ATI RN
Oxygen Therapy NCLEX Questions Questions
Question 1 of 5
A 90-year-old woman has been in an automobile crash and sustained four fractured ribs on the left side of her thorax. Based on her age and the injury, what complication is she at risk for?
Correct Answer: A
Rationale: Fractured ribs and advanced age increase the risk of pneumonia due to impaired breathing and reduced ability to clear secretions.
Question 2 of 5
The process of exchanging gases through the alveolar capillary membrane is known as
Correct Answer: B
Rationale: The correct answer is B: Diffusion. This is because the exchange of gases between the alveoli and capillaries occurs through diffusion, where oxygen and carbon dioxide move from areas of high concentration to low concentration. Disassociation (A) refers to the separation of molecules, not gas exchange. Perfusion (C) is the movement of blood into the capillaries, not gas exchange. Ventilation (D) is the process of moving air in and out of the lungs, not the actual exchange of gases between the alveoli and capillaries.
Question 3 of 5
Which nursing diagnosis is the priority when caring for a patient with a traumatic brain injury who had a tracheostomy placed?
Correct Answer: B
Rationale: The correct answer is B: Impaired gas exchange. This is the priority nursing diagnosis for a patient with a traumatic brain injury and a tracheostomy because it directly affects the patient's oxygenation and ventilation, which are essential for sustaining life. Impaired gas exchange can lead to hypoxia and respiratory distress, requiring immediate intervention to ensure adequate oxygenation. Choice A, Risk for skin breakdown, is important but not the priority as it can be managed with proper positioning and skin care. Choice C, Ineffective airway clearance, is related to the tracheostomy but is not the priority over ensuring adequate gas exchange. Choice D, Risk for infection, is also important but does not take precedence over addressing impaired gas exchange, which is critical for the patient's immediate well-being.
Question 4 of 5
A nurse is assessing a client with chronic hypoxemia. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Polycythemia. Chronic hypoxemia leads to decreased oxygen levels in the blood, causing the body to produce more red blood cells (polycythemia) to compensate for the lack of oxygen. This can result in increased blood viscosity and potential clotting issues. A: Cyanosis of the lips is more commonly seen with acute hypoxemia, not chronic hypoxemia. B: Peripheral neuropathy is not a direct consequence of chronic hypoxemia but can be seen in conditions like diabetes. D: Hyperactive deep tendon reflexes are not typically associated with chronic hypoxemia. In summary, the nurse should expect polycythemia in a client with chronic hypoxemia due to the compensatory mechanism of increased red blood cell production.
Question 5 of 5
A client with pneumonia has a pulse oximetry reading of 88%. What intervention should the nurse perform first?
Correct Answer: B
Rationale: The correct answer is B: Raise the head of the bed. Elevating the client's head helps improve ventilation and oxygenation by facilitating better lung expansion. This intervention can help enhance oxygen exchange, which is crucial for a client with pneumonia and low oxygen saturation. Increasing the oxygen flow rate (choice A) may be necessary but should not be the first intervention. Notifying the healthcare provider (choice C) is important but not the immediate priority. Encouraging deep breathing exercises (choice D) can be beneficial but may not address the immediate need for improved oxygenation.