A 17 year-old female who weighs 50 kg (110 lb) is admitted to the surgical intensive care unit following open laparotomy and repair of the liver laceration sustained during a fall. The patient is intubated and recieving volume-controlled mechanical ventilation. The following data are available:Mode                              SIMVFIO2                                0.50Mandatory rate             12Total rate                        28Tidal volume                  450 mlPEEP                                5 cm H2OPressure support            6 cm H2OInspiratory flow              30 L/minFlow pattern                   square waveSpO2                                      97%The patient is hemodynamically stable and afebrile. The respiratory therapist notes intercostal retractions and paradoxical chest-abdominal motion during inspiration. The therapist should do which of the following to improve ventilator synchrony?

A 65 year old patient with COPD is recieving 28% oxygen by a tracheostomy collar through an 8.0 mm cuffed tracheostomy tube. The patient’s medical history is signficant for respiratory failure with mechanical ventilation and difficulty with tracheostomy tube removal. The patient occasionally requires nocturnal mechanical ventilation. To slowly progress to decannulation, the respiratory therapist should recommend:

Which of the following is the best way to determine a patient’s spontaneous minute ventilaton?

While evaluating a patient’s thorax, the respiratory therapist observes paradoxical movement of the left chest, which is most consistent with:

Which of the following is most likely responsible when a pressure-cycled ventilator fails to cycle to expiration?

Which of the following is used to calibrate the mouth flow transducer of a body plethysmograph?

During chest percussion and postural drainage therapy, the patient’s heart rate  remains stable at 100 beats/min and SpO2 is 96%. However, when the respiratory therapist begins endotracheal suctioning, the patient’s heart rate drops rapidly. The most likely reason for this is:

Following an MI, a 60 y/o patient with CHF is receiving mechanical ventilation. The patients BP is 85/56 mmHg. Ventilator settings are as follows:FIO2                         0.60Mandatory rate      10/minTidal volume           650 mlPEEP                       10 cmH2O SpO2 is 80%, which of the following should the respiratory therapist recommend first?

A patient is receiving volume controlled ventilation and the following Flow vs. Time waveform is noted:Which of the following is present?

A 28 y/o male is taken to the emergency department following a fainting episode that occurred while assisting in a patient transport. His blood pressure was 76/50 mmHg. There is no known history of any illnesses and the patient is known to exercise frequently. Hemoglobin, and hematocrit are normal and vitals are now stable. An arterial blood gas was drawn on room air and results are below:pH                    7.34PaCO2                45 torrPaO2                40 torrHCO3               23 mEq/LBE                    -2 mEq/LThe most likely cause for these results is: