TEST BANK
Respiratory Critical Care
David W. Chang, Gary White, Ruben Restrepo, and Jonathan Waugh
1st Edition
,Table of Contents
Chapter 01 Principles of Mechanical Ventilation 1
Chapter 02 Classification of Mechanical Ventilation 6
Chapter 03 Modes of Mechanical Ventilation 11
Chapter 04 Non-invasive and Invasive Airway Management 16
Chapter 05 Initiation of Mechanical Ventilation 21
Chapter 06 Monitoring in Mechanical Ventilation 27
Chapter 07 Waveform Analysis and Application 31
Chapter 08 Management of Mechanical Ventilation 39
Chapter 09 Critical Care Procedures 44
Chapter 10 Pharmacotherapy in Critical Care 49
Chapter 11 Weaning from Mechanical Ventilation 54
Chapter 12 Neonatal and Pediatric Mechanical Ventilation 59
Chapter 13 Medical Critical Care Issues 64
Chapter 14 Traumatic Critical Care Issues 70
Chapter 15 Critical Care Guidelines and Bundles 75
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Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
Chapter 01 Principles of Mechanical Ventilation
Multiple Choice
1. Airway resistance is an important concept in mechanical ventilation, because when the airway
radius is reduced by 50% airflow resistance increases by:
A. 2 times.
B. 4 times.
C. 8 times.
D. 16 times.
Ans: D
2. For mechanically ventilated patients, pressure support ventilation (PSV) is useful to
compensate for the increased work of breathing due to:
A. airflow resistance.
B. compliance.
C. respiratory muscle fatigue.
D. ventilation/perfusion mismatch.
Ans: A
3. What does the pressure gradient (ΔP) represent in the compliance (C = ∆V/∆P) and airway
resistance (R = ΔP/V̇) equations?
A. Peak inspiratory pressure
B. Oxygen consumption
C. Work of breathing
D. Metabolic rate
Ans: C
4. Ventilatory failure develops when the patient’s minute alveolar ventilation cannot keep up
with the:
A. oxygen consumption.
B. carbon dioxide production.
C. acid-base balance.
D. pulmonary perfusion.
Ans: B
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Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
5. During mechanical ventilation, one method to evaluate compliance change is to use the:
A. volume–time waveform.
B. pressure–time waveform.
C. pressure–volume waveform.
D. flow–volume waveform.
Ans: C
6. A decrease of the peak inspiratory pressure–plateau pressure (PIP–Pplat) gradient implies that
the
A. airflow resistance has increased.
B. airflow resistance has decreased.
C. total compliance has increased.
D. total compliance has decreased.
Ans: B
7. During volume-controlled ventilation, a patient’s plateau pressure has been increasing over
the past 3 hours. This is indicative of:
A. increasing airflow resistance.
B. decreasing airflow resistance.
C. increasing compliance.
D. decreasing compliance.
Ans: D
8. During volume-controlled ventilation, a patient’s peak inspiratory pressure has been
increasing over the past 8 hours. What is the cause of this change?
A. Increasing airflow resistance or decreasing compliance
B. Decreasing airflow resistance or increasing compliance
C. Increasing airflow resistance
D. Decreasing compliance
Ans: A
9. During mechanical ventilation, the flow is paused momentarily at end inspiration. This
maneuver is done to:
A. evaluate a patient’s lung compliance.
B. evaluate a patient’s airway resistance.
C. obtain the peak inspiratory pressure.
D. obtain the dynamic compliance.
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Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
Ans: A
10. The equation corrected tidal volume/(peak inspiratory pressure − PEEP) is used to calculate
the patient’s:
