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2025 TMC MECHANICAL VENTILATION PRACTICE
EXAM / 35Qs&As|LATEST UPDATE|A+GRADE
A 43 - year-old male client was admitted to the emergency department with a suspected drug overdose. The client is receiving oxygen via nonrebreather but is unconscious and isn't making any respiratory efforts to breathe. The client's body weight is 57 kg and his ABG results are as follows: pH 7. PaCO2 74 torr HCO3 20 mEq/L PaO2 315 torr Which of the following would you recommend? A. Apply BiPAP with: IPAP 20 cm H2O, EPAP 5 cm H2O, FiO2 30% B. Intubate and apply: SIMV, tidal volume 600 mL, rate 6/min, FiO2 40% C. Intubate and apply: A/C ventilation, tidal volume 450 mL, rate 12/min, FiO 50% D. Apply CPAP at 10 cm H2O and an FiO2 of 100% - -------- ANS:->> C A 63 - year-old female client is intubated and receiving mechanical ventilation in the pressure controlled A/C mode. If the client's compliance were to decrease, which of the following would you expect to
occur? A. Her delivered volume will decrease B. Her peak pressure will increase C. Her inspiratory time will increase D. Her PEEP level will decrease - -------- ANS:->> A A 70 - year-old male client is intubated and receiving mechanical ventilation in the volume controlled A/C mode. After performing endotracheal suctioning, which of the following would indicate the effective clearance of retained secretions? A. An increased tidal volume B. A decreased inspiratory time C. A decreased plateau pressure
C. Place the client on CPAP and monitor closely D. Maintain the current ventilator settings and re-evaluate later - -------- ANS:->> B? D! A 51 - year-old female client with a history of asthma is receiving mechanical ventilation in the assist- control mode. Upon assessment, you note that she is struggling to initiate inspiration. Which of the following settings would you check first in order to resolve of this problem? A. Tidal volume B. Pressure limit C. Sensitivity D. PEEP - -------- ANS:->>------- C During the assessment of an adult client who is receiving mechanical ventilation, you suddenly notice the simultaneous sounding of both the high pressure and low volume alarms. What is the most likely cause of this finding? A. There is a disconnection in the ventilator circuit B. There is a leak in the ET tube cuff C. There is a mucous plug in the ET tube
D. The client has developed pneumonia - -------- ANS:->> -- C A 68 - year-old male client with COPD is receiving volume control SIMV with the following settings: Tidal volume 480 mL Rate 12/min Pressure support 10 cm H2O PEEP 5 cm H2O During a spontaneous breathing trial via T-tube, the client's breathing rate increased drastically which required that he be placed back on the ventilator. Which of the following would you recommend during the next breathing trial? A. Increase the sedation dosage B. CPAP with pressure support via ET tube C. CPAP without pressure support via ET tube D. Extubate and provide BiPAP via full face mask - -------- ANS:->> B A 63-year-old male client with a tracheostomy is being mechanically ventilated in the ICU. Upon assessment, you noticed that as the client coughs, blood and secretions were blown back into the circuit. What action should you take at this time? A. Flush the blood out of the circuit with normal saline
C. (PIP - Paw) D. (Paw - Pplat) - -------- ANS:->> ----- B An alert 59 - year-old male client is orally intubated with an endotracheal tube. During a weaning trial, the client was switched to CPAP mode with an FiO2 of 40%. Within the first 5 minutes, the client's respiratory rate has increased from 22 to 31 breaths/min with increased usage of accessory muscles while breathing. Which of the following would you recommend? A. Return the client to full ventilatory support B. Increase the FiO2 to 50% C. Apply 5- 10 cm H2O of pressure support D. Extubate the client and reassess - -------- ANS:->> -- C? A.. A stable adult client who is receiving mechanical ventilation displays the following results: pH 7. PaCO2 29 mm Hg HCO3 24 mEq/L BE + PaO2 87 mm Hg SaO2 96% Which of the following would you recommend?
