Chapter 45: Noninvasive Ventilation

Chapter 45: Noninvasive Ventilation

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which of the following devices is considered to be the first electrically powered negative pressure ventilator?

a.	the Bird
b.	the iron lung
c.	the chest cuirass
d.	the rocking bed

 

 

ANS:  B

The first electrically powered, negative-pressure ventilator was known as the “iron lung.”

 

DIF:    Recall             REF:   p. 1132          OBJ:   5

 

2. Why did the use of intermittent positive-pressure breathing declined in the 1980s?

a.	due to a lack of scientific evidence to support its use for delivering aerosolized medication
b.	due to its cost of implementation
c.	due to its complexity
d.	replaced by newer technology

 

 

ANS:  A

The use of intermittent positive-pressure breathing declined significantly in the mid 1980s after a randomized, controlled trial revealed no benefit, compared to a simple small-volume nebulizer, in the treatment of patients with chronic obstructive pulmonary disease.

 

DIF:    Recall             REF:   p. 1133          OBJ:   5

 

3. All of the following are goals of noninvasive ventilation (NIV) in the acute care setting, except:

a.	Avoid intubation.
b.	Decrease incidence of ventilation-associated pneumonia.
c.	Decrease length of stay.
d.	Improve mobility.

 

 

ANS:  D

Avoiding intubation and invasive positive-pressure ventilation, improving survival, decreasing the length of ventilatory support, decreasing the length of hospitalization, and decreasing the incidence of ventilator associated pneumonia are major goals of NIV in the acute care setting (emergency department, intensive care unit, or hospital ward).

 

DIF:    Recall             REF:   p. 1134          OBJ:   1

 

4. Which of the following therapies should be considered as first line of therapy in patients with exacerbation of chronic obstructive pulmonary disease (COPD)?

a.	noninvasive ventilation (NIV)
b.	mechanical ventilation
c.	high-flow nasal cannula
d.	systemic steroids

 

 

ANS:  A

The differences in reported outcome between these studies suggests that NIV should be considered standard of care for COPD patients in an acute exacerbation and offered as first-line therapy to patients in all institutions treating the COPD patient.

 

DIF:    Recall             REF:   p. 1134          OBJ:   5

 

5. Your patient has acute pulmonary edema from left heart failure. Which therapy should be tried first?

a.	noninvasive ventilation (NIV)
b.	continuous positive airway pressure (CPAP)
c.	mechanical ventilation
d.	positive end-expiratory pressure

 

 

ANS:  B

CPAP is considered by most first-line therapy for acute cardiogenic pulmonary edema.

 

DIF:    Application    REF:   p. 1134          OBJ:   5