TEST BANK
Mechanical Ventilation
David C. Shelledy, and Jay I. Peters
1st Edition
,Table of Contents
Chapter 01 Introduction to Critical Respiratory Care 1
Chapter 02 Respiratory Failure 13
Chapter 03 Principles of Mechanical Ventilation 37
Chapter 04 Mechanical Ventilators 58
Chapter 05 Indications for Mechanical Ventilation 72
Chapter 06 Ventilator Initiation 84
Chapter 07 Patient Stabilization Adjusting Ventilator Support 108
Chapter 08 Critical Care Patient Assessment and Monitoring Part I-Assessment 129
Chapter 09 Critical Care Patient Assessment and Monitoring Part II-Monitoring and Care 141
Chapter 10 Non-Invasive Ventilation 171
Chapter 11 High Frequency Oscillatory Ventilation for Acute Respiratory Distress
Syndrome in Adults 182
Chapter 12 Diagnostic and Supportive Procedures in the ICU 193
Chapter 13 Point of Care Ultrasound in Critical Care 204
Chapter 14 Mechanical Ventilation During Extracorporeal Membrane Oxygenation 215
Chapter 15 Neonatal and Pediatric Critical Care 227
Chapter 16 Ventilator Discontinuance 239
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Chapter 01 Introduction to Critical Respiratory Care
Multiple Choice
1. Respiratory care can be defined as the healthcare discipline that specializes in promotion of:
A. activities of daily living
B. cardiopulmonary function
C. general health and well being
D. diagnosis and treatment of disease
Answer: B
Complexity: easy
Rationale: respiratory care specializes in cardiopulmonary health, while many other health
careers include optimizing patient’s activities of daily living, general health and well-being, and
diagnosis and treatment of disease.
H1: Overview
2. Patients at high risk for life-threatening health problems requiring sophisticated support and
monitoring are best cared for in the:
A. Long-term acute care unit
B. Emergency department
C. Intensive care unit
D. Step-down unit
Answer: C
Complexity: moderate
Rationale: intensive care units specialize in caring for patients at high risk for life-threatening
health problems requiring sophisticated support and monitoring. Long-term acute care units often
care for post-ICU patients, while step down units provide an intermediate level of care.
Emergency departments are generally for acute illness or injury which may be life-threatening,
and complex, however, critically ill patients are then generally transferred to the ICU.
H1: Critical Respiratory Care
3. The care and management of severely ill patients who require sophisticated support and
constant monitoring can be defined as:
A. critical care
B. sub-acute care
C. chronic care
D. supportive care
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Answer: A
Complexity: easy
Rationale: the definition of critical care is the care and management of critically ill patients who
require sophisticated support, and constant monitoring.
H1: Critical Respiratory Care
4. All the following conditions often require ICU admission and mechanical ventilation
EXCEPT:
A. ARDS
B. stable COPD
C. shock
D. sepsis
Answer: B
Complexity: moderate
Rationale: Stable COPD patients generally do not require ICU admission and mechanical
ventilation. Patients with acute exacerbation of COPD, however, may require ICU admission
and mechanical ventilatory support.
H1: Critical Respiratory Care
5. Choose the correct statement(s) about critical care
I. requires complex decision-making to ensure therapy is adjusted as patients’ needs change.
II. patients are often unstable and require frequent adjustments in the support provided.
III. patients are at high risk for life-threatening health problems
IV. sophisticated support and monitoring are often required
A. I only
B. I and II
C. III
D. I, II, III, IV
Answer: D
Complexity: complex
Rationale: all of the above statements are accurate when describing critical care.
H1: Critical Respiratory Care
6. Critical respiratory care includes which of the following:
I. diagnostic and monitoring procedures
II. management of artificial airways
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
III. performing basic and advanced respiratory care
IV. management of mechanical ventilation.
A. I and II
B. III and IV
C. IV only
D. I, II, III, IV
Answer: D
Complexity: complex
Rationale: all of the above statements are accurate when describing critical respiratory care.
H1: Critical Respiratory Care
7. Types of intensive care units include all the following EXCEPT:
A. medical intensive care
B. surgical intensive care
C. newborn nursery
D. pediatric intensive care
Answer: C
Complexity: moderate
Rationale: medical, surgical and pediatric are common types of intensive care units. The more
nurseries, on the other hand, often take care of well babies.
