Exam 2: Oxygenation (NCLEX) Prep Questions With Solved Solutions.
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Course
Gas exchange and oxygenation
Institution
Gas Exchange And Oxygenation
An RN from the orthopedic unit has been floated to the medical unit. Which client assignment for the floated RN is best?
A. The client with a resolving pulmonary embolus who is receiving oxygen at 6 L/min through a nasal cannula
B. The client with chronic lung disease who is being evaluated for...
Exam 2: Oxygenation (NCLEX) Prep
Questions With Solved Solutions.
An RN from the orthopedic unit has been floated to the medical unit. Which client assignment for the
floated RN is best?
A. The client with a resolving pulmonary embolus who is receiving oxygen at 6 L/min through a nasal
cannula
B. The client with chronic lung disease who is being evaluated for possible home oxygen use
C. The client with a newly placed tracheostomy who is receiving oxygen through a tracheostomy collar
D. The client with chronic bronchitis who is receiving oxygen at 60% through a Venturi mask - Answer A
Orthopedic nurses are familiar with pulmonary emboli and with administration of oxygen through nasal
cannulas.
Which value indicates clinical hypoxemia and the need to increase oxygen delivery?
A. Hemoglobin of 22 g/dL
B. PaCO2 of 30 mm Hg
C. PaO2 of 65 mm Hg
D. Oxygen saturation of 88% - Answer C
PaO2 of 65 mm Hg indicates low levels of oxygen in the arterial blood; this is termed hypoxemia.
A client with COPD has a physician's prescription stating, "Adjust oxygen to SpO2 at 90% to 92%." Which
nursing action can be delegated to a nursing assistant working under the supervision of an RN?
A. Adjust the position of the oxygen tubing
B. Assess for signs and symptoms of hypoventilation
C. Change the O2 flow rate to keep SpO2 as prescribed
D. Choose which O2 delivery device should be used for the client - Answer A
The scope of a nursing assistant's work includes positioning of oxygen tubing for client comfort.
,A client who smokes is being discharged home on oxygen. The client states, "My lungs are already
damaged, so I'm not going to quit smoking." What is the discharge nurse's best response?
A. "You can quit when you are ready."
B. "It's never too late to quit."
C. "Just turn off your oxygen when you smoke."
D. "You are right, the damage has been done. But let's talk about why smoking around oxygen is
dangerous." - Answer D
This is a great opening for the nurse to educate the client about the dangers of smoking in the presence
of oxygen, as well as the benefits of quitting.
Which client has the most urgent need for frequent nursing assessment?
A. An older client who was admitted 2 hours ago with emphysema and dyspnea and has a 45-year 2-
pack-per-day smoking history, and is receiving 50% oxygen through a Venturi mask
B. A young client who has had a tracheostomy for 1 week, who is on room air with SpO2 in the upper
90's, who has been receiving antibiotic therapy for 16 hours, and who has foul-smelling drainage on the
tracheostomy ties
C. An older adult client who is anxious to go home with her new tank of oxygen and supply of nasal
cannulas and is being discharged with a new prescription for home oxygen therapy
D. A middle-aged client who was admitted yesterday with pneumonia and is receiving oxygen at 2 L/min
through a nasal cannula - Answer A
An older adult client with a long history of smoking and chronic lung disease who is receiving high-flow
oxygen delivery is at elevated risk for respiratory depression owing to the hypoxic drive of respirations
countered by high levels of oxygen. This client must be assessed frequently while receiving high-flow
oxygen.
A client has just been admitted to the emergency department and requires high-flow oxygen therapy
after suffering facial burns and smoke inhalation. Which oxygen delivery device should the nurse use
initially?
A. Face tent
,B. Venturi mask
C. Nasal cannula
D. Non-rebreather mask - Answer A
A client with smoke inhalation and facial burns who requires high-flow oxygen should initially be placed
on a face tent because this is the only noninvasive high-flow device that will minimize painful and
contaminating contact with burned facial tissue.
A (DNR) client has a non-rebreather oxygen mask and breathing appears to be labored. What does the
nurse do first?
A. Ensures that the tubing is patent and that oxygen flow is high
B. Notifies the chaplain and the family member of record
C. Calls the Rapid Response Team and prepares to intubate
D. Comforts the client and confirms that signed DNR orders are in the chart - Answer A
Labored breathing and ultimately suffocation can occur if the reservoir bag kinks, or if the oxygen source
disconnects or is not set to high flow levels.
The client is admitted to the hospital for COPD, and the physician requests a nasal cannula at 2 L/min.
Within 30 minutes, the client's color improves. What does the nurse continue to monitor that may
require immediate attention?
A. Increasing carbon dioxide levels
B. Decreasing respiratory rate
C. Increasing adventitious breath sounds
D. Increased coughing - Answer B
Respiratory rate and depth should be monitored closely while the client receives oxygen, because
hypoventilation is seen during the first 30 minutes of oxygen therapy in clients with hypoxic drive for
respiration. The client's color will improve (from ashen or gray to pink) because of an increase in PaO2
level before apnea or respiratory arrest occurs from loss of the hypoxic drive.
A client who has experienced a panic attack is being transferred to the medical-surgical ward. The
transfer nurse reports that the client is doing much better after receiving bronchodilators via nebulizer
and a small dose of oral Valium 4 hours ago in the emergency department. Vital signs are stable with
, oxygen delivered at 4 L/min via simple facemask. Why is this client at high risk for subsequent respiratory
distress?
A. The client is not being treated for asthma
B. The client has a mental disorder
C. The client received a dose of Valium
D. The client is receiving oxygen at 4 L/min - Answer D
A simple facemask must receive oxygen at a rate of at least 5 L/min to prevent inhalation of exhaled
breath, which has low levels of oxygen and can eventually suffocate the client.
A patient has been diagnosed with severe iron deficiency anemia. During physical assessment for which
of the following symptoms would the nurse assess to determine the patient's oxygen status?
A: Increased breathlessness but increased activity tolerance
B: Decreased breathlessness and decreased activity tolerance
C: Increased activity tolerance and decreased breathlessness
D: Decreased activity tolerance and increased breathlessness - Answer D
A 6-year-old boy is admitted to the pediatric unit with chills and a fever of 104°F (40°C). What
physiological process explains why the child is at risk for developing dyspnea?
B: Blood glucose stores are depleted, and the cells do not have energy to use oxygen.
C: Carbon dioxide production increases as result of hyperventilation.
D: Carbon dioxide production decreases as a result of hypoventilation. - Answer A
The nurse is caring for a patient who has decreased mobility. Which intervention is a simple and cost-
effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall
expansion?
A: Antibiotics
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