ATI RN
NCLEX Questions on Oxygenation and Perfusion Questions
Question 1 of 5
A nurse caring for a patient with COPD knows that which oxygen delivery device is most appropriate?
Correct Answer: C
Rationale: The correct answer is C: Partial non-rebreather mask. This device provides a higher concentration of oxygen compared to a nasal cannula or simple face mask, which is crucial for COPD patients who often have impaired gas exchange. The non-rebreather mask (choice D) is not appropriate as it can lead to CO2 retention in COPD patients. The nasal cannula (choice A) and simple face mask (choice B) do not provide as high an oxygen concentration as the partial non-rebreather mask, making them less suitable for COPD patients who require higher oxygen levels.
Question 2 of 5
The nurse is caring for a client with acute asthma exacerbation. What priority assessment would concern the nurse most?
Correct Answer: C
Rationale: The correct answer is C because inspiratory wheezing and a respiratory rate greater than 30 indicate severe airway obstruction and impending respiratory failure in acute asthma exacerbation. This warrants immediate intervention to prevent respiratory arrest. A: Shortness of breath and low-grade fever are common in asthma exacerbation but not as concerning as severe airway obstruction. B: Low oxygen saturation and elevated pulse rate are also expected in asthma exacerbation but are not as critical as severe airway obstruction. D: Tachycardia and pursed-lip breathing are common in asthma exacerbation but do not indicate severe airway obstruction as clearly as inspiratory wheezing and high respiratory rate.
Question 3 of 5
The nurse is caring for a client with chronic bronchitis who has a productive cough. What intervention should the nurse implement to promote effective airway clearance?
Correct Answer: A
Rationale: Correct Answer: A: Encourage fluid intake of at least 2 liters per day. Rationale: 1. Adequate hydration helps to keep respiratory secretions thin and easier to expectorate. 2. Increased fluid intake helps to prevent dehydration, which can thicken secretions and worsen cough. 3. Hydration is essential for overall health and helps to maintain optimal pulmonary function. Summary: B: Limiting activity may lead to decreased respiratory effort and impaired airway clearance. C: Cough suppressants can hinder the body's natural mechanism to clear secretions. D: Providing supplemental oxygen may help with oxygenation but does not directly promote effective airway clearance.
Question 4 of 5
The nurse is teaching a client with a new diagnosis of COPD about pursed-lip breathing. What is the primary benefit of this technique?
Correct Answer: B
Rationale: The correct answer is B: Reduces airway resistance. Pursed-lip breathing helps to slow down the exhalation process, which in turn reduces the amount of air trapped in the lungs and decreases airway resistance. This technique promotes better oxygen exchange and helps the client breathe more efficiently. A: Increases oxygen intake - Pursed-lip breathing does not directly increase oxygen intake but rather improves the efficiency of oxygen exchange by reducing airway resistance. C: Slows the respiratory rate - While pursed-lip breathing may slow down the breathing pattern, the primary benefit is the reduction of airway resistance, not solely slowing the respiratory rate. D: Prevents hyperventilation - Pursed-lip breathing can help prevent hyperventilation by promoting more controlled breathing, but the primary benefit is the reduction of airway resistance for clients with COPD.
Question 5 of 5
The nurse is assessing a client with a chest tube. Which finding requires immediate action?
Correct Answer: A
Rationale: The correct answer is A because continuous bubbling in the water seal chamber indicates an air leak in the chest tube system, which can lead to pneumothorax. Immediate action is needed to prevent respiratory compromise. Choice B is incorrect because drainage of 50 mL in the past hour is within normal limits for a chest tube output. Choice C, tidaling in the water seal chamber, is a normal finding indicating proper functioning of the chest tube system. Choice D is incorrect because although the chest tube dressing intact with no drainage is a good sign, it does not require immediate action compared to an air leak.