問題一覧
1
The filling pressure of the ventricle at the end of ventricular diastole is known as which of the following?
Preload
2
Which measurement is typically used to indicate right ventricular preload?
Right ventricular end-diastolic pressure (RVEDP)
3
Which of the following can be used to estimate the contractility of the ventricles?
Ejection fraction
4
Calculate the ejection fraction of a female patient with a stroke volume of 40 mL and an end- diastolic volume of 125 mL.
0.32
5
Left ventricular afterload is indicated by which of the following?
Systemic vascular resistance
6
The most determining factor for preload is which of the following?
Venous return
7
An increase in systemic vascular resistance will cause which of the following to occur?
Increase left ventricular afterload
8
The main component of a hemodynamic monitoring system is which of the following?
Strain gauge transducer
9
The function of the transducer in the invasive vascular monitoring system is to do which of the following?
Convert the fluid pressure to an electrical signal.
10
Which of the following is true concerning the insertion of a radial arterial line?
1. The catheter tip must face upstream.
2. The catheter tip must face downstream.
3. The transducer must be higher than the catheter tip.
4. The transducer must be level with the catheter tip.
1, 4
11
While checking an indwelling central venous pressure (CVP) catheter the respiratory therapist observes that the transducer is at the epistatic line. The respiratory therapist should do which of the following at this time?
Accept the CVP reading obtained.
12
While attempting to draw blood from an indwelling arterial catheter, the respiratory therapist notices a dampened waveform and has difficulty withdrawing blood for sampling. What should the respiratory therapist’s immediate action be?
Remove the catheter.
13
The respiratory therapist preparing to insert an arterial line in the right radial artery performs an Allen’s test. The result of the Allen’s test is 20 seconds. The respiratory therapist should do which of the following?
Perform an Allen’s test on the left hand.
14
Common complications of systemic artery catheterization include all but which of the following?
Phlebitis
15
The measurement that can be used to estimate right ventricular preload is which of the following?
Central Venous Pressure
16
Absolute confirmation of placement of a central venous pressure catheter is done with which of the following?
Chest x-ray
17
The complications that may occur during the insertion of a central venous pressure line include all of the following except:
Infection
18
The vessels that often require a surgical cut down when used for pulmonary artery catheter access include which of the following?
1. Femoral vein
2. Subclavian vein
3. Internal jugular vein
4. Antecubital vein
2, 4
19
During the introduction of a pulmonary artery catheter the waveform seen in the figure is visible on the monitor. This waveform represents which of the following locations?
Right atrium
20
During the insertion of a pulmonary artery catheter, the balloon needs to be inflated with air when it enters which of the following?
Intrathoracic vessel
21
The most appropriate insertion site(s) for a pulmonary catheter in a patient with phlebitis include which of the following?
1. Internal jugular vein
2. Subclavian vein
3. Antecubital vein
4. Femoral vein
1, 2
22
Excessive pulmonary artery catheter movement can cause which of the following to occur?
Catheter knotting
23
The waveform of a pulmonary catheter, shown in the figure, is located in which of the following?
Pulmonary artery
24
A pulmonary artery catheter must be wedged in which of the following locations?
Zone 3
25
The range for the time a pulmonary artery catheter should be inflated is which of the following?
15 to 30 seconds
26
Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 9 g%, arterial oxygen saturation (SaO2) = 96%, arterial partial pressure of oxygen (PaO2) = 97 mm Hg.
11.9 vol%
27
Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 17 g%, arterial oxygen saturation (SaO2) = 93%, arterial partial pressure of oxygen (PaO2) = 64 mm Hg.
21.4 vol%
28
A patient with an oxygen consumption of 340 mL/min, arterial oxygen content of 17.3 vol % and mixed venous oxygen content of 12.8 vol % has a cardiac output of which of the following?
7.6 mL/min
29
Calculate cardiac output using the Fick Principle for the following values:
3.7 L/min
30
A patient with the hemodynamic values below has a cardiac output of which of the following?
2.9 mL/min
31
Calculate the cardiac index using the following data: Cardiac output = 4.6 L/min
3.8 L/min
32
Calculate a 90-kg patient’s cardiac index with the following measurements: cardiac output 3.8 L/min, body surface area 3 m2
1.3 L/min
33
Calculate the cardiac index for a patient with the following data: heart rate = 80 beats/min, stroke volume = 55 mL, and body surface area = 2.8 m2.
0.57 L/min
34
Calculate the stroke index using the following data: cardiac output = 3.7 L/min, heart rate = 90 beats/min, and body surface area = 1.7 m2.
24 mL
35
Calculate the stroke volume (SV) and the stroke volume index (SI) using the following information: cardiac output = 4.5 L/min, heart rate = 110 beats/min, and body surface area = 1.3 m2.
SV = 41 mL: SI = 31.5 mL/m2
36
If the heart rate is 80 beats per minute, how long is one beat?
1.3 seconds
37
Calculate the left ventricular stroke work for a patient with a body surface area of 1.1 m2, blood pressure 105/68 mm Hg, heart rate 86 beats per minute, and cardiac output of 4.3 L/min.