H1: Critical Respiratory Care
8. A patient with acute exacerbation of COPD may initially be admitted to which of the
following ICUs?
A. MICU
B. SICU
C. NICU
D. LTAC
Answer: A
Complexity: moderate
Rationale: of the choices listed, the medical intensive care unit (MICU) is generally the best
venue for a medically ill patient with acute exacerbation of COPD.
H1: Critical Respiratory Care
9. A patient following an acute MI may initially be admitted to which of the following ICUs?
A. CCU
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
B. SICU
C. NICU
D. PICU
Answer: A
Complexity: easy
Rationale: the coronary care unit (CCU) is accustomed to caring for patients post-MI.
H1: Critical Respiratory Care
10. Following thoracic trauma surgery, a patient may initially be admitted to which of the
following ICUs?
A. CCU
B. SICU
C. NICU
D. PICU
Answer: B
Complexity: easy
Rationale: the surgical intensive care unit (SICU) specializes in caring for critically ill patients
following surgery.
H1: Critical Respiratory Care
11. Choose the correct statements about ICU levels:
I. Level I Trauma Center provides the highest level of support
II. Level III Trauma Center provides the highest level of support
III. Level III NICU provides the highest level of support
IV. Level I NICU provides the highest level of support
A. I only
B. I and III
C. III only
D. I and IV
E. IV only
Answer: B
Complexity: complex
Rationale: Level I trauma centers provide the most complex care for trauma patients, while level
III neonatal units provide the most complex care for newborns.
H1: Critical Respiratory Care
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
12. Acute care hospitals often have units which provide a lower level of care than the ICU but a
higher level of care than general medical and surgical wards. These units are known as:
A. Moderate care units
B. Step-down units
C. Alternate care units
D. Long-term acute care units
Answer: B
Complexity: moderate
Rationale: step down units are specifically designed to provide a level of care less than that
provided in the ICU, but greater than that provided on general medical surgical wards.
H1: Critical Respiratory Care
13. Choose the correct statements about the ICU interprofessional care team:
I. Specially trained physicians, nurses, and respiratory therapists are needed to staff the ICU.
II. Specialty credentials are available for nurses who work in the ICU.
III. Specialty credentials are available for respiratory therapists who work in the ICU.
IV. Interprofessional practice (IPP) occurs when multiple health workers from different
professional backgrounds work together to deliver the highest quality of care.
A. I only
B. I and III
C. III only
D. IV only
E. I, II, III and IV
Answer: E
Complexity: complex
Rationale: all of the statements above are correct with respect to interprofessional ICU care
teams.
H1: Critical Respiratory Care
14. Interprofessional education (IPE) occurs when:
A. two or more professions learn with, from and about each other to improve collaboration and
the quality of care
B. multiple health workers from different professional backgrounds work together with patients,
families, and communities to deliver the highest quality of care.
C. Physicians provide in-service education to nurses
D. respiratory therapists provide ventilator training to medical students
Answer: A
Complexity: complex
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Rationale: IPE occurs when two or more professions learn together while interprofessional
practice (IPP) occurs when multiple health care workers from different professional backgrounds
work together.
H1: Critical Respiratory Care
15. Units or hospitals that provide care to patients with serious medical conditions that require an
extended hospital stay but no longer require intensive care are:
A. Long-term acute care hospitals (LTACs)
B. Step-down units (SDUs)
C. Neurologic intensive care units (NICUs)
D. Skilled nursing facilities (SNFs)
Answer: A
Complexity: moderate
Rationale: seriously ill patients requiring extended care for a relatively long period of time (e.g.,
30 days) are often transferred to a long-term acute care hospital setting.
H1: Critical Respiratory Care
16. Which of the following types of specialty hospitals provide high levels of care to neonatal
patients?
A. orthopedic hospitals
B. cardiac specialty hospitals
C. children’s hospitals
D. academic medical centers
Answer: C
Complexity: easy
Rationale: Children’s hospitals generally specialize in providing high levels of neonatal intensive
care to critically ill newborn infants.
H1: Critical Respiratory Care
17. Which of the following types of specialty hospitals provide high levels of care to patients
requiring hip surgery?
A. orthopedics
B. cardiac specialty
C. children’s
D. academic medical centers
Answer: A
Complexity: easy
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Rationale: orthopedic specialty hospitals specialize in the care for patients with orthopedic
problems, often requiring orthopedic surgery, such as hip replacement surgery.
