question 1 of 50 a 8 year old child is being weaned from a continuous volume- cycled ventilator....

Question 1 of 50A 8 year old child is being weaned from a continuous volume-cycled ventilator. Each time the therapist attempts to wean by decreasing the SIMV rate by 2 breaths, the child develops diaphoresis and tachypnea. Which of the following should the respiratory care practitioner recommend?

A. attempt T-tube weaning trialsB. use pressure support with SIMVC. increase the FiO2 by 10% during the weaning attemptsD. discontinue all weaning attempts

Question 2 of 50 A 32 week gestational age infant is being mechanically ventilated with the following settings:

FiO2 0.35 Rate 24 b/min. PEEP 10 cmH2O pressure PIP 25 cmH2O pressure

Arterial blood gas results show: pH 7.39 PCO2 34 mmHg PO2 97 mmHg HCO3- 21 mEq/L

Based upon the above information, the respiratory care practitioner should recommend:A. decreasing the PEEPB. decreasing the FiO2C. decreasing the PIPD. increasing the rate

Question 3 of 50 During a routine ventilator parameter check on a patient, you notice the low pressure alarm is being briefly activated prior to each breath. Which of the following is most likely the cause?

A. the patient is fighting the ventilatorB. the flow rate is set too fastC. the alarm delay is set too shortD. the peak pressure limit is set too high

Question 4 of 50 A 11 year old child weighing 45 kg (99 lbs) is being mechanically ventilated with a volume-cycled ventilator at the following settings:

Mode SIMV Set Rate 10 br/min. Total Rate 12 br/min. VT 450 ml FiO2 0.60 PEEP 5 cmH2O

Arterial blood gas results show:

pH 7.35 PCO2 46 mmHg PO2 108 mmHg HCO3- 22 mEq/L

Which of the following would you recommend at this time?

A. increase SIMV to 12B. decrease PEEP to 3C. increase VT to 475 mlD. decrease FiO2 to 0.55

Question 5 of 50 The peak inspiratory pressure on a pressure limited, time-cycled ventilator was changed from 20 cmH2O pressure to 25 cmH2O pressure. Which of the following alarms need to be adjusted at this time?

A. PEEPB. low pressureC. peak pressureD. I:E ratio

Question 6 of 50 A 78 year old male patient is being treated for obstructive sleep apnea at night with bilevel positive airway pressure. Arterial blood gas results reveal an elevated PCO2 level. The respiratory care practitioner should recommend increasing the:

A. oxygen concentrationB. expiratory positive airway pressure (EPAP)C. inspiratory flow rateD. inspiratory positive airway pressure (IPAP)

Question 7 of 50 A 3 year old child with cystic fibrosis is being mechanically ventilated by a time-cycled, pressure limited ventilator at the following settings:

PIP 34 cmH2O I time 1.0 second Rate 22 br/min. FiO2 0.60 PEEP 6 cmH2O Mode SIMV



The respiratory care practitioner should recommend adjusting the:

A. PEEP to 8 cmH2OB. FiO2 to 0.65C. Rate 24 br/min.D. Pressure 36 cmH2O

Question 8 of 50 A 60 year old male patient weighs 80 kg (176 lbs) and is on a volume-cycled ventilator at a set VT of 800 ml, a peak pressure reading of 65 cmH2O, exhaled VT measured at 760 ml, peak inspiratory flowrate is 60 L/min., a plateau pressure reading of 58 cmH2O and a PEEP of 5 cmH2O. Which of the following is most likely occurring at this time?

A. dynamic compliance is decreasingB. static compliance is increasingC. airway resistance is increasingD. thoracic compliance is increasing

Question 9 of 50 A 79 year old female weighing 54 kg (119 lbs) is a post-operative total hip replacement patient who is receiving mechanical ventilation at the following settings:

Mode A/C FiO2 0.45 Set rate 12 br/min. Total rate 18 br/min. VT 600 ml




A. add 5 cmH2O PEEP therapyB. decrease VT to 550 mlC. initiate SIMV at 12 br/min.D. decrease FiO2 0.40

Question 10 of 50A 75 kg (165 lbs) male patient is being mechanically ventilated following coronary artery bypass surgery. He is currently on the following settings:

Mode SIMV Set rate 10 br/min. Total rate 14 br/min. FiO2 0.40 VT 750 ml PEEP 8 cmH2O



You would recommend which of the following at this time?

