ATI RN
NCLEX Practice Questions Oxygenation Questions
Question 1 of 5
A client with COPD is prescribed a corticosteroid inhaler. What teaching point should the nurse emphasize?
Correct Answer: B
Rationale: The correct answer is B) Rinse your mouth after each use. This teaching point is crucial for a client using a corticosteroid inhaler for COPD to prevent the development of oral thrush, a common side effect of inhaled corticosteroids. Rinsing the mouth helps to remove any medication residue that could lead to fungal overgrowth in the mouth. Option A) Use the inhaler only when symptoms worsen is incorrect because corticosteroid inhalers are typically used on a regular schedule to manage inflammation and prevent symptoms from worsening. Option C) Shake the inhaler only if symptoms persist is incorrect because corticosteroid inhalers need to be shaken before each use to ensure proper dispersion of the medication for effective delivery to the lungs. Option D) Use the inhaler before a bronchodilator is incorrect because bronchodilators are usually used first to help open the airways, followed by corticosteroid inhalers to reduce inflammation. In an educational context, it is essential for nurses to provide clear and accurate instructions on the use of inhalers to promote optimal therapeutic outcomes and prevent adverse effects. Teaching patients about proper inhaler technique and potential side effects empowers them to effectively manage their condition and improve their quality of life.
Question 2 of 5
A client is being treated for carbon monoxide poisoning. What is the nurse's priority action?
Correct Answer: A
Rationale: The correct answer is A) Administer 100% oxygen via a non-rebreather mask. The top priority in treating carbon monoxide poisoning is to increase the oxygen-carrying capacity of the blood. Carbon monoxide binds to hemoglobin with a much higher affinity than oxygen, leading to tissue hypoxia. By administering 100% oxygen, the nurse helps to displace carbon monoxide from hemoglobin and increase the oxygen saturation in the blood, which is crucial in treating carbon monoxide poisoning. Option B) Monitor for signs of respiratory acidosis is incorrect because while carbon monoxide poisoning can lead to tissue hypoxia, it does not primarily cause respiratory acidosis. Option C) Obtain an arterial blood gas sample is not the priority as initiating treatment to address the hypoxia is more critical before confirming the diagnosis. Option D) Placing the client in a high Fowler's position would not directly address the underlying issue of carbon monoxide poisoning and is not the most urgent intervention in this situation. In an educational context, understanding the priority actions in managing carbon monoxide poisoning is vital for nurses to provide timely and effective care. This scenario highlights the importance of recognizing the pathophysiology of carbon monoxide poisoning and the immediate interventions required to improve oxygenation and patient outcomes.
Question 3 of 5
The nurse is assessing a patient with chronic bronchitis who reports increased fatigue and productive cough. What finding requires immediate action?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) Oxygen saturation of 89%. This finding requires immediate action because a saturation level below 90% indicates severe hypoxemia, which can lead to serious complications such as organ damage or respiratory failure. Oxygen saturation is a critical parameter to assess the adequacy of oxygenation in patients with respiratory conditions like chronic bronchitis. Option B) Productive cough with green sputum is a common symptom of chronic bronchitis and, although it may indicate an infection, it does not require immediate action as the change in sputum color alone is not an emergency. Option C) Heart rate of 92 beats per minute is within the normal range for many adults and, while it should be monitored, it does not indicate an immediate need for intervention in this context. Option D) Increased sputum production is also a common symptom in chronic bronchitis and does not necessitate immediate action unless accompanied by other concerning symptoms. Educationally, this question highlights the importance of prioritizing assessments based on the urgency of the patient's condition. Understanding the significance of oxygen saturation levels in respiratory disorders is crucial for nurses to intervene promptly and prevent potential complications.
Question 4 of 5
The nurse has just auscultated coarse crackles bilaterally on a patient with a tracheostomy tube in place. If the patient is unsuccessful in coughing up secretions, what action should the nurse take?
Correct Answer: C
Rationale: In this scenario, option C is the correct answer. When coarse crackles are heard in a patient with a tracheostomy tube and they are unable to cough up secretions, suctioning is necessary to clear the airway and prevent respiratory complications. Using a sterile catheter to suction helps remove the secretions effectively. Option A, encouraging increased incentive spirometer use, is incorrect because it focuses on lung expansion rather than directly addressing the need for clearing secretions. Option B, encouraging increased oral fluid intake, is also incorrect as it does not address the immediate need for airway clearance. Option D, preoxygenating the patient before suctioning, is not the priority action when the patient is having difficulty clearing secretions. Educationally, this question highlights the importance of prompt and effective airway management in patients with tracheostomy tubes, especially when abnormal breath sounds are present. Nurses must be adept at recognizing respiratory distress signs and taking appropriate action to maintain airway patency and oxygenation. Mastering these skills is crucial for nurses caring for patients with compromised respiratory function.
Question 5 of 5
The nurse assesses a patient with chronic bronchitis. Which finding is a priority to report to the provider?
Correct Answer: C
Rationale: In the context of a patient with chronic bronchitis, a respiratory rate of 28 breaths per minute is a priority finding to report to the provider because it indicates respiratory distress and potential respiratory failure. This high respiratory rate may suggest inadequate oxygenation, increased work of breathing, and impending respiratory arrest. Prompt intervention is crucial to prevent further deterioration in the patient's condition. Option A: The presence of bilateral ankle edema is concerning for fluid retention, which may be related to heart failure or renal issues. While important, it is not the most immediate concern in a patient with chronic bronchitis. Option B: Green and thick sputum may indicate a bacterial infection, but it is not as urgent as the respiratory distress indicated by a high respiratory rate. Option D: An oxygen saturation of 91% is low and requires monitoring and intervention, but a high respiratory rate takes precedence as it indicates immediate respiratory compromise. In an educational context, understanding the priority of findings in patients with respiratory conditions is crucial for nurses to provide timely and appropriate care. Recognizing signs of respiratory distress and knowing when to escalate care are essential skills for nurses caring for patients with respiratory conditions like chronic bronchitis.