49.5 g-m/m2
38
The hemodynamic values for a patient in the cardiovascular care unit are: blood pressure (BP) 96/60 mm Hg, pulmonary artery pressure (PAP) 29 mm Hg, pulmonary capillary wedge pressure (PCWP) 14 mm Hg, stroke volume (SV) 50 mL. The patient has a body surface area of 1.6 m2. Calculate the patient’s left ventricular stroke work (LVSW).
30.6 g-m/m2
39
Calculate the right ventricular stroke work (RVSW) given the following patient data: pulmonary artery pressure (PAP) = 35/25 mm Hg, cardiac output (C.O.) = 3.6 L
6.2 g-m/m2
40
Calculate the right ventricular stroke work (RVSW) for a patient with the following measurements: pulmonary artery pressure (PAP) 50/32 mm Hg, cardiac output (C.O.) 4.0 L/min, heart rate (HR) 127/min, body surface area (BSA) 1.72 m2.
9.5 g-m/m2
41
The following hemodynamic measurements were obtained from a patient in the intensive care unit: pulmonary artery pressure (PAP) = 67/25 mm Hg, pulmonary artery occlusion pressure (PAOP) = 18 mm Hg, blood pressure (BP) = 100/50 mm Hg, central venous pressure (CVP) = 17 mm Hg, cardiac output (C.O.) = 5.7 L/min, and heart rate (HR) = 75 beats/min. Calculate this patient’s pulmonary vascular resistance (PVR).
295 dyne x sec x cm-5
42
Calculate the pulmonary vascular resistance (PVR) given the following measurements obtained during a hemodynamic study: pulmonary artery pressure (PAP) = 40/22 mm Hg, pulmonary artery occlusion pressure (PAOP) = 12 mm Hg, blood pressure (BP) = 156/80 mm Hg, central venous pressure (CVP) = 19 mm Hg, cardiac output (C.O.) = 4.8 L/min, and heart rate (HR) = 68 beats/min.
267 dyne x sec x cm-5
43
The following hemodynamic measurements were obtained from a patient in the intensive care unit: pulmonary artery pressure (PAP) = 67/25 mm Hg, pulmonary artery occlusion pressure (PAOP) = 18 mm Hg, blood pressure (BP) = 100/50 mm Hg, central venous pressure (CVP) = 17 mm Hg, cardiac output (C.O.) = 5.7 L/min, and heart rate (HR) = 75 beats/min. Calculate this patient’s systemic vascular resistance (SVR).
1,165 dyne x sec x cm-5
44
Calculate the systemic vascular resistance (SVR) given the following measurements obtained during a hemodynamic study: pulmonary artery pressure (PAP) = 40/22 mm Hg, pulmonary artery occlusion pressure (PAOP) = 12 mm Hg, blood pressure (BP) = 156/80 mm Hg, central venous pressure (CVP) = 19 mm Hg, cardiac output (C.O.) = 4.8 L/min, and heart rate (HR) = 68 beats/min.
1,496 dyne x sec x cm-5
45
A patient with a mitral valve stenosis is most likely to have which of the following pulmonary artery occlusion pressure (PAOP) values?
20 mm Hg
46
The hemodynamic measurement that is indicative of a patient with right heart failure is which of the following?
Central venous pressure (CVP) = 16 mm Hg
47
An increase in systemic vascular resistance can be elevated by which of the following disorders?
Hypervolemia
48
The hemodynamic parameter that is not within normal limits includes which of the following?
Mean arterial pressure (MAP) = 18 mm Hg
49
A high cardiac output can cause which of the following complications with a pulmonary artery catheter?
Catheter whip
50
Advancing a pulmonary artery catheter into a smaller artery may cause which of the following complications?
Pulmonary infarction
51
During the inspiratory phase of spontaneous breathing, what happens to the pulmonary artery (PA) waveform?
The PA waveform trend decreases.
52
An intubated patient with no known history of congestive heart failure is in the ICU. The patient is comatose and currently receiving mechanical ventilation via volume-controlled continuous mandatory ventilation (VC-CMV), set rate 12 bpm, set tidal volume (VT) 400 mL, positive-end- expiratory pressure (PEEP) 18 cm H2O, fractional inspired oxygen (FIO2) 0.35, and the patient is not assisting. Hemodynamic measurements show the following: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 33/20 mm Hg, and pulmonary artery occlusion pressure (PAOP) 16 mm Hg. Arterial blood gas (ABG) results are: pH 7.43, arterial partial pressure of carbon dioxide (PaCO2) 38 mm Hg, arterial partial pressure of oxygen (PaO2) 90 mm Hg. The physician asks for recommendations to improve this patient’s hemodynamics. The most appropriate recommendation for this patient is which of the following?
Decrease the PEEP incrementally and recheck hemodynamic measurements.
53
A patient in the ICU has a chest x-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 24/13 mm Hg, and pulmonary artery occlusion pressure (PAOP) 21 mm Hg. These findings are consistent with which of the following?
Cardiogenic pulmonary edema
54
A patient in the ICU has a chest x-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 3 mm Hg, pulmonary artery pressure (PAP) 21/10 mm Hg, and pulmonary artery occlusion pressure (PAOP) 8 mm Hg. These findings are consistent with which of the following?
