Description

NRNP 6566 Week 7 Knowledge Check

1. Question: When the ventilator delivers set tidal volume at a set breath rate to control minute ventilation this is:
2. Question: This ventilator mode provides a set tidal volume at a set breath rate. Spontaneous breaths between or above the mandatory breath rate will not receive the set tidal volume but may receive pressure support:
3. Question: Hypercapneic respiratory failure mechanism include all of the following except:
4. Question: Indications for mechanical ventilation include all of the following excpt:
5. Question: When the ventilator delivers set pressure at a set breath rate. Tidal volume and minute ventilation will vary this is:
6. Question: Acute ventilatory failure is defined as:
7. Question: This ventilator mode provides mandatory breaths at a set rate, or frequency, which are triggered, limited, and cycled by the ventilator:
8. Question: Hypoxic respiratory failure includes all of the following except:
9. Question: This ventilator mode provides a preset level of inspiratory pressure on the ventilator. Respiratory rate, inspiratory time, and tidal volume are controlled by the patient. Can be used to support spontaneous breaths on IMV mode or for weaning patients from mechanical ventilation.
10. Question: Dual-modes include all of the following except:
    

    ---

NRNP 6566 Week 7 Knowledge Check

1. Question: Indications for ECMO include:
2. Question: All of the following are indications for spontaneous breathing trial to assess the patient’s ability to discontinue mechanical ventilation except:
3. Question: Contraindications for non-invasive positive pressure ventilation include all of the following except:
4. Question: All of the following are signs of spontaneous breathing trail failure except:
5. Question: True/False – Venovenous Extracorporeal Membrane Oxygenation (ECMO) is used to support the respiratory system by removing blood from a large artery such as the femoral artery and returning it to another large vein that is contralateral such as the femoral or superior vena cava.
6. Question: True/False – The primary difference between ACV and CMV is that the trigger depends on patient effort and the ventilator’s sensitivity to the patient’s
7. Question: Positive-End Expiratory pressure (PEEP) is a supplemental setting used to augment airway pressures during the expiratory phase in an effort to recruit functional alveoli by preventing collapse during expiration, and to reduce the need for high amounts of supplemental oxygen that can injure functional alveolar units. What is the recommended initial range for PEEP when initiating mechanical ventilation:
8. Question: The initial tidal volume (Vt) is based on ideal body weight and is in what range:
9. Question: The serum anion gap is the difference between the anions and cations within the serum. What is the formula for determining the anion gap:
10. Question: True/False – NIPPV refers to the delivery of positive or negative airway pressure with an invasive tracheal airway.
    

    ---

NRNP 6566 Week 7 Knowledge Check

1. Question: Acute ventilatory failure is defined as:
2. Question: Hypercapneic respiratory failure mechanism include all of the following except:
3. Question: This ventilator mode provides mandatory breaths at a set rate, or frequency, which are triggered, limited, and cycled by the ventilator:
4. Question: This ventilator mode provides a preset level of inspiratory pressure on the Respiratory rate, inspiratory time, and tidal volume are controlled by the patient. Can be used to support spontaneous breaths on IMV mode or for weaning patients from mechanical ventilation.
5. Question: Hypoxic respiratory failure includes all of the following except:
6. Question: Dual-modes include all of the following except:
7. Question: Indications for mechanical ventilation include all of the following except: Apnea
8. Question: When the ventilator delivers set tidal volume at a set breath rate to control minute ventilation this is:
9. Question: When the ventilator delivers set pressure at a set breath Tidal volume and minute ventilation will vary this is:
10. Question: This ventilator mode provides a set tidal volume at a set breath rate. Spontaneous breaths between or above the mandatory breath rate will not receive the set tidal volume but may receive pressure support:
    

    ---

NRNP 6566 Week 7 Knowledge Check

1. Question: When possible, where is the best place to position the board for a chest X-ray?
2. Question: When reviewing an X-ray, all of the following are correct EXCEPT:
3. Question: Prostate-specific antigen (PSA) is controversial; however, it is useful in some cases. What is the normal level of PSA for an older man over 65?
4. Question: What area of the heart conducts the electrical signal down and up through the heart from the nodes to the myocardium?
5.  Question: Your patient’s liver enzyme panel results came back. Which of the following are abnormal results?
6. Question: The pulmonic valve is one of two semilunar valves in the heart. The other is the:
7. Question: When performing a CBC on your older adult, all of the following values are within normal levels EXCEPT:
8. Question: What area of the heart is considered the “pacemaker of the heart”?
9. Question: When reviewing the chest X-ray, a review of the bony structures of the clavicle, ribs, and spine can indicate which of the following pathologies if present?
10. Question: The EKG or ECG is looking at the electrical activity of the heart. True or false?
    

