CCRN Mechanical Ventilation Management 2

Question 1

A patient on volume-control ventilation suddenly shows a rising peak inspiratory pressure with an unchanged plateau pressure. What does this indicate?

Accepted Answer

An airway resistance problem such as secretions or bronchospasm

Answer

Decreased lung compliance

Answer

Pneumothorax

Answer

Auto-PEEP

Question 2

Which finding best confirms correct endotracheal tube placement after intubation?

Accepted Answer

Sustained waveform capnography (ETCO2)

Answer

Equal chest rise

Answer

Auscultation of breath sounds

Answer

Improving SpO2

Question 3

A patient develops auto-PEEP (intrinsic PEEP). Which ventilator change most directly addresses it?

Accepted Answer

Decrease respiratory rate to lengthen expiratory time

Answer

Increase tidal volume

Answer

Increase set PEEP above auto-PEEP only

Answer

Increase inspiratory flow to extremes

Question 4

In ARDS, lung-protective ventilation targets which tidal volume?

Accepted Answer

6 mL/kg of predicted body weight

Answer

10 mL/kg of actual body weight

Answer

12 mL/kg of predicted body weight

Answer

4 mL/kg of actual body weight

Question 5

Plateau pressure should be maintained below which value to limit ventilator-induced lung injury?

Accepted Answer

30 cm H2O

Answer

40 cm H2O

Answer

50 cm H2O

Answer

20 cm H2O

Question 6

A ventilated patient becomes acutely hypotensive with distended neck veins, absent breath sounds on one side, and tracheal deviation. What is the priority intervention?

Accepted Answer

Immediate needle decompression for tension pneumothorax

Answer

Increase PEEP

Answer

Administer a fluid bolus and reassess

Answer

Obtain a chest x-ray before acting

Question 7

Which intervention is a core component of the ventilator-associated pneumonia (VAP) prevention bundle?

Accepted Answer

Elevate the head of bed 30–45 degrees

Answer

Keep the patient supine and flat

Answer

Routine daily prophylactic antibiotics

Answer

Change the ventilator circuit every 24 hours