Acute respiratory distress syndrome
55
Ventricular contractility can be estimated by which of the following?
Ejection fraction
56
During mechanical ventilation of a patient with COPD, the PaCO2 = 58 mm Hg and the = 5.5 L/min. The desired PaCO2 for this patient is 45 mm Hg. To what should the be changed?
7.1 L/min
57
A patient with CHF is being mechanically ventilated. The patient’s current PaCO2 = 28 mm Hg, and the ventilator set rate is 16/minute. The desired PaCO2 for this patient is 40 mm Hg. To what should the set rate be changed?
11 / min
58
A patient with pneumonia and underlying COPD is being mechanically ventilated in the VC-CMV mode with VT 650 mL. The resulting PaCO2 is 62 mm Hg. What change should be made to the VT to obtain a desired PaCO2 of 50 mm Hg for this patient?
800 mL
59
The average tidal volume range in an individual with no pulmonary problems is which of the following?
5 to 8 mL/kg IBW
60
A male patient (76-kg IBW) with no history of pulmonary disease is brought to the emergency department for treatment of a drug overdose. He is intubated and placed on mechanical ventilation with VC-CMV, f = 12/min, VT = 450 mL. The resulting arterial blood gas values are: pH 7.32, PaCO2 53 mm Hg, and HCO3- 25 mEq/L. The most appropriate action to correct the acid-base disturbance is which of the following?
Increase VT to 595 mL
61
A female patient (59-kg IBW) with no history of pulmonary disease is being invasively ventilated with VC-CMV, f = 12/min, VT = 470 mL, PEEP = 5 cm H2O, FIO2 = 0.5. ABG results with these settings are: pH 7.31, PaCO2 54 mm Hg, PaO2 92 mm Hg, SaO2 90%, HCO3- 24 mEq/L. The most appropriate action for the respiratory therapist to take is which of the following?
Increase f to 16/min
62
A male patient (74-kg IBW) is being ventilated with PC-CMV, f = 12/min, PIP = 20 cm H2O, TI = 1.5 seconds; the resulting flow-time scalar is shown below. The patient’s measured VT is 435 mL. ABG results on these settings are: pH 7.32, PaCO2 54 mm Hg, HCO3- 25 mEq/L. The most appropriate action to take is which of the following?
Increase PIP to 27 cm H2O
63
A 28-year-old female (55-kg IBW) is being mechanically ventilated with VC-CMV, f = 14/min, VT = 700 mL. The patient has no history of pulmonary disease. The resulting ABG values are: pH 7.55, PaCO2 27 mm Hg, HCO3- 23 mEq/L. The most appropriate action to take is which of the following?
Decrease VT to 450 mL
64
A male patient (83 kg IBW) is intubated and ventilated with PC-CMV, f = 12/min, set PIP = 28 cm H2O, resulting in a VT of 430 mL. The ABG results on this setting are: pH 7.35, PaCO2 45 mm Hg, and HCO3- 23 mEq/L. Forty-eight hours later on the same settings, the ABG results are: pH 7.54, PaCO2 27 mm Hg, and HCO3- 21 mEq/L with an exhaled VT of 800 mL. The most appropriate action at this time is which of the following?
Decrease PIP to 19 cm H2O
65
A patient with an IBW of 68 kg is intubated and being mechanically ventilated with VC-CMV, f = 12/min, and VT = 470 mL. The patient has a combined respiratory rate of 25/min. The ABG results are: pH 7.56, PaCO2 26 mm Hg, and HCO3- 22 mEq/L. The most appropriate action is to do which of the following?
Change the mode to VC-IMV
66
Metabolic acidosis may be caused by which of the following?
Overdose with salicylate
67
Metabolic alkalosis can be caused by which of the following?
Potassium deficiency
68
If respiratory acidosis persists after alveolar ventilation of a patient has been increased, which of the following could be the cause?
Pulmonary embolism
69
A 59-kg IBW female patient is being mechanically ventilated in the CMV mode, f = 12/min, VT = 400 mL, PEEP = 5 cm H2O, FIO2 = 0.5. The ABG results on these settings show a respiratory acidosis and severe hypoxemia. The respiratory therapist increases the set VT and increases the PEEP to 12 cm H2O. The resulting ABGs show improved oxygenation, but the patient still has a respiratory acidosis. The respiratory acidosis may be due to which of the following?
Increased dead space
70
A patient diagnosed with sepsis who is being mechanically ventilated has a combined
minute ventilation of 25 L/min with a PaCO2 of 38 mm Hg. The reason for these findings is most likely which of the following?
1. Increased
2. Decreased
3. Increased VD/VT
4. Decreased VD/VT
1, 3
71
In which of the following situations should iatrogenic hyperventilation be considered?
Acute neurological deterioration with increased intracranial pressure
72
Treatment for increased intracranial pressure includes all of the following except which technique?
Iatrogenic hyperventilation
73
Permissive hypercapnia would benefit patients with which of the following?
