ATI RN
NCLEX Practice Questions Oxygenation Questions
Question 1 of 5
A client with COPD is prescribed tiotropium (Spiriva). What should the nurse include in the teaching plan?
Correct Answer: B
Rationale: In the context of a client with COPD being prescribed tiotropium (Spiriva), option B, "This medication is used for long-term management, not quick relief," is the correct answer. This is because tiotropium is a long-acting bronchodilator that helps to manage COPD symptoms over time by improving lung function and reducing exacerbations. It is not meant for immediate relief of symptoms during exacerbations, as stated in option A. Option C, "Avoid eating grapefruit while taking this medication," is incorrect as there is no known interaction between tiotropium and grapefruit. Option D, "Take the medication with food to prevent stomach upset," is also incorrect as tiotropium is typically taken on an empty stomach. In an educational context, it is crucial for nurses to understand the rationale behind medication administration to provide effective patient education. By emphasizing that tiotropium is a long-term management medication, nurses can ensure that patients use it correctly to achieve optimal therapeutic outcomes in the management of COPD. This knowledge helps in promoting patient adherence and self-management in the long-term care of COPD.
Question 2 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 3 of 5
The nurse is preparing to administer a nebulized bronchodilator to a client. Which assessment finding is most concerning?
Correct Answer: A
Rationale: In this scenario, option A, a heart rate of 115 beats per minute, is the most concerning assessment finding. The rationale behind this is that an elevated heart rate can indicate cardiac stress or overstimulation from the bronchodilator, potentially leading to cardiac complications. Option B, an oxygen saturation of 90%, while suboptimal, may be expected in a client receiving a bronchodilator for oxygenation issues. It is concerning but not as immediately critical as an elevated heart rate. Option C, a respiratory rate of 22 breaths per minute, is within normal range and does not immediately indicate a critical issue. Option D, the client reporting mild hand tremors, is a common side effect of bronchodilators and is not as concerning as the potential cardiac implications of an elevated heart rate. Educationally, understanding these assessment findings in the context of administering bronchodilators is crucial for nurses to ensure prompt recognition of potential complications and appropriate intervention to optimize patient outcomes. Nursing students preparing for the NCLEX need to grasp the prioritization of assessments to provide safe and effective care to clients receiving respiratory treatments.
Question 4 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 5 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.