Exam (elaborations)

NURS 310- Fundamentals of Nursing- CH 41.- EAQs- Oxygenation Questions with Correct Answers

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the nurse is caring for a patient who presents wit
which diagnostic test provides instant feedback ab
which age related change in the older adult may re

Institution NURS 310- Fundamentals of Nursing
Course NURS 310- Fundamentals of Nursing

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NURS 310- Fundamentals of Nursing- CH
41.- EAQs- Oxygenation Questions with
Correct Answers
The nurse is caring for a patient who presents with an oxygen saturation 85% on room air. Which
assessment finding is most likely affecting this patient's oxygenation?

1

Heart rate 48 beats/min

2

Blood pressure 100/62 mm Hg

3

Alert and oriented to name only

4

Urinary output 500 mL/24 hours - Correct Answer Bradycardia (heartbeat less than 60 beats/min)
can decrease cardiac output, which decreases oxygenation. The patient has a heart rate of 48
beats/min, which can cause the oxygen saturation of 85%. The patient's blood pressure is the result
of the decreased heart rate and cardiac output. The low oxygenation could lead to decreased
orientation. The decreased cardiac output from the bradycardia can decrease urinary output.

Which diagnostic test provides instant feedback about a patient's oxygenation status?

1

Capnography

2

Bronchoscopy

3

Thoracentesis

4

Pulse oximetr - Correct Answer Pulse oximetry is a diagnostic test that provides instant feedback
about a patient's oxygenation level. Capnography is a diagnostic test that provides instant
information about the patient's ventilation and perfusion, not oxygenation status. Bronchoscopy
allows for visual examination of the tracheobronchial tree; it does not provide instant feedback
about oxygenation status. Thoracentesis is a procedure done on the chest wall and pleural space to
drain fluid, not provide instant feedback about oxygenation status.

,Which age-related change in the older adult may result in decreased tissue oxygenation caused by
impaired chest expansion? Select all that apply. One, some, or all responses may be correct.

1

Change in cough mechanism

2

Impairment of the immune system

3

Ossification of costal cartilage

4

Decreased intervertebral space

5

Diminished respiratory muscle strength - Correct Answer Ossification of costal cartilage, decreased
intervertebral space, and diminished respiratory muscle strength will all impair chest expansion,
which leads to decreased tissue oxygenation. A change in the cough mechanism may lead to
atelectasis because of retained pulmonary secretions; however, it does not impair chest expansion.
An impaired immune system can predispose to respiratory infections but will not impair chest
expansion.

Which condition causes decreased tissue oxygenation because of the decreased oxygen-carrying
capacity of the blood?

1

Obesity

2

Anemia

3

Pregnancy

4

Neuromuscular disease - Correct Answer Anemia decreases the oxygen-carrying capacity of blood by
reducing the amount of available hemoglobin to transport oxygen. The other conditions cause
decreased oxygenation for other reasons. Decreased oxygenation may result from reduced lung
volumes (not from the decreased oxygen-carrying capacity) in patients who are obese. An increased
metabolic rate and pressure on the diaphragm from the growing fetus (not the decreased oxygen-
carrying capacity) may result in decreased oxygenation in patients who are pregnant. An impaired
ability to expand and contract the chest wall (not the decreased oxygen-carrying capacity) may result
in decreased tissue oxygenation in patients who have neuromuscular diseases.

,A patient experiences impaired oxygenation due to postoperative atelectasis. When planning care for
the patient, which goal does the nurse prioritize to resolve the condition?

1

Reduce oxygen to 2 L/nasal cannula.

2

Use incentive spirometer hourly as instructed.

3

Decrease respiratory rate to 18 breaths/min.

4

Perform nebulizer treatments independently. - Correct Answer Atelectasis occurs when lungs are not
expanding to their full capacity, causing alveolar collapse. The way to improve oxygenation with
atelectasis is deep breathing and incentive spirometry. Therefore an appropriate goal is to use the
incentive spirometer every hour as instructed by the nurse. Reducing oxygen and decreasing the
respiratory rate shows improvement, but not that a goal is met. Performing nebulizer treatments
independently would be a goal toward self-management.

Which nursing action would the nurse perform first for the patient lying supine in bed, short of
breath?

Correct1

Raise the head of the bed to 45 degrees.

2

Take the patient's oxygen saturation with a pulse oximeter.

3

Obtain the patient's blood pressure and respiratory rate.

4

Notify the health care provider of the patient's shortness of breath. - Correct Answer The nurse
would raise the head of the bed first. Raising the head of the bed brings the diaphragm down and
allows for better chest expansion, thus improving ventilation. Taking the oxygen saturation, blood
pressure, and respiratory rate would be included in the assessment, but raising the head of the bed
would be the priority action. Depending on the situation, the nurse may need to notify the health
care provider but only after completing an in-depth assessment; it is not the first action the nurse
would take.

Which abnormality is caused by chronic hypoxemia?

1

Edema

, 2

Clubbing

3

Cyanosis

4

Splinter hemorrhages - Correct Answer Clubbing in the fingertips is associated with chronic
hypoxemia. Edema is associated with right-sided heart failure, not hypoxemia. Neck vein distention is
caused by right-sided heart failure, not chronic hypoxemia. Splinter hemorrhages are caused by
infective endocarditis, not chronic hypoxemia.

Which condition would a patient with a respiratory rate of 25 breaths/min have?

1

Apnea

2

Bradypnea

3

Tachypnea

4

Orthopnea - Correct Answer The patient has tachypnea because the rate is 25 breaths/min.
Tachypnea is a condition in which the respiratory rate is greater than 20 breaths/min. Apnea is a
condition in which there is an absence of respirations lasting for 15 seconds or more, not a
respiratory rate of 25 breaths/min. Bradypnea is a condition in which the respiratory rate generally
ranges below 12 breaths/min, not for a respiratory rate of 25 breaths/min. Orthopnea is an abnormal
condition in which a patient struggles to breathe when lying flat, not having a respiratory rate of 25
breaths/min.

Which action would the nurse take first for the patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min and becomes short of breath while in the supine position
during a bath?

1

Increase the flow of oxygen.

2

Perform tracheal suctioning.

3

Report this to the health care provider.

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