Acute lung injury
74
A 45-year-old female (58-kg IBW) with a past medical history of asthma arrives at the emergency department short of breath, anxious, diaphoretic, and unable to perform a peak expiratory flow measurement. She also has a combined acidosis. Breath sounds reveal the patient is not moving much air. The patient is intubated, stabilized, and transported to the ICU. The ventilator settings are: PC-CMV, f = 12/min, PIP = 30 cm H2O, FIO2 = 0.6, and PEEP = 3 cm H2O. The patient is sedated and paralyzed; the resulting ABGs are: pH 7.17, PaCO2 69.3 mm Hg, PaO2 90 mm Hg, and HCO3- 21 mEq/L after continuous bronchodilator therapy. The respiratory rate is increased to 20/min, and the next ABG results are: pH 7.26, PaCO2 58 mm Hg, PaO2 96 mm Hg, and HCO3- 22 mEq/L. The respiratory therapist should suggest which of the following at this time?
Continue with current therapy
75
At what point during deep suctioning should negative pressure be applied?
After 1-cm withdrawal from the point of resistance
76
A suction catheter long enough to reach a mainstem bronchus should be what length?
56 cm (22 in)
77
What size suction catheter is appropriate for use in a patient with a 7-mm ET tube?
10 Fr
78
What size suction catheter is appropriate for use in a patient with a 6-mm ET tube?
8 Fr
79
Advantages of closed suctioning include which of the following?
1. No need to prehyperoxygenate or posthyperoxygenate
2. No need to prehyperventilate or posthyperventilate
3. Decreased risk of infection for caregiver
4. No loss of PEEP during the procedure a.
3, 4
80
During a closed suctioning procedure, the patient’s heart rate changes from 95 beats/min to 58 beats/min. The respiratory therapist should take what immediate action?
Stop the procedure and use the ventilator to hyperoxygenate the patient with 100% oxygen.
81
Which of the following is recommended when administering aerosols to mechanically ventilated patients with a small-volume nebulizer?
Use the ventilator nebulizer system when appropriate.
82
When using a SVN or pMDI with NPPV, where in the NPPV circuit should the device be placed to obtain the greatest aerosol deposition?
Between the leak port and the face mask
83
Which of the following ventilator graphics could be used to assess the response to bronchodilator therapy for a patient receiving mechanical ventilation with VC-CMV?
1. Pressure-time scalar
2. Flow-time scalar
3. Pressure-volume loop
4. Volume-time scalar
1, 2, 4
84
A mechanically ventilated patient continues to have rhonchi after deep suctioning. The respiratory therapist should recommend which of the following?
Vest Airway Clearance System
85
Bedside bronchoscopy of an invasively ventilated patient is being performed by a physician and respiratory therapist. Fentanyl and midazolam were used for conscious sedation. After the bronchoscopy, the patient is not arousable. Which of the following should be done at this time?
Administer naloxone
86
An invasively ventilated patient with ARDS is on PC-CMV, PIP = 30 cm H2O, PEEP = 12 cm H2O, FIO2 = 1.0. The patient’s returned VT is 320 mL. The ABG results on these settings are: pH 7.3, PaCO2 53 mm Hg, PaO2 62 mm Hg. The patient is placed in the prone position, and after 1 hour, ABG results show: pH 7.38, PaCO2 46mm Hg, PaO2 83 mm Hg. The respiratory therapist should do which of the following?
Keep the patient in the prone position and decrease the FIO2.
87
A patient with extensive infiltrates throughout the right lung should be placed in which of the following positions to improve oxygenation?
Left lung down laterally
88
What effect does positive pressure ventilation have on fluid balance?
It increases plasma ADH levels.
89
The waveform of a pulmonary catheter, shown in the figure, is located in which of the following?
pulmonary artery
90
What is the cardiac output when O2 consumption = 360 mL/min, CaO2 = 16.2 vol% and mixed venous O2 content = 10.7 vol%?
5.8 mL/min
91
CVP = 3 mm Hg, PAP = 21/10 mmHg, and PAOP = 8 mmHg, and patient has bilateral infiltrates, this is consistent with what?
ARDS
92
What is SVR when PAP = 50/20 mmHg, PAOP = 15 mmHg, BP 120/70 mmHg, CVP = 15 mmHg, CO = 4.5 L/min, HR = 60 b/min?
1280 dyne x sec x cm-5
93
If the heart rate is 62 bpm, how long is one beat?
1 second
94
Calculate the stroke index using the following data: CO = 4.0 L/min, HR = 70 beats/min, and BSA = 2 m2?
29 mL/m2
95
Which of the following measurements can be used to estimate right ventricular preload?
CVP
96
Common causes of respiratory alkalosis include, which of the following?
MV, anxiety, hypoxia with compensatory hyperventilation, Parenchymal disease
97
What size suction catheter is appropriate for use in a patient with a 8.5 mm ET tube?
12 Fr
98
COPD patient with VC-CMV with VT 450 mL, the PaCO2 = 62. What should the VT be for the desired PaCO2 of 50?
550
99
Which of the following is normal ratio of dead space to tidal volume?
0.2-0.4
100
The average tidal volume range in a individual with no pulmonary problems is which of the following?
6-8
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47問 • 2年前問題一覧
1
The filling pressure of the ventricle at the end of ventricular diastole is known as which of the following?
