Which of the following are useful strategies in managing the psychological problems encountered in weaning some patients from ventilator support?
1. Secure a psychiatric consult.
2. Decrease environmental stress.
3. Avoid mental stimulation.
4. Teach relaxation methods.
a. 1 and 3 only
b. 1, 2, and 4 only
c. 3 and 4 only
d. 2 and 3 only
Q. 2 A patient whom you are trying to wean below 5 cm H2O pressure support develops respiratory muscle fatigue.
Which of the following would you recommend to overcome this problem?
1. Make sure there is adequate O2 transport or cardiac output.
2. Make sure that the patient is adequately nourished.
3. Check and replace any depleted electrolytes.
4. Clear secretions and provide bronchodilation.
a. 2 and 4 only
b. 1, 2, and 3 only
c. 3 and 4 only
d. 1, 2, 3, and 4
Q. 3 In considering a patient for extubation, which of the following would you recommend to mini-mize the risk of postextubation aspiration?
a. Perform and confirm a positive cuff leak test.
b. Discontinue (DC) tube feeding 4 to 6 hr before extubation.
c. Perform deep endotracheal suctioning be-fore extubation.
d. Keep the cuff inflated when removing the tube.
Q. 4 Common causes for weaning failure include which of the following? 1. Myocardial ischemia 2. Critical illness polyneuropathy 3. Psychological dependence 4. Secondary polycythemia
a. 1 and 3 only
b. 1, 2, and 3 only
c. 3 and 4 only
d. 2, 3, and 4 only
Q. 5 Which of the following patients are at high risk for severe laryngeal edema after an endotracheal tube extubation?
1. Pediatric burn victim
2. Patient with epiglottitis
3. Smoke inhalation patient
4. Pulmonary fibrosis patient
a. 2 and 4 only
b. 1, 2, and 3 only
c. 3 and 4 only
d. 1, 2, 3, and 4
Q. 6 What patients are at high risk for postextubation upper airway obstruction? 1. Those with neuromuscular disorders 2. Those who have had major neck surgery 3. Those with infectious masses or abscesses
a. 2 and 3 only
b. 1 and 2 only
c. 1 and 3 only
d. 1, 2, and 3
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