    ---

NRNP 6566 Week 7 Knowledge Check

1. Question: A patient with respiratory failure has hemodynamic monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP) of 10 cm H2O. Which information indicates that a change in the ventilator settings may be required?
2. Question: The APRN is monitoring a newly intubated patient. He appears to be very anxious and “fighting” the ventilator. What would be the most appropriate action?
3. Question: A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side.
4. Question: A 34 year ole email who weights 96 kg (211 lbs.) and is 165 cm (5 ft. 6 inches) tall has chest trauma due to a motorcycle accident. The patient has just been intubated, sedated and paralyzed with morphine sulfate and pancuronium bromide. What initial ventilator settings are appropriate for this patient? Where do you think the problem lies with this particular patient?
5. Question: A 40 year-old. 6-foot tall man has been inpatient on the step down unit for the past 2 days. He was admitted for fever and cough with production of yellow sputum. His admission blood pressure was 128/72 and initial chest x-ray showed a left lower lobe infiltrate. His ABG on room air showed: pH 7.31, PCO2 30, PO2 78, HCO3 17. He was started on antibiotics and progress notes from he past two days indicate improvement in his condition.The APRN is called by the nurse because of worsening of the patients condition….. On your arrival to the room, vitals signs are. BP. 86/60 P 118 RR 38 oxygen saturation on a non-rebreather mask is 78% (this am it was 97% on 2L per NC). The patient is laboring to breath with accessory muscle use. He is less responsive, diaphoretic, and is speaking in short sentences. Repeat chest x-ray shows bilateral diffuse lung opacities. ABG on the non-rebreather mask show: pH 7.18, PCO2 47, PO2 56, HCO313. The decision to intubate the patient is made. What initial ventilator settings would you order?
6. Question: Four hours after mechanical ventilation is initiated for a patient with chronic obstructive pulmo-nary disease (COPD), the patient’s arterial blood gas (ABG) results include a pH of 7.50, PaO2 of 80 mm Hg, PaCO2 of 29 mm Hg, and HCO3- of 23 mEq/. What change in ventilator settings would be indicated?
7. Question: The APRN is notified that an intubated patients endotracheal tube (ET) was marked at 21 cm and is not at the 24 cm line. The patient appears anxious and restless. What action should the APRN take?
8. Question: A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side. What management steps should you institute at this point?
9. Question: A 59 year old man was admitted to the ICU for a COPD exacerbation. He was intubated earlier in the day. Initially after being intubated his static pressure was 23 cm H2o and peak pressure 47 cm H20. The APRN is notified that currently his peak pressure has risen to 62 cm H20 and the static pressure is 42 cm H20. His heart rate has increased from 88 to 112beats / minute and his blood pressure has decreased from 112/88 to 92/ 72. He has decreased breath sounds on the left side….. What do states and peek pressures represent on the ventilator?
10. Question: A 58 year-old man with a history of COPD presents to the emergency room with a two dayhistoryofincreasingshortnessofbreaththatstartedafterarecentviralinfection.His current oxygen saturation is 87% on room air. He is able to speak one to two words at a time and is working hard to breath. On exam, he has diffuse wheezes and a prolonged expiratory phase. His chest x-ray reveals changes consistent with COPD but no new focal infiltrates. An arterial blood gas (ABG) is done and shows pH 7.15, PCO2 57, PO2 61, … What are the indications for initiating mechanical ventilation?
    

    ---

NRNP 6566 Week 7 Knowledge Check

1. Question: For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
2. Question: A 54-year-old female has a 30-year pack smoking history. She recently underwent pulmonary function testing which showed moderate obstructive lung disease. What would your treatment plan (including medications) include for this patient?
3. Question: Mr. A is a 25-year-old male who comes to the ER complaining of increasing shortness of breath and upper respiratory symptoms – cough, fever, and progressive dyspnea for three days. On exam he appears cyanotic, has respiratory distress and inspiratory crackles over the left base. RR = 40 CXR – left lobar pneumonia. Temp = 102° and WBC = 17,000. ABG and electrolytes:
4. Question: A 23-year-old male with Type 1 diabetes presents to the ER complaining of fatigue and malaise. He tells you he has skipped his insulin injections the previous two days. His labsare:
5. Question: For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
6. Question: For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
7. Question: A 65-year-old female suddenly becomes hypotensive one day following surgery for a fractured femur. Her ABG before surgery on room air showed a pO2 of 84 and pCo2 of 39.
8. Question: For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example2221
9. Question: For the following ABGs, identify the level of hypoxemia, the primary acid base disorder, and the type of compensation. Example – acute respiratory acidosis with metabolic alkalosis and severe hypoxemia
10. Question: A 14-year-old female asthmatic is brought to the ER in moderate respiratory distress. Her PEF is 55% of predicted. What would your immediate medication orders include?