Test Bank for PILBEAM’S Mechanical
Ventilation, 6th Edition, J M Cairo
100% Complete with Questions and
Answers Graded A+
Chapter 01: Basic Terms and Concepts of Mechanical Ventilation
Cairo: Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications, 6th
Edition
MULTIPLE CHOICE
1. Calculate the pressure needed to overcome airway resistance during positive-pressure
ventilation when the proximal airway pressure (PAw) is 35 cm H2O and the alveolar pressure
(PA) is 5 cm H2O.
a. 7 cm H2O
b. 30 cm H2O
c. 40 cm H2O
d. 175 cm H2O
CORRECT ANSWER>>B
The transairway pressure (PTA) is used to calculate the pressure required to overcome airway
resistance during mechanical ventilation. This formula is PTA = Paw - PA.
REF: pg. 4
2. The term used to describe the tendency of a structure to return to its original form after being
stretched or acted on by an outside force is which of the following?
a. Elastance
b. Compliance
c. Viscous resistance
d. Distending pressure
CORRECT ANSWER>>A
The elastance of a structure is the tendency of that structure to return to its original shape after
being stretched. The more elastance a structure has, the more difficult it is to stretch. The
compliance of a structure is the ease with which the structure distends or stretches.
Compliance is the opposite of elastance. Viscous resistance is the opposition to movement
offered by adjacent structures such as the lungs and their adjacent organs. Distending pressure
is pressure required to maintain inflation, for example, alveolar distending pressure.
REF: pg. 5
3. Calculate the pressure required to achieve a tidal volume of 400 mL for an intubated patient
with a respiratory system compliance of 15 mL/cm H2O.
a. 6 cm H2O
b. 26.7 cm H2O
, c. 37.5 cm H2O
d. 41.5 cm H2O
CORRECT ANSWER>>B
C = V/ P then P = V/ C
REF: pg. 5
4. Which of the following conditions causes pulmonary compliance to increase?
a. Asthma
b. Kyphoscoliosis
c. Emphysema
d. Acute respiratory distress syndrome (ARDS)
CORRECT ANSWER>>C
Emphysema causes an increase in pulmonary compliance, whereas ARDS and kyphoscoliosis
cause decreases in pulmonary compliance. Asthma attacks cause increase in airway resistance.
REF: pg. 6 | pg. 7
5. Calculate the effective static compliance (Cs) given the following information about a patient
receiving mechanical ventilation: peak inspiratory pressure (PIP) is 56 cm H2O, plateau
pressure (Pplateau) is 40 cm H2O, exhaled tidal volume (VT) is 650 mL, and positive end
expiratory pressure (PEEP) is 10 cm H2O.
a. 14.1 mL/cm H2O
b. 16.3 mL/cm H2O
c. 21.7 mL/cm H2O
d. 40.6 mL/cm H2O
CORRECT ANSWER>>C
The formula for calculating effective static compliance is Cs = VT/(Pplateau EEP).
REF: pg. 6 | pg. 7
6. Based upon the following patient information, calculate the patient’s static lung compliance:
exhaled tidal volume (VT) is 675 mL, peak inspiratory pressure (PIP) is 28 cm H2O, plateau
pressure (Pplateau) is 8 cm H2O, and PEEP is set at 5 cm H2O.
a. 0.02 L/cm H2O
b. 0.03 L/cm H2O
c. 0.22 L/cm H2O
d. 0.34 L/cm H2O
CORRECT ANSWER>>C
The formula for calculating effective static compliance is Cs = VT/(Pplateau EEP).
REF: pg. 5 | pg. 6
7. A patient receiving mechanical ventilation has an exhaled tidal volume (VT) of 500 mL and a
positive end expiratory pressure setting (PEEP) of 5 cm H2O. Patient-ventilator system checks
reveal the following data:
Time PIP (cm H2O) Pplateau (cm H2O)
0600 27 15
0800 29 15
, 1000 36 13
The respiratory therapist should recommend which of the following for this patient?
