Mechanical Ventilation Final Exam: Practice Questions (2025)

Key Topics Covered

• Ventilation Modes and Settings: Understanding different ventilation modes such as CPAP, SIMV, PSV, and how these affect patient care.
• Weaning from Mechanical Ventilation: Criteria for successful weaning and extubation readiness.
• Clinical Assessments During Ventilation: Evaluating patient conditions that affect weaning and ventilation success.
• Ventilator Management: Adjusting settings to manage conditions like auto-PEEP, airway resistance, and static compliance.
• Specialized Ventilation Techniques: High Frequency Oscillatory Ventilation (HFOV), ECMO therapy, and their indications.
• Patient Conditions and Ventilation Adjustments: Managing conditions like respiratory distress syndrome, COPD, and apnea during mechanical ventilation.

Important Practice Questions

Ventilation and Support Techniques

1. Tools for Partial Support: SIMV is noted as effective for altering partial ventilatory support.
2. Weaning Criteria: Key indicators include vital capacity >5 mL/kg, minute ventilation <15 L with satisfactory blood gases.
3. Weaning Outcomes: Important metrics include PaO2 >75 mm Hg, P(A-a)O2 <450 mm Hg on 100% O2, QS/QT <45%.

Clinical Assessments

4. Decrease in Peak Airway Pressure: A significant drop in peak airway pressure signals a possible positive change in patient condition or ventilator setup.
5. Static Compliance: Importance of monitoring static compliance (e.g., 22 mL/cm H2O considered normal).
6. Deadspace Ventilation: Interpretation of blood gas values to determine deadspace (e.g., 25% wasted ventilation).

Special Ventilation Techniques

7. Use of HFOV: Set initial power, achieve chest wiggle, manage mean airway pressure.
8. Criteria for ECMO: Conditions like severe RDS and gestational age >34 weeks can indicate ECMO consideration.

Managing Patient Conditions

9. COPD Management: Preoperative ABGs often show typical COPD patterns; crucial in surgical settings.
10. Respiratory Muscle Dysfunction: Factors include electrolyte imbalance, muscle atrophy, low oxygen delivery.

Problem Solving and Alarm Management

11. High-Pressure Alarms: Common causes include atelectasis, bronchospasm, mucus plugs.
12. Auto-PEEP Resolution: Strategies include increasing expiratory time, reducing VT and frequency.

Oxygenation and Gas Exchange

13. Improving Oxygenation: Increase FiO2 or PEEP as needed based on patient condition.
14. Handling Hypercapnia: Adjustments to VT or RR can manage elevated PaCO2.

Key Concepts in Neonatal Ventilation

15. Neonate Intubation and HFOV: Criteria for surfactant therapy, implications for neonates with RDS.
16. Surfactant Dosage: Specific dosages and timing for neonatal care (e.g., Curosurf at 4 mL/kg).

Conclusion

Understanding mechanical ventilation is crucial for effective patient care and exam success in respiratory therapy. This guide provides a comprehensive overview of common questions and scenarios you may encounter, ensuring preparedness for clinical application and certification exams.