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Chapter 50: Noninvasive Ventilation
Kacmarek: Egan’s Fundamentals of Respiratory Care, 12th Edition latest exam 2025
MULTIPLE CHOICE
1. Which of the following devices is considered to be the first electrically powered
negative-pressure ventilator?
a. The Bird
b. The iron lung
c. The chest cuirass
d. The rocking bed
ANS: B
The first electrically powered, negative-pressure ventilator was known as the “iron lung.”
DIF: Recall OBJ: 8
2. Why did the use of intermittent positive-pressure breathing decline in the 1980s?
a. Due to a lack of scientific evidence to support its use for delivering
aerosolized medication
b. Due to its cost of implementation
c. Due to its complexity
d. Replaced by newer technology
ANS: A
The use of intermittent positive-pressure breathing declined significantly in the mid-1980s
when evidence showed no b e n eGf iRt AcoDmEpSarLeAd Bto.sCmOalMl volume
nebulizers.
DIF: Recall OBJ: 5
3. Which of the following are goals of noninvasive ventilation (NIV) in the acute care setting?
1. Avoid intubation.
2. Decrease incidence of ventilation-associated pneumonia.
3. Decrease length of stay.
4. Improve mobility.
a.
2 and 4 only
b.
1, 2, and 3 only
c.
1 and 3 only
d.
1, 3, and 4 only
ANS: B
Avoiding intubation and invasive positive-pressure ventilation, improving survival,
decreasing the length of ventilatory support, decreasing the length of hospitalization, and
decreasing the incidence of ventilator-associated pneumonia are major goals of NIV in the
acute care setting (emergency department, intensive care unit, or hospital ward).
DIF: Recall OBJ: 1
4. Which of the following therapies should be considered as first line of therapy in patients with
exacerbation of chronic obstructive pulmonary disease (COPD)?
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a. Noninvasive ventilation (NIV)
b. Mechanical ventilation
c. High-flow nasal cannula
d. Systemic steroids
ANS: A
The differences in reported outcome between these studies suggest that NIV should
be considered standard of care for COPD patients in an acute exacerbation and
offered as first-line therapy to patients in all institutions treating the COPD patient.
DIF: Recall OBJ: 4
5. Your patient has acute pulmonary edema from left heart failure. Which therapy should be
tried first?
a. Noninvasive ventilation (NIV)
b. Continuous positive airway pressure (CPAP)
c. Mechanical ventilation
d. Positive end-expiratory pressure
ANS: B
CPAP has been shown to reduce the need for intubation in patients with severe cardiogenic
pulmonary edema.
DIF: Application OBJ: 3 | 5
6. Which of the following noninvasive ventilation (NIV) settings are adequate for a patient with
cardiogenic pulmonary edema?
a. CPAP at 10 to 15 cm H2O with oxygen
b. CPAP at 10 to 15 cm H2O with 50% oxygen
c. CPAP at 8 to 12 cm H2O with 100% oxygen
d. CPAP at 8 to 12 cm H2O with 50% oxygen
ANS: C
CPAP should be administered at 8 to 12 cm H2O with 100% oxygen.
DIF: Application OBJ: 5
7. Which of the following are possible solutions to correct a large air leak during noninvasive
ventilation?
1. Selecting an appropriately sized mask
2. Applying chin straps
3. Using a full-face mask
4. Decreasing the inspiratory time
a.
1 and 2 only
b.
2 and 2 only
c.
1, 2, and 3 only
d.
1, 2, 3, and 4
ANS: C
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Small air leaks should be expected during noninvasive ventilation. Large air leaks should be
addressed immediately. Air leaks can be avoided by selecting an appropriately sized mask,
changing to a full-face mask, repositioning the mask, readjusting the straps and adding a
forehead spacer.
DIF: Application OBJ: 12
8. Which of the following are benefits of continuous positive airway pressure (CPAP) in
postoperative major abdominal surgery?
1. Lower mortality
2. Lower intubation rate
3. Lower incidence of pneumonia
4. Lower rate of sepsis
a.
1 and 3 only
b.
1, 2, and 3 only
c.
3 and 4 only
d.
2, 3, and 4 only
ANS: D
Several investigators have reported favorable results used NIV instead of standard O2 therapy
for ARF during the postoperative period after major abdominal surgery or thoracic surgery.
Positive findings include improved oxygenation, fewer infections and lower rate of intubation.
Although these results are encouraging, additional randomized trials are needed to define the
role of NIV in the treatment of postop ARF. At the present time, there is insufficient evidence
to support routine use of NIV after major surgery.
DIF: Recall OBJ: 1
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