ATI RN
NCLEX Questions for Oxygenation Questions
Question 1 of 5
A nurse is caring for a patient with a history of stroke who is exhibiting facial drooping. What is the priority intervention?
Correct Answer: A
Rationale: The correct answer is A: Administer pain relief. In a patient exhibiting facial drooping, the priority intervention is to assess for stroke symptoms, specifically to rule out a current stroke. Administering pain relief can help determine if the drooping is due to a stroke or another cause. Administering nitroglycerin (B) is not appropriate for facial drooping. Monitoring oxygen saturation levels (C) is important but not the priority in this situation. Administering analgesics (D) is similar to pain relief but does not address the urgency of assessing for stroke symptoms.
Question 2 of 5
The nurse discusses management of upper respiratory infections (URIs) with a patient who has acute sinusitis. Which statement by the patient indicates that additional teaching is needed?
Correct Answer: B
Rationale: In this scenario, option B is the correct answer because the statement about using nasal decongestant spray until the congestion is gone indicates a need for additional teaching. Prolonged use of decongestant sprays can lead to a rebound effect, worsening congestion in the long run. This is a crucial point to understand in managing acute sinusitis. Option A is incorrect because staying well hydrated is a beneficial practice to help thin mucus and alleviate congestion. Option C is incorrect as acetaminophen can be used to manage sinus discomfort and pain. Option D is also incorrect because monitoring changes in nasal secretions and sputum is an important part of self-care management to assess for worsening symptoms or potential complications. In an educational context, it is essential for patients to understand the appropriate and safe use of medications and home remedies for managing upper respiratory infections like acute sinusitis. Teaching patients about potential risks of overusing certain medications, like decongestant sprays, is crucial to prevent complications and promote effective symptom management. Empowering patients with accurate information helps them make informed decisions about their health and well-being.
Question 3 of 5
A patient with bacterial pneumonia has coarse crackles and thick sputum. Which action should the nurse plan to promote airway clearance?
Correct Answer: C
Rationale: The correct answer is C) Assist the patient to splint the chest when coughing. This option is the most appropriate action to promote airway clearance in a patient with bacterial pneumonia presenting with coarse crackles and thick sputum. By splinting the chest during coughing, the patient can effectively mobilize and expel the thick sputum, which helps clear the airways and improve oxygenation. Option A) Restricting oral fluids during the day is incorrect as hydration is crucial in thinning the sputum, making it easier to cough up and clear the airways. Dehydration can lead to thicker secretions, exacerbating the problem. Option B) Teaching the pursed-lip breathing technique is beneficial for patients with chronic lung conditions like COPD to improve oxygen exchange. However, in a patient with bacterial pneumonia and thick sputum, the priority is to facilitate the removal of secretions through effective coughing rather than focusing solely on breathing techniques. Option D) Encouraging the patient to wear the nasal O₂ cannula may be necessary for supplemental oxygen therapy in some cases of pneumonia, but it does not directly address the issue of airway clearance. Oxygen therapy aims to improve oxygenation but does not specifically aid in mobilizing and clearing the sputum from the airways. In an educational context, understanding the rationale behind each option helps nurses make informed clinical decisions based on the patient's condition. By prioritizing interventions that directly address the underlying issue, such as promoting airway clearance in this scenario, nurses can provide optimal care and improve patient outcomes. Encouraging critical thinking and clinical reasoning skills through NCLEX-style questions helps reinforce the importance of evidence-based practice in nursing care.
Question 4 of 5
A patient with idiopathic pulmonary arterial hypertension (IPAH) is receiving nifedipine (Procardia). Which assessment would best indicate to the nurse that the patient's condition is improving?
Correct Answer: C
Rationale: In the context of a patient with idiopathic pulmonary arterial hypertension (IPAH) receiving nifedipine, the best indicator of improvement in the patient's condition is their report of a decrease in exertional dyspnea (Option C). Decreased dyspnea signifies improved pulmonary artery pressure and oxygenation, which are key treatment goals in IPAH management. This symptom directly reflects how well the medication is working to alleviate the pressure on the pulmonary arteries, allowing for improved oxygen exchange in the lungs. Option A, the chest x-ray indicating clear lung fields, while important, may not always directly correlate with the patient's symptomatic improvement or the effectiveness of the medication in managing IPAH. Option B, heart rate between 60 and 100 beats/minute, is a general parameter for heart rate control but does not specifically address the improvement in pulmonary hypertension or oxygenation in IPAH. Option D, blood pressure less than 140/90 mm Hg, is a parameter for blood pressure control and is not directly related to the improvement in IPAH symptoms, such as dyspnea. Educationally, understanding the rationale behind selecting the most appropriate assessment parameter in monitoring patients with IPAH on nifedipine is crucial for nurses and healthcare providers. It highlights the importance of focusing on specific symptoms related to the condition being treated and how they can be used to evaluate the effectiveness of the therapy provided. This knowledge enhances the quality of patient care by ensuring that assessments are tailored to monitor the relevant aspects of the patient's condition accurately.
Question 5 of 5
The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?
Correct Answer: B
Rationale: The correct answer to this NCLEX question is option B: "The patient rapidly inhales the medication." This action indicates successful teaching about the administration of Advair Diskus. Rapid inhalation is crucial for this dry powder inhaler to ensure proper delivery of the medication into the lungs. Unlike metered-dose inhalers (MDIs) that require slow inhalation to coordinate with the release of the medication, dry powder inhalers like Advair Diskus require a quick, forceful inhalation to effectively disperse the medication for optimal absorption. Option A, shaking the device before use, is incorrect because Advair Diskus does not require shaking before administration. Shaking the device can actually disrupt the consistency of the medication inside. Option C, attaching a spacer to the Diskus, is also incorrect because spacers are not used with dry powder inhalers like Advair Diskus. Spacers are typically used with MDIs to help improve medication delivery and coordination. Option D, performing huff coughing after inhalation, is not a step associated with the administration of Advair Diskus and does not indicate successful teaching. In an educational context, it is essential for nurses to understand the proper administration techniques for different types of inhalers to effectively teach patients with respiratory conditions. By ensuring patients understand the correct inhalation techniques for medications like Advair Diskus, nurses can help improve patient outcomes and medication efficacy. Understanding these nuances can help nurses provide comprehensive education and support to patients managing chronic respiratory conditions like chronic bronchitis.