A. decrease the FiO2B. decrease the rate to 8C. increase the PEEP to 10 cmH2OD. maintain the current settings

Question 11 of 50 A 28 week gestational age infant with severe respiratory distress syndrome is being mechanically ventilated with a time-cycled, pressure limited ventilator at the following settings:

Flow rate 6 LPM Set rate 32 br/min. PIP 28 cmH2O FiO2 0.70 PEEP 5 cmH2O I time 0.8 seconds

Umbilical arterial blood gas results reveal:

pH 7.40 PCO2 39 mmHg PO2 42 mmHg HCO3- 23mEq/L

Based on the above information, the respiratory care practitioner should recommend which of the following?

A. I time to 1.0 secondsB. PEEP to 7cmH2OC. FiO2 to 0.75D. PIP to 30 cmH2O

Question 12 of 50 A 45 year old female patient who weighs 60 kg (132 lbs) remains intubated in the recovery room after an exploratory laparoscopy. She is currently receiving 6 cmH2O of CPAP with an FiO2 of 0.35 for the past 2 hours. Arterial blood gases and vital signs are stable with the following information obtained:

RR 16 br/min. MIP -36 cmH2O VT 400 ml VC 1.2 L

Based upon the above information, the respiratory care practitioner should recommend:

A. maintain the current therapyB. decrease the CPAP to 4 cmH2OC. extubate and monitor the patientD. obtain a portable chest x-ray

Question 13 of 50 Which of the following will decrease the mean airway pressure on a patient receiving continuous volume-cycled ventilation?

A. decrease the inspiratory timeB. decrease the peak flowrateC. decrease the expiratory timeD. decrease the triggering effort

Question 14 of 50 A 19 year old male patient weighing 78 kg (172 lbs) was brought into the ER with a suspected drug overdose. He is now intubated and being mechanically ventilated with a volume-cycled ventilator at the following settings:

Mode A/C Set rate 12 br/min. Total rate 12 br/min. VT 850 ml FiO2 0.50 Peak flow 30 LPM

The physician notes the ratio light is flashing and has asked the respiratory care practitioner to make the appropriate adjustment. You would do which of the following:

A. increase the flowB. decrease the tidal volume to 800 mlC. decrease the FiO2D. increase the sensitivity

Question 15 of 50 A 10 year old child with muscular dystrophy is on a chest cuirass at a -10 cmH2O pressure, at a rate of 12 br/min. with the following arterial blood gases:


Which of the following would you recommend?

A. switch to a volume-cycled ventilatorB. increase the rate to 14 br/min.C. change the pressure to -15 cmH2OD. switch to a pressure-cycled ventilator

Question 16 of 50 A 58 year old, 65 kg (143 lbs) women arrives to the surgical ICU following aortic adbominal aneurysm repair surgery. She has 40 pack year history of cigarette smoking and is currently smoking 1 pack a day. The physician has writtten an order to initiate mechanical ventilation. All of the following controls need to be adjusted by the respiratory care practitioner prior to starting mechanical ventilation for this patient, EXCEPT:

A. FiO2B. VTC. fD. PEEP

Question 17 of 50Which of the following is NOT an indication for continuous positive airway pressure?

A. a Qs/Qt of < 15%B. PaO2 < 50 mmHg on an FiO2 > 0.60C. a spontaneously breathing patientD. an increased A-a DO2 gradient

Question 18 of 50 A spontaneously breathing 76 year old patient who weighs 60 kg (132 lbs) is on a FiO2 of 0.45 via a trach collar has had a change in their tidal volume from 600 ml to 300 ml and their respiratory rate went from 12 br/min. to 24 br/min.. Which of the following changed due to the change in the tidal volume and rate?

A. minute ventilationB. alveolar ventilationC. anatomical deadspaceD. mechanical deadspace

Question 19 of 50During an incentive spirometry treatment using a volume orientated device, the patient inhales to TLC and exhales slowly to FRC what other instructions would you give to improve distribution?

A. continue with the current instructionsB. switch to a flow orientated deviceC. initiate IPPBD. inspiratory hold

Question 20 of 50 A 75 kg (165 lbs) patient is receiving volume-cycled mechanical ventilation, the respiratory care practitioner notes the following:

Mode SIMV Set rate 12 br/min. Total rate 16 br/min. FiO2 0.35 VT 700 ml

The arterial blood gases are as follows:



A. increase the FiO2 to 0.40B. add 5 cmH2O PEEPC. increase VT to 750 mlD. increase SIMV to 14 br/min.

Question 21 of 50A 15 year old female patient who weighs 55 kg (121 lbs) has multiple trauma from a four wheeler accident and has developed ARDS. The respiratory care practitoner notes the following data:

Mode SIMV Set rate 12 br/min. Total rate 14 br/min. FiO2 0.60 PEEP 10 cmH2O VT 600 ml

The arterial blood gases are as follows:


The patient becomes agitated and is using accessory muscles and is attempting to pull out the IV lines. Which of the following would you recommend at this time?