1. Tracheobronchial suctioning
2. Increase in the set tidal volume
3. Beta adrenergic bronchodilator therapy
4. Increase positive end expiratory pressure
a. 1 and 3 only
b. 2 and 4 only
c. 1, 2, and 3 only
d. 2, 3, and 4 only
CORRECT ANSWER>>A
Calculate the transairway pressure (PTA) by subtracting the plateau pressure from the peak
inspiratory pressure. Analyzing the PTA will show any changes in the pressure needed to
overcome airway resistance. Analyzing the Pplateau will demonstrate any changes in
compliance. The Pplateau remained the same for the first two checks and then actually dropped
at the 1000-hour check. Analyzing the PTA, however, shows a slight increase between 0600
and 0800 (from 12 to 14 cm H2O) and then a sharp increase to 23 cm H2O at 1000. Increases
in PTA signify increases in airway resistance. Airway resistance may be caused by secretion
buildup, bronchospasm, mucosal edema, and mucosal inflammation. Tracheobronchial
suctioning will remove any secretion buildup, and a beta adrenergic bronchodilator will
reverse bronchospasm. Increasing the tidal volume will add to the airway resistance according
to Poiseuille’s law. Increasing the PEEP will not address the root of this patient’s problem; the
patient’s compliance is normal.
REF: pg. 7
8. The values below pertain to a patient who is being mechanically ventilated with a measured
exhaled tidal volume (VT) of 700 mL.
Time Peak Inspiratory Pressure (cm H2O) Plateau Pressure (cm H2O)
0800 35 30
1000 39 34
1100 45 39
1130 50 44
Analysis of this data points to which of the following conclusions?
a.Airway resistance is increasing.
b.Airway resistance is decreasing.
c.Lung compliance is increasing.
d.Lung compliance is decreasing.
CORRECT ANSWER>>D
To evaluate this information the transairway pressure (PTA) is calculated for the different
times: 0800 PTA = 5 cm H2O, 1000 PTA = 5 cm H2O, 1100 PTA = 6 cm H2O, and 1130 PTA = 6
cm H2O. This data shows that there is no significant increase or decrease in this patient’s
airway resistance. Analysis of the patient’s plateau pressure (Pplateau) reveals an increase of 15
cm H2O over the three and a half hour time period. This is directly related to a decrease in
lung compliance. Calculation of the lung compliance (CS = VT/(Pplateau – EEP) at each time
interval reveals a steady decrease from 20 mL/cm H2O to 14 mL/cm H2O.
, REF: pg. 7
9. The respiratory therapist should expect which of the following findings while ventilating a
patient with acute respiratory distress syndrome (ARDS)?
a. An elevated plateau pressure (Pplateau)
b. A decreased elastic resistance
c. A low peak inspiratory pressure (PIP)
d. A large transairway pressure (PTA) gradient
CORRECT ANSWER>>A
ARDS is a pathological condition that is associated with a reduction in lung compliance. The
formula for static compliance (CS) utilizes the measured plateau pressure (Pplateau) in its
denominator (CS = VT /(Pplateau EEP). Therefore, with a consistent exhaled tidal volume (VT),
an elevated Pplateau will decrease CS.
REF: pg. 6 | pg. 7
10. The formula used for the calculation of static compliance (CS) is which of the following?
a. (Peak inspiratory pressure (PIP) EEP)/tidal volume (VT)
b. (Plateau pressure (Pplateau) EEP)/tidal volume (VT)
c. Tidal volume/(plateau pressure EEP)
d. Tidal volume/(peak pressure (PIP) plateau pressure (Pplateau))
CORRECT ANSWER>>C
CS = VT/(Pplateau EEP)
REF: pg. 7
11. Plateau pressure (Pplateau) is measured during which phase of the ventilatory cycle?
a. Inspiration
b. End-inspiration
c. Expiration
d. End-expiration
CORRECT ANSWER>>B
The calculation of compliance requires the measurement of the plateau pressure. This pressure
measurement is made during no-flow conditions. The airway pressure (Paw) is measured at
end-inspiration. The inspiratory pressure is taken when the pressure reaches its maximum
during a delivered mechanical breath. The pressure that occurs during expiration is a dynamic
measurement and drops during expiration. The pressure reading at end-expiration is the
baseline pressure; this reading is either at zero (atmospheric pressure) or at above atmospheric
pressure (PEEP).
