Q.1 Which of the following is the primary purpose of endotracheal intubation in critically ill patients?
To administer medications
To secure the airway and facilitate mechanical ventilation
To measure blood pressure
To provide enteral nutrition
Explanation - Endotracheal intubation ensures airway patency and allows mechanical ventilation in patients with respiratory failure or airway compromise.
Correct answer is: To secure the airway and facilitate mechanical ventilation
Q.2 Which of the following is a contraindication for nasotracheal intubation?
Facial trauma with basal skull fracture
Hypoxemia
COPD exacerbation
Elective surgery
Explanation - Nasotracheal intubation is contraindicated in basal skull fractures due to the risk of intracranial tube placement.
Correct answer is: Facial trauma with basal skull fracture
Q.3 What is the normal range for tidal volume in adult patients receiving mechanical ventilation?
4-8 mL/kg of ideal body weight
10-12 mL/kg of ideal body weight
2-4 mL/kg of ideal body weight
8-10 mL/kg of actual body weight
Explanation - Low tidal volume ventilation (4-8 mL/kg IBW) is recommended to prevent ventilator-induced lung injury.
Correct answer is: 4-8 mL/kg of ideal body weight
Q.4 Which of the following ventilator modes allows spontaneous breathing with pressure support only?
Assist-Control (AC)
Pressure Support Ventilation (PSV)
Synchronized Intermittent Mandatory Ventilation (SIMV)
Continuous Mandatory Ventilation (CMV)
Explanation - PSV allows patients to breathe spontaneously with each breath assisted by a preset pressure.
Correct answer is: Pressure Support Ventilation (PSV)
Q.5 What is the main purpose of positive end-expiratory pressure (PEEP) in mechanical ventilation?
Increase heart rate
Prevent alveolar collapse and improve oxygenation
Lower blood pressure
Reduce tidal volume
Explanation - PEEP maintains alveoli open at the end of expiration, improving oxygenation and preventing atelectasis.
Correct answer is: Prevent alveolar collapse and improve oxygenation
Q.6 Which complication is most commonly associated with prolonged endotracheal intubation?
Pulmonary embolism
Tracheal stenosis
Myocardial infarction
Renal failure
Explanation - Prolonged intubation can lead to tracheal injury and subsequent stenosis due to cuff pressure.
Correct answer is: Tracheal stenosis
Q.7 Which of the following is the best initial intervention for a mechanically ventilated patient with sudden oxygen desaturation?
Increase sedation
Check airway patency and ventilator connections
Administer diuretics
Increase tidal volume immediately
Explanation - Airway obstruction, secretions, or disconnection are common causes of sudden desaturation and should be checked first.
Correct answer is: Check airway patency and ventilator connections
Q.8 Which arterial blood gas change is expected in a patient with hypoventilation on mechanical ventilation?
Respiratory alkalosis
Respiratory acidosis
Metabolic acidosis
Metabolic alkalosis
Explanation - Hypoventilation leads to CO2 retention, causing respiratory acidosis.
Correct answer is: Respiratory acidosis
Q.9 Which nursing intervention is critical to prevent ventilator-associated pneumonia (VAP)?
Daily chest X-rays
Head-of-bed elevation to 30–45°
Hourly vital signs
Routine suctioning every hour
Explanation - Elevating the head reduces aspiration risk, a key preventive measure for VAP.
Correct answer is: Head-of-bed elevation to 30–45°
Q.10 What is the recommended cuff pressure for an endotracheal tube to prevent tracheal injury?
5–10 mmHg
20–30 cm H2O
50–60 cm H2O
80–100 mmHg
Explanation - Maintaining cuff pressure between 20–30 cm H2O prevents tracheal mucosal ischemia while ensuring a seal.
Correct answer is: 20–30 cm H2O
Q.11 Which of the following is a sign of successful weaning from mechanical ventilation?
Persistent tachypnea
Stable oxygen saturation and spontaneous tidal volume
Decreasing blood pressure
Increasing PEEP requirement
Explanation - Successful weaning is indicated by the patient maintaining adequate oxygenation and ventilation without support.
Correct answer is: Stable oxygen saturation and spontaneous tidal volume
Q.12 Which of the following is the most appropriate suctioning technique for an intubated patient?
Open suctioning with sterile technique
Blind suctioning without gloves
Continuous suctioning for 5 minutes
Suction only after extubation
Explanation - Sterile technique prevents infection; suctioning should be intermittent and brief to prevent hypoxia.