A. switch to assist/control modeB. curareC. pavulonD. versed

Question 22 of 50 A 70 kg (154 lbs) post-cardiopulmonary arrest patient is on a volume-cycled ventilator in the assist/control mode. The respiratory care practitioner notes the following data:

Set rate 8 br/min. Total rate 8 br/min. FiO2 0.65 VT 850 ml

The arterial blood gas results are as follows:


Which of the following ventilator adjustments would you recommend first?

A. institute PEEP therapy at 5 cmH2OB. increase the rate to 12 br/min.C. increase the FiO2 to 0.70D. increase the VT to 900 ml

Question 23 of 50 A 62 year old patient weighing 50 kg (110 lbs) with a history of emphysema is on a volume-cycled ventilator due to acute respiratory failure. The respiratory care practitioner notes the following:

Mode SIMV Set rate 6 br/min. Total rate 16 br/min. VT 600 ml FiO2 0.28

Arterial blood gases are as follows:



A. increase the SIMV to 8 br/min.B. increase the FiO2 to 0.30C. maintain the current settingsD. increase the VT to 650 ml

Question 24 of 50 Which of the following pathologies would be LEAST appropriate for pressure-cycled ventilation?

A. kyphosisB. muscular dystrophyC. chronic CO2 retainerD. drug overdose

Question 25 of 50 A 12 year old female weighing 40 kg (88 lb) is receiving continuous mechanical ventilation following an accidental drug overdose. The respiratory care practitoner notes the following:

Mode SIMV Set rate 12 br/min. Total rate 12 br/min. VT 750 ml FiO2 0.30

Arterial blood gases are as follows:



A. decrease the tidal volumeB. decrease the respiratory rateC. decrease the FiO2D. add mechanical deadspace

Question 26 of 50 Which of the following parameters are acceptable for weaning a patient from continuous mechanical ventilation?

I. VD/VT 65% II. MIP -18 cmH2O III. Qs/Qt 10% IV. A-aDO2 12 mmHg (21% oxygen)

A. III & IV onlyB. I & II onlyC. I, II & III onlyD. I, II, III & IV

Question 27 of 50 During an incentive spirometry treatment using a flow device, the float will not rise during inspiration. This may be due to all of the following, EXCEPT:

A. a crack in the casingB. an obstructed mouthpieceC. inspiratory effort is too strongD. inspiratory flow is too slow

Question 28 of 50 Which of the following can help decrease auto PEEP for a patient who is receiving continuous mechanical ventilation?

I. increase the flow II. change from a decelerating wave to a constant square wave III. add expiratory retard IV. add inspiratory hold

A. I & III onlyB. II & IV onlyC. I, II & III onlyD. I, II, III & IV

Question 29 of 50 A 39 year old male weighing 85 kg (187 lbs) is on a volume-cycled ventilator following mitral valve replacement surgery. Ventilator settings are as follows:

FiO2 0.45 Set rate 12 br/min. Total rate 22 br/min. VT 900 ml Flow rate 30 LPM Mode SIMV

The patient appears to be agitated and restless. The physician asks for your recommendation. You would recommend which of the following?

A. switch to pressure support ventilationB. switch to pressure control ventilationC. administer VersedD. increase the flow

Question 30 of 50 A 46 year old female patient weighing 65 kg (143 lbs) is on a volume-cycled ventilator following a motor vehicle accident. Ventilator settings are as follows:

FiO2 0.40 Mode SIMV Set rate 6 br/min. Total rate 16 br/min. VT 700 ml Pressure support 25 cmH2O

Arterial blood gas results are as follows:


Based upon the above information, you would recommend which of the following at this time?

A. decrease pressure support to 20 cmH2OB. decrease FiO2 to 0.30C. place on a T-tube at 50% oxygenD. decrease SIMV to 3 br/min.

Question 31 of 50 A 52-year-old 5 ft, 9 in. tall male patient weighs 85 kg (187 lb) is being mechanically ventilated. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode Assist/Control FIO2 0.40 Mandatory rate 10 Total rate 10 VT 650 mL PEEP 5 cm H2O Mechanical VD 100 mL

pH 7.28 PaCO2 74 torr PaO2 57 torr SaO2 86% HCO3 23 mEq/L BE 0 mEq/L

Which of the following changes should be recommended at this time?

