TMC Mechanical Ventilation Practice Questions and Answers A 43-year-old male patient was admitted to the emergency department with a suspected drug overdose. The patient is receiving oxygen via nonrebreather but is unconscious and isn't making any respiratory efforts to breathe. The patient's body weight is 57 kg and his ABG results are as follows: pH 7.28 PaCO2 74 torr HCO3 20 mEq/L PaO2 315 torr Which of the following would you recommend? A. Apply BiPAP with: IPAP 20 cm H2O, EPAP 5 cm H2O, FiO2 30% B. Intubate and apply: SIMV, tidal volume 600 mL, rate 6/min, FiO2 40% C. Intubate and apply: A/C ventilation, tidal volume 450 mL, rate 12/min, FiO2 50% D. Apply CPAP at 10 cm H2O and an FiO2 of 100% - ANSWER C A 63-year-old female patient is intubated and receiving mechanical ventilation in the pressure controlled A/C mode. If the patient's compliance were to decrease, which of the following would you expect to occur? A. Her delivered volume will decrease B. Her peak pressure will increase C. Her inspiratory time will increase D. Her PEEP level will decrease - ANSWER A A 70-year-old male patient is intubated and receiving mechanical ventilation in the volume controlled A/C mode. After performing endotracheal suctioning, which of the following would indicate the effective clearance of retained secretions? A. An increased tidal volume B. A decreased inspiratory time C. A decreased plateau pressure D. A decreased peak pressure - ANSWER D A 176 lb male patient is intubated and receiving volume control A/C ventilation with the following settings: FiO2 of 40%, Rate of 12/min, and Tidal Volume of 550 mL. An ABG was analyzed and the following results were obtained: ABG Results and Ventilator Settings pH 7.39 PaCO2 37 mmHg HCO3- 23 mEq/L PaO2 107 mmHg Spontaneous Tidal Volume 180 mL Spontaneous Rate 37/min Vital Capacity 550 mL MIP/NIF -12 cm H2O Which of the following would you recommend? A. Place the patient on a 40% T-piece and monitor closely B. Switch the patient to SIMV at a rate of 5/minute C. Place the patient on CPAP and monitor closely D. Maintain the current ventilator settings and re-evaluate later - ANSWER B? D! A 51-year-old female patient with a history of asthma is receiving mechanical ventilation in the assist-control mode. Upon assessment, you note that she is struggling to initiate inspiration. Which of the following settings would you check first in order to resolve of this problem? A. Tidal volume B. Pressure limit C. Sensitivity
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