ATI LPN
Fundamentals of Nursing Oxygenation NCLEX Questions Questions
Question 1 of 5
A client diagnosed with chronic obstructive lung disease who is receiving oxygen at 1.5 liters per minute via nasal cannula is complaining of shortness of breath. What action should the nurse take?
Correct Answer: C
Rationale: For COPD clients pursed-lip breathing (C) helps prolong exhalation keeping airways open and reducing air trapping alleviating shortness of breath. Increasing oxygen (A) risks CO2 retention in COPD and requires physician approval. Lowering to semi-Fowler's (B) may not help and could worsen breathing. Encouraging rapid breathing (D) can increase air trapping and fatigue making C the appropriate action to improve comfort and oxygenation.
Question 2 of 5
The nurse is preparing to assist with the removal of a chest tube that is a simple insertion without a purse-string suture. What materials should the nurse gather for this procedure?
Correct Answer: A
Rationale: Without a purse-string suture the chest tube site lacks closure risking air entry into the chest cavity. An occlusive dressing (A) such as petroleum gauze with tape seals the site to prevent pneumothorax. 4x4 gauze (B) adhesive pads (C) and non-adherent dressings (D) do not provide an airtight seal making A essential for safety during removal.
Question 3 of 5
During tracheal suctioning,the nurse notes that the client heart rate has increased from 80 to $100 \mathrm{bpm}$. Based upon this assessment what action should the nurse take?
Correct Answer: D
Rationale: An increase from 80 to 100 bpm (D) is expected during suctioning due to stress but is not dangerous requiring completion as quickly as possible to minimize distress. Discontinuing immediately (A) risks leaving secretions. Resuscitation (B) is unnecessary for this change. Continuing until clear (C) may prolong stress making D the appropriate action to balance airway clearance and client comfort.
Question 4 of 5
A clients blood gas analysis results show an increase in carbon dioxide level. What will the nurse most likely assess in this client?
Correct Answer: B
Rationale: Elevated $\mathrm{CO} 2$ (hypercapnia) stimulates chemoreceptors triggering increased respiratory rate (B) to expel excess $\mathrm{CO} 2$ the strongest respiratory stimulant. Decreased rate (A) would worsen hypercapnia. Increased blood pressure (C) and decreased bowel sounds (D) are unrelated to $\mathrm{CO} 2$ levels making B the expected assessment finding.
Question 5 of 5
A client is concerned about maintaining a healthy respiratory system. What should the nurse instruct the client to do to promote a healthy respiratory status?
Correct Answer: B
Rationale: Promoting respiratory health involves regular exercise (B) to enhance lung capacity not smoking (C) to avoid damage and breathing through the nose (D) for filtration and humidification. Pursed-lip breathing (A) is specific for COPD not general health. Mouth breathing (E not listed) is less effective making B C and D appropriate instructions.