Preload
2
Which measurement is typically used to indicate right ventricular preload?
Right ventricular end-diastolic pressure (RVEDP)
3
Which of the following can be used to estimate the contractility of the ventricles?
Ejection fraction
4
Calculate the ejection fraction of a female patient with a stroke volume of 40 mL and an end- diastolic volume of 125 mL.
0.32
5
Left ventricular afterload is indicated by which of the following?
Systemic vascular resistance
6
The most determining factor for preload is which of the following?
Venous return
7
An increase in systemic vascular resistance will cause which of the following to occur?
Increase left ventricular afterload
8
The main component of a hemodynamic monitoring system is which of the following?
Strain gauge transducer
9
The function of the transducer in the invasive vascular monitoring system is to do which of the following?
Convert the fluid pressure to an electrical signal.
10
Which of the following is true concerning the insertion of a radial arterial line?
1. The catheter tip must face upstream.
2. The catheter tip must face downstream.
3. The transducer must be higher than the catheter tip.
4. The transducer must be level with the catheter tip.
1, 4
11
While checking an indwelling central venous pressure (CVP) catheter the respiratory therapist observes that the transducer is at the epistatic line. The respiratory therapist should do which of the following at this time?
Accept the CVP reading obtained.
12
While attempting to draw blood from an indwelling arterial catheter, the respiratory therapist notices a dampened waveform and has difficulty withdrawing blood for sampling. What should the respiratory therapist’s immediate action be?
Remove the catheter.
13
The respiratory therapist preparing to insert an arterial line in the right radial artery performs an Allen’s test. The result of the Allen’s test is 20 seconds. The respiratory therapist should do which of the following?
Perform an Allen’s test on the left hand.
14
Common complications of systemic artery catheterization include all but which of the following?
Phlebitis
15
The measurement that can be used to estimate right ventricular preload is which of the following?
Central Venous Pressure
16
Absolute confirmation of placement of a central venous pressure catheter is done with which of the following?
Chest x-ray
17
The complications that may occur during the insertion of a central venous pressure line include all of the following except:
Infection
18
The vessels that often require a surgical cut down when used for pulmonary artery catheter access include which of the following?
1. Femoral vein
2. Subclavian vein
3. Internal jugular vein
4. Antecubital vein
2, 4
19
During the introduction of a pulmonary artery catheter the waveform seen in the figure is visible on the monitor. This waveform represents which of the following locations?
Right atrium
20
During the insertion of a pulmonary artery catheter, the balloon needs to be inflated with air when it enters which of the following?
Intrathoracic vessel
21
The most appropriate insertion site(s) for a pulmonary catheter in a patient with phlebitis include which of the following?
1. Internal jugular vein
2. Subclavian vein
3. Antecubital vein
4. Femoral vein
1, 2
22
Excessive pulmonary artery catheter movement can cause which of the following to occur?
Catheter knotting
23
The waveform of a pulmonary catheter, shown in the figure, is located in which of the following?
Pulmonary artery
24
A pulmonary artery catheter must be wedged in which of the following locations?
Zone 3
25
The range for the time a pulmonary artery catheter should be inflated is which of the following?
15 to 30 seconds
26
Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 9 g%, arterial oxygen saturation (SaO2) = 96%, arterial partial pressure of oxygen (PaO2) = 97 mm Hg.
11.9 vol%
27
Calculate the arterial oxygen content for a patient with the following arterial blood gas measurements: Hgb = 17 g%, arterial oxygen saturation (SaO2) = 93%, arterial partial pressure of oxygen (PaO2) = 64 mm Hg.
21.4 vol%
28
A patient with an oxygen consumption of 340 mL/min, arterial oxygen content of 17.3 vol % and mixed venous oxygen content of 12.8 vol % has a cardiac output of which of the following?
7.6 mL/min
29
Calculate cardiac output using the Fick Principle for the following values:
3.7 L/min
30
A patient with the hemodynamic values below has a cardiac output of which of the following?
2.9 mL/min
31
Calculate the cardiac index using the following data: Cardiac output = 4.6 L/min
3.8 L/min
32
Calculate a 90-kg patient’s cardiac index with the following measurements: cardiac output 3.8 L/min, body surface area 3 m2
1.3 L/min
33
Calculate the cardiac index for a patient with the following data: heart rate = 80 beats/min, stroke volume = 55 mL, and body surface area = 2.8 m2.
0.57 L/min
34
Calculate the stroke index using the following data: cardiac output = 3.7 L/min, heart rate = 90 beats/min, and body surface area = 1.7 m2.
24 mL
35
Calculate the stroke volume (SV) and the stroke volume index (SI) using the following information: cardiac output = 4.5 L/min, heart rate = 110 beats/min, and body surface area = 1.3 m2.
SV = 41 mL: SI = 31.5 mL/m2
36
If the heart rate is 80 beats per minute, how long is one beat?
1.3 seconds
37
Calculate the left ventricular stroke work for a patient with a body surface area of 1.1 m2, blood pressure 105/68 mm Hg, heart rate 86 beats per minute, and cardiac output of 4.3 L/min.
