.53, PaCO2 = 30 mm Hg, PaO2 = 102 mm Hg, HCO3 = 24 mEq/L, a/c rate = 12/min, total rate = 18/min, tidal volume = 800 ml, FiO2 = 30%. Based on the information provided, you would make which of the following changes to the ventilator setting?

  1. Change to SIMV mode
  2. Decrease a/c rate to 10/min
  3. Decrease FiO2 to 25%
  4. Increase the tidal volume to 850 ml

 

Question 30

In humans, water makes up approximately _______ of the total body weight.

  1. 40%
  2. 50%
  3. 60%
  4. 70%

 

Question 31

Mr. Johns is being mechanically ventilated with these settings: Mode = SIMV, rate = 12/min, tidal volume = 600 mL, FiO2 = 50%, PEEP = 0 cm H2O. Auto-PEEP of 6 cm H2O is observed consistently. You would change the:

  1. frequency to 14/min
  2. mode to assist control
  3. PEEP to 5 cm H2O
  4. tidal volume to 700 mL

 

Question 32

Upon entering the ICU, you are alerted by a series of low pressure alarms from the ventilator. You would check the patient and ventilator for all of the following conditions except:

  1. circuit disconnection
  2. airway obstruction
  3. ETT cuff leak
  4. loose humidifier connection

 

Question 33

Auto-PEEP may be reduced or eliminated by all of the following methods except:

  1. increasing the expiratory time
  2. reducing the VT
  3. reducing the frequency
  4. reducing the inspiratory flow

 

Question 34

The ABG report of Mr. Orin, a patient on mechanical ventilation, is as follows: pH = 7.50, PaCO2 = 32 mm Hg, PaO2 = 83 mm Hg. The physician asks you to make appropriate changes to the settings on the ventilator. Which of the following controls would have the leastimpact in correcting the patient’s condition as indicated by the ABG results?

  1. FiO2
  2. PS level
  3. RR
  4. VT

 

Question 35

The total rate of a mechanically ventilated patient is 10/min. At this rate, the ABG reveals a PaCO2 of 60 mm Hg. Assuming the VT and deadspace reamin constant, calculate the RR necessary to achieve a PaCO2 of 40 mm Hg.

  1. 6/min
  2. 8/min
  3. 12/min
  4. 15/min

 

Question 36

All of the following statements are true regarding mechanical tidal volume except:

  1. increasing the tidal volume is the most common approach to improving minute ventilation.
  2. tidal volume should be set according to the patient’s ideal body weight.
  3. increasing the tidal volume should be considered when the patient’s ventilatory rate exceeds an ideal breathing pattern.
  4. insufficient tidal volume increases the risk of atelectasis and hypercapnia.

 

Question 37

The most common trigger for apnea alrams is:

  1. apnea
  2. loose humidifier fittin
  3. cuff leak
  4. disconnection

 

Question 38

The following electrolytes are collected from a patient with severe sepsis who has been on a mechanical ventilator for two weeks. Which of the following electrolytes is out of its normal range?

  1. Sodium = 138 mEq/L
  2. Potassium = 1.5 mEq/L
  3. Chloride = 105 mEq/L
  4. Bicarbonate = 25 mEq/L

 

Question 39

The degree of ventilation may be increased by increasing all of the following ventilator parameters except:

  1. VT
  2. PEEP
  3. PS
  4. Rate

 

Question 40

The major cation in the extracellular fluid compartment is __________ and it plays an important role in ____________ balance.

  1. sodium; fluid
  2. potassium; fluid
  3. calcium; acid-base
  4. magnesium; acid-base

 

Question 41

Low VT strategy is done to reduce the risk of ______________ and the tagret volume is reached when _________________.

  1. atelectasis; PIP is
  2. atelectasis; plateau pressure is
  3. barotraumas; PIP is
  4. barotraumas; plateau pressure is

 

Question 42

The PaCO2 of Ms. Hart, a 40-year-old mechanically ventilated dependent patient with normal cardiopulmonary status, is 60 mm Hg. This value indicates _____________ and should be managed by ______________ the mechanical VT or RR.

