Progressive Care Nursing Certification (PCCN) Practice Exam

Which complication is most commonly associated with mechanical ventilation and PEEP therapy?

1. Atelectasis

2. Oxygen toxicity

3. Reduced cardiac output

4. Acute respiratory distress syndrome (ARDS)

The correct answer is: Reduced cardiac output

The correct answer identifies reduced cardiac output as a complication commonly associated with mechanical ventilation and PEEP (Positive End-Expiratory Pressure) therapy. When mechanical ventilation is employed, particularly with the application of PEEP, intrathoracic pressure can be elevated, leading to a decrease in venous return to the heart. This reduction in preload can subsequently result in lowered stroke volume and cardiac output, particularly in patients with compromised cardiovascular health. While certain other complications like atelectasis, oxygen toxicity, and the development of ARDS can arise from mechanical ventilation, they are not as directly associated with the use of PEEP as reduced cardiac output. Atelectasis is primarily a result of inadequate ventilation or secretion management, oxygen toxicity is more about prolonged exposure to high oxygen concentrations, and ARDS typically denotes a lung process rather than a direct effect of mechanical ventilation itself. Thus, the interplay of PEEP with cardiac physiology makes reduced cardiac output a well-recognized concern in the context of this therapy.