Answer to Question 1
ANS: C
A. Incorrect response: See the explanation associated with response C.
B. Incorrect response: See the explanation associated with response C.
C. Correct response: The description volume control, or volume targeted, ventilation means that volume is the variable that remains constant throughout the delivery of the breath. In addition to setting the tidal volume, the therapist is responsible for setting the inspiratory flow or inspiratory time, inspiratory flow pattern, and the mandatory rate. During a volume-controlled breath, the tidal volume, inspiratory flow, and flow pattern do not change despite alterations in lung characteristics (i.e., lung compliance and/or airway resistance).
D. Incorrect response: See the explanation associated with response C.
Answer to Question 2
ANS: AI. Correct response: Auto-PEEP is the inadvertent retention of air in the lungs at the end of exhalation. Dynamic hyperinflation (air trapping develops because of incomplete emptying of the lungs. Patients (COPD and status asthmaticus) whose lungs are characterized by long time constants are susceptible to this problem. Other causes include:
High minute ventilation (<10 to 20 l> Small ID endotracheal tube
Bronchospasm
Increased lung secretions
Mucosal edema
Short expiratory time
Inverse ratio ventilation
II. Incorrect response: A deflated endotracheal tube cuff would not activate the low-pressure alarm. It would stimulate a low-pressure alarm, a low-volume alarm, low minute ventilation alarm, or an apnea alarm.
III. Correct response: Any condition that increases airway resistance and interferes with lung emptying can cause auto-PEEP.
IV. Incorrect response: Changing the flow waveform configuration from square (rectangular) to a descending ramp pattern does not influence lung emptying or cause auto-PEEP.