  1. hyperventilation; increasing
  2. hyperventilation; decreasing
  3. hypoventilation; increasing
  4. hypoventilation; decreasing

1. The body’s mechanism for conducting air in and out of the lungs is known as which of the following?: Spontaneous ventilation

2. Which of the following are involved in external respiration?: Alveoli and pulmonary capillaries

3. All of the following could be the cause of a patient’s peak pressure increasing from 35 to 45 cm H2O except:

a. Bronchospasm

b. Resolving pulmonary edema

c. The patient biting on the endotracheal tube. Secretions in the airway

d. Secretions in the airway

4. The pressure required to maintain alveolar inflation is known as which of the following?

a. Transairway pressure (PTA )

b. Transthoracic pressure (PTT)

c. Transrespiratory pressure (PTR)

d. Transpulmonary pressure (PL)

5. The term used to describe the tendency of a structure to return to its original form after being stretched or acted on by an outside force is which of the following?

a. Elastance

b. Compliance

c. Viscous resistance

d. Distending pressure

6. The condition that causes pulmonary compliance to increase is which of the following?

a. Asthma

b. Kyphoscoliosis

c. Emphysema

d. Acute respiratory distress syndrome (ARDS)

7. Use this figure to compute the static compliance (CS) for an intubated patient with an exhaled tidal volume (VT) of 500 mL.

a. 14 mL/cm H2O

b. 20 mL/cm H2O

c. 33 mL/cm H2O

d. 50 mL/cm H2O

8. The ventilator that functions most physiologically uses which of the following?

a. Open loop

b. Double circuit

c. Positive pressure

d. Negative pressure

9. Plateau pressure (Pplateau) is measured during which phase of the ventilatory cycle?

a. Inspiration

b. End-inspiration

c. Expiration

d. End-expiration

10. Calculate airway resistance (Raw) for a ventilator patient, in cm H2O/L/sec, with the following information: Peak inspiratory pressure (PIP) is 20 cm H2O, plateau pressure (Pplateau) is 15 cm H2O, PEEP is 5 cm H2O, and set flow rate is 50 L/min.

a. 5 Raw

b. 6 Raw

c. 10 Raw

d. 15 Raw

11. Calculate the static compliance (CS), in mL/cm H2O, when PIP is 47 cm H2O, plateau pressure (Pplateau) is 27 cm H2O, baseline pressure is 10 cm H2O, and exhaled tidal volume (VT) is 725 mL.

a. 43 CS

b. 36 CS

c. 20 CS

d. 0.065 CS

12. Air accidentally trapped in the lungs due to mechanical ventilation is known as which of the following?

a. Plateau pressure (Pplateau)

b. Functional residual capacity (FRC)

c. Extrinsic positive end expiratory pressure (extrinsic PEEP)

d. Intrinsic positive end expiratory pressure (intrinsic PEEP)

13. Which of the following statements is (are) true?

I. During inspiration with positive pressure ventilation, intrapleural pressure becomes positive.

II. During inspiration with negative pressure ventilation, intrapleural pressure is negative.

III. During spontaneous ventilation, intrapleural pressure is most negative at the beginning of inspiration

IV. During positive pressure ventilation, intrapleural pressure is about – 15 cmH2)

Answer: I, II, III

14. The respiratory therapist enters modes and parameters into the ventilator with which of the following?

a. Control logic

b. Input power

c. User interface

d. Drive mechanism

15. The function of the exhalation valve is to do which of the following?

a. Adjust the flow going to the patient

b. Close during exhalation to vent patient gas

c. Seal the external circuit during inspiration

d. Determine the volume being delivered

16. In the image, what does “B” represent?

a. Expiratory valve line

b. Exhalation valve

c. Expiratory line

d. Main inspiratory line

17. There are two types of pneumatically powered ventilators: pneumatic and fluidic

A. True

B. False

18. Closed-loop ventilator logic systems are called “unintelligent” because they cannot be programmed to respond to changing conditions.

A. True

B. False

19. Modern ICU ventilators use flow control valves. These valves control or direct gas flow by opening or closing either completely or in small increments. 

A. True

B. False

20. The power source used by the ventilator provides the energy to perform the work of ventilating the patient. Ventilator power sources include:

A. Electrical

B. Pneumatic

C. Dual electrical-pneumatic

D. All of the above

21. Early ventilators such as the tank ventilator and chest cuirass were designed to operate as:

A. Positive pressure ventilators

B. Negative pressure ventilators

C. Constant pressure ventilators

D. Volume-cycled ventilators

22. The equation of motion describes the relationships between which of the following?

a. Pressure and flow during a mechanical breath

b. Pressure and volume during a spontaneous breath

c. Flow and volume during a mechanical or spontaneous breath

d. Flow, volume, and pressure during a spontaneous or mechanical breath

23. How many variables can a ventilator control at one time?

a. One

b. Two

c. Three

d. Four

24. An increase in airway resistance during volume-controlled ventilation will have which of the following effects?

a. Volume increase

b. Flow decrease

c. Pressure increase

d. Rate decrease

25. An increase in airway resistance during pressure-targeted ventilation will have which of the following effects?

a. Volume decrease

b. Flow increase

c. Pressure increase

d. Rate decrease

26. The most commonly used patient-trigger variables include which of the following?: 1. Flow, 2. Time, 3. Pressure, 4. Volume

a. 1 and 3 only

b. 2 and 4 only

c. 1 and 4 only

d. 2 and 3 only

27. A patient who has been sedated and paralyzed by medication is being controlled by the ventilator. The set rate is 15 bpm. How many seconds does it take for inspiration and expiration to occur?

