Neonatal Nurse Practitioner Practice Exam 2025 – 400 Free Practice Questions to Pass the Exam

The initial management in this scenario focuses on addressing the abnormal arterial blood gas values, particularly the high PCO₂ level of 49 mm Hg and low pH of 7.23, which indicate a respiratory acidosis with some metabolic compensation. The high PCO₂ suggests that the neonate is experiencing hypoventilation, leading to inadequate removal of carbon dioxide from the body.

Increasing the peak inspiratory pressure on the ventilator is the appropriate response because it enhances the tidal volume delivered to the neonate. This increased pressure can help improve ventilation, allowing for greater clearance of carbon dioxide and thus correcting the hypercapnia. It can effectively promote better gas exchange in the alveoli, ultimately leading to an improvement in both the PCO₂ and pH levels.

Other options, such as bicarbonate administration, are generally not indicated for acute respiratory acidosis because they do not address the underlying problem of hypoventilation, and may even exacerbate issues related to oxygen delivery and ventilation. Increasing positive end-expiratory pressure could lead to further hypoventilation in a patient already struggling to remove CO₂ effectively. Reducing the ventilator rate might worsen the hypoventilation and elevate CO₂ levels further, which is contrary to the