H1: Critical Respiratory Care
True/False
18. Certain skilled nursing facilities (SNFs) will accept patients who are ventilator dependent and
may require prolonged ventilator weaning.
Answer: True
Complexity: moderate
Rationale: Certain SNFs routinely accept patients who are ventilator dependent.
H1: Critical Respiratory Care
Multiple Choice
19. Assessment of the respiratory care patient in the ICU should include:
I. evaluation and monitoring of the patient’s oxygenation, ventilation, and circulation.
II. review of the medical records, history and physical exam, review of laboratory studies,
medical imaging, results of cardiac and hemodynamic tests
III. monitoring and review of critical care monitoring flowsheets
IV. physical assessment to identify the signs of respiratory distress, hypoxia and hypercapnia
A. I, II, III, and IV
B. I only
C. III only
D. IV only
E. I, III and IV
Answer: A
Complexity: complex
Rationale: all the statements provided should be included as part of the assessment of the
respiratory care patient in the ICU
H1: Assessment of the Patient in the ICU
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
20. A wide range of laboratory studies may be ordered to assist in the assessment of the ICU
patient. These include:
I. serum electrolytes
II. hemoglobin and hematocrit
III. complete blood count
IV. serum lactate
A. I only
B. I and III
C. III only
D. IV only
E. I, II, III and IV
Answer: E
Complexity: complex
Rationale: laboratory studies often ordered in the ICU include all of those listed.
H1: Assessment of the Patient in the ICU
21. Arterial blood gas studies can:
I. quantify the degree of hypoxemia
II. identify hypoventilation
III. identify hyperventilation
IV. assess acid-base balance.
A. I only
B. II and III
C. IV only
D. I, II, III
E. I, II, III and IV
Answer: E
Complexity: complex
Rationale: arterial blood gases can quantify the degree of hypoxemia, identify, hypo and
hyperventilation, and assess acid-base balance.
H1: Assessment of the Patient in the ICU
22. ICU bedside imaging includes all the following EXCEPT:
A. portable chest radiographs
B. bedside sonography
C. computed tomography
D. portable ultrasound
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Mechanical Ventilation
David C. Shelledy, and Jay I. Peters
1st Edition
,Table of Contents
Chapter 01 Introduction to Critical Respiratory Care 1
Chapter 02 Respiratory Failure 13
Chapter 03 Principles of Mechanical Ventilation 37
Chapter 04 Mechanical Ventilators 58
Chapter 05 Indications for Mechanical Ventilation 72
Chapter 06 Ventilator Initiation 84
Chapter 07 Patient Stabilization Adjusting Ventilator Support 108
Chapter 08 Critical Care Patient Assessment and Monitoring Part I-Assessment 129
Chapter 09 Critical Care Patient Assessment and Monitoring Part II-Monitoring and Care 141
Chapter 10 Non-Invasive Ventilation 171
Chapter 11 High Frequency Oscillatory Ventilation for Acute Respiratory Distress
Syndrome in Adults 182
Chapter 12 Diagnostic and Supportive Procedures in the ICU 193
Chapter 13 Point of Care Ultrasound in Critical Care 204
Chapter 14 Mechanical Ventilation During Extracorporeal Membrane Oxygenation 215
Chapter 15 Neonatal and Pediatric Critical Care 227
Chapter 16 Ventilator Discontinuance 239
,______________________________________________________________________________________________
Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Chapter 01 Introduction to Critical Respiratory Care
Multiple Choice
1. Respiratory care can be defined as the healthcare discipline that specializes in promotion of:
A. activities of daily living
B. cardiopulmonary function
C. general health and well being
D. diagnosis and treatment of disease
Answer: B
Complexity: easy
Rationale: respiratory care specializes in cardiopulmonary health, while many other health
careers include optimizing patient’s activities of daily living, general health and well-being, and
diagnosis and treatment of disease.
H1: Overview
2. Patients at high risk for life-threatening health problems requiring sophisticated support and
monitoring are best cared for in the:
A. Long-term acute care unit
B. Emergency department
C. Intensive care unit
D. Step-down unit
Answer: C
Complexity: moderate
Rationale: intensive care units specialize in caring for patients at high risk for life-threatening
health problems requiring sophisticated support and monitoring. Long-term acute care units often
care for post-ICU patients, while step down units provide an intermediate level of care.
Emergency departments are generally for acute illness or injury which may be life-threatening,
and complex, however, critically ill patients are then generally transferred to the ICU.
