ATI RN
NCLEX Style Questions on Oxygenation Questions
Question 1 of 5
The nurse has completed the assessment for a client in the clinic with a diagnosis of chronic asthma. What would be the priority goal the nurse should discuss with the client?
Correct Answer: C
Rationale: The correct answer is C: Recognizing triggers that cause asthma attacks. This is the priority goal because identifying triggers helps the client avoid or minimize asthma attacks, leading to better management of the condition. By recognizing triggers, the client can take proactive measures to prevent exacerbations. Choices A, B, and D are important aspects of asthma management, but recognizing triggers is crucial for preventing asthma attacks and improving overall quality of life. Maintaining a regular exercise routine (A) can be beneficial but may not be the priority if triggers are not controlled. Complying with medication instructions (B) is important for treatment adherence, but identifying triggers can help reduce the need for rescue medications. Understanding physical limitations (D) is important for self-management, but recognizing triggers is more directly related to preventing asthma exacerbations.
Question 2 of 5
The nurse is caring for a client post-lobectomy. What is the most important nursing action to prevent complications?
Correct Answer: B
Rationale: The correct answer is B: Encouraging frequent use of the incentive spirometer. Post-lobectomy, the risk of atelectasis is high due to decreased lung capacity. Incentive spirometer helps prevent this by promoting deep breathing and lung expansion. Administering analgesics (A) is important, but not the most crucial. Limiting fluid intake (C) is incorrect as hydration is essential post-surgery. Positioning the client on the operative side (D) can hinder lung expansion.
Question 3 of 5
The nurse is caring for a client with pneumothorax who has a chest tube. What intervention should the nurse prioritize?
Correct Answer: C
Rationale: The correct answer is C: Keeping the drainage system below the chest level. This is crucial to ensure proper drainage and prevent air from entering the pleural space. Placing the system below the chest level allows gravity to assist in drainage. Choice A is incorrect because ambulation may increase the risk of dislodging the chest tube. Choice B is incorrect as clamping the chest tube can lead to tension pneumothorax. Choice D is incorrect as changing the chest tube dressing daily is not a priority over maintaining proper positioning of the drainage system.
Question 4 of 5
The nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD). Which dietary recommendation is most appropriate?
Correct Answer: B
Rationale: The correct answer is B: Eat small, frequent meals to reduce fatigue. For a client with COPD, consuming small, frequent meals helps reduce the energy expenditure required for digestion, thereby reducing fatigue. This approach also prevents overeating, which can lead to increased breathlessness. Option A is incorrect because high-carbohydrate meals may lead to excess energy intake and contribute to weight gain, which can exacerbate COPD symptoms. Option C is incorrect as protein is essential for muscle strength and repair, especially important for individuals with COPD who may experience muscle wasting. Option D is incorrect as there is no direct evidence linking dairy consumption to increased mucus production in individuals with COPD.
Question 5 of 5
The nurse is caring for a client with a tracheostomy. Which intervention is the priority?
Correct Answer: B
Rationale: The correct answer is B: Ensuring a replacement tracheostomy tube is at the bedside. This is the priority because in the event of accidental dislodgement or obstruction of the current tracheostomy tube, a replacement must be readily available to maintain the client's airway. Without a replacement tube, the client could experience severe respiratory distress or even airway obstruction, which could be life-threatening. Cleaning the stoma site every 24 hours (Choice A) is important for hygiene but is not the immediate priority. Suctioning the tracheostomy every 8 hours (Choice C) is a routine maintenance task and should be done as needed based on assessment. Providing humidified oxygen through the tracheostomy (Choice D) is important for maintaining proper oxygenation but ensuring a replacement tube takes precedence to maintain airway patency.