REF: pg. 7
12. The condition that is associated with an increase in airway resistance is which of the
following?
a. Pulmonary edema
b. Bronchospasm
c. Fibrosis
d. Ascites
CORRECT ANSWER>>B
Ventilation, 6th Edition, J M Cairo
100% Complete with Questions and
Answers Graded A+
Chapter 01: Basic Terms and Concepts of Mechanical Ventilation
Cairo: Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications, 6th
Edition
MULTIPLE CHOICE
1. Calculate the pressure needed to overcome airway resistance during positive-pressure
ventilation when the proximal airway pressure (PAw) is 35 cm H2O and the alveolar pressure
(PA) is 5 cm H2O.
a. 7 cm H2O
b. 30 cm H2O
c. 40 cm H2O
d. 175 cm H2O
CORRECT ANSWER>>B
The transairway pressure (PTA) is used to calculate the pressure required to overcome airway
resistance during mechanical ventilation. This formula is PTA = Paw - PA.
REF: pg. 4
2. The term used to describe the tendency of a structure to return to its original form after being
stretched or acted on by an outside force is which of the following?
a. Elastance
b. Compliance
c. Viscous resistance
d. Distending pressure
CORRECT ANSWER>>A
The elastance of a structure is the tendency of that structure to return to its original shape after
being stretched. The more elastance a structure has, the more difficult it is to stretch. The
compliance of a structure is the ease with which the structure distends or stretches.
Compliance is the opposite of elastance. Viscous resistance is the opposition to movement
offered by adjacent structures such as the lungs and their adjacent organs. Distending pressure
is pressure required to maintain inflation, for example, alveolar distending pressure.
REF: pg. 5
3. Calculate the pressure required to achieve a tidal volume of 400 mL for an intubated patient
with a respiratory system compliance of 15 mL/cm H2O.
a. 6 cm H2O
b. 26.7 cm H2O
, c. 37.5 cm H2O
d. 41.5 cm H2O
CORRECT ANSWER>>B
C = V/ P then P = V/ C
REF: pg. 5
4. Which of the following conditions causes pulmonary compliance to increase?
a. Asthma
b. Kyphoscoliosis
c. Emphysema
d. Acute respiratory distress syndrome (ARDS)
CORRECT ANSWER>>C
Emphysema causes an increase in pulmonary compliance, whereas ARDS and kyphoscoliosis
cause decreases in pulmonary compliance. Asthma attacks cause increase in airway resistance.
REF: pg. 6 | pg. 7
5. Calculate the effective static compliance (Cs) given the following information about a patient
receiving mechanical ventilation: peak inspiratory pressure (PIP) is 56 cm H2O, plateau
pressure (Pplateau) is 40 cm H2O, exhaled tidal volume (VT) is 650 mL, and positive end
expiratory pressure (PEEP) is 10 cm H2O.
a. 14.1 mL/cm H2O
b. 16.3 mL/cm H2O
c. 21.7 mL/cm H2O
d. 40.6 mL/cm H2O
CORRECT ANSWER>>C
The formula for calculating effective static compliance is Cs = VT/(Pplateau EEP).
REF: pg. 6 | pg. 7
6. Based upon the following patient information, calculate the patient’s static lung compliance:
exhaled tidal volume (VT) is 675 mL, peak inspiratory pressure (PIP) is 28 cm H2O, plateau
pressure (Pplateau) is 8 cm H2O, and PEEP is set at 5 cm H2O.
a. 0.02 L/cm H2O
b. 0.03 L/cm H2O
c. 0.22 L/cm H2O
d. 0.34 L/cm H2O
CORRECT ANSWER>>C
The formula for calculating effective static compliance is Cs = VT/(Pplateau EEP).
REF: pg. 5 | pg. 6
7. A patient receiving mechanical ventilation has an exhaled tidal volume (VT) of 500 mL and a
positive end expiratory pressure setting (PEEP) of 5 cm H2O. Patient-ventilator system checks
reveal the following data:
Time PIP (cm H2O) Pplateau (cm H2O)
0600 27 15
0800 29 15
, 1000 36 13
The respiratory therapist should recommend which of the following for this patient?
