Before a ventilator is used, an operational verification check is performed. A simple variation of this procedure is also performed under which of the following circumstances?
a. Before a blood gas sample is obtained.
b. When the physician's order specifies a change in ventilator settings.
c. Before a patient is reconnected to a venti-lator after the ventilator circuit has been changed or disassembled for any reason.
d. Before the patient's hemodynamic status is monitored.
Q. 2 A physical examination of the chest is performed on a patient who is being mechanically venti-lated. Breath sounds and percussion are normal except over the right middle lobe, where late in-spiratory crackles are heard.
This area is dull to percussion. An evaluative chest radiograph image reveals infiltrates in the right middle lobe. Based on these findings alone, which of the following is the most likely problem?
a. Pneumothorax in the right hemithorax
b. Congestive heart failure
c. Right middle lobe pneumonia
d. Asthma affecting the right side only
Q. 3 The low-pressure and low-tidal volume alarms are sounding on a mechanically ventilated patient. Measurement of the cuff pressure reveals 18 cm H2O. What action should be taken?
a. Replace the endotracheal tube with a larg-er size.
b. Add enough air to the cuff to maintain the cuff pressure at 34 cm H2O.
c. Increase the set pressure to increase the tidal volume and compensate for the leak.
d. Add air until a slight leak is heard while auscultating the larynx, then measure pressure.
Q. 4 A patient's transairway pressure (PTA) is rising while the plateau pressure (Pplateau) remains un-changed. The treatment plan that could correct this problem includes which of the following?
1. Administer a bronchodilator.
2. Insert a chest tube.
3. Measure unintended positive end-expiratory pressure (auto-PEEP).
4. Suction airway secretions.
a. 2 only
b. 2 and 4 only
c. 1 and 4 only
d. 1 and 3 only
Q. 5 The pressure at which large numbers of alveoli become overinflated in a patient with acute res-piratory distress syndrome (ARDS) is located on the static pressure-volume curve at which of the following?
a. Upper inflection point
b. Lower inflection point
c. Peak inspiratory pressure
d. Between the lower and upper inflection points
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