Although treated with several antiarrhythmic drugs, a patient with ventricular
tachycardia begins to exhibit hypotension and decreased consciousness.
Which of the following actions would you recommend at this time?
immediately initiate
CPR apply
cardioversion
administer
epinephrine
defibrillate the patient. Ans- apply cardioversion
*If drug management fails, if the ventricular rate exceeds 150/min, or if the
patient becomes hemodynamically unstable, synchronous cardioversion is
indicated.
A physician orders intubation and volume-controlled A/C ventilation for a 6-
foot, 3-inch tall 190-lb (86-kg) adult male patient with ARDS. Which of the
following ventilator settings would you aim for to support this patient?
A doctor institutes volume-controlled ventilation for a 70-kg ARDS patient
with a targeted tidal volume of 420 mL To maintain adequate ventilation
with this tidal volume, the maximum respiratory rate you would allow is:
25/
min
35/mi
n
20/mi
n
30/min. Ans- 35/min
,Which of the following PaCO2 levels would be considered a positive result
for brain death determination at the end of an apnea test?
-at least 50 mm Hg
,-at least 45 mm Hg
-at least 60 mm Hg
-at least 55 mm Hg. Ans- at least 60 mm Hg
or 20+ from baseline CO2
A COPD patient receiving volume-controlled A/C ventilation at a rate of 15
and a VT of 650 mL exhibits signs of air trapping (auto-PEEP). Which of the
following alternatives would you recommend to help overcome this problem?
1. add an end-inspiratory pause
2. switch to SIMV and decrease the rate
3. increase the inspiratory flow
2 and 3
only 1, 2,
and 3 1
and 3 only
1 and 2 only. Ans- 2 and 3 only
* Adding an end-inspiratory pause would cause more airtrapping
A patient who just underwent major thoracic surgery is placed on
pressure-controlled A/C ventilation with 10 cmH2O PEEP. You observe
continuous bubbling in the water seal chamber of his pleural drainage
system. Which of the following is the most likely cause of this
observation?
-the patient has a pleural effusion
-the suction/ vacuum pressure is too low
-the drainage system is obstructed
-the patient has a bronchopleural fistula. Ans- the patient has a
bronchopleural fistula
* Constant bubbling indicates a leak; either in the patient or in the
tubing/chamber system.
To measure the amount of auto-PEEP present in a patient receiving
ventilatory support, you would:
-measure pressure during an end-expiratory pause
-measure expiratory flow before and after bronchodilator
-measure pressure at volume increments using a super syringe
-measure pressure during an end-inspiratory pause. Ans- measure pressure
during an end-expiratory pause
Which of the following indicate that a pleural drainage system is working
, properly?
1. the water seal chamber level rises and falls with breathing
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