Neonatal Nurse Practitioner Practice Exam

What defines Intermittent Mandatory Ventilation (IMV)?

1. Continuous support synchronized with infant's breathing

2. Scheduled ventilatory breaths that may interfere with spontaneous breaths

3. Only providing pressure support during inspiration

4. It allows for complete spontaneous breath control

The correct answer is: Scheduled ventilatory breaths that may interfere with spontaneous breaths

Intermittent Mandatory Ventilation (IMV) is characterized by the delivery of ventilatory breaths at predetermined intervals while still allowing the patient to breathe spontaneously between these mandatory breaths. The primary feature of IMV is that it provides scheduled ventilatory assistance that can overlap or interfere with the infant's own spontaneous breaths. This means that if the infant initiates a breath at the same time a ventilator-delivered breath is scheduled, the ventilator's mandatory breath may contribute higher pressure and volume into the lungs, potentially affecting the quality of spontaneous ventilation. The concept embedded in IMV is designed to take into account the patient's own respiratory efforts, thereby promoting lung function and aiding in weaning from mechanical ventilation while ensuring adequate ventilation and oxygenation. Understanding this dynamic is crucial for neonatal nurse practitioners as they manage ventilatory support in vulnerable neonates. The other options describe aspects that do not accurately reflect IMV. Continuous support synchronized with breathing is more indicative of Synchronised Intermittent Mandatory Ventilation (SIMV) or Continuous Positive Airway Pressure (CPAP). Providing pressure support exclusively during inspiration refers to Pressure Support Ventilation (PSV), which differs significantly as it does not deliver mandatory breaths but rather supports spontaneous breathing. Lastly, complete spontaneous breath control is