49.5 g-m/m2
38
The hemodynamic values for a patient in the cardiovascular care unit are: blood pressure (BP) 96/60 mm Hg, pulmonary artery pressure (PAP) 29 mm Hg, pulmonary capillary wedge pressure (PCWP) 14 mm Hg, stroke volume (SV) 50 mL. The patient has a body surface area of 1.6 m2. Calculate the patient’s left ventricular stroke work (LVSW).
30.6 g-m/m2
39
Calculate the right ventricular stroke work (RVSW) given the following patient data: pulmonary artery pressure (PAP) = 35/25 mm Hg, cardiac output (C.O.) = 3.6 L
6.2 g-m/m2
40
Calculate the right ventricular stroke work (RVSW) for a patient with the following measurements: pulmonary artery pressure (PAP) 50/32 mm Hg, cardiac output (C.O.) 4.0 L/min, heart rate (HR) 127/min, body surface area (BSA) 1.72 m2.
9.5 g-m/m2
41
The following hemodynamic measurements were obtained from a patient in the intensive care unit: pulmonary artery pressure (PAP) = 67/25 mm Hg, pulmonary artery occlusion pressure (PAOP) = 18 mm Hg, blood pressure (BP) = 100/50 mm Hg, central venous pressure (CVP) = 17 mm Hg, cardiac output (C.O.) = 5.7 L/min, and heart rate (HR) = 75 beats/min. Calculate this patient’s pulmonary vascular resistance (PVR).
295 dyne x sec x cm-5
42
Calculate the pulmonary vascular resistance (PVR) given the following measurements obtained during a hemodynamic study: pulmonary artery pressure (PAP) = 40/22 mm Hg, pulmonary artery occlusion pressure (PAOP) = 12 mm Hg, blood pressure (BP) = 156/80 mm Hg, central venous pressure (CVP) = 19 mm Hg, cardiac output (C.O.) = 4.8 L/min, and heart rate (HR) = 68 beats/min.
267 dyne x sec x cm-5
43
The following hemodynamic measurements were obtained from a patient in the intensive care unit: pulmonary artery pressure (PAP) = 67/25 mm Hg, pulmonary artery occlusion pressure (PAOP) = 18 mm Hg, blood pressure (BP) = 100/50 mm Hg, central venous pressure (CVP) = 17 mm Hg, cardiac output (C.O.) = 5.7 L/min, and heart rate (HR) = 75 beats/min. Calculate this patient’s systemic vascular resistance (SVR).
1,165 dyne x sec x cm-5
44
Calculate the systemic vascular resistance (SVR) given the following measurements obtained during a hemodynamic study: pulmonary artery pressure (PAP) = 40/22 mm Hg, pulmonary artery occlusion pressure (PAOP) = 12 mm Hg, blood pressure (BP) = 156/80 mm Hg, central venous pressure (CVP) = 19 mm Hg, cardiac output (C.O.) = 4.8 L/min, and heart rate (HR) = 68 beats/min.
1,496 dyne x sec x cm-5
45
A patient with a mitral valve stenosis is most likely to have which of the following pulmonary artery occlusion pressure (PAOP) values?
20 mm Hg
46
The hemodynamic measurement that is indicative of a patient with right heart failure is which of the following?
Central venous pressure (CVP) = 16 mm Hg
47
An increase in systemic vascular resistance can be elevated by which of the following disorders?
Hypervolemia
48
The hemodynamic parameter that is not within normal limits includes which of the following?
Mean arterial pressure (MAP) = 18 mm Hg
49
A high cardiac output can cause which of the following complications with a pulmonary artery catheter?
Catheter whip
50
Advancing a pulmonary artery catheter into a smaller artery may cause which of the following complications?
Pulmonary infarction
51
During the inspiratory phase of spontaneous breathing, what happens to the pulmonary artery (PA) waveform?
The PA waveform trend decreases.
52
An intubated patient with no known history of congestive heart failure is in the ICU. The patient is comatose and currently receiving mechanical ventilation via volume-controlled continuous mandatory ventilation (VC-CMV), set rate 12 bpm, set tidal volume (VT) 400 mL, positive-end- expiratory pressure (PEEP) 18 cm H2O, fractional inspired oxygen (FIO2) 0.35, and the patient is not assisting. Hemodynamic measurements show the following: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 33/20 mm Hg, and pulmonary artery occlusion pressure (PAOP) 16 mm Hg. Arterial blood gas (ABG) results are: pH 7.43, arterial partial pressure of carbon dioxide (PaCO2) 38 mm Hg, arterial partial pressure of oxygen (PaO2) 90 mm Hg. The physician asks for recommendations to improve this patient’s hemodynamics. The most appropriate recommendation for this patient is which of the following?
Decrease the PEEP incrementally and recheck hemodynamic measurements.
53
A patient in the ICU has a chest x-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 5 mm Hg, pulmonary artery pressure (PAP) 24/13 mm Hg, and pulmonary artery occlusion pressure (PAOP) 21 mm Hg. These findings are consistent with which of the following?
Cardiogenic pulmonary edema
54
A patient in the ICU has a chest x-ray that shows bilateral infiltrates and has the following hemodynamic measurements: central venous pressure (CVP) 3 mm Hg, pulmonary artery pressure (PAP) 21/10 mm Hg, and pulmonary artery occlusion pressure (PAOP) 8 mm Hg. These findings are consistent with which of the following?