A. Decrease the VT to 550 mLB. Decrease the mandatory rate to 8C. Decrease the mechanical deadspaceD. Decrease the FIO2 to 0.35

Question 32 of 50 A 75 kg (165 lb) patient with a sub-arachnoid hemorrhage is being mechanically ventilated with a volume-controlled ventilator at the following settings

Mode Assist control VT 700 mL Mandatory rate 12 Total rate 12 FIO2 .40 PEEP 0 I:E Ratio 1:2

Arterial Blood Gas analysis reveals the following

pH 7.35 PaCO2 41 torr PaO2 85 torr HCO3- 23 mEq/L SaO2 94%

The respiratory therapist should recommend

A. increase the tidal volumeB. decrease the respiratory rateC. increase the FIO2D. add inflation hold

Question 33 of 50 A 52-year-old 5 ft, 9 in. tall male patient weighs 85 kg (187 lb) is being mechanically ventilated. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode Assist/Control FIO2 0.40 Mandatory rate 16 Total rate 16 VT 850 mL PEEP 5 cm H2O



A. Decrease the rate to 12B. Decrease the VT to 600 mLC. Increase the FIO2 to 0.45D. Increase the PEEP to 8 cm H2O

Question 34 of 50 A 34-year-old male patient is 5 ft, 10 in. tall and weighs 81 kg (178 lb). He has suffered multiple trauma in an automobile accident and is being mechanically ventilated. Chest radiograph reveals diffuse infiltrates with reticulogranular formation. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode SIMV FIO2 0.60 Mandatory rate 10 VT 700 mL PIP 38 cm H2O Plateau pressure 29 cm H2O PEEP 10 cm H2O



A. Increase the PEEP to 30 cm H2OB. Increase the VT to 800 mLC. Increase the mandatory rate to 16D. Change the mode to control, sedate as necessary

Question 35 of 50A 52-year-old 6 ft, 1 in. tall male patient weighs 85 kg (187 lb) is being mechanically ventilated. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode Assist/Control FIO2 0.40 Mandatory rate 10 Total rate 10 VT 850 mL PEEP 10 cm H2O

pH 7.49 PaCO2 28 torr PaO2 87 torr SaO2 96% HCO3 25 mEq/L BE +1 mEq/L


A. Decrease the rate to 5B. Decrease the VT to 450 mLC. Increase the PEEP to 15 cm H2OD. Add 50 mL of mechanical deadspace

Question 36 of 50 A patient who is 5 ft, 8 in. tall and weighs 68 kg (150 lb) is being mechanically ventilated. Chest radiograph reveals bilateral infiltrates. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode SIMV FIO2 0.50 Mandatory rate 10 Total rate 20 VT 700 mL Spontaneous VT 250 mL PIP 26 cm H2O Plateau pressure 20 cm H2O PEEP 5 cm H2O



A. Increase the PEEP to 15 cm H2OB. Increase the VT to 900 mLC. Increase the mandatory rate to 16D. Maintain current settings

Question 37 of 50 A 80 kg (176 lb) patient with pulmonary fibrosis is being mechanically ventilated with a volume-controlled ventilator at the following settings

Mode SIMV VT 700 mL Mandatory rate 15 Total rate 15 FIO2 0.45 PEEP +10 I:E Ratio 1:2 PIP 50 cmH2O



The respiratory therapist should recommend:

A. increasing the FIO2 to 60%.B. decreasing the respiratory rate.C. increase the PEEP level to 20 cm H2O.D. changing to pressure control mode.

Question 38 of 50 A 68 kg (150 lb) patient with left lower lobe pneumonia is being mechanically ventilated with a volume-controlled ventilator at the following settings

Mode Assist control VT 800 mL Mandatory rate 12 Total rate 12 FIO2 0.55 PEEP +5 I:E Ratio 1:3 PIP 45 cmH2O



The respiratory therapist should recommend:

A. increasing the tidal volume.B. decreasing the respiratory rate.C. increase the PEEP level.D. changing to pressure control mode.