a. 2 seconds

b. 4 seconds

c. 6 seconds

d. 8 seconds

28. The trigger variable in the controlled mode is which of the following?

a. Flow

b. Time

c. Pressure

d. Volume

29. The inspiratory and expiratory flow sensors are reading a base flow of 5 liters per minute (L/min). The flow trigger is set to 2 L/min. The expiratory flow sensor must read what flow to trigger inspiration?

a. 1 L/min

b. 2 L/min

c. 3 L/min

d. 4 L/min

30. The patient trigger that requires the least amount of work of breathing for the patient is which of the following?

a. Time

b. Flow

c. Pressure

d. Volume

31. The limit variable set on a mechanical ventilator will do which of the following?

a. End inspiration

b. Begin inspiration

c. Control the maximum value allowed

d. Control the minimum value allowed

32. The variable that a ventilator uses to end inspiration is known as which of the following?

a. Cycle

b. Limit

c. Trigger

d. Baseline

33. The most common method of terminating inspiration during pressure support ventilation is which of the following?

a. Flow

b. Time

c. Pressure

d. Volume

34. What is the flow-cycle setting for the following pressure supported breath?

D. 50% 

35. Which maneuver will maintain air in the lungs at the end of inspiration, before the exhalation valve opens?

a. Pressure limit

b. Inspiratory hold

c. Expiratory hold

d. Expiratory resistance

36. A ventilator is set to deliver a 600 mL tidal volume. The flow rate is set at 40 L/min and the frequency is set at 10 breaths/min. If the flow rate is doubled and the patient is not assisting, which of the following will occur?

a. The frequency will decrease.

b. The tidal volume will increase.

c. The expiratory time will increase.

d. The inspiratory time will increase.

37. A patient with an opiate drug overdose is unconscious and has the following arterial blood gas results on room air: pH 7.20; partial pressure of carbon dioxide (PaCO2) 88 mm Hg; partial pressure of oxygen (PaO2) 42 mm Hg; bicarbonate (HCO3-) 25 mEq/L. Which of the following best describes this patient’s condition?

a. Chronic hypoxemic respiratory failure

b. Chronic hypercapnic respiratory failure

c. Acute hypoxemic respiratory failure

d. Acute hypercapnic respiratory failure

38. A patient with inadequate oxygenation of the brain may display which of the following conditions?: 1. Confusion, 2. Excitement, 3. Somnolence, 4. Compliance

a. 1 and 2 only

b. 1 and 3 only

c. 2 and 4 only

d. 3 and 4 only

39. Which of the following values are indicative of acute respiratory failure and the need for ventilatory support?: 1. Maximum inspiratory pressure (MIP) = – 25 cm H2O, 2. Dead space to tidal volume ratio (VD/VT) = 0.4, 3. Vital capacity (VC) = 8 mL/kg IBW, 4. pH = 7.20

a. 1 and 2 only

b. 2 and 3 only

c. 3 and 4 only

d. 1 and 4 only

40. A 46-year-old male presents to the emergency department with a chief complaint of shortness of breath. Physical assessment reveals: pulse 102, blood pressure 138/80, respiratory rate 25 with accessory muscle use, and breath sounds are decreased with bilateral inspiratory and expiratory wheezing with a prolonged expiratory phase. The peak expiratory flow rate is 100 L/min. The immediate action by the respiratory therapist should include which of the following?

a. Intubate and mechanically ventilate.

b. Administer oxygen via non-rebreather mask.

c. Administer continuous bronchodilator therapy.

d. Initiate noninvasive positive pressure ventilation.

