Pilbeam’s Mechanical Ventilation 7th Edition – Complete Test Bank with Verified Answers (Cairo) Chapter 1-23 | All Chapters

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Chapter 01: Basic Terms and Concepts of Mechanical Ventilation
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Cairo: Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications, 7th
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Edition
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MULTIPLE CHOICE b-g




1. The body’s mechanism for conducting air in and out of the lungs is known as which of the
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gfollowing?
a. External respiration b-g




b. Internal respiration b-g




c. Spontaneous ventilation b-g




d. Mechanical ventilation b-g




ANS: b - g C
The conduction of air in and out of the body is known as ventilation. Since the question asks
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




for the body’s mechanism, this would be spontaneous ventilation. External respiration
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




involves the exchange of oxygen (O2) and carbon dioxide (CO2) between the alveoli and the
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




pulmonary capillaries. Internal respiration occurs at the cellular level and involves movement
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of oxygen from the systemic blood into the cells.
g b-g b-g b-g b-g b-g b-g b-g b-g




REF: b - g b - g pg. 2 b-g




2. Which of the following are involved in external respiration?
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a. Red blood cells and body cells b-g b-g b-g b-g b-g




b. Scalenes and trapezius muscles b-g b-g b-g




c. Alveoli and pulmonary capillaries b-g b-g b-g




d. External oblique and transverse abdominal muscles b-g b-g b-g b-g b-g




ANS: b - g C
External respiration involves the exchange of oxygen and carbon dioxide (CO2) between the
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




alveoli and the pulmonary capillaries. Internal respiration occurs at the cellular level and
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




involves movement of oxygen from the systemic blood into the cells. Scalene and trapezius
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




muscles are accessory muscles of inspiration. External oblique and transverse abdominal
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muscles are accessory muscles of expiration.
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REF: b - g b - g pg. 2 b-g




3. The graph that shows intrapleural pressure changes during normal spontaneous breathing is
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depicted by which of the following?
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a.

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b.




c.




d.




ANS: b - g B
During spontaneous breathing, the intrapleural pressure drops from about 5 cm H2O at end-
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




expiration to about 10 cm H2O at end-inspiration. The graph depicted for answer B shows
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




that change from 5 cm H2O to 10 cm H2O.
g b-g b-g b-g b-g b-g b-g b-g b-g b-g




REF: b - g b - g pg. 3 b-g




4. During spontaneous inspiration alveolar pressure (PA) is about:
b-g b-g b-g b-g b-g b-g b-g b-g .
a. 1 cm H2O b-g b-g




b. +1 cm H2O
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c. 0 cm H2O b-g b-g




d. 5 cm H2O b-g b-g




ANS: b - g A
1 cm H2O is the lowest alveolar pressure will become during normal spontaneous
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ventilation. During the exhalation of a normal spontaneous breath the alveolar pressure will
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




become +1 cm H2O.
g b-g b-g b-g




REF: b - g b - g pg. 4 b-g




5. The pressure required to maintain alveolar inflation is known as which of the following?
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a. Transairway pressure (PTA) b-g b-g




b. Transthoracic pressure (PTT) b-g b-g




c. Transrespiratory pressure (PTR) b-g b-g




d. Transpulmonary pressure (PL) b-g b-g




ANS: b - g D

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The definition of transpulmonary pressure (PL) is the pressure required to maintain alveolar
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inflation. Transairway pressure (PTA) is the pressure gradient required to produce airflow in the
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conducting tubes. Transrespiratory pressure (PTR) is the pressure to inflate the lungs and
g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




airways during positive-pressure ventilation. Transthoracic pressure (PTT) represents the
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pressure required to expand or contract the lungs and the chest wall at the same time.
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REF: b - g b - g pg. 4 b-g




6. Calculate the pressure needed to overcome airway resistance during positive-pressure
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gventilation when the proximal airway pressure (PAw) is 35 cm H2O and the alveolar pressure
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g(PA) is 5 cm H2O. b-g b-g b-g b-g




a. 7 cm H2O b-g b-g




b. 30 cm H2O b-g b-g




c. 40 cm H2O b-g b-g




d. 175 cm H2O b-g b-g




ANS: b - g B
The transairway pressure (PTA) is used to calculate the pressure required to overcome airway
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resistance during mechanical ventilation. This formula is PTA = Paw - PA.
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REF: b - g b - g pg. 4 b-g




7. The term used to describe the tendency of a structure to return to its original form after
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being stretched or acted on by an outside force is which of the following?
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a. Elastance
b. Compliance
c. Viscous resistance b-g




d. Distending pressure b-g




ANS: b - g A
The elastance of a structure is the tendency of that structure to return to its original shape after
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being stretched. The more elastance a structure has, the more difficult it is to stretch. The
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compliance of a structure is the ease with which the structure distends or stretches.
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Compliance is the opposite of elastance. Viscous resistance is the opposition to movement
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offered by adjacent structures such as the lungs and their adjacent organs. Distending pressure
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is pressure required to maintain inflation, for example, alveolar distending pressure.
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REF: b - g b - g pg. 5 b-g




8. Calculate the pressure required to achieve a tidal volume of 400 mL for an intubated patient
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gwith a respiratory system compliance of 15 mL/cm H2O.
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a. 6 cm H2O b-g b-g




b. 26.7 cm H2O b-g b-g




c. 37.5 cm H2O b-g b-g




d. 41.5 cm H2O b-g b-g




ANS: b - g B
C = V/ P then P = V/ C
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REF: b - g b - g pg. 5 b-g

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9. Which of the following conditions causes pulmonary compliance to increase?
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a. Asthma
b. Kyphoscoliosis
c. Emphysema
d. Acute respiratory distress syndrome (ARDS) b-g b-g b-g b-g




ANS: b - g C
Emphysema causes an increase in pulmonary compliance, whereas ARDS and kyphoscoliosis
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cause decreases in pulmonary compliance. Asthma attacks cause increase in airway resistance.
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REF: b - g b - g pg. 6 | pg. 7 b-g b-g b-g b-g




10. Calculate the effective static compliance (Cs) given the following information about a patient
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greceiving mechanical ventilation: peak inspiratory pressure (PIP) is 56 cm H2O, plateau
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gpressure (Pplateau) is 40 cm H2O, exhaled tidal volume (VT) is 650 mL, and positive end
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gexpiratory pressure (PEEP) is 10 cm H2O. b-g b-g b-g b-g b-g b-g




a. 14.1 mL/cm H2O b-g b-g




b. 16.3 mL/cm H2O b-g b-g




c. 21.7 mL/cm H2O b-g b-g




d. 40.6 mL/cm H2O b-g b-g




ANS: b - g C
The formula for calculating effective static compliance is Cs = VT/(Pplateau
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g EEP).
b-g




REF: b - g b - g pg. 6 | pg. 7 b-g b-g b-g b-g




11. Based upon the following patient information, calculate the patient’s static lung compliance:
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gexhaled tidal volume (VT) is 675 mL, peak inspiratory pressure (PIP) is 28 cm H2O,
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gplateau pressure (Pplateau) is 8 cm H2O, and PEEP is set at 5 cm H2O.
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g




a. 0.02 L/cm H2O b-g b-g




b. 0.03 L/cm H2O b-g b-g




c. 0.22 L/cm H2O b-g b-g




d. 0.34 L/cm H2O b-g b-g




ANS: b - g C
The formula for calculating effective static compliance is Cs = VT/(Pplateau
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g EEP).
b-g




REF: b - g b - g pg. 5 | pg. 6 b-g b-g b-g b-g




12. A patient receiving mechanical ventilation has an exhaled tidal volume (VT) of 500 mL and a
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




gpositive end expiratory pressure setting (PEEP) of 5 cm H2O. Patient-ventilator system checks
b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-




greveal the following data:
b-g b-g b-g




Time PIP (cm H2O) b-g b-g Pplateau (cm H2O) b-g b-g




0600 27 15
0800 29 15
1000 36 13

The respiratory therapist should recommend which of the following for this patient?
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1. Tracheobronchial suctioning b-g




2. Increase in the set tidal volume b-g b-g b-g b-g b-g