Mechanical Ventilation: Understanding Key Concepts and Parameters, Exams of Nursing

Download Mechanical Ventilation: Understanding Key Concepts and Parameters and more Exams Nursing in PDF only on Docsity! NR 340 CRITICAL CARE NURSING Mechanical Ventilation Latest Review Exam Q & A 2024 1. What is the primary physiological goal of mechanical ventilation? - A) To increase oxygen delivery to tissues - B) To decrease respiratory muscle workload - C) To ensure proper carbon dioxide elimination - D) All of the above Answer: D) All of the above Rationale: Mechanical ventilation aims to support or replace spontaneous breathing by ensuring adequate oxygenation, reducing the work of breathing, and maintaining appropriate CO2 levels. 2. Which mode of mechanical ventilation allows the patient to initiate breaths but provides a set tidal volume with each breath? - A) Continuous Positive Airway Pressure (CPAP) - B) Assist-Control Ventilation (ACV) - C) Synchronized Intermittent Mandatory Ventilation (SIMV) - D) Pressure Support Ventilation (PSV) Answer: B) Assist-Control Ventilation (ACV) Rationale: ACV provides a predetermined tidal volume with each breath, whether the breath is patient-initiated or machine-initiated. 3. In the context of mechanical ventilation, what does PEEP stand for? - A) Peak Expiratory End Pressure - B) Positive End-Expiratory Pressure - C) Post Expiration Enhancement Pressure - D) Pressure Equalization End Protocol Answer: B) Positive End-Expiratory Pressure Rationale: PEEP refers to the pressure applied at the end of the expiration phase to prevent alveolar collapse and improve oxygenation. 4. What is the most common complication associated with mechanical ventilation? - A) Pneumothorax - B) Ventilator-associated pneumonia (VAP) - C) Barotrauma - D) Oxygen toxicity Answer: B) Ventilator-associated pneumonia (VAP) Rationale: VAP is a significant concern due to the invasive nature of - A) Peak inspiratory pressure - B) Plateau pressure - C) PEEP - D) Pressure limit Answer: D) Pressure limit Rationale: The pressure limit is set to avoid excessive pressures that could cause lung injury. 13. Which of the following is NOT a standard parameter monitored during mechanical ventilation? - A) End-tidal CO2 - B) Peak inspiratory pressure - C) Blood urea nitrogen (BUN) levels - D) Oxygen saturation Answer: C) Blood urea nitrogen (BUN) levels Rationale: While BUN levels are important for assessing renal function, they are not directly monitored in the context of mechanical ventilation. 14. What is the significance of the FiO2 setting on a ventilator? - A) It controls the fraction of inspired oxygen delivered to the patient. - B) It determines the flow rate of air to the patient. - C) It adjusts the level of PEEP. - D) It sets the respiratory rate. Answer: A) It controls the fraction of inspired oxygen delivered to the patient. Rationale: FiO2 is adjusted to meet the patient's oxygenation needs without causing oxygen toxicity. 15. When a patient on mechanical ventilation has a sudden drop in oxygen saturation, what should be the first action taken by the nurse? - A) Increase the FiO2 - B) Perform a respiratory assessment - C) Decrease the tidal volume - D) Increase the respiratory rate Answer: B) Perform a respiratory assessment Rationale: A sudden drop in oxygen saturation warrants an immediate assessment to determine the cause and appropriate intervention. 1. Which of the following parameters is commonly monitored during mechanical ventilation? A. Blood pressure B. Heart rate C. Respiratory rate D. Temperature Answer: C. Respiratory rate Rationale: Monitoring respiratory rate is crucial in assessing the effectiveness of mechanical ventilation and ensuring proper oxygenation and ventilation. 2. What is the purpose of positive end-expiratory pressure (PEEP) in mechanical ventilation? A. To prevent alveolar collapse B. To decrease oxygenation C. To increase carbon dioxide levels D. To decrease work of breathing Answer: A. To prevent alveolar collapse Rationale: PEEP helps keep alveoli open at the end of expiration, preventing collapse and improving oxygenation. 3. Which mode of mechanical ventilation allows for spontaneous breathing efforts by the patient? A. Assist-control B. Pressure support C. SIMV D. Volume control Answer: B. Pressure support Rationale: Pressure support mode provides a set level of pressure support for each breath, allowing the patient to initiate breaths on their own. 4. What is the purpose of FiO2 in mechanical ventilation? A. To support respiratory muscles B. To control tidal volume C. To deliver supplemental oxygen D. To monitor patient comfort Answer: C. To deliver supplemental oxygen Rationale: FiO2 refers to the fraction of inspired oxygen delivered to the patient; it is adjusted to maintain adequate oxygen levels in the blood. 5. Which of the following is a potential complication of prolonged mechanical ventilation? A. Hypoxemia B. Hypothermia C. Barotrauma D. Hypertension Answer: C. Barotrauma Rationale: Barotrauma is a potential complication of mechanical ventilation, resulting from high pressures damaging the lungs. 