A 65-year-old, 73-inch-tall, 195 lb male patient was admitted 2 days ago for renal failure. The patient has a history of chronic obstructive pulmonary disease (COPD) and has a pulse of 122 breaths/min, BP 153/88, and temperature 37 C.
The patient is intubated for acute-on-chronic respiratory failure with hypoxemia. The physician requests volume-controlled continuous mandatory ventilation (VC-CMV). The initial settings for the ventilator should be which of the following?
a. VT = 700 mL, rate = 12 breaths/min, PEEP = 3 cm H2O
b. VT = 900 mL, rate = 10 breaths/min, PEEP = 5 cm H2O
c. VT = 450 mL, rate = 20 breaths/min, PEEP = 8 cm H2O
d. VT = 800 mL, rate = 15 breaths/min, PEEP = 10 cm H2O
Q. 2 With which flow waveform pattern will the mean airway pressure be the highest?
a. Sine
b. Square
c. Ascending ramp
d. Descending ramp
Q. 3 The pattern that has been shown to improve the distribution of gas in the lungs for an intubated patient on volume-controlled continuous mandatory ventilation (VC-CMV) is which of the fol-lowing?
a. Sine waveform
b. Ascending ramp
c. Descending ramp
d. Square waveform
Q. 4 A 57-year-old, 5'3, 165 lb female patient arrives in the open heart unit following coronary artery bypass surgery.
The patient has a history of diabetes and no history of pulmonary disease. The most appropriate initial volume-controlled continuous mandatory ventilation (VC-CMV) settings are which of the following?
a. VT = 220 mL, rate = 25 breaths/min, PEEP = 10 cm H2O
b. VT = 360 mL, rate = 15 breaths/min, PEEP = 5 cm H2O
c. VT = 550 mL, rate = 12 breaths/min, PEEP = 12 cm H2O
d. VT = 750 mL, rate = 10 breaths/min, PEEP = 8 cm H2O
Q. 5 A 5'2 female patient with normal lungs has been intubated and requires mechanical ventilation with volume-controlled continuous mandatory ventilation (VC-CMV).
The tidal volume (VT) and ventilator rate settings that should be recommended for this patient are which of the following?
a. VT = 315 mL, rate = 20 breaths/min
b. VT = 364 mL, rate = 14 breaths/min
c. VT = 468 mL, rate = 12 breaths/min
d. VT = 563 mL, rate = 10 breaths/min
Q. 6 A 26-year-old, 6'6, 250 lb male patient, is still under the effects of anesthesia following knee surgery. His body temperature is 37 C. He has no history of lung disease.
The appropriate initial minute ventilation for this patient is which of the following?
a. 8.9 L/min
b. 9.7 L/min
c. 11.4 L/min
d. 13.6 L/min
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