Acute Care Nurse Practitioner Mechanical Ventilation and Respiratory Support 2

Question 1

Prone positioning in ARDS is recommended when PaO₂/FiO₂ ratio is below which threshold?

Accepted Answer

150 mmHg

Answer

300 mmHg

Answer

200 mmHg

Answer

100 mmHg

Question 2

Which ventilator setting should be adjusted to correct hypercapnia in a patient on volume control ventilation?

Accepted Answer

Increase respiratory rate or tidal volume

Answer

Increase FiO₂

Answer

Increase PEEP

Answer

Switch to pressure support

Question 3

A spontaneous breathing trial (SBT) should be attempted when which criteria are met?

Accepted Answer

FiO₂ ≤0.40, PEEP ≤5, hemodynamically stable, able to follow commands

Answer

FiO₂ ≤0.60, PEEP ≤8, spontaneous respiratory rate >30

Answer

MAP >65 on 2 vasopressors, FiO₂ ≤0.50

Answer

GCS >10, PEEP ≤10, FiO₂ ≤0.70

Question 4

Which parameter is MOST predictive of successful extubation?

Accepted Answer

Rapid shallow breathing index (RSBI) <105

Answer

PaO₂/FiO₂ >200

Answer

Minute ventilation <10 L/min

Answer

Negative inspiratory force (NIF) < −30 cmH₂O

Question 5

An ACNP manages a patient with severe bronchospasm on mechanical ventilation. Which strategy minimizes air trapping?

Accepted Answer

Decrease respiratory rate and increase expiratory time

Answer

Increase respiratory rate to 20/min

Answer

Increase inspiratory time

Answer

Add PEEP to 15 cmH₂O

Question 6

High-flow nasal cannula (HFNC) is MOST appropriate as a first-line intervention in which condition?

Accepted Answer

Acute hypoxemic respiratory failure with PaO₂/FiO₂ <300

Answer

Hypercapnic COPD exacerbation requiring ventilatory support

Answer

Post-extubation stridor from laryngeal edema

Answer

Apneic patient requiring immediate airway