6. What is the purpose of tidal volume in mechanical ventilation? A. To measure respiratory rate B. To calculate minute ventilation C. To measure lung compliance D. To deliver a set volume of air per breath Answer: D. To deliver a set volume of air per breath Rationale: Tidal volume refers to the volume of air delivered with each breath during mechanical ventilation. 7. Which of the following is an indicator of ventilator dyssynchrony? A. Decreased PaO2 B. Increased respiratory rate C. Asynchronous chest rise D. Decreased tidal volume Answer: C. Asynchronous chest rise Answer: D. To prevent air trapping Rationale: Expiratory time refers to the duration of the expiratory phase in mechanical ventilation, allowing for adequate exhalation and preventing air trapping. 15. Which of the following parameters should be monitored closely in patients receiving neuromuscular blockade during mechanical ventilation? A. Serum electrolytes B. Blood glucose levels C. Intracranial pressure D. Train-of-four ratio Answer: D. Train-of-four ratio Rationale: Monitoring the train-of-four ratio is crucial in assessing the level of neuromuscular blockade and avoiding complications such as prolonged paralysis. 16. Which of the following is a common indication for invasive mechanical ventilation? A. Obesity B. Chronic obstructive pulmonary disease (COPD) C. Anxiety D. Hypertension Answer: B. Chronic obstructive pulmonary disease (COPD) Rationale: Patients with severe COPD may require invasive mechanical ventilation due to respiratory failure and worsening gas exchange. 17. Which of the following interventions may be used to optimize patient- ventilator synchrony? A. Increasing sedation levels B. Increasing FiO2 C. Adjusting tidal volume D. Increasing inspiratory time Answer: C. Adjusting tidal volume Rationale: Adjusting tidal volume can help optimize patient-ventilator synchrony by ensuring the patient receives the appropriate level of respiratory support. 18. Which of the following modes of mechanical ventilation is commonly used in patients with neuromuscular disorders? A. Assist-control B. SIMV C. Pressure support D. Volume control Answer: A. Assist-control Rationale: Assist-control mode is often used in patients with neuromuscular disorders to provide full ventilatory support and assist with patient effort. 19. Which of the following statements is true regarding permissive hypercapnia in mechanically ventilated patients? A. It is a rare complication B. It results in alkalosis C. It is used to prevent barotrauma D. It allows for higher PaCO2 levels Answer: D. It allows for higher PaCO2 levels Rationale: Permissive hypercapnia is a ventilation strategy that allows for higher PaCO2 levels to prevent barotrauma and minimize ventilator- induced lung injury. 20. Which of the following parameters should be monitored to assess oxygenation in mechanically ventilated patients? A. Pulmonary artery pressure B. Arterial blood gas values C. Blood glucose levels D. Serum creatinine Answer: B. Arterial blood gas values Rationale: Monitoring arterial blood gas values, including PaO2 and SaO2, is essential in assessing oxygenation and making adjustments to the ventilator settings. 21. Which of the following interventions may be used to optimize lung recruitment in mechanically ventilated patients? A. Decreasing PEEP B. Administering sedatives C. Prone positioning D. Increasing FiO2 Answer: C. Prone positioning Rationale: Prone positioning can help optimize lung recruitment and improve oxygenation in mechanically ventilated patients with acute respiratory distress syndrome (ARDS). 22. Which of the following modes of mechanical ventilation provides a ventilation pattern that mimics normal breathing? A. Pressure support B. SIMV C. Assist-control D. Volume control Answer: D. Volume control Rationale: Volume control mode delivers a set tidal volume with each breath, mimicking normal breathing patterns and providing consistent ventilation. 23. Which of the following parameters should be monitored to assess ventilator-associated pneumonia (VAP) in mechanically ventilated patients? A. White blood cell count B. Sodium levels C. Liver function tests D. Blood pressure Answer: A. White blood cell count Rationale: Monitoring white blood cell count can help assess for signs of infection, including ventilator-associated pneumonia (VAP), in mechanically ventilated patients. Which of the following complications is associated with mechanical ventilation? A) Hypotension B) Hypokalemia C) Hypernatremia D) Hypothermia Answer: A) Hypotension Rationale: Hypotension can occur as a complication of mechanical ventilation due to factors such as decreased venous return and increased intrathoracic pressure. Question 6: What is the purpose of positive end-expiratory pressure (PEEP) in mechanical ventilation? A) To increase the patient's heart rate B) To prevent alveolar collapse C) To decrease the respiratory rate D) To improve oxygen saturation Answer: B) To prevent alveolar collapse Rationale: PEEP helps maintain lung volume at the end of expiration, preventing alveolar collapse and improving oxygenation. Question 7: Which ventilator setting controls the volume of air delivered to the patient? A) FiO2 