CCRN - Review Mechanical Ventilation Management Questions and Answers

Question 1

A patient with Acute Respiratory Distress Syndrome (ARDS) is on Assist-Control ventilation.
The ventilator's high-pressure alarm sounds.
The peak inspiratory pressure (PIP) is 50 cm H2O, and the plateau pressure (Pplat) is 42 cm H2O.
Which intervention is the highest priority for the nurse?

Accepted Answer

Decrease the set tidal volume.

Answer

Perform deep endotracheal suctioning.

Answer

Check the ventilator tubing for kinks or water.

Answer

Administer a prescribed bronchodilator.

Question 2

A critical care nurse is managing a patient on Synchronized Intermittent Mandatory Ventilation (SIMV) with a set rate of 12 breaths/minute. The patient's total respiratory rate is 22 breaths/minute. How does the ventilator support the 10 patient-initiated breaths?

Accepted Answer

They are supported with a set level of pressure support.

Answer

They are delivered with the full set tidal volume.

Answer

They receive no support from the ventilator.

Answer

They are delivered with the same inspiratory time as mandatory breaths.

Question 3

A patient is undergoing a spontaneous breathing trial (SBT) to assess for weaning readiness. Which of the following findings would be the strongest indicator of SBT failure, requiring the patient to be placed back on their previous ventilator settings?

Accepted Answer

A Rapid Shallow Breathing Index (RSBI) of 130 breaths/min/L.

Answer

A heart rate increase from 88 to 105 beats/min.

Answer

A blood pressure change from 120/80 mmHg to 135/88 mmHg.

Answer

A slight increase in patient anxiety noted by the nurse.

Question 4

A patient intubated for a COPD exacerbation has the following arterial blood gas results on volume-controlled ventilation: pH 7.26, PaCO2 68 mmHg, PaO2 88 mmHg, HCO3 29 mEq/L. The current ventilator settings are: Rate 14, Tidal Volume 500 mL, FiO2 0.40, PEEP 5 cm H2O. Which ventilator adjustment is most appropriate to correct the patient's acid-base imbalance?

Accepted Answer

Increase the respiratory rate to 18.

Answer

Increase the FiO2 to 0.50.

Answer

Decrease the tidal volume to 400 mL.

Answer

Increase the PEEP to 8 cm H2O.

Question 5

A 70 kg male patient is intubated for ARDS. To adhere to a lung-protective ventilation strategy, the nurse should anticipate setting the initial tidal volume to which of the following ranges?

Accepted Answer

280 - 420 mL (4-6 mL/kg)

Answer

700 - 840 mL (10-12 mL/kg)

Answer

560 - 700 mL (8-10 mL/kg)

Answer

150 - 250 mL (2-3.5 mL/kg)

Question 6

The nurse is caring for a patient on mechanical ventilation when the low-pressure alarm sounds. The nurse assesses the patient and finds them with a decreased level of consciousness and diminished breath sounds on the left side. Which of the following is the most likely cause?

Accepted Answer

The ventilator tubing has become disconnected from the endotracheal tube.

Answer

The patient is biting the endotracheal tube.

Answer

There is a mucus plug in the mainstem bronchus.

Answer

The patient has developed a tension pneumothorax.