ATI RN
NCLEX Questions for Oxygenation Questions
Question 1 of 5
A patient with tuberculosis is started on isoniazid. What should the nurse monitor for?
Correct Answer: B
Rationale: The correct answer is B: Peripheral neuropathy symptoms. Isoniazid can lead to peripheral neuropathy due to vitamin B6 deficiency. The nurse should monitor for numbness, tingling, or weakness in extremities. Signs of hepatotoxicity (choice A) are associated with other TB medications. Orange discoloration of body fluids (choice C) is a side effect of rifampin. Changes in visual acuity (choice D) are not typically associated with isoniazid.
Question 2 of 5
The nurse observes continuous bubbling in the water-seal chamber of a chest tube. What does this indicate?
Correct Answer: B
Rationale: The continuous bubbling in the water-seal chamber indicates an air leak in the system. When air leaks into the chest tube system, it creates bubbling in the water-seal chamber. This indicates that the system is not airtight, compromising its ability to remove air or fluid from the pleural space effectively. Choices A, C, and D are incorrect because continuous bubbling does not indicate proper functioning of the chest tube, presence of a pneumothorax, or high suction pressure.
Question 3 of 5
A patient with pulmonary embolism (PE) is receiving heparin therapy. What lab result should the nurse monitor closely?
Correct Answer: B
Rationale: The correct answer is B, activated partial thromboplastin time (aPTT). Monitoring aPTT is crucial for patients on heparin therapy to ensure the therapeutic range is maintained for anticoagulation. A prolonged aPTT indicates the desired anticoagulant effect of heparin. Platelet count (A) is important to monitor for heparin-induced thrombocytopenia, not routine monitoring. Prothrombin time (PT) (C) and international normalized ratio (INR) (D) are used to monitor warfarin therapy, not heparin.
Question 4 of 5
Which intervention should the nurse implement for a patient with a chest tube and continuous bubbling in the water-seal chamber?
Correct Answer: D
Rationale: The correct answer is D because checking all connections for a loose fitting is essential in this situation. This step ensures that there are no leaks or disconnections along the chest tube system, which could be causing the continuous bubbling in the water-seal chamber. Clamping the chest tube (Choice A) could lead to a tension pneumothorax and is not recommended. Notifying the healthcare provider of an air leak (Choice B) can be done after checking the connections. Repositioning the tubing (Choice C) may not address the underlying issue of a loose connection.
Question 5 of 5
A patient who has a history of chronic obstructive pulmonary disease (COPD) was hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels of 89% to 90%). In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching?
Correct Answer: C
Rationale: The correct answer is C: Arrange for the patient's caregiver to be present during the teaching. Rationale: 1. Involving the patient's caregiver promotes better understanding and support for the patient's care at home. 2. Caregivers can assist in reinforcing teaching, ensuring the patient follows instructions. 3. Caregivers can help monitor the patient for any signs of worsening condition or noncompliance. 4. This approach is effective in addressing potential barriers to compliance and continuity of care. Summary of other choices: A: Having the patient repeat instructions may not guarantee understanding or retention of information. B: Teaching just before discharge may not allow enough time for the patient and caregiver to fully grasp and prepare for home care. D: Starting teaching during admission may overwhelm the patient and may not address the need for ongoing support at home.