H1: Critical Respiratory Care
3. The care and management of severely ill patients who require sophisticated support and
constant monitoring can be defined as:
A. critical care
B. sub-acute care
C. chronic care
D. supportive care
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1|Page
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Answer: A
Complexity: easy
Rationale: the definition of critical care is the care and management of critically ill patients who
require sophisticated support, and constant monitoring.
H1: Critical Respiratory Care
4. All the following conditions often require ICU admission and mechanical ventilation
EXCEPT:
A. ARDS
B. stable COPD
C. shock
D. sepsis
Answer: B
Complexity: moderate
Rationale: Stable COPD patients generally do not require ICU admission and mechanical
ventilation. Patients with acute exacerbation of COPD, however, may require ICU admission
and mechanical ventilatory support.
H1: Critical Respiratory Care
5. Choose the correct statement(s) about critical care
I. requires complex decision-making to ensure therapy is adjusted as patients’ needs change.
II. patients are often unstable and require frequent adjustments in the support provided.
III. patients are at high risk for life-threatening health problems
IV. sophisticated support and monitoring are often required
A. I only
B. I and II
C. III
D. I, II, III, IV
Answer: D
Complexity: complex
Rationale: all of the above statements are accurate when describing critical care.
H1: Critical Respiratory Care
6. Critical respiratory care includes which of the following:
I. diagnostic and monitoring procedures
II. management of artificial airways
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2|Page
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
III. performing basic and advanced respiratory care
IV. management of mechanical ventilation.
A. I and II
B. III and IV
C. IV only
D. I, II, III, IV
Answer: D
Complexity: complex
Rationale: all of the above statements are accurate when describing critical respiratory care.
H1: Critical Respiratory Care
7. Types of intensive care units include all the following EXCEPT:
A. medical intensive care
B. surgical intensive care
C. newborn nursery
D. pediatric intensive care
Answer: C
Complexity: moderate
Rationale: medical, surgical and pediatric are common types of intensive care units. The more
nurseries, on the other hand, often take care of well babies.
H1: Critical Respiratory Care
8. A patient with acute exacerbation of COPD may initially be admitted to which of the
following ICUs?
A. MICU
B. SICU
C. NICU
D. LTAC
Answer: A
Complexity: moderate
Rationale: of the choices listed, the medical intensive care unit (MICU) is generally the best
venue for a medically ill patient with acute exacerbation of COPD.
H1: Critical Respiratory Care
9. A patient following an acute MI may initially be admitted to which of the following ICUs?
A. CCU
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
B. SICU
C. NICU
D. PICU
Answer: A
Complexity: easy
Rationale: the coronary care unit (CCU) is accustomed to caring for patients post-MI.
H1: Critical Respiratory Care
10. Following thoracic trauma surgery, a patient may initially be admitted to which of the
following ICUs?
A. CCU
B. SICU
C. NICU
D. PICU
Answer: B
Complexity: easy
Rationale: the surgical intensive care unit (SICU) specializes in caring for critically ill patients
following surgery.
H1: Critical Respiratory Care
11. Choose the correct statements about ICU levels:
I. Level I Trauma Center provides the highest level of support
II. Level III Trauma Center provides the highest level of support
III. Level III NICU provides the highest level of support
IV. Level I NICU provides the highest level of support
A. I only
B. I and III
C. III only
D. I and IV
E. IV only
Answer: B
Complexity: complex
Rationale: Level I trauma centers provide the most complex care for trauma patients, while level
III neonatal units provide the most complex care for newborns.
H1: Critical Respiratory Care
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,______________________________________________________________________________________________
Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
12. Acute care hospitals often have units which provide a lower level of care than the ICU but a
higher level of care than general medical and surgical wards. These units are known as:
A. Moderate care units
B. Step-down units
C. Alternate care units
D. Long-term acute care units
Answer: B
Complexity: moderate
Rationale: step down units are specifically designed to provide a level of care less than that
provided in the ICU, but greater than that provided on general medical surgical wards.
H1: Critical Respiratory Care
13. Choose the correct statements about the ICU interprofessional care team:
I. Specially trained physicians, nurses, and respiratory therapists are needed to staff the ICU.
II. Specialty credentials are available for nurses who work in the ICU.
III. Specialty credentials are available for respiratory therapists who work in the ICU.
IV. Interprofessional practice (IPP) occurs when multiple health workers from different
professional backgrounds work together to deliver the highest quality of care.