A. static compliance.
B. dynamic compliance.
C. airway resistance.
D. transpulmonary pressure.
Ans: B
11. A higher than normal lung compliance is often seen in patients with:
A. tension pneumothorax.
B. acute respiratory distress syndrome.
C. emphysema.
D. atelectasis.
Ans: C
12. Which of the following pressure changes is consistent with atelectasis?
A. Increase in Pplat, increase in PIP
B. Decrease in Pplat, decrease in PIP
C. No change in Pplat, increase in PIP
D. No change in Pplat, decrease in PIP
Ans: A
13. Which of the following pressure changes correlates with acute bronchospasm?
A. Increase in Pplat, decrease in PIP
B. No change in Pplat, increase in PIP
C. No change in Pplat, decrease in PIP
D. Decrease in Pplat, no change in PIP
Ans: B
14. A mechanically ventilated patient has shown significant clinical improvement. The lung
consolidation and bronchospasm are almost completely resolved. Which of the following
demonstrates the patient’s improvement?
A. Decrease in Pplat, large decrease in PIP
B. No change in Pplat, decrease in PIP
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Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
C. Increase in Pplat, large increase in PIP
D. Decrease in Pplat, increase in PIP
Ans: A
15. A rapid shallow breathing pattern leads to V̇/Q̇ mismatch due to a(n):
A. decrease in lung compliance.
B. increase in airflow resistance.
C. decrease in cardiac output.
D. increase in dead space ventilation.
Ans: D
16. Hypoventilation is a condition that results in a(n):
A. decrease in pH.
B. decrease in PaO2.
C. increase in PaCO2.
D. increase in cardiac output.
Ans: C
17. Refractory hypoxemia is usually caused by:
A. intrapulmonary shunting.
B. hypoventilation.
C. cardiac arrest.
D. dead space ventilation.
Ans: A
18. Which of the following factors at the alveolocapillary membrane affect the gas diffusion
rate?
A. Capillary flow, surface area, gas pressure gradient
B. Thickness, capillary flow, surface area
C. Thickness, surface area, gas pressure gradient
D. Thickness, capillary flow, surface area, gas pressure gradient
Ans: D
19. A patient arrives at the emergency department with complaint of shortness of breath. She
also shows cyanosis, diminished sensorium, bradycardia, and hypotension. Based on this
information, the patient is most likely to have:
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Respiratory Critical Care
David W. Chang, Gary White, Ruben Restrepo, and Jonathan Waugh
1st Edition
,Table of Contents
Chapter 01 Principles of Mechanical Ventilation 1
Chapter 02 Classification of Mechanical Ventilation 6
Chapter 03 Modes of Mechanical Ventilation 11
Chapter 04 Non-invasive and Invasive Airway Management 16
Chapter 05 Initiation of Mechanical Ventilation 21
Chapter 06 Monitoring in Mechanical Ventilation 27
Chapter 07 Waveform Analysis and Application 31
Chapter 08 Management of Mechanical Ventilation 39
Chapter 09 Critical Care Procedures 44
Chapter 10 Pharmacotherapy in Critical Care 49
Chapter 11 Weaning from Mechanical Ventilation 54
Chapter 12 Neonatal and Pediatric Mechanical Ventilation 59
Chapter 13 Medical Critical Care Issues 64
Chapter 14 Traumatic Critical Care Issues 70
Chapter 15 Critical Care Guidelines and Bundles 75
,______________________________________________________________________________________________
Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
Chapter 01 Principles of Mechanical Ventilation
Multiple Choice
1. Airway resistance is an important concept in mechanical ventilation, because when the airway
radius is reduced by 50% airflow resistance increases by:
A. 2 times.
B. 4 times.
C. 8 times.
D. 16 times.
Ans: D
2. For mechanically ventilated patients, pressure support ventilation (PSV) is useful to
compensate for the increased work of breathing due to:
A. airflow resistance.
B. compliance.
C. respiratory muscle fatigue.
D. ventilation/perfusion mismatch.
Ans: A
3. What does the pressure gradient (ΔP) represent in the compliance (C = ∆V/∆P) and airway
resistance (R = ΔP/V̇) equations?
