Mechanical Ventilation Final Exam Study
Guide questions and answers
Which of the following is an indicator of weaning failure?
A. Decreasing VD/VT
B. Increasing MIP
C. Increasing f/VT
D. Decreasing f - ANSWER: ✔✔C. Increasing f/VT
Based on the weaning protocol described in the textbook, all of the following conditions must be met for
consideration of a weaning attempt except:
A. Hemodynamic stability
B. Little or no sedation required
C. PaO2/FIO2
D. Presence of inspiratory effort - ANSWER: ✔✔C. PaO2/FIO2
Terminal weaning is defined as _______________ of mechanical ventilation that results in the
______________ of a patient.
A. Withdrawal; death
B. Withholding; death
C. Withdrawal; vegetative state
D. Withholding; vegetative state - ANSWER: ✔✔A. Withdrawal; death
Other causes of increased airflow resistance during mechanical ventilation include all of the following
conditions except:
A. Kinking of the ET tube
B. Secretions in ET tube
C. Use of a humidifier
,D. Use of an HME - ANSWER: ✔✔C. Use of a humidifier
All of the following pulmonary measurements suggest readiness for weaning attempt except:
A. Maximal inspiratory pressure = -12 cm H2O
B. VD/VT = 40%
C. Static compliance = 32 mL/cm H2O
D. f/VT = 80 breaths/min/L - ANSWER: ✔✔A. Maximal inspiratory pressure = -12 cm H2O
If pulse oximetry is used to monitor a patient's oxygenation status, the pulse oximetry O2 saturation
(SpO2) should be kept in the mid-80s for allowance of machine inaccuracies.
A. True
B. False - ANSWER: ✔✔B. False
The ____ is measured by dividing the patient's tidal volume (measured at the airway opening) by the
difference in the plateau pressure and the PEEP.
A. Airway resistance
B. Static lung compliance
C. Deadspace to tidal volume ratio
D. Dynamic lung compliance - ANSWER: ✔✔B. Static lung compliance
Patients who fail the SBT often do so within the first 10 minutes of the trial.
A. True
B. False - ANSWER: ✔✔B. False
_________ is an indicator of weaning failure.
A. Increasing PaO2
B. Increasing PaCO2
C. Increasing SpO2
D. Increasing PaO2/FIO2 - ANSWER: ✔✔B. Increasing PaCO2
,Patients who fail the spontaneous breathing trial (SBT) may exhibit which of the following clinical signs
and symptoms. Select all that apply.
A. Agitation
B. Cyanosis
C. Diaphoresis
D. All of the above - ANSWER: ✔✔D. All of the above
___ remains an effective tool in altering the degree of partial ventilatory support during continuous
mechanical ventilation.
A. ATC
B. CPAP
C. PS
D. SIMV - ANSWER: ✔✔D. SIMV
Generally accepted ventilatory weaning criteria includes a ____.
A. Vital capacity of greater than 5 mL/kg
B. Minute ventilation of less than 15 L with satisfactory blood gases
C. Spontaneous VT of greater than 5 mL/kg
D. PaCO2 of less than 65 mm Hg with normal pH - ANSWER: ✔✔C. Spontaneous VT of greater than 5
mL/kg
For a successful weaning outcome, ____.
A. The PaO2 should be > 75 mm Hg
B. The P(A-a)O2 should be < 450 mm Hg while on 100% O2.
C. The PaO2/FIO2 should be 150 mm Hg
D. The QS/QT should be < 45% - ANSWER: ✔✔C. The PaO2/FIO2 should be 150 mm Hg
, While assessing a 64 year-old patient receiving volume controlled ventilation, you note that the peak
airway pressure has decreased from 52 cm H2O to 32 cm H2O. There have been no other changes to the
ventilator settings. Which of the following actions would be appropriate at this time?
A. Increase the volume setting until the pressure equals 52 cm H2O
B. Increase the flow setting until the pressure equals 52 cm H2O C. Check for increased secretions and
suction if needed
D. Check the circuit for system leaks - ANSWER: ✔✔D. Check the circuit for system leaks
The ____ is used to estimate how much pulmonary perfusion is wasted.
A. P/F index
B. QS/QT ratio
C. P(A-a)O2 gradient
D. CaO2 content - ANSWER: ✔✔B. QS/QT ratio
Which of the following patient conditions is the least important consideration prior to weaning a patient
from mechanical ventilation?
A. Frequent arrhythmias
B. Severe acidosis
C. Ventilatory failure
D. Use of PEEP - ANSWER: ✔✔D. Use of PEEP
The blood gases and related parameters of a patient are as follows: pH = 7.43, PaCO2 = 40 mm Hg, PaO2
= 80 mm Hg, PECO2 = 30 mm Hg. What portion of the tidal volume is considered wasted (deadspace)
ventilation?
A. 15%
B. 25%
C. 50%
D. 75% - ANSWER: ✔✔B. 25%
A patient has the following oxygen content measurements: CcO2 = 20 vol%, CaO2 = 18 vol%, CvO2 = 13
vol%. The calculated QS/QT is about _________ and it reflects ___________ shunting.