Acute respiratory distress syndrome
55
Ventricular contractility can be estimated by which of the following?
Ejection fraction
56
During mechanical ventilation of a patient with COPD, the PaCO2 = 58 mm Hg and the = 5.5 L/min. The desired PaCO2 for this patient is 45 mm Hg. To what should the be changed?
7.1 L/min
57
A patient with CHF is being mechanically ventilated. The patient’s current PaCO2 = 28 mm Hg, and the ventilator set rate is 16/minute. The desired PaCO2 for this patient is 40 mm Hg. To what should the set rate be changed?
11 / min
58
A patient with pneumonia and underlying COPD is being mechanically ventilated in the VC-CMV mode with VT 650 mL. The resulting PaCO2 is 62 mm Hg. What change should be made to the VT to obtain a desired PaCO2 of 50 mm Hg for this patient?
800 mL
59
The average tidal volume range in an individual with no pulmonary problems is which of the following?
5 to 8 mL/kg IBW
60
A male patient (76-kg IBW) with no history of pulmonary disease is brought to the emergency department for treatment of a drug overdose. He is intubated and placed on mechanical ventilation with VC-CMV, f = 12/min, VT = 450 mL. The resulting arterial blood gas values are: pH 7.32, PaCO2 53 mm Hg, and HCO3- 25 mEq/L. The most appropriate action to correct the acid-base disturbance is which of the following?
Increase VT to 595 mL
61
A female patient (59-kg IBW) with no history of pulmonary disease is being invasively ventilated with VC-CMV, f = 12/min, VT = 470 mL, PEEP = 5 cm H2O, FIO2 = 0.5. ABG results with these settings are: pH 7.31, PaCO2 54 mm Hg, PaO2 92 mm Hg, SaO2 90%, HCO3- 24 mEq/L. The most appropriate action for the respiratory therapist to take is which of the following?
Increase f to 16/min
62
A male patient (74-kg IBW) is being ventilated with PC-CMV, f = 12/min, PIP = 20 cm H2O, TI = 1.5 seconds; the resulting flow-time scalar is shown below. The patient’s measured VT is 435 mL. ABG results on these settings are: pH 7.32, PaCO2 54 mm Hg, HCO3- 25 mEq/L. The most appropriate action to take is which of the following?
Increase PIP to 27 cm H2O
63
A 28-year-old female (55-kg IBW) is being mechanically ventilated with VC-CMV, f = 14/min, VT = 700 mL. The patient has no history of pulmonary disease. The resulting ABG values are: pH 7.55, PaCO2 27 mm Hg, HCO3- 23 mEq/L. The most appropriate action to take is which of the following?
Decrease VT to 450 mL
64
A male patient (83 kg IBW) is intubated and ventilated with PC-CMV, f = 12/min, set PIP = 28 cm H2O, resulting in a VT of 430 mL. The ABG results on this setting are: pH 7.35, PaCO2 45 mm Hg, and HCO3- 23 mEq/L. Forty-eight hours later on the same settings, the ABG results are: pH 7.54, PaCO2 27 mm Hg, and HCO3- 21 mEq/L with an exhaled VT of 800 mL. The most appropriate action at this time is which of the following?
Decrease PIP to 19 cm H2O
65
A patient with an IBW of 68 kg is intubated and being mechanically ventilated with VC-CMV, f = 12/min, and VT = 470 mL. The patient has a combined respiratory rate of 25/min. The ABG results are: pH 7.56, PaCO2 26 mm Hg, and HCO3- 22 mEq/L. The most appropriate action is to do which of the following?
Change the mode to VC-IMV
66
Metabolic acidosis may be caused by which of the following?
Overdose with salicylate
67
Metabolic alkalosis can be caused by which of the following?
Potassium deficiency
68
If respiratory acidosis persists after alveolar ventilation of a patient has been increased, which of the following could be the cause?
Pulmonary embolism
69
A 59-kg IBW female patient is being mechanically ventilated in the CMV mode, f = 12/min, VT = 400 mL, PEEP = 5 cm H2O, FIO2 = 0.5. The ABG results on these settings show a respiratory acidosis and severe hypoxemia. The respiratory therapist increases the set VT and increases the PEEP to 12 cm H2O. The resulting ABGs show improved oxygenation, but the patient still has a respiratory acidosis. The respiratory acidosis may be due to which of the following?
Increased dead space
70
A patient diagnosed with sepsis who is being mechanically ventilated has a combined
minute ventilation of 25 L/min with a PaCO2 of 38 mm Hg. The reason for these findings is most likely which of the following?
1. Increased
2. Decreased
3. Increased VD/VT
4. Decreased VD/VT
1, 3
71
In which of the following situations should iatrogenic hyperventilation be considered?
Acute neurological deterioration with increased intracranial pressure
72
Treatment for increased intracranial pressure includes all of the following except which technique?
Iatrogenic hyperventilation
73
Permissive hypercapnia would benefit patients with which of the following?
