PEDIATRIC MECHANICAL VENTILATION

1.

Multiple Choice

5 mins

1 pt

Mechanical requirement depend on all EXCEPT:

Type of surgery

Length of Surgery

Patient Position

Tidal volume

2.

Multiple Choice

5 mins

1 pt

What is physiological PEEP ____ and what does it do?

1-2 cm H20; Maintain alveoli patency

6-10 cmH20; increase Tidal volume

3-5 cm H20; push oxygen down to the lungs

3-5 cm H20; maintain alveoli patency

3.

Multiple Choice

5 mins

1 pt

If Respiratory rate is too high, the risk include all the following EXCEPT:

Inadequate expiratory time

Breath Stacking

Development of Intrinsic PEEP

Prolonged Expiatory time

4.

Multiple Choice

5 mins

1 pt

Ventilators have two major functions?

Volume; SIMV

Volume; Pressure

Pressure; PSV-Pro

Barotrauma alert; Volume alert

5.

Multiple Choice

5 mins

1 pt

What can happen if the cuff pressure is too low?

Nothing higher is better

It will break

Tissue damage

Aspiration

6.

Multiple Choice

5 mins

1 pt

What can happen if the cuff pressure is too high?

Nothing higher is better

It will break

Tissue damage

Aspiration

7.

Multiple Choice

5 mins

1 pt

Which of the following patients would be appropriate for pressure support (PS).

Ventilated and sedated patient that is unresponsive.

A Gift of Hope patient being prepared for the OR

A patient that is ready to be weaned off of the ventilator

A ventilator dependent spinal cord injury patient with a paralyzed diaphragm.

8.

Multiple Select

5 mins

1 pt

Which of the following is true?

Positive End Expiratory Pressure (PEEP) keeps the alveoli open during exhalation.

Allows for more lung recruitment.

Is a common ventilator mode.

Is considered normal when set at +5, in most patients.

9.

Multiple Choice

5 mins

1 pt

The nurse suspects respiratory failure secondary to hypoventilation in a patient with which condition?

anxiety

neuromuscular disease

pulmonary embolism

volume A/C ventilation at a rate of 20 breaths/min

10.

Multiple Choice

5 mins

1 pt

To prevent VAP, it is recommended that the head of bed be elevated to at least what degree?

15 degrees

20 degrees

30 degrees

45 degrees

11.

Multiple Choice

5 mins

1 pt

Interpret the following ABG: pH 7.48, Pa02 56, PaC02 30, HC03 25, Fi02 45

uncompensated respiratory alkalosis

uncompensated metabolic acidosis

uncompensated respiratory acidosis

compensated respiratory acidosis

12.

Multiple Choice

5 mins

1 pt

What is the primary goal for a patient with ARDS?

increase respiratory rate

achieve adequate oxygenation

volume control

keep C02 within normal range

13.

Multiple Select

5 mins

1 pt

Which nursing management strategies help to prevent ventilator associated pneumonia?

Bedrest

Subglottic suction of secretions

Change ventilator circuit tubing every 8 hours

Elevate HOB 30-45 degrees

Oral care with chlorhexidine

14.

Multiple Choice

5 mins

1 pt

Interpret the following ABG: pH 7.34, Pa02 90, PaC02 70, HC03 36, Fi02 45

compensated respiratory alkalosis

uncompensated respiratory alkalosis

compensated respiratory acidosis

uncompensated respiratory acidosis

15.

Multiple Choice

5 mins

1 pt

A client with acute respiratory distress syndrome (ARDS) is showing signs of increased dyspnea. The nurse notes the following ABGs: pH 7.35, PaCO₂ 25, HCO₃ 22, PaO₂ 95. Which finding is abnormal?

pH

PaCO₂

HCO₃

PaO₂

16.

Multiple Choice

5 mins

1 pt

You increase the level of CPAP on an infant admitted for RSV to improve oxygenation following blood gas results reflecting a PaCO2 of 45mmHg and PaO2 of 72mmHg. 15 minutes later blood gas results are as follows: pH 7.33, PaCO2 52mmHg, PaO2 66mmHg. What could have been the complication?

FiO2 should have been increased

There might be a leak in the system

The CPAP level was raised too high

The CPAP level was not raised high enough

17.

Multiple Choice

5 mins

1 pt

Why are retractions so prominent in neonates in comparison to large children and adults?

Because they aren't strong yet

Neonates have fast respiratory rates

Neonates have thin and weak musculature and a less rigid thorax

Neonates have small airways

18.

Multiple Choice

5 mins

1 pt

Which of the following BiPAP settings can influence upper airway stability?

EPAP

IPAP

Rise time

Mode

19.

Multiple Choice

5 mins

1 pt

What is the major cause of metabolic acidosis?

hyperventilation

hypoventilation

ketoacidosis

renal failure

20.

Multiple Choice

5 mins

1 pt

Which condition manifest with hypoventilation?

Respiratory acidosis

respiratory alkalosis

metabolic acidosis

metabolic alkalosis

21.

Multiple Choice

5 mins

1 pt

What is the normal range value for PaCO2

30 to 40 mmHg

22-26 mmHg

35-45 mmHg

33-43 mmHg

22.

Multiple Choice

5 mins

1 pt

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder?

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

23.

Multiple Choice

5 mins

1 pt

A patient with a prolonged episode of nausea, vomiting and diarrhea has an ABG ordered on admission. You might expect the results to show:

Metabolic acidosis

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

24.

Multiple Choice

5 mins

1 pt

Which following mode of ventilation reduces the work of breathing by overcoming the resistance created by ventilator tubing?.

Assist Control mode.

Pressure Support mode.

Controlled Mandatory Ventilation.

Synchronous Intermitten Mandatory Ventilation.

25.

Multiple Choice

5 mins

1 pt

An unconscious baby is receiving mechanical ventilation.

Which nursing diagnosis takes priority?

Self-care deficit related to unconsciousness.

Risk for impaired skin integrity related to immobility.

Ineffective airway clearance related to the inability to expectorate.

Imbalanced nutrition: less than body requirements related to inability to swallow.

26.

Multiple Choice

5 mins

1 pt

Which complication is common in neonates who receive prolonged mechanical ventilation at birth?

Renal failure

Hydrocephalus

Esophageal atresia

Bronchopulmonary dysplasia

27.

Multiple Choice

5 mins

1 pt

SIMV supports ______ breathing patient and can be used in _______ and _______ modes

Paralyzed; Volume; Pressure

Spontaneous Volume; Pressure

Spontaneous; Pressure; Inverse ratio

Controlled; Volume; Vaporized oxydation

28.

Multiple Choice

5 mins

1 pt

In severe alkalosis with low potassium levels what abnormal EKG may be present

Tented T waves

Negative QRS complex in AVF

U waves

Negative QRS complex in lead I

29.

Multiple Choice

5 mins

1 pt

Which of the following may be a reason to order an ABG on a patient?

The patient suddenly develops shortness of breath

An asthmatic is starting to show signs of tiring

A diabetic has developed Kussmaul respirations

All of the above

30.

Multiple Choice

5 mins

1 pt

You are reviewing the results of an ABG. When the pH and the PaCO2 values are moving in opposite directions, the primary problem is:

Respiratory

Renal

Metabolic

Compensation

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