Acute Care Nurse Practitioner Mechanical Ventilation and Respiratory Support

Question 1

What tidal volume is recommended for lung-protective ventilation in ARDS per the ARDSNet protocol?

Accepted Answer

6–8 mL/kg predicted body weight

Answer

ARDSNet recommends tidal volumes of 6 mL/kg predicted body weight (PBW) to prevent ventilator-induced lung injury.

Question 2

A patient on mechanical ventilation has a plateau pressure of 34 cmH₂O. What is the MOST appropriate intervention?

Accepted Answer

Decrease tidal volume

Answer

Plateau pressure >30 cmH₂O indicates alveolar overdistension; reducing tidal volume is the primary intervention to protect the lungs.

Question 3

Which PEEP strategy is recommended for patients with moderate-to-severe ARDS (PaO₂/FiO₂ <150)?

Accepted Answer

Higher PEEP per ARDS table or titration

Answer

Patients with moderate-severe ARDS benefit from higher PEEP (typically ≥12–14 cmH₂O) to recruit alveoli and improve oxygenation.

Question 4

An ACNP notes increasing peak airway pressures with unchanged plateau pressures in a ventilated patient. What does this indicate?

Accepted Answer

Increased airway resistance

Answer

Increased peak pressures with stable plateau pressures indicate elevated airway resistance, suggesting bronchospasm or secretion buildup.

Question 5

Which ventilator mode delivers a set tidal volume regardless of patient effort or airway resistance?

Accepted Answer

Volume control ventilation (VCV)

Answer

VCV delivers a fixed tidal volume with each breath, with pressure varying based on compliance and resistance.

Acute Care Nurse Practitioner Practice Test