A patient receiving ventilatory support is being provided with humidification using a heat and
moisture exchanger (HME). A physician orders a bronchodilator drug administered through a
metered dose inhaler (MDI) via the ventilator circuit. Which to do to ensure delivery of the drug to the patient?

What is the most reliable indicator that the gas delivered by a servo-controlled heated-wire
humidifier system is fully saturated at the airway?

For which of the following patients might you recommend bland aerosol therapy
administration?
1. Patient with upper airway edema
2. Patient with a bypassed upper airway
3. Patient who must provide a sputum specimen

Which of the following would indicate that administration of a bland water aerosol to a patient
with postextubation upper airway edema was having the desired effect?
1. Decreased work of breathing
2. Improved vital signs
3. Decreased stridor or dyspnea
4. Improved O2 saturation

Which of the following nebulizers uses a piezoelectric transducer to generate liquid particle
aerosols?

A patient has been supported by a mechanical ventilator using a heat and moisture exchanger
for the last 3 days. Suctioning reveals an increase in the amount and tenacity of secretions.
Which of the following actions is indicated?

In checking a servo-controlled heated-wire humidifier system, you notice that a few drops of
condensate tend to form but only near the patient’s airway. Based on this observation, what
can you conclude?

For which of the following patients would you recommend bland aerosol therapy
administration?
1. Patient with a history of airway hyperresponsiveness
2. Patient with a bypassed upper airway
3. Patient with active bronchoconstriction

What is the most common device used to generate bland aerosols?

Which of the following principles is used by the ultrasonic nebulizer to produce aerosol
droplets?
a. Evaporative cooling
b. Mechanical baffling
c. Fractional distillation
d. High-frequency vibrations

How often should heat and moisture exchangers be inspected and replaced?

When checking a patient attached to a servo-controlled heated-wire humidifier breathing
circuit, you notice no visible condensate anywhere in the tubing. Based on this observation,
you can conclude that the relative humidity of the delivered gas is which of the following?

Hazards and complications of bland aerosol therapy include which of the following?
1. Bronchospasm
2. Overhydration
3. Infection
4. Hemoconcentration

Which of the following are true regarding large-volume jet nebulizers?
1. A variable air-entrainment port allows air mixing and different FiO2 values.
2. Liquid particles are generated by mechanical vibration energy.
3. They are pneumatically powered and attach directly to a flowmeter.
4. Baffling causes impaction or removal of large, unstable particles.

Which of the following are components of an ultrasonic nebulizer?
1. Air-entrainment orifice
2. Radiofrequency generator
3. Nebulizer chamber
4. Piezoelectric transducer
5. Blower or fan

During routine use on an intubated patient, a heated humidifier should deliver inspired gas at?

When is a heat and moisture exchanger (HME) performing well?

Which of the following indicate a potential need for administration of a water or isotonic
saline aerosol?
1. Stridor or brassy, crouplike cough
2. Evidence of increased volume of secretions
3. Hoarseness after extubation
4. Patient discomfort after bronchoscopy

What is the total water output of unheated large-volume jet nebulizers?
a. 10 to 16 mg H2O/L
b. 16 to 25 mg H2O/L
c. 26 to 35 mg H2O/L
d. 33 to 55 mg H2O/L

The aerosol output (in mg/L) of an ultrasonic nebulizer depends mainly on which of the
following?
a. Signal amplitude
b. Chamber baffling
c. Source current
d. Signal frequency

Which of the following are the proper temperature alarm settings for a heated humidifier used
during mechanical ventilation?

Which of the following reduce the risk of nosocomial infection when using heated
humidification systems?
1. Use of wick or membrane humidifiers
2. Use of heated-wire delivery circuits
3. High humidifier reservoir temperatures
4. Frequent changing of delivery circuits

For which of the following patients might you recommend administration of a hypertonic
saline aerosol?
1. Acquired immune deficiency syndrome (AIDS) patient with severe pneumonia symptoms
2. Patient with a bypassed upper airway
3. Patient suspected of having tuberculosis

What is the total water output of heated large-volume jet nebulizers?
a. 16 to 25 mg H2O/L
b. 26 to 35 mg H2O/L
c. 33 to 55 mg H2O/L
d. 56 to 75 mg H2O/L

To produce the highest possible density aerosol from an ultrasonic nebulizer, how would you
set the controls?
a. Amplitude low, flow rate high
b. Amplitude high, flow rate low
c. Amplitude low, flow rate low
d. Amplitude high, flow rate high