Progressive Care Nursing Certification (PCCN) Practice Exam

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At which FiO2 level is oxygen toxicity typically thought to develop?

30-40% for longer than 48 hrs
40-50% for longer than 2 hrs
more than 50% for longer than 24-28 hrs
FiO2 does not cause oxygen toxicity

The correct answer is: more than 50% for longer than 24-28 hrs

Oxygen toxicity is primarily a concern when patients are exposed to high concentrations of oxygen over extended periods. The threshold commonly referenced in clinical guidelines indicates that an FiO2 greater than 50% may lead to toxicity if maintained for longer than 24 to 28 hours. This is due to the biochemical effects of high concentrations of oxygen, which can lead to the production of reactive oxygen species (ROS). These ROS can damage cellular structures, including lipids, proteins, and DNA, leading to complications such as pulmonary inflammation and atelectasis. Maintaining oxygen therapy above this threshold for the specified time frame significantly increases the risk of complications associated with oxygen toxicity, making it crucial for healthcare providers to monitor oxygen levels and adjust therapy accordingly to mitigate this risk. While lower levels of FiO2, such as 30-40% or 40-50%, can still carry some risk when used over extended periods, the consensus is that the highest concern lies beyond the 50% threshold. This is why the specified option is recognized as the correct response regarding the risk of oxygen toxicity.