ATI RN
NCLEX Questions on Oxygen Therapy Questions
Question 1 of 5
A patient presents with dyspnea and pleuritic chest pain. Which condition should the nurse suspect?
Correct Answer: B
Rationale: The correct answer is B: Pulmonary embolism. This is suspected in a patient with dyspnea and pleuritic chest pain due to a blood clot blocking blood flow in the lungs. Pneumonia (A) presents with cough and fever. Asthma exacerbation (C) presents with wheezing and cough. Bronchitis (D) presents with productive cough and chest discomfort. Pulmonary embolism is the most critical condition to consider in a patient with sudden-onset dyspnea and pleuritic chest pain.
Question 2 of 5
A patient with severe respiratory distress has a PaO2 of 48 mm Hg. What should the nurse do first?
Correct Answer: A
Rationale: The correct answer is A: Administer oxygen therapy immediately. In severe respiratory distress with a PaO2 of 48 mm Hg, the priority is to improve oxygenation. Administering oxygen therapy will help increase the PaO2 levels quickly, improving oxygen delivery to vital organs. Positioning the patient in high Fowler's (B) can help with breathing but does not address the immediate need for oxygen. Intubation (C) may be necessary but is not the first step. Notifying the healthcare provider (D) can cause delays in providing essential oxygen therapy.
Question 3 of 5
A patient is receiving antibiotics for pneumonia. Which assessment finding requires immediate follow-up?
Correct Answer: B
Rationale: The correct answer is B: Oxygen saturation of 88% on room air. This finding indicates severe hypoxemia, which is a medical emergency requiring immediate intervention to prevent hypoxia-related complications. Hypoxemia can lead to tissue damage and organ dysfunction. Immediate follow-up may involve providing supplemental oxygen and assessing the patient's respiratory status. Choice A: Temperature of 101°F is slightly elevated but not an immediate concern in the context of pneumonia treatment. Choice C: Productive cough with yellow sputum is a common symptom of pneumonia and does not require immediate follow-up unless accompanied by other concerning symptoms. Choice D: Crackles in both lung bases are expected in pneumonia and do not necessitate immediate action unless associated with respiratory distress.
Question 4 of 5
The nurse reviews arterial blood gas results: pH 7.30, PaCO2 55 mm Hg, HCO3- 24 mEq/L. What is the interpretation?
Correct Answer: B
Rationale: The correct interpretation is uncompensated respiratory acidosis (Choice B). Step-by-step rationale: 1. pH is low (acidosis): Indicates an acid-base imbalance. 2. PaCO2 is high (55 mm Hg): Indicates respiratory acidosis. 3. HCO3- is within normal range (24 mEq/L): Indicates no compensation by the kidneys. Therefore, the patient is experiencing respiratory acidosis without compensatory metabolic changes. Other choices are incorrect: A: Metabolic acidosis: HCO3- is within normal range. C: Partially compensated metabolic acidosis: PaCO2 is high, not low. D: Compensated respiratory alkalosis: pH is low, indicating acidosis.
Question 5 of 5
A patient with a pulmonary embolism (PE) is admitted. What is the priority nursing intervention?
Correct Answer: B
Rationale: The correct answer is B: Provide oxygen therapy as needed. In a patient with a pulmonary embolism, ensuring adequate oxygenation is the priority to prevent hypoxia and tissue damage. Oxygen therapy helps improve oxygen saturation levels, reducing the workload on the heart and lungs. Administering anticoagulants (Choice A) is important but not the immediate priority. Positioning in high Fowler's (Choice C) may help with breathing but doesn't address immediate oxygen needs. Notifying the healthcare provider (Choice D) is essential but not the immediate action needed to stabilize the patient.