RCP 160 midterm review| 109 QUESTIONS| WITH COMPLETE SOLUTIONS

Patient whom is 40 years old (89kg) with respiratory acidosis and currently on mechanical ventilation. Patient has no history of pulmonary disease. Patient in on VC/CMV, VT 550, RR 17. ABG shows PaCO2 50mm Hg and ph 7.31. Which setting would you adjust first? A. Ti B. RR C. Te D. Vt correct answer: Vt Acute respiratory acidosis is associated with which of the following? A. Parenchymal lung problems B. ketoacidosis C. biots breathing D. gout correct answer: parenchymal lung problems Common causes of respiratory alkalosis include all except which of the following? A. Hypoxia with compensatory hyperventilation B. Anxiety C. Metabolic problems D. Chest wall abnormalities correct answer: chest wall abnormalities What is the most likely patient situation in which respiratory acidosis persists even after alveolar ventilation has been increase? A. metabolic acidosis B. increased physiologic dead space C. normal Vd/Vt D. hyperoxia correct answer: increased physiologic dead space Increased metabolism and carbon dioxide production commonly occurs in which of the following patient situations except? A. Fever B. Sepsis C. appropriate MV settings D. those who have undergone multiple surgical procedures correct answer: appropriate MV settings Airway clearance should be performed when? A. Routinely B. Whenever Ppl is increased C. Only when necessary D. As a last resort when the patient is coding correct answer: only when necessary What is the correct catheter size for a patient with an ETT ID of 8.0? A. 16F B. 14F C. 14F D. 12F correct answer: 12F Indication for aerosols in the mechanically ventilated patient include which of the following? A. Increased airway resistance B. Coarse breath sounds C. Treatment of excessive secretions D. Peripheral inflammatory disease correct answer: increased airway resistance During MV MDI's should be: A. Placed in the expiratory limb circuit B. Placed in the inspiratory limb circuit C. In line with the HME D. Placed between the ventilator and heated humidifier correct answer: placed in the inspiratory limb circuit A patient with pneumonia and underlying COPD is being mechanically ventilated in the VC-CMV mode with VT650 mL. The resulting PaCO2 is 62 mm Hg. What change should be made to the VT to obtain a desired PaCO2 of 50 mm Hg for this patient? A. 400 mL B. 800 mL C. 1000 mL D. 1200 mL correct answer: 800 mL A male patient (80-kg IBW) with no history of pulmonary disease is brought to the emergency department for treatment of a drug overdose. He is intubated and placed on mechanical ventilation with VC-CMV, f = 12/min, VT = 500 mL. The resulting arterial blood gas values are: pH 7.32, PaCO2 53 mm Hg, and HCO3- 25 mEq/L. The most appropriate action to correct the acid-base disturbance is which of the following? A. Increase VT to 600 mL. B. Increase VT to 700 mL. C. Increase frequency to 17/min. D. Decrease frequency to 10/min. correct answer: Increase VT to 600 mL. A male patient (74-kg IBW) is being ventilated with PC-CMV, f = 12/min, PIP = 20 cm H2O, TI = 1.5 seconds; the resulting flow-time scalar is shown below. The patient's measured VT is 435 mL. ABG results on these settings are: pH 7.32, PaCO2 54 mm Hg, HCO3- 25 mEq/L. The most appropriate action to take is which of the following? Image