Acute lung injury
74
A 45-year-old female (58-kg IBW) with a past medical history of asthma arrives at the emergency department short of breath, anxious, diaphoretic, and unable to perform a peak expiratory flow measurement. She also has a combined acidosis. Breath sounds reveal the patient is not moving much air. The patient is intubated, stabilized, and transported to the ICU. The ventilator settings are: PC-CMV, f = 12/min, PIP = 30 cm H2O, FIO2 = 0.6, and PEEP = 3 cm H2O. The patient is sedated and paralyzed; the resulting ABGs are: pH 7.17, PaCO2 69.3 mm Hg, PaO2 90 mm Hg, and HCO3- 21 mEq/L after continuous bronchodilator therapy. The respiratory rate is increased to 20/min, and the next ABG results are: pH 7.26, PaCO2 58 mm Hg, PaO2 96 mm Hg, and HCO3- 22 mEq/L. The respiratory therapist should suggest which of the following at this time?
Continue with current therapy
75
At what point during deep suctioning should negative pressure be applied?
After 1-cm withdrawal from the point of resistance
76
A suction catheter long enough to reach a mainstem bronchus should be what length?
56 cm (22 in)
77
What size suction catheter is appropriate for use in a patient with a 7-mm ET tube?
10 Fr
78
What size suction catheter is appropriate for use in a patient with a 6-mm ET tube?
8 Fr
79
Advantages of closed suctioning include which of the following?
1. No need to prehyperoxygenate or posthyperoxygenate
2. No need to prehyperventilate or posthyperventilate
3. Decreased risk of infection for caregiver
4. No loss of PEEP during the procedure a.
3, 4
80
During a closed suctioning procedure, the patient’s heart rate changes from 95 beats/min to 58 beats/min. The respiratory therapist should take what immediate action?
Stop the procedure and use the ventilator to hyperoxygenate the patient with 100% oxygen.
81
Which of the following is recommended when administering aerosols to mechanically ventilated patients with a small-volume nebulizer?
Use the ventilator nebulizer system when appropriate.
82
When using a SVN or pMDI with NPPV, where in the NPPV circuit should the device be placed to obtain the greatest aerosol deposition?
Between the leak port and the face mask
83
Which of the following ventilator graphics could be used to assess the response to bronchodilator therapy for a patient receiving mechanical ventilation with VC-CMV?
1. Pressure-time scalar
2. Flow-time scalar
3. Pressure-volume loop
4. Volume-time scalar
1, 2, 4
84
A mechanically ventilated patient continues to have rhonchi after deep suctioning. The respiratory therapist should recommend which of the following?
Vest Airway Clearance System
85
Bedside bronchoscopy of an invasively ventilated patient is being performed by a physician and respiratory therapist. Fentanyl and midazolam were used for conscious sedation. After the bronchoscopy, the patient is not arousable. Which of the following should be done at this time?
Administer naloxone
86
An invasively ventilated patient with ARDS is on PC-CMV, PIP = 30 cm H2O, PEEP = 12 cm H2O, FIO2 = 1.0. The patient’s returned VT is 320 mL. The ABG results on these settings are: pH 7.3, PaCO2 53 mm Hg, PaO2 62 mm Hg. The patient is placed in the prone position, and after 1 hour, ABG results show: pH 7.38, PaCO2 46mm Hg, PaO2 83 mm Hg. The respiratory therapist should do which of the following?
Keep the patient in the prone position and decrease the FIO2.
87
A patient with extensive infiltrates throughout the right lung should be placed in which of the following positions to improve oxygenation?
Left lung down laterally
88
What effect does positive pressure ventilation have on fluid balance?
It increases plasma ADH levels.
89
The waveform of a pulmonary catheter, shown in the figure, is located in which of the following?
pulmonary artery
90
What is the cardiac output when O2 consumption = 360 mL/min, CaO2 = 16.2 vol% and mixed venous O2 content = 10.7 vol%?
5.8 mL/min
91
CVP = 3 mm Hg, PAP = 21/10 mmHg, and PAOP = 8 mmHg, and patient has bilateral infiltrates, this is consistent with what?
ARDS
92
What is SVR when PAP = 50/20 mmHg, PAOP = 15 mmHg, BP 120/70 mmHg, CVP = 15 mmHg, CO = 4.5 L/min, HR = 60 b/min?
1280 dyne x sec x cm-5
93
If the heart rate is 62 bpm, how long is one beat?
1 second
94
Calculate the stroke index using the following data: CO = 4.0 L/min, HR = 70 beats/min, and BSA = 2 m2?
29 mL/m2
95
Which of the following measurements can be used to estimate right ventricular preload?
CVP
96
Common causes of respiratory alkalosis include, which of the following?
MV, anxiety, hypoxia with compensatory hyperventilation, Parenchymal disease
97
What size suction catheter is appropriate for use in a patient with a 8.5 mm ET tube?
12 Fr
98
COPD patient with VC-CMV with VT 450 mL, the PaCO2 = 62. What should the VT be for the desired PaCO2 of 50?
550
99
Which of the following is normal ratio of dead space to tidal volume?
0.2-0.4
100
The average tidal volume range in a individual with no pulmonary problems is which of the following?
6-8