Question 39 of 50A patient who is 5 ft, 8 in. tall and weighs 68 kg (150 lb) is being mechanically ventilated. Chest radiograph reveals bilateral infiltrates. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode SIMV FIO2 0.50 Mandatory rate 10 Total rate 20 VT 700 mL Spontaneous VT 250 mL PEEP 5 cm H2O



A. Change to pressure control ventilation at 35 cm H2OB. Change to inverse ratio ventilation, sedate as necessaryC. Initiate pressure support ventilation at 10 cm H2OD. Maintain current settings

Question 40 of 50

The respiratory therapist reviews the ventilator flow sheet for a post-op patient. The ventilator settings have not been changed during the past 24 hours. The peak and plateau pressures were recorded as above. This information would indicate:

A. Airway resistance is increasingB. Lung compliance is decreasingC. The patient can begin weaningD. The PEEP should be increased

Question 41 of 50

The respiratory therapist reviews the ventilator flow sheet for a post-op patient. The ventilator settings have not changed during the past 24 hours. The peak and plateau pressures were recorded as above. This information would indicate:

A. Airway resistance is increasingB. Lung compliance is decreasingC. The patient needs to be suctioningD. The patient can begin weaning

Question 42 of 50

The respiratory therapist reviews the ventilator flow sheet for a post-op patient. The ventilator settings have not been changed during the past 24 hours. The peak and plateau pressures were recorded as above. This information would indicate:

A. Airway resistance is increasingB. Lung compliance is increasingC. The patient can begin weaningD. The PEEP should be increased

Question 43 of 50 A 65 kg (143 lb) patient with a sub-arachnoid hemorrhage is being mechanically ventilated with a volume-controlled ventilator at the following settings

Mode SIMV VT 800 mL Mandatory rate 12 Total rate 12 FIO2 0.40 PEEP 0 I:E Ratio 1:2



The respiratory therapist should recommend

A. decreasing the tidal volumeB. increasing the respiratory rateC. adding 5 cmH2O of PEEPD. maintaining current settings

Question 44 of 50 A 57-year-old male patient with severe left-sided pneumonia is being mechanically ventilated. The chest radiograph shows left side consolidation with air bronchograms. An arterial blood gas has been obtained. Ventilatory data and blood gas results are below:

Mode Assist/Control FIO2 0.80 Mandatory rate 20 Total rate 20 VT 650 mL PIP 30 cm H2O Plateau Pressure 25 cm H2O PEEP 15 cm H2O

pH 7.38 PaCO2 43 torr PaO2 52 torr HCO3 24 mEq/L BE 0 mEq/L

Which of the following should the therapist recommend?

A. Increase the FIO2 to 1.0B. Decrease the PEEP to 10 cm H2OC. Increase the VT to 800 mLD. Decrease the mandatory rate to 15

Question 45 of 50 A 20-year-old, 90 kg (198 lb) man is receiving mechanical ventilation. The chest radiograph shows diffuse irregular infiltrates. Pertinent data are below:

Mode SIMV Mandatory rate 10 Total rate 20 VT 0.5 L FIO2 0.60 PEEP 5 cm H2O Peak flow 65 L/min I:E ratio 1:2


The therapist should recommend

A. Decrease the mandatory rateB. Increase the tidal volumeC. Decrease the FIO2D. Decrease the peak flow

Question 46 of 50 A patient has come to the pulmonary function lab for pre-op testing. The patient performs a maximum inspiration followed by a maximum forceful expiration. This procedure would measure:

A. RVB. FRCC. TLCD. FVC

Question 47 of 50A patient complaining of dyspnea has the following arterial blood gas results:

pH - 7.36 PaCO2 - 56 torr PaO2 - 49 torr HCO3 - 34 mEq/L SaO2 - 80% FIO2 - .21

These results are best described as:

A. acute respiratory acidosisB. acute metabolic alkalosisC. chronic respiratory acidosisD. chronic metabolic alkalosis

Question 48 of 50 A patient involved in an automobile accident is receiving continuous IV fluids in the intensive care unit. Which of the following could indicate that a fluid overload is present?

I. fine rales II. fluffy infiltrates III. peripheral edema

A. I and II onlyB. II and III onlyC. I and III onlyD. I, II and III

Question 49 of 50 What would the therapist palpate when assessing a patient with a tension pneumothorax?

A. hyperresonanceB. tracheal deviationC. absent breath soundsD. increased work of breathing

Question 50 of 50 A patient is receiving non-invasive positive pressure assisted ventilation (NIPPV) with a Bi-level positive airway pressure ventilator at the following settings.

IPAP - 25 cmH2O EPAP - 5 cmH2O rate - 10 br/min

Arterial blood gas results are:

pH - 7.49 PaCO2 - 29 torr PaO2 - 110 torr HCO3- - 25 mEq/L SaO2 - 98%

Which of the following should the therapist recommend?

A. increase the IPAPB. decrease the IPAPC. increase the EPAPD. decrease the EPAP

question 1 of 50 a 8 year old child is being weaned from a continuous volume- cycled ventilator....

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