FCCS FCCS Respiratory Management 2 — Questions and Answers
Question 1: In a patient on mechanical ventilation, sudden increase in peak airway pressure with unchanged plateau pressure most likely indicates:
- Pneumothorax
- Increased airway resistance (e.g., bronchospasm, secretions) (Correct answer)
- Decreased lung compliance
- Right mainstem intubation
Correct answer: Increased airway resistance (e.g., bronchospasm, secretions)
A rise in peak pressure without a change in plateau pressure reflects increased airway resistance, suggesting bronchospasm or secretion buildup.
Question 2: What is the primary purpose of PEEP in mechanical ventilation?
- Increase tidal volume
- Prevent alveolar collapse and improve oxygenation (Correct answer)
- Reduce respiratory rate
- Decrease FiO2 requirements acutely
Correct answer: Prevent alveolar collapse and improve oxygenation
PEEP maintains positive end-expiratory pressure to keep alveoli open, preventing cyclic collapse and improving ventilation-perfusion matching.
Question 3: Which acid-base disturbance is most commonly caused by mechanical hyperventilation?
- Metabolic acidosis
- Respiratory alkalosis (Correct answer)
- Metabolic alkalosis
- Respiratory acidosis
Correct answer: Respiratory alkalosis
Excessive ventilation lowers PaCO2, raising blood pH and causing respiratory alkalosis.
Question 4: Before oral intubation, pre-oxygenation should ideally achieve what SpO2?
- Greater than 88%
- Greater than 95%
- 100% (Correct answer)
- Greater than 90%
Correct answer: 100%
Pre-oxygenation to 100% SpO2 maximizes oxygen reserves and extends the safe apnea time during intubation attempts.
Question 5: Endotracheal tube cuff pressure should be maintained between which values to prevent tracheal injury?
- 5–10 cmH2O
- 20–30 cmH2O (Correct answer)
- 35–45 cmH2O
- 50–60 cmH2O
Correct answer: 20–30 cmH2O
Cuff pressure of 20–30 cmH2O provides an adequate seal while preventing tracheal mucosal ischemia from excessive pressure.
Question 6: Which breath sound finding is most consistent with right mainstem intubation?
- Bilateral wheezing
- Absent breath sounds on the left (Correct answer)
- Stridor over the trachea
- Crackles bilaterally
Correct answer: Absent breath sounds on the left
Right mainstem intubation ventilates only the right lung, causing absent or diminished breath sounds on the left side.
FCCS FCCS Respiratory Management 2
In a patient on mechanical ventilation, sudden increase in peak airway pressure with unchanged plateau pressure most likely indicates: