The nurse has a patient on mechanical ventilation and the pulmonologist wants the patient to receive 10 breaths/min from the ventilator but wants to encourage the patient to breathe spontaneously in between the mechanical breaths at his own tidal volume. What is this mode of ventilation called?
Intermittent mandatory ventilation
Controlled ventilation
Positive end-expiratory pressure
Assist/control ventilation
The Correct Answer is A
Rationale:
A. Intermittent mandatory ventilation (IMV) is correct because IMV delivers a preset number of mandatory breaths per minute while allowing the patient to breathe spontaneously in between these breaths. The patient controls the rate and tidal volume of the spontaneous breaths, which helps maintain respiratory muscle function and promotes weaning from mechanical ventilation.
B. Controlled ventilation is incorrect because in this mode, the ventilator delivers all breaths at a preset rate and tidal volume, regardless of the patient’s own respiratory efforts. The patient cannot trigger spontaneous breaths, making it less suitable for patients who can breathe partially on their own.
C. Positive end-expiratory pressure (PEEP) is incorrect because PEEP is not a mode of ventilation; it is a ventilator setting that maintains positive pressure in the lungs at the end of exhalation. PEEP helps improve oxygenation but does not determine the mode or rate of breaths.
D. Assist/control ventilation (A/C) is incorrect because in A/C mode, the ventilator delivers a preset tidal volume with every patient-initiated breath, and also provides mandatory breaths at a set rate if the patient does not initiate them. While it allows some patient-initiated breaths, the tidal volume is controlled by the ventilator, not the patient’s spontaneous effort as in IMV.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Clinical judgment and clinical reasoning skills are incorrect because this competency involves analyzing patient data, prioritizing nursing diagnoses, and making clinical decisions about care. While judgment is always involved in nursing actions, the scenario focuses on communication and teamwork rather than clinical decision-making about the patient’s condition.
B. Collaboration with patients, families, and team members is correct because the nurse acts as a liaison between the family and the physician, ensuring open communication and coordinating a meeting. This reflects interprofessional collaboration and partnership with the family to support patient-centered care.
C. Facilitation of learning for patients, families, and team members is incorrect because teaching or educating is not the primary action described. The nurse is arranging communication, not directly providing education or instruction.
D. Advocacy and moral agency in solving ethical issues is incorrect because, although nurses do advocate for patients and families, this situation does not involve an ethical dilemma, conflict, or violation of patient rights. The primary focus is on improving communication through collaboration.
Correct Answer is A
Explanation
A.
Step 1: Convert weight from pounds to kilograms
154 ÷ 2.2 = 70 kg
Step 2: Calculate the dose in mcg/min
2 mcg/kg/min × 70 kg = 140 mcg/min
Step 3: Convert mcg/min to mcg/hr
140 mcg/min × 60 min/hr = 8,400 mcg/hr
Step 4: Convert mcg/hr to mg/hr
8,400 mcg ÷ 1,000 = 8.4 mg/hr
Step 5: Determine the concentration of Dobutamine
250 mg in 250 mL → 1 mg/mL
Step 6: Calculate the infusion rate in mL/hr
8.4 mg/hr ÷ 1 mg/mL = 8.4 mL/hr
Answer: 8.4 mL/hr
B. This is inaccurate, check rationale for choice A
C. This is inaccurate, check rationale for choice A
D. This is inaccurate, check rationale for choice A
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