(2026/2027) UPDATE |Galen
1. A patient on a mechanical ventilator triggers the high-pressure alarm. Which
action should the nurse take first?
A. Auscultate the patient’s breath sounds and check for secretions.
B. Check for a leak in the ventilator circuit.
C. Increase the oxygen concentration to 100%.
D. Call the physician immediately.
Answer: A
Rationale: High-pressure alarms are triggered by obstructions such as secretions,
coughing, or biting the tube. Auscultating and suctioning is the first priority.
2. Which ventilator setting is designed to keep the alveoli open at the end of
expiration to improve gas exchange?
A. Tidal Volume (Vt)
B. Fraction of Inspired Oxygen (FiO2)
C. Inspiratory Flow Rate
D. Positive End-Expiratory Pressure (PEEP)
Answer: D
Rationale: PEEP maintains pressure in the lungs at the end of expiration to prevent
alveolar collapse and improve oxygenation.
,3. What is the primary difference between Assist-Control (AC) and Synchronized
Intermittent Mandatory Ventilation (SIMV)?
A. SIMV does not allow the patient to take spontaneous breaths.
B. AC provides a full preset volume for every breath, including spontaneous ones.
C. AC is used only for weaning patients from the ventilator.
D. SIMV requires the patient to be paralyzed with neuromuscular blockers.
Answer: B
Rationale: In AC mode, every breath (ventilator-initiated or patient-initiated) receives the
preset tidal volume. In SIMV, spontaneous breaths are at the patient’s own volume.
4. A patient is receiving propofol for sedation while on a ventilator. What is a
critical nursing assessment for this medication?
A. Monitor for hypertension.
B. Monitor serum triglyceride levels and blood pressure.
C. Check for urinary retention.
D. Assess for extrapyramidal symptoms.
Answer: B
Rationale: Propofol is a lipid-based emulsion that can cause hypotension and
hypertriglyceridemia, potentially leading to pancreatitis.
5. The nurse notes a low-pressure alarm on the ventilator. What is the most
likely cause?
A. The patient is biting the endotracheal tube.
B. Kinked ventilator tubing.
C. Disconnection from the ventilator circuit.
D. Pneumothorax development.
Answer: C
Rationale: Low-pressure alarms usually signify a leak or a disconnection in the circuit
where the pressure cannot be maintained.
, 6. Which drug is the reversal agent for benzodiazepines like Midazolam?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Acetylcysteine
Answer: B
Rationale: Flumazenil is the specific antagonist for benzodiazepine overdose or reversal.
7. Before administering a neuromuscular blocking agent (NMBA) like
Vecuronium, which medication must be administered first?
A. A corticosteroid.
B. A sedative and an analgesic.
C. An antibiotic.
D. Atropine.
Answer: B
Rationale: NMBAs paralyze muscles but do not provide sedation or pain relief. Patients
must be sedated and have pain controlled before being paralyzed to prevent psychological
trauma.
8. The ‘Train of Four’ (TOF) monitoring is used to assess the effectiveness of
which type of medication?
A. Inotropic agents
B. Vasopressors
C. Sedatives
D. Neuromuscular blocking agents
Answer: D
Rationale: TOF uses peripheral nerve stimulation to determine the level of paralysis in
patients receiving neuromuscular blockers.