B) PEEP C) Tidal volume D) Respiratory rate Answer: C) Tidal volume Rationale: Tidal volume determines the amount of air delivered to the patient with each breath during mechanical ventilation. Question 8: Which of the following indicates ineffective ventilation in a mechanically ventilated patient? A) Decreased PaCO2 levels B) Increased pH levels C) Rapid shallow breathing pattern D) Bradypnea Answer: C) Rapid shallow breathing pattern Rationale: A rapid shallow breathing pattern can indicate ineffective ventilation and the need for adjustment of ventilator settings. Question 9: Which of the following complications can occur as a result of prolonged mechanical ventilation? A) Hypoventilation B) Atelectasis C) Pulmonary embolism D) Respiratory alkalosis Answer: B) Atelectasis Rationale: Prolonged mechanical ventilation can lead to atelectasis, a condition characterized by the collapse of lung tissue. Question 10: What is the purpose of pressure support ventilation (PSV) in mechanical ventilation? A) To prevent aspiration B) To enhance oxygenation C) To reduce the work of breathing D) To promote lung compliance Answer: C) To reduce the work of breathing Rationale: Pressure support ventilation assists the patient by providing additional pressure during inspiration, reducing the effort required for breathing. Question 11: Which of the following parameters is used to assess oxygenation status in a mechanically ventilated patient? A) PaO2 B) PaCO2 C) pH D) HCO3- Answer: A) PaO2 Rationale: PaO2 (partial pressure of oxygen) is a key parameter used to evaluate the oxygenation status of a patient on mechanical ventilation. Question 12: Which of the following ventilator modes allows the patient to breathe spontaneously between ventilator breaths? A) Pressure control ventilation B) Volume control ventilation C) Synchronized intermittent mandatory ventilation D) Pressure support ventilation Answer: D) Pressure support ventilation Rationale: Pressure support ventilation permits the patient to initiate breaths and receive support during inspiration, allowing for spontaneous breathing. Question 13: What is the purpose of neuromuscular blocking agents in mechanical ventilation? A) To reduce anxiety in the patient B) To prevent deep vein thrombosis C) To facilitate ventilator synchrony D) To promote early mobility Answer: C) To facilitate ventilator synchrony Rationale: Neuromuscular blocking agents can be used to improve ventilator synchrony and patient-ventilator interaction in certain cases. Question 14: Which of the following best describes the term "ventilator-associated pneumonia"? A) Infection of the ventilator machine Answer: D) Severe asthma exacerbation Rationale: Severe asthma exacerbation leading to respiratory failure may necessitate the initiation of mechanical ventilation to support the patient's breathing. Question 21: What is the purpose of a high-flow nasal cannula in respiratory support? A) To deliver precise FiO2 to the patient B) To administer bronchodilator medications C) To prevent aspiration during feeding D) To provide non-invasive respiratory support Answer: D) To provide non-invasive respiratory support Rationale: A high-flow nasal cannula delivers heated and humidified oxygen at high flow rates, providing non-invasive respiratory support to patients. Question 22: Which of the following factors can influence the effectiveness of mechanical ventilation? A) Patient's body weight B) Room temperature C) Presence of air conditioning D) Ventilator circuit compliance Answer: D) Ventilator circuit compliance Rationale: Ventilator circuit compliance, which refers to the ability of the circuit to expand and contract, can impact the delivery of ventilation to the patient. Question 23: What is the purpose of a ventilator bundle in the management of mechanically ventilated patients? A) To secure the endotracheal tube in place B) To prevent ventilator-associated pneumonia and other complications C) To adjust ventilator settings based on patient needs D) To administer sedative medications Answer: B) To prevent ventilator-associated pneumonia and other complications Rationale: A ventilator bundle comprises a set of interventions aimed at reducing the risk of ventilator-associated complications, including pneumonia. Question 24: Which of the following parameters is used to assess the effectiveness of ventilation in a mechanically ventilated patient? A) SpO2 B) ECG rhythm C) Blood pressure D) EtCO2 Answer: D) EtCO2 Rationale: End-tidal carbon dioxide (EtCO2) monitoring is used to assess the adequacy of ventilation and ensure proper elimination of carbon dioxide. Question 25: What is the purpose of a spontaneous breathing trial in the weaning process from mechanical ventilation? A) To assess the patient's ability to cough effectively B) To evaluate the readiness for extubation C) To administer bronchodilator therapy D) To monitor for signs of hypoxemia Answer: B) To evaluate the readiness for extubation Rationale: A spontaneous breathing trial helps determine whether a patient is ready to be extubated from mechanical ventilation by assessing their ability to breathe without ventilatory support.