A nurse is counseling a pregnant patient at 30 weeks gestation who is at risk for preterm delivery. The nurse explains the role of pulmonary surfactant in fetal lung maturity. Which of the following statements best demonstrates a comprehensive understanding of surfactant's production, function, and clinical significance?
The surfactant layer increases alveolar surface tension to stabilize the alveoli during both inhalation and exhalation, preventing overexpansion of the lungs and ensuring steady oxygen diffusion.
Surfactant is secreted continuously from the fetal trachea throughout gestation to lubricate airways and enhance mucus clearance, facilitating respiratory function immediately after birth.
Surfactant production peaks at 20 weeks gestation and remains stable throughout pregnancy: therefore, preterm infants born after this point typically do not experience respiratory complications related to lung immaturity.
Pulmonary surfactant production begins between 24 to 28 weeks gestation, primarily from type II alveolar cells: its primary role is to lower alveolar surface tension, preventing atelectasis and promoting lung compliance, which is critical for effective gas exchange after birth.
The Correct Answer is D
A. surfactant actually reduces alveolar surface tension, allowing alveoli to expand more easily during inhalation and preventing collapse during exhalation, rather than increasing tension.
B. Surfactant is not primarily for airway lubrication or mucus clearance. Its main role is to lower alveolar surface tension to prevent collapse and facilitate lung compliance.
C. Surfactant production does not peak at 20 weeks. It begins around 24 weeks, with significant amounts produced after 32–34 weeks, which is why preterm infants are at high risk for respiratory distress syndrome.
D. This statement accurately describes the timing of surfactant production, the source (type II alveolar cells), its physiological function, and its clinical significance in preventing respiratory distress in neonates.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Striae gravidarum can appear in the second or third trimester, not exclusively in the third. Their severity is strongly influenced by genetic predisposition, hormonal changes, and the degree of skin stretching rather than fetal growth.
B. Striae gravidarum result from dermal tearing as the skin stretches beyond its elastic capacity. Hormones such as cortisol and estrogen reduce fibroblast activity and collagen strength, predisposing the skin to rupture and forming stretch marks.
C. Striae gravidarum are caused by autoimmune destruction of dermal tissue, commonly seen in There is no autoimmune mechanism involved in the development of striae. They are purely structural and hormonal changes in the skin rather than immune-mediated conditions.
D. Striae actually result from decreased dermal elasticity and collagen integrity. Estrogen and glucocorticoids impair collagen synthesis, leading to thinning and tearing of the dermal layer instead of thickening.
Correct Answer is ["C","D","E","F"]
Explanation
A. Progestin-only pills (mini-pill): Although safer than combined oral contraceptives for smokers, this option requires strict daily adherence at the same time each day. Because the client frequently forgets to take daily medications, this method is not ideal for her lifestyle.
B. Combined oral contraceptive pills (COCs): COCs are contraindicated in women under 35 who smoke due to an increased risk of thromboembolic events. Additionally, her difficulty with medication adherence makes this method unreliable and potentially unsafe.
C. Copper intrauterine device (Paragard): The copper IUD is hormone-free, highly effective, and long-acting for up to 10 years. It requires minimal maintenance once inserted, making it an excellent choice for a young woman seeking long-term contraception without daily responsibility.
D. Nexplanon (subdermal implant): This implant provides up to 3 years of highly effective contraception and requires no daily action. It is safe for smokers and ideal for clients preferring a low-maintenance option.
E. Male condoms: Condoms are accessible, protect against sexually transmitted infections, and can be used in combination with another method for dual protection. They are an appropriate recommendation for any sexually active individual.
F. Depo-Provera (DMPA) injection every 3 months: The Depo-Provera injection offers long-acting contraception with infrequent dosing. It is a suitable choice for someone who forgets daily pills and is safe for smokers, though it requires quarterly clinic visits.
G. Fertility awareness methods: These methods require consistent tracking of ovulation signs and daily attention. Given the client’s history of irregular menses and difficulty with daily adherence, this method would be unreliable and inappropriate.
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