The nurse anticipates that positive-end-expiratory-pressure (PEEP) will be utilized when a patient with acute respiratory distress syndrome (ARDS) is placed on mechanical ventilation for which purpose?
Provide for delivery of 100% oxygen to the lungs under pressure
Prevent the fibrotic infiltration of the lung tissue
Apply positive pressure during inhalation to fully inflate the lungs
Prevent alveolar collapse during expiration
The Correct Answer is D
A. Provide for delivery of 100% oxygen to the lungs under pressure: PEEP does not specifically deliver 100% oxygen; rather, it maintains alveolar patency at end expiration. Oxygen concentration is set separately on the ventilator.
B. Prevent the fibrotic infiltration of the lung tissue: PEEP does not directly prevent fibrosis. ARDS-related fibrosis is a long-term complication, and PEEP’s role is primarily mechanical, not anti-fibrotic.
C. Apply positive pressure during inhalation to fully inflate the lungs: Positive pressure during inhalation is provided by the tidal volume or inspiratory pressure, not PEEP. PEEP maintains pressure at the end of exhalation, not during inspiration.
D. Prevent alveolar collapse during expiration: PEEP maintains a baseline positive pressure in the lungs at the end of expiration, preventing alveolar collapse (atelectasis). This improves oxygenation, increases functional residual capacity, and reduces ventilator-induced lung injury in ARDS patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["20"]
Explanation
- Identify the ordered infusion rate and available concentration
Infusion Rate: 9 mL/hr
Available Concentration: 1000 mg/100 mL = 10 mg/mL
- Calculate the total mg/hr being infused
Total mg/hr = 9 × 10
= 90 mg/hr
- Convert mg/hr to mcg/min
90 mg/hr × 1000 mcg/mg = 90,000 mcg/hr
90,000 ÷ 60 min = 1,500 mcg/min
- Calculate mcg/kg/min
Patient weight: 75 kg
Rate = 1,500 ÷ 75
= 20 mcg/kg/min
Correct Answer is D
Explanation
A. Elevated hematocrit: An elevated hematocrit reflects increased red blood cell concentration and may be associated with dehydration or polycythemia, but it is not a typical complication of oral anticoagulant therapy. Anticoagulants increase bleeding risk rather than causing hemoconcentration.
B. Dizziness: Dizziness can have multiple etiologies, including orthostatic hypotension, anemia, or medication effects. While it may warrant evaluation, it is nonspecific and not necessarily an immediate sign of anticoagulant-related complications. It becomes more concerning if associated with signs of significant blood loss or hemodynamic instability.
C. Blood pressure 150/88: A blood pressure of 150/88 mmHg is elevated but does not constitute a hypertensive emergency. Although uncontrolled hypertension can increase the risk of hemorrhagic complications in anticoagulated patients, this value alone does not require immediate emergency reporting unless accompanied by neurological symptoms.
D. Bleeding profusely: Profuse bleeding is a critical complication of oral anticoagulant therapy, as these medications impair clot formation by inhibiting vitamin K–dependent clotting factors or thrombin activity. Uncontrolled bleeding can rapidly lead to hypovolemia, shock, or intracranial hemorrhage. Immediate medical attention is necessary to assess coagulation status and administer reversal agents if indicated.
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