41. Which of the following patients is showing the signs of acute respiratory distress?

a. One who is in a semi-Fowler position, watching TV, with a 2 L/min nasal cannula

b. One in the high Fowler position, diaphoretic, anxious and unable to complete a sentence

c. One who is leaning forward on a table, using accessory muscles, and pursed-lip breathing

d. One in the high Fowler position, with a 2 L/min nasal cannula, eating breakfast

42. The underlying physiological process leading to pure hypercapnic respiratory failure is which of the following?

a. Ventilation/perfusion mismatch

b. Intrapulmonary shunting

c. Diffusion impairment

d. Alveolar hypoventilation

43. Which of the following are conditions affecting the central nervous system that is associated with reduced drive to breathe?

A. General anesthesia

B. Stroke

C. Narcotics

D. All of the above

44. A patient has recently been diagnosed with obstructive sleep apnea. The most appropriate treatment includes which of the following? 

a. Pressure Support Ventilation (PSV)

b. Noninvasive Positive Pressure Ventilation (NPPV)

c. Continuous Positive Airway Pressure (CPAP)

d. Pressure Controlled Continuous Mandatory Ventilation (PC-CMV)

45. Which of the following is the minimum ventilator rate that is considered full ventilatory support?

a. 4 breaths/minute

b. 6 breaths/minute

c. 8 breaths/minute

d. 10 breaths/minute

46. Partial ventilatory support can be provided by which of the following ventilator modes?: 1. Pressure Controlled Continuous Mandatory Ventilation (PC-CMV) set rate 8 breaths/minute, 2. Volume Controlled Synchronized Intermittent Mandatory Ventilation (VC-SIMV) set rate 4 breaths/minute, 3. Pressure Controlled Synchronized Intermittent Mandatory Ventilation (PC-SIMV) set rate 10 breaths/minute, 4. VC- MMV set Ve8 L/minute

a. 1 and 2 only

b. 2 and 3 only

c. 2 and 4 only

d. 3 and 4 only

47. Of the following breath descriptions, which one is considered spontaneous?

a. Flow triggered, pressure limited, flow cycled

b. Time triggered, volume limited, volume cycled

c. Pressure triggered, pressure limited, time cycled

d. Patient triggered, patient cycled, baseline pressure +5 cm H2O

48. What type of breath occurs when the ventilator controls the timing, tidal volume, or inspiratory pressure?

a. Assisted

b. Mandatory

c. Spontaneous

d. Controlled

49. An assisted breath in PC-CMV mode can be described by which of the following?

a. Time triggered, pressure limited, time cycled

b. Patient triggered, pressure limited, time cycled

c. Time triggered, pressure limited, pressure cycled

d. Patient triggered, volume limited, volume cycled

50. Full ventilatory support is provided by which of the following modes?

a. Pressure Support Ventilation (PSV) with Continuous Positive Airway Pressure (CPAP)

b. Volume Support Ventilation (VSV) with Continuous Positive Airway Pressure (CPAP)

c. Volume-Controlled Synchronized Intermittent Mandatory Ventilation (VC-SIMV) rate 6 with pressure support (PS)

d. Pressure-Controlled Synchronized Intermittent Mandatory Ventilation (PC-SIMV) rate 12 with pressure support (PS)

51. When a patient does not breathe spontaneously while in the airway pressure release ventilation (APRV) mode, the pressure-time scalar looks like that of which of the following?

a. Pressure Support Ventilation (PSV)

b. Continuous Positive Airway Pressure (CPAP)

c. Pressure-Controlled Inverse Ratio Ventilation (PCIRV)

d. Volume-Controlled Continuous Mandatory Ventilation (VC-CMV)

52. A breath that is patient triggered, pressure targeted, and time cycled is which of the following?

a. Assisted breath

b. Mandatory breath

c. Spontaneous breath

d. Synchronized breath

53. A patient triggered, pressure limited, flow cycled breath describes which of the following?

a. Spontaneous breath

b. Pressure-support breath

c. Volume-control breath

d. Pressure-control breath

54. The ventilator mode that delivers pressure breaths that are patient- or time-triggered, volume targeted, time cycled, and where the pressure is automatically adjusted to maintain delivery of the targeted volume is which of the following?

a. Volume Support Ventilation (VSV

b. Pressure Augmentation (Paug)

c. MMV

d. Pressure Regulated Volume Control (PRVC)

Final Thoughts

So there you have it! I sincerely hope that this Mechanical Ventilation final exam study guide was helpful for you. I’m confident in the fact that if you go through the practice questions again and again, it will absolutely boost your knowledge of Mechanical Ventilators to the next level.

If you put in the hard work now by learning this information, your future self will thank you because this important knowledge will help you pass your board exams and become the best Respiratory Therapist that you can possibly be! Thanks for reading, good luck, and as always, breathe easy my friend.