Guide questions and answers
Which of the following is an indicator of weaning failure?
A. Decreasing VD/VT
B. Increasing MIP
C. Increasing f/VT
D. Decreasing f - ANSWER: ✔✔C. Increasing f/VT
Based on the weaning protocol described in the textbook, all of the following conditions must be met for
consideration of a weaning attempt except:
A. Hemodynamic stability
B. Little or no sedation required
C. PaO2/FIO2
D. Presence of inspiratory effort - ANSWER: ✔✔C. PaO2/FIO2
Terminal weaning is defined as _______________ of mechanical ventilation that results in the
______________ of a patient.
A. Withdrawal; death
B. Withholding; death
C. Withdrawal; vegetative state
D. Withholding; vegetative state - ANSWER: ✔✔A. Withdrawal; death
Other causes of increased airflow resistance during mechanical ventilation include all of the following
conditions except:
A. Kinking of the ET tube
B. Secretions in ET tube
C. Use of a humidifier
,D. Use of an HME - ANSWER: ✔✔C. Use of a humidifier
All of the following pulmonary measurements suggest readiness for weaning attempt except:
A. Maximal inspiratory pressure = -12 cm H2O
B. VD/VT = 40%
C. Static compliance = 32 mL/cm H2O
D. f/VT = 80 breaths/min/L - ANSWER: ✔✔A. Maximal inspiratory pressure = -12 cm H2O
If pulse oximetry is used to monitor a patient's oxygenation status, the pulse oximetry O2 saturation
(SpO2) should be kept in the mid-80s for allowance of machine inaccuracies.
A. True
B. False - ANSWER: ✔✔B. False
The ____ is measured by dividing the patient's tidal volume (measured at the airway opening) by the
difference in the plateau pressure and the PEEP.
A. Airway resistance
B. Static lung compliance
C. Deadspace to tidal volume ratio
D. Dynamic lung compliance - ANSWER: ✔✔B. Static lung compliance
Patients who fail the SBT often do so within the first 10 minutes of the trial.
A. True
B. False - ANSWER: ✔✔B. False
_________ is an indicator of weaning failure.
A. Increasing PaO2
B. Increasing PaCO2
C. Increasing SpO2
D. Increasing PaO2/FIO2 - ANSWER: ✔✔B. Increasing PaCO2
,Patients who fail the spontaneous breathing trial (SBT) may exhibit which of the following clinical signs
and symptoms. Select all that apply.
A. Agitation
B. Cyanosis
C. Diaphoresis
D. All of the above - ANSWER: ✔✔D. All of the above
___ remains an effective tool in altering the degree of partial ventilatory support during continuous
mechanical ventilation.
A. ATC
B. CPAP
C. PS
D. SIMV - ANSWER: ✔✔D. SIMV
Generally accepted ventilatory weaning criteria includes a ____.
A. Vital capacity of greater than 5 mL/kg
B. Minute ventilation of less than 15 L with satisfactory blood gases
C. Spontaneous VT of greater than 5 mL/kg
D. PaCO2 of less than 65 mm Hg with normal pH - ANSWER: ✔✔C. Spontaneous VT of greater than 5
mL/kg
For a successful weaning outcome, ____.
A. The PaO2 should be > 75 mm Hg
B. The P(A-a)O2 should be < 450 mm Hg while on 100% O2.
C. The PaO2/FIO2 should be 150 mm Hg
D. The QS/QT should be < 45% - ANSWER: ✔✔C. The PaO2/FIO2 should be 150 mm Hg
, While assessing a 64 year-old patient receiving volume controlled ventilation, you note that the peak
airway pressure has decreased from 52 cm H2O to 32 cm H2O. There have been no other changes to the
ventilator settings. Which of the following actions would be appropriate at this time?
A. Increase the volume setting until the pressure equals 52 cm H2O
B. Increase the flow setting until the pressure equals 52 cm H2O C. Check for increased secretions and
suction if needed
D. Check the circuit for system leaks - ANSWER: ✔✔D. Check the circuit for system leaks
The ____ is used to estimate how much pulmonary perfusion is wasted.
A. P/F index
B. QS/QT ratio
C. P(A-a)O2 gradient
D. CaO2 content - ANSWER: ✔✔B. QS/QT ratio
Which of the following patient conditions is the least important consideration prior to weaning a patient
from mechanical ventilation?
A. Frequent arrhythmias
B. Severe acidosis
C. Ventilatory failure
D. Use of PEEP - ANSWER: ✔✔D. Use of PEEP
The blood gases and related parameters of a patient are as follows: pH = 7.43, PaCO2 = 40 mm Hg, PaO2
= 80 mm Hg, PECO2 = 30 mm Hg. What portion of the tidal volume is considered wasted (deadspace)
ventilation?
A. 15%
B. 25%
C. 50%
D. 75% - ANSWER: ✔✔B. 25%
A patient has the following oxygen content measurements: CcO2 = 20 vol%, CaO2 = 18 vol%, CvO2 = 13
vol%. The calculated QS/QT is about _________ and it reflects ___________ shunting.