A. Peak inspiratory pressure
B. Oxygen consumption
C. Work of breathing
D. Metabolic rate
Ans: C
4. Ventilatory failure develops when the patient’s minute alveolar ventilation cannot keep up
with the:
A. oxygen consumption.
B. carbon dioxide production.
C. acid-base balance.
D. pulmonary perfusion.
Ans: B
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,______________________________________________________________________________________________
Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
5. During mechanical ventilation, one method to evaluate compliance change is to use the:
A. volume–time waveform.
B. pressure–time waveform.
C. pressure–volume waveform.
D. flow–volume waveform.
Ans: C
6. A decrease of the peak inspiratory pressure–plateau pressure (PIP–Pplat) gradient implies that
the
A. airflow resistance has increased.
B. airflow resistance has decreased.
C. total compliance has increased.
D. total compliance has decreased.
Ans: B
7. During volume-controlled ventilation, a patient’s plateau pressure has been increasing over
the past 3 hours. This is indicative of:
A. increasing airflow resistance.
B. decreasing airflow resistance.
C. increasing compliance.
D. decreasing compliance.
Ans: D
8. During volume-controlled ventilation, a patient’s peak inspiratory pressure has been
increasing over the past 8 hours. What is the cause of this change?
A. Increasing airflow resistance or decreasing compliance
B. Decreasing airflow resistance or increasing compliance
C. Increasing airflow resistance
D. Decreasing compliance
Ans: A
9. During mechanical ventilation, the flow is paused momentarily at end inspiration. This
maneuver is done to:
A. evaluate a patient’s lung compliance.
B. evaluate a patient’s airway resistance.
C. obtain the peak inspiratory pressure.
D. obtain the dynamic compliance.
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
Ans: A
10. The equation corrected tidal volume/(peak inspiratory pressure − PEEP) is used to calculate
the patient’s:
A. static compliance.
B. dynamic compliance.
C. airway resistance.
D. transpulmonary pressure.
Ans: B
11. A higher than normal lung compliance is often seen in patients with:
A. tension pneumothorax.
B. acute respiratory distress syndrome.
C. emphysema.
D. atelectasis.
Ans: C
12. Which of the following pressure changes is consistent with atelectasis?
A. Increase in Pplat, increase in PIP
B. Decrease in Pplat, decrease in PIP
C. No change in Pplat, increase in PIP
D. No change in Pplat, decrease in PIP
Ans: A
13. Which of the following pressure changes correlates with acute bronchospasm?
A. Increase in Pplat, decrease in PIP
B. No change in Pplat, increase in PIP
C. No change in Pplat, decrease in PIP
D. Decrease in Pplat, no change in PIP
Ans: B
14. A mechanically ventilated patient has shown significant clinical improvement. The lung
consolidation and bronchospasm are almost completely resolved. Which of the following
demonstrates the patient’s improvement?
A. Decrease in Pplat, large decrease in PIP
B. No change in Pplat, decrease in PIP
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Test Bank - Respiratory Critical Care, 1st Edition (Chang, 2021)
C. Increase in Pplat, large increase in PIP
D. Decrease in Pplat, increase in PIP
Ans: A
15. A rapid shallow breathing pattern leads to V̇/Q̇ mismatch due to a(n):
A. decrease in lung compliance.
B. increase in airflow resistance.
C. decrease in cardiac output.
D. increase in dead space ventilation.
Ans: D
16. Hypoventilation is a condition that results in a(n):
A. decrease in pH.
B. decrease in PaO2.
C. increase in PaCO2.
D. increase in cardiac output.
Ans: C
17. Refractory hypoxemia is usually caused by:
A. intrapulmonary shunting.
B. hypoventilation.
C. cardiac arrest.
D. dead space ventilation.
Ans: A
18. Which of the following factors at the alveolocapillary membrane affect the gas diffusion
rate?
A. Capillary flow, surface area, gas pressure gradient
B. Thickness, capillary flow, surface area
C. Thickness, surface area, gas pressure gradient
D. Thickness, capillary flow, surface area, gas pressure gradient
Ans: D
19. A patient arrives at the emergency department with complaint of shortness of breath. She
also shows cyanosis, diminished sensorium, bradycardia, and hypotension. Based on this
information, the patient is most likely to have:
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