Chapter 44: Initiating and Adjusting Ventilatory Support

Chapter 44: Initiating and Adjusting Ventilatory Support

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which of the following is the LEAST frequent cause of acute respiratory failure needing mechanical ventilation?

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?

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?

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?
5. support or manipulate gas exchange
6. reduce or manipulate the work of breathing
7. increase lung volume

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 V_T 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?

ANS:  B

Plateau pressure (P_plat) during mechanical ventilation reflects alveolar pressure, the best bedside clinical reflection of transalveolar pressure. Limiting P_plat 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