ATI RN
Oxygenation NCLEX Questions Questions
Question 1 of 5
A patient recovering from a thoracotomy has no chest tube drainage for 2 hours. What should the nurse do first?
Correct Answer: B
Rationale: The correct answer is B: Assess the chest tube for kinks or obstructions. This is the first step because if there are any kinks or obstructions in the chest tube, it could lead to inadequate drainage and potentially cause complications such as pneumothorax or hemothorax. Repositioning the patient (choice A) may be necessary after ensuring the chest tube is functioning properly. Notifying the healthcare provider (choice C) should be done after assessing the chest tube. Increasing suction pressure (choice D) without assessing for kinks or obstructions may worsen the situation.
Question 2 of 5
A patient with acute asthma exacerbation reports worsening symptoms despite frequent inhaler use. What should the nurse prioritize?
Correct Answer: B
Rationale: Correct Answer: B (Reassess the patient's peak expiratory flow) Rationale: Reassessing the peak expiratory flow is crucial to determine the severity of the asthma exacerbation and guide further treatment. It helps assess lung function and response to therapy, aiding in adjusting the treatment plan promptly. This step is essential in managing acute asthma exacerbations effectively. Administering systemic corticosteroids (choice A) is important but should follow proper assessment. Teaching about triggers (choice C) is beneficial but not the priority during an exacerbation. Notifying the healthcare provider (choice D) can be done after reassessment.
Question 3 of 5
The nurse palpates the posterior chest while the patient says "99" and notes absent fremitus. Which action should the nurse take next?
Correct Answer: D
Rationale: The correct answer is D: Auscultate anterior and posterior breath sounds bilaterally. This is the next appropriate action after noting absent fremitus during palpation of the posterior chest. Auscultation helps assess breath sounds and detects abnormalities such as wheezing or crackles. It provides valuable information about the patient's lung health and can help identify potential respiratory issues. Palpating the anterior chest or observing for barrel chest (choice A) is not the immediate priority when fremitus is absent. Encouraging the patient to turn, cough, and deep breathe (choice B) may be beneficial but does not directly address the absence of fremitus. Reviewing the chest x-ray report for evidence of pneumonia (choice C) is important but does not address the immediate need to further assess breath sounds in this scenario.
Question 4 of 5
A patient with a history of asthma is admitted with an exacerbation. Which action should the nurse take first?
Correct Answer: B
Rationale: The correct answer is B: Administer a short-acting bronchodilator. The first step in managing an asthma exacerbation is to provide quick relief by administering a short-acting bronchodilator like albuterol. This medication helps to open up the airways rapidly, providing immediate relief of symptoms such as wheezing and shortness of breath. Administering a bronchodilator is crucial in the acute management of an asthma exacerbation as it targets bronchoconstriction. Oral steroids (choice C) are typically used for more severe exacerbations or when initial bronchodilator therapy is ineffective. Administering an inhaled beta-agonist (choice D) is a valid option, but a short-acting bronchodilator is preferred for immediate relief in the initial management of an exacerbation.
Question 5 of 5
A nurse is caring for a patient with a history of asthma. Which intervention should the nurse prioritize?
Correct Answer: D
Rationale: The correct answer is D: Administer a bronchodilator. This is the priority intervention because bronchodilators help to quickly open the airways during an asthma attack, improving breathing. Administering a bronchodilator is crucial for managing acute asthma symptoms. Encouraging the patient to avoid triggers (choice B) is important for long-term asthma management but not the priority during an acute attack. Administering an inhaled corticosteroid (choice C) is more for long-term control and prevention of asthma symptoms, not for immediate relief during an attack. Choice A is a duplicate of the correct answer and does not provide additional information.