A. I only
B. I and III
C. III only
D. IV only
E. I, II, III and IV
Answer: E
Complexity: complex
Rationale: all of the statements above are correct with respect to interprofessional ICU care
teams.
H1: Critical Respiratory Care
14. Interprofessional education (IPE) occurs when:
A. two or more professions learn with, from and about each other to improve collaboration and
the quality of care
B. multiple health workers from different professional backgrounds work together with patients,
families, and communities to deliver the highest quality of care.
C. Physicians provide in-service education to nurses
D. respiratory therapists provide ventilator training to medical students
Answer: A
Complexity: complex
______________________________________________________________________________________________
5|Page
,______________________________________________________________________________________________
Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Rationale: IPE occurs when two or more professions learn together while interprofessional
practice (IPP) occurs when multiple health care workers from different professional backgrounds
work together.
H1: Critical Respiratory Care
15. Units or hospitals that provide care to patients with serious medical conditions that require an
extended hospital stay but no longer require intensive care are:
A. Long-term acute care hospitals (LTACs)
B. Step-down units (SDUs)
C. Neurologic intensive care units (NICUs)
D. Skilled nursing facilities (SNFs)
Answer: A
Complexity: moderate
Rationale: seriously ill patients requiring extended care for a relatively long period of time (e.g.,
30 days) are often transferred to a long-term acute care hospital setting.
H1: Critical Respiratory Care
16. Which of the following types of specialty hospitals provide high levels of care to neonatal
patients?
A. orthopedic hospitals
B. cardiac specialty hospitals
C. children’s hospitals
D. academic medical centers
Answer: C
Complexity: easy
Rationale: Children’s hospitals generally specialize in providing high levels of neonatal intensive
care to critically ill newborn infants.
H1: Critical Respiratory Care
17. Which of the following types of specialty hospitals provide high levels of care to patients
requiring hip surgery?
A. orthopedics
B. cardiac specialty
C. children’s
D. academic medical centers
Answer: A
Complexity: easy
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
Rationale: orthopedic specialty hospitals specialize in the care for patients with orthopedic
problems, often requiring orthopedic surgery, such as hip replacement surgery.
H1: Critical Respiratory Care
True/False
18. Certain skilled nursing facilities (SNFs) will accept patients who are ventilator dependent and
may require prolonged ventilator weaning.
Answer: True
Complexity: moderate
Rationale: Certain SNFs routinely accept patients who are ventilator dependent.
H1: Critical Respiratory Care
Multiple Choice
19. Assessment of the respiratory care patient in the ICU should include:
I. evaluation and monitoring of the patient’s oxygenation, ventilation, and circulation.
II. review of the medical records, history and physical exam, review of laboratory studies,
medical imaging, results of cardiac and hemodynamic tests
III. monitoring and review of critical care monitoring flowsheets
IV. physical assessment to identify the signs of respiratory distress, hypoxia and hypercapnia
A. I, II, III, and IV
B. I only
C. III only
D. IV only
E. I, III and IV
Answer: A
Complexity: complex
Rationale: all the statements provided should be included as part of the assessment of the
respiratory care patient in the ICU
H1: Assessment of the Patient in the ICU
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Test Bank - Mechanical Ventilation, 1st Edition (Shelledy, 2020)
20. A wide range of laboratory studies may be ordered to assist in the assessment of the ICU
patient. These include:
I. serum electrolytes
II. hemoglobin and hematocrit
III. complete blood count
IV. serum lactate
A. I only
B. I and III
C. III only
D. IV only
E. I, II, III and IV
Answer: E
Complexity: complex
Rationale: laboratory studies often ordered in the ICU include all of those listed.
H1: Assessment of the Patient in the ICU
21. Arterial blood gas studies can:
I. quantify the degree of hypoxemia
II. identify hypoventilation
III. identify hyperventilation
IV. assess acid-base balance.
A. I only
B. II and III
C. IV only
D. I, II, III
E. I, II, III and IV
Answer: E
Complexity: complex
Rationale: arterial blood gases can quantify the degree of hypoxemia, identify, hypo and
hyperventilation, and assess acid-base balance.
H1: Assessment of the Patient in the ICU
22. ICU bedside imaging includes all the following EXCEPT:
A. portable chest radiographs
B. bedside sonography
C. computed tomography
D. portable ultrasound
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