Correct answer is: Open suctioning with sterile technique
Q.13 Which ventilator parameter primarily controls the rate of breaths delivered per minute?
Tidal volume
Respiratory rate
PEEP
FiO2
Explanation - The respiratory rate setting determines how many breaths the ventilator delivers per minute.
Correct answer is: Respiratory rate
Q.14 Which of the following indicates ventilator-induced lung injury (VILI)?
Subcutaneous emphysema and barotrauma
Bradycardia
Hypotension alone
Hyperglycemia
Explanation - Excessive ventilator pressures or volumes can cause alveolar rupture, leading to barotrauma or VILI.
Correct answer is: Subcutaneous emphysema and barotrauma
Q.15 Which ventilator alarm indicates a possible airway obstruction or kinked tube?
Low-pressure alarm
High-pressure alarm
Apnea alarm
Oxygen saturation alarm
Explanation - High airway pressure alarms often indicate obstruction, secretions, or tube kinking.
Correct answer is: High-pressure alarm
Q.16 Which of the following is an advantage of using a cuffed endotracheal tube in adults?
Prevents air leak and aspiration
Increases patient comfort
Reduces need for sedation
Facilitates spontaneous breathing
Explanation - Cuffed tubes create a seal in the trachea, reducing aspiration risk and ensuring effective ventilation.
Correct answer is: Prevents air leak and aspiration
Q.17 Which ventilator mode provides a guaranteed tidal volume for every breath?
Pressure Control Ventilation (PCV)
Assist-Control Ventilation (ACV)
Pressure Support Ventilation (PSV)
CPAP
Explanation - ACV delivers a set tidal volume for both spontaneous and mandatory breaths, ensuring consistent ventilation.
Correct answer is: Assist-Control Ventilation (ACV)
Q.18 Which intervention is most important to prevent accidental extubation in an ICU patient?
Frequent sedation holidays
Proper securing of the endotracheal tube
Increasing tidal volume
Reducing FiO2
Explanation - Endotracheal tubes must be properly secured to prevent accidental dislodgement, a serious complication.
Correct answer is: Proper securing of the endotracheal tube
Q.19 Which of the following oxygen delivery settings affects the fraction of inspired oxygen (FiO2)?
Tidal volume
Respiratory rate
Ventilator oxygen setting
PEEP
Explanation - FiO2 is directly adjusted on the ventilator to control oxygen delivery to the patient.
Correct answer is: Ventilator oxygen setting
Q.20 Which is a clinical sign of inadequate ventilation in a mechanically ventilated patient?
Bradycardia
Hypercapnia
Hypothermia
Hypertension
Explanation - High CO2 levels indicate hypoventilation and inadequate gas exchange.
Correct answer is: Hypercapnia
Q.21 Which of the following is the most accurate method for confirming correct endotracheal tube placement?
Auscultation of bilateral breath sounds and epigastrium
Observing chest rise only
Capnography (ETCO2 monitoring)
Patient verbal confirmation
Explanation - Capnography provides continuous confirmation of tracheal placement by detecting exhaled CO2.
Correct answer is: Capnography (ETCO2 monitoring)
Q.22 Which of the following is considered a high-risk scenario for barotrauma in ventilated patients?
High tidal volumes and high PEEP
Low FiO2
Low tidal volumes
Spontaneous breathing
Explanation - Excessive pressures and volumes increase alveolar overdistension and risk of barotrauma.
Correct answer is: High tidal volumes and high PEEP
Q.23 Which of the following is the primary goal of mechanical ventilation in ARDS patients?
Normalize PaCO2 at all costs
Maintain oxygenation while minimizing ventilator-induced lung injury
Increase tidal volume to maximum
Eliminate PEEP
Explanation - ARDS management focuses on protective ventilation strategies to prevent further lung injury while ensuring adequate oxygenation.
Correct answer is: Maintain oxygenation while minimizing ventilator-induced lung injury
Q.24 Which of the following nursing interventions helps reduce the risk of ventilator-associated events (VAEs)?
Daily sedation interruption and spontaneous breathing trials
Continuous use of high tidal volumes
Routine deep suctioning every 2 hours
Maintaining head-of-bed flat
Explanation - These interventions reduce ventilator dependency and complications such as pneumonia.
Correct answer is: Daily sedation interruption and spontaneous breathing trials