1. Tracheobronchial suctioning
2. Increase in the set tidal volume
3. Beta adrenergic bronchodilator therapy
4. Increase positive end expiratory pressure
a. 1 and 3 only
b. 2 and 4 only
c. 1, 2, and 3 only
d. 2, 3, and 4 only
CORRECT ANSWER>>A
Calculate the transairway pressure (PTA) by subtracting the plateau pressure from the peak
inspiratory pressure. Analyzing the PTA will show any changes in the pressure needed to
overcome airway resistance. Analyzing the Pplateau will demonstrate any changes in
compliance. The Pplateau remained the same for the first two checks and then actually dropped
at the 1000-hour check. Analyzing the PTA, however, shows a slight increase between 0600
and 0800 (from 12 to 14 cm H2O) and then a sharp increase to 23 cm H2O at 1000. Increases
in PTA signify increases in airway resistance. Airway resistance may be caused by secretion
buildup, bronchospasm, mucosal edema, and mucosal inflammation. Tracheobronchial
suctioning will remove any secretion buildup, and a beta adrenergic bronchodilator will
reverse bronchospasm. Increasing the tidal volume will add to the airway resistance according
to Poiseuille’s law. Increasing the PEEP will not address the root of this patient’s problem; the
patient’s compliance is normal.
REF: pg. 7
8. The values below pertain to a patient who is being mechanically ventilated with a measured
exhaled tidal volume (VT) of 700 mL.
Time Peak Inspiratory Pressure (cm H2O) Plateau Pressure (cm H2O)
0800 35 30
1000 39 34
1100 45 39
1130 50 44
Analysis of this data points to which of the following conclusions?
a.Airway resistance is increasing.
b.Airway resistance is decreasing.
c.Lung compliance is increasing.
d.Lung compliance is decreasing.
CORRECT ANSWER>>D
To evaluate this information the transairway pressure (PTA) is calculated for the different
times: 0800 PTA = 5 cm H2O, 1000 PTA = 5 cm H2O, 1100 PTA = 6 cm H2O, and 1130 PTA = 6
cm H2O. This data shows that there is no significant increase or decrease in this patient’s
airway resistance. Analysis of the patient’s plateau pressure (Pplateau) reveals an increase of 15
cm H2O over the three and a half hour time period. This is directly related to a decrease in
lung compliance. Calculation of the lung compliance (CS = VT/(Pplateau – EEP) at each time
interval reveals a steady decrease from 20 mL/cm H2O to 14 mL/cm H2O.
, REF: pg. 7
9. The respiratory therapist should expect which of the following findings while ventilating a
patient with acute respiratory distress syndrome (ARDS)?
a. An elevated plateau pressure (Pplateau)
b. A decreased elastic resistance
c. A low peak inspiratory pressure (PIP)
d. A large transairway pressure (PTA) gradient
CORRECT ANSWER>>A
ARDS is a pathological condition that is associated with a reduction in lung compliance. The
formula for static compliance (CS) utilizes the measured plateau pressure (Pplateau) in its
denominator (CS = VT /(Pplateau EEP). Therefore, with a consistent exhaled tidal volume (VT),
an elevated Pplateau will decrease CS.
REF: pg. 6 | pg. 7
10. The formula used for the calculation of static compliance (CS) is which of the following?
a. (Peak inspiratory pressure (PIP) EEP)/tidal volume (VT)
b. (Plateau pressure (Pplateau) EEP)/tidal volume (VT)
c. Tidal volume/(plateau pressure EEP)
d. Tidal volume/(peak pressure (PIP) plateau pressure (Pplateau))
CORRECT ANSWER>>C
CS = VT/(Pplateau EEP)
REF: pg. 7
11. Plateau pressure (Pplateau) is measured during which phase of the ventilatory cycle?
a. Inspiration
b. End-inspiration
c. Expiration
d. End-expiration
CORRECT ANSWER>>B
The calculation of compliance requires the measurement of the plateau pressure. This pressure
measurement is made during no-flow conditions. The airway pressure (Paw) is measured at
end-inspiration. The inspiratory pressure is taken when the pressure reaches its maximum
during a delivered mechanical breath. The pressure that occurs during expiration is a dynamic
measurement and drops during expiration. The pressure reading at end-expiration is the
baseline pressure; this reading is either at zero (atmospheric pressure) or at above atmospheric
pressure (PEEP).
REF: pg. 7
12. The condition that is associated with an increase in airway resistance is which of the
following?
a. Pulmonary edema
b. Bronchospasm
c. Fibrosis
d. Ascites
CORRECT ANSWER>>B
