ATI LPN
Fundamentals of Nursing Oxygenation NCLEX Questions Questions
Question 1 of 4
The nurse is preparing to assist with the removal of a chest tube that is a simple insertion without a purse-string suture. What materials should the nurse gather for this procedure?
Correct Answer: A
Rationale: Without a purse-string suture the chest tube site lacks closure risking air entry into the chest cavity. An occlusive dressing (A) such as petroleum gauze with tape seals the site to prevent pneumothorax. 4x4 gauze (B) adhesive pads (C) and non-adherent dressings (D) do not provide an airtight seal making A essential for safety during removal.
Question 2 of 4
A clients blood gas analysis results show an increase in carbon dioxide level. What will the nurse most likely assess in this client?
Correct Answer: B
Rationale: Elevated $\mathrm{CO} 2$ (hypercapnia) stimulates chemoreceptors triggering increased respiratory rate (B) to expel excess $\mathrm{CO} 2$ the strongest respiratory stimulant. Decreased rate (A) would worsen hypercapnia. Increased blood pressure (C) and decreased bowel sounds (D) are unrelated to $\mathrm{CO} 2$ levels making B the expected assessment finding.
Question 3 of 4
A client is concerned about maintaining a healthy respiratory system. What should the nurse instruct the client to do to promote a healthy respiratory status?
Correct Answer: B
Rationale: Promoting respiratory health involves regular exercise (B) to enhance lung capacity not smoking (C) to avoid damage and breathing through the nose (D) for filtration and humidification. Pursed-lip breathing (A) is specific for COPD not general health. Mouth breathing (E not listed) is less effective making B C and D appropriate instructions.
Question 4 of 4
The nurse is documenting the completion of tracheostomy suctioning and tracheostomy care in a clients medical record. What should this documentation include?
Correct Answer: A
Rationale: Documentation includes lung sounds before and after (A) to assess airway clearance sputum characteristics (B) for infection signs and skin integrity around the stoma (C) for breakdown. Tie knot side (D) is not typically documented. Oxygen flow rate (E not listed) is irrelevant here making A B and C essential for thorough records.