A. Add 10 cm H2O PEEP B. Increase the minute ventilation C. Decrease the tidal volume D. Maintain the current setting - -------- ANS:->> - C A 68 - year-old female client in the ICU is receiving mechanical ventilation but appears to be breathing asynchronously with the ventilator. Which of the following medications would you recommend? A. Fluoxetine (Prozac) B. Lorazepam (Ativan) C. Dextroamphetamine (Dexedrine) D. Cisatracurium (Nimbex) - -------- ANS:->> -- B A 70 - year-old male client with COPD is receiving ventilatory support in a volume-controlled mode. Upon assessment, the high pressure alarm suddenly begins to sound. Which of the following would recommend? A. Increase the flow setting B. Increase the pressure limit setting
C. The need for neuromuscular paralysis D. Increased work of breathing - -------- ANS:->>-- B? D? During the ventilator check of an adult client who weighs 77 kg, you note the following settings:
- Exhaled tidal volume 550 mL
- PIP 35 cm H2O
- High pressure limit 65 cm H2O
- Low pressure alarm 25 cm H2O
- Low tidal volume alarm 500 mL Which of the following changes should be made at this time? A. Increase the set tidal volume to 700 mL B. Increase the low tidal volume alarm to 600 mL C. Decrease the high pressure limit to 45 - 50 cmH2O D. Decrease the low pressure alarm to 10 cmH2O - -------- ANS:->> C
Which of the following tidal volume settings for mechanical ventilation would be most appropriate for a 5'2" female client with normal lungs? A. 200 mL B. 400 mL C. 600 mL D. 700 mL - -------- ANS:->> ------- B The physician has chosen to use the SIMV mode of ventilation over the Assist/Control mode. Which of the following is an advantage of the SIMV mode? A. SIMV maintains respiratory muscle strength B. SIMV prevents hyperventilation C. SIMV increases pleural pressures D. SIMV increases the need for sedation - -------- ANS:->> A
of the following is most important? A. The type of device that is being used B. The quality and amount of nursing supervision C. The client's size and clinical condition D. The amount of spontaneous ventilatory effort - -------- ANS:->> A C! A 60 - year-old male client is receiving ventilatory support in the SIMV mode. A blood gas sample was collected and analysis shows a PaCO2 of 60 mmHg. Which of the following would you recommend? A. Increase the frequency B. Increase the FiO C. Increase the mechanical deadspace in the ventilator circuit D. Decrease the tidal volume - -------- ANS:->> ---A
The physician has ordered mechanical ventilation in the pressure control A/C mode for a 55 kg postoperative male client. Which of the following initial settings would you choose? A. PIP = 25 cm H2O; Rate = 30/min; Inspiratory time = 1 second B. PIP = 32 cm H2O; Rate = 12/min; Inspiratory time = 2 seconds C. PIP = 40 cm H2O; Rate = 20/min; Inspiratory time = 1 second D. PIP = 25 cm H2O; Rate = 12/min; Inspiratory time = 1 second - -------- ANS:-
------------------------------------------------------------------------------------ D While assessing a mechanically ventilated client after a neurosurgical procedure, the client has an intracranial pressure of 20 mmHg but is otherwise stable. The latest ABG results are as follows: pH 7. PaCO2 48 mmHg HCO3 24 mEq/L PaO2 88 mmHg SpO2 95% Based on this information, which of the following would you recommend? A. Increase the minute ventilation
pH 7. PaCO2 49 torr HCO3 24 mEq/L BE - 2 mEq/L PaO2 84 torr SpO2 95% Based on the given information, which of the following changes is appropriate at this time? A. Increase the FiO B. Increase the tidal volume C. Increase the set rate D. Maintain the current settings - -------- ANS:->> - C? An adult client is receiving mechanical ventilation with a PEEP setting of 10 cmH2O. The physician has requested that you increase the setting to 14 cmH2O. After making the adjustment, there is a rapid drop in the client's blood pressure and a significant increase in heart rate. Which of the following actions should you take?
A. Increase the FiO2 by 10% B. Lower the PEEP back to 10 cmH2O C. Administer sodium bicarb D. Obtain a stat EKG - -------- ANS:->> --- B A 58 - year-old female is receiving volume control A/C ventilation at a rate of 12/min with a tidal volume of 450 mL. The FiO2 is set at 40% and her ABG results are as follows: pH 7. PaCO2 44 torr HCO3 22 mEq/L BE 0 PaO2 91 torr SaO2 97% Based on this information, you should recommend which of the following? A. Decrease the minute ventilation B. Discontinue mechanical ventilation C. Administer IV bicarbonate
The physician has requested a mode of ventilation in which you can maintain a precise I:E ratio. Which of the following modes would you select? A. Synchronous Intermittent Mandatory Ventilation B. Control Mode Ventilation C. Assist-Control Ventilation D. Pressure Support Ventilation - -------- ANS:->>-- B An adult client who is receiving mechanical ventilation has a peak airway pressure of 60 cmH2O and a plateau pressure of 45 cmH2O. The ventilator flow rate is set at 60 L/min. What is the client's airway resistance? A. 5 cm H2O/L/sec B. 15 cm H2O/L/sec C. 30 cm H2O/L/sec
D. 60 cm H2O/L/sec - -------- ANS:->> --- B (Pip-plateau) / flow A 74 kg male client is intubated and receiving volume control A/C ventilation with the following settings: FiO2 of 50% set rate of 15 tidal volume of 550 mL. The client's total respiratory rate is 29 breaths/min. His ABG results are as follows: pH 7. PaCO2 27 torr HCO3 23 mEq/L BE - 2 PaO2 82 torr SaO2 97% Which of the following would you recommend? A. Increase the FiO B. Increase the ventilator rate C. Increase the tidal volume
