A client diagnosed with adult respiratory distress syndrome has positive end expiratory pressure (PEEP) added to the treatment.
A nurse should understand that PEEP has been ordered to promote what client outcome?

To increase the shunting effect of oxygen.

To improve oxygenation of the client.

To assist with weaning the client off the ventilator.

To decrease the amount of oxygen in the alveoli.

Answer and Explanation

The Correct Answer is B

Choice A rationale

PEEP, or positive end-expiratory pressure, is applied to increase functional residual capacity and prevent alveolar collapse. It does not increase the shunting effect of oxygen; rather, it aims to reduce physiological shunting by recruiting collapsed alveoli, improving ventilation-perfusion matching, and thus enhancing gas exchange. Increasing shunting would be a detrimental outcome, not a therapeutic goal.

Choice B rationale

PEEP improves oxygenation by maintaining positive pressure in the airways at the end of exhalation, which prevents alveolar collapse and recruits previously collapsed alveoli. This increases the surface area available for gas exchange, allowing for more efficient diffusion of oxygen into the pulmonary capillaries and subsequently into the bloodstream, thus enhancing arterial oxygen saturation.

Choice C rationale

While PEEP is a component of ventilatory support, its primary purpose is not to directly assist with weaning the client off the ventilator. PEEP optimizes lung mechanics and oxygenation, which can indirectly contribute to a client's readiness for weaning by improving their overall respiratory status. However, weaning protocols involve reducing ventilator support, not necessarily increasing PEEP.

Choice D rationale

PEEP actively works to increase, not decrease, the amount of oxygen in the alveoli by preventing their collapse and ensuring they remain open for gas exchange throughout the respiratory cycle. By maintaining alveolar patency, PEEP facilitates a higher residual volume of oxygen in the lungs, improving the driving pressure for oxygen diffusion across the alveolar-capillary membrane.

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Correct Answer is C

Explanation

Choice A rationale

Phantom breast pain is a neuropathic pain phenomenon that can occur after mastectomy, characterized by sensations of pain, itching, or tingling in the removed breast. While distressing for the client, it is a common neurological sequela and not typically considered an acute surgical complication indicating immediate danger.

Choice B rationale

A combination of numbness and pain around the breast incision is expected post-mastectomy. Numbness results from nerve transection during surgery, while pain is an anticipated consequence of tissue injury and inflammation. These are normal postoperative sensations, managed with analgesia, and do not typically signify a complication.

Choice C rationale

Lymphedema, characterized by swelling in the arm on the same side as the mastectomy, indicates a complication. It results from impaired lymphatic drainage due to lymph node removal or damage during surgery. This can lead to chronic swelling, discomfort, and increased risk of infection, requiring immediate intervention to manage and prevent progression.

Choice D rationale

A wound dressing saturated with blood every two hours indicates excessive bleeding, which is a significant complication post-mastectomy. While some serosanguineous drainage is normal, continuous saturation suggests active hemorrhage or a hematoma, requiring immediate assessment and potential surgical intervention to control the bleeding.

A. Black Coffee. B. Freshly squeezed orange juice. C. Sweetened ice tea. D. Milk.

Correct Answer is C

Explanation

Choice A rationale

Black coffee is generally considered safe for individuals with gout and does not typically trigger attacks. In fact, some studies suggest that regular coffee consumption might even have a protective effect against gout due to its xanthine oxidase inhibiting properties, although more research is needed to confirm this definitively.

Choice B rationale

Freshly squeezed orange juice, while containing fructose, is not typically a direct trigger for gout attacks. While high fructose intake can increase uric acid levels, the amount in a single glass of orange juice is usually not sufficient to acutely precipitate an attack in the same way as highly sweetened beverages.

Choice C rationale

Sweetened ice tea, especially if it contains high-fructose corn syrup or significant amounts of added sugar, can trigger a gout attack. Fructose is metabolized in the liver, leading to increased uric acid production and decreased uric acid excretion, thereby elevating serum uric acid levels and increasing the risk of crystal formation and acute inflammation.

Choice D rationale

Milk, particularly low-fat dairy products, is generally considered beneficial for individuals with gout. Dairy proteins, specifically casein and lactalbumin, promote the excretion of uric acid in the urine and have anti-inflammatory effects. Therefore, milk intake can actually help to lower uric acid levels and reduce the risk of gout attacks.

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A client diagnosed with adult respiratory distress syndrome has positive end expiratory pressure (PEEP) added to the treatment. A nurse should understand that PEEP has been ordered to promote what client outcome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client during the first 24 hours post mastectomy. Which of the following observations made by the nurse should indicate a complication from the mastectomy procedure?

Correct Answer is C

Explanation

A nurse is teaching a client who has Gout about dietary recommendations. The nurse should teach the client that which of the following beverages can trigger an attack?

Correct Answer is C

Explanation

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A client diagnosed with adult respiratory distress syndrome has positive end expiratory pressure (PEEP) added to the treatment.
A nurse should understand that PEEP has been ordered to promote what client outcome?