ATI RN
NCLEX Questions for Oxygenation Questions
Question 1 of 5
The nurse prepares a patient with a left-sided pleural effusion for a thoracentesis. How should the nurse position the patient?
Correct Answer: D
Rationale: The correct answer is option D, sitting upright with the arms supported on an over bed table, for several reasons. Firstly, this position allows gravity to assist in moving the fluid away from the puncture site, making it easier to access the pleural space during thoracentesis. Secondly, sitting upright promotes lung expansion, making it easier for the healthcare provider to insert the needle accurately. Additionally, supporting the arms on an over bed table helps the patient maintain a steady position and reduces the risk of accidental movement during the procedure. Option A, High-Fowler's position with the left arm extended, is incorrect because while the patient is upright, extending the left arm may not provide optimal access to the pleural space on the left side. Option B, supine with the head of the bed elevated 30 degrees, is incorrect as this position does not facilitate gravity-assisted drainage of the pleural effusion or optimal lung expansion. Option C, on the right side with the left arm extended above the head, is also incorrect as it does not provide easy access to the pleural space on the left side and may not promote optimal lung expansion. In an educational context, it is crucial for nurses to understand the rationale behind positioning patients for procedures like thoracentesis to ensure the safety, comfort, and effectiveness of the intervention. Proper positioning can impact the success of the procedure and the patient's overall well-being. This knowledge is essential for nurses who work in settings where thoracentesis is performed and for those preparing for exams like the NCLEX that assess their clinical reasoning skills.
Question 2 of 5
A patient with bacterial pneumonia has coarse crackles and thick sputum. Which action should the nurse plan to promote airway clearance?
Correct Answer: C
Rationale: The correct answer is C) Assist the patient to splint the chest when coughing. This option is the most appropriate action to promote airway clearance in a patient with bacterial pneumonia presenting with coarse crackles and thick sputum. By splinting the chest during coughing, the patient can effectively mobilize and expel the thick sputum, which helps clear the airways and improve oxygenation. Option A) Restricting oral fluids during the day is incorrect as hydration is crucial in thinning the sputum, making it easier to cough up and clear the airways. Dehydration can lead to thicker secretions, exacerbating the problem. Option B) Teaching the pursed-lip breathing technique is beneficial for patients with chronic lung conditions like COPD to improve oxygen exchange. However, in a patient with bacterial pneumonia and thick sputum, the priority is to facilitate the removal of secretions through effective coughing rather than focusing solely on breathing techniques. Option D) Encouraging the patient to wear the nasal O₂ cannula may be necessary for supplemental oxygen therapy in some cases of pneumonia, but it does not directly address the issue of airway clearance. Oxygen therapy aims to improve oxygenation but does not specifically aid in mobilizing and clearing the sputum from the airways. In an educational context, understanding the rationale behind each option helps nurses make informed clinical decisions based on the patient's condition. By prioritizing interventions that directly address the underlying issue, such as promoting airway clearance in this scenario, nurses can provide optimal care and improve patient outcomes. Encouraging critical thinking and clinical reasoning skills through NCLEX-style questions helps reinforce the importance of evidence-based practice in nursing care.
Question 3 of 5
A patient with idiopathic pulmonary arterial hypertension (IPAH) is receiving nifedipine (Procardia). Which assessment would best indicate to the nurse that the patient's condition is improving?
Correct Answer: C
Rationale: In the context of a patient with idiopathic pulmonary arterial hypertension (IPAH) receiving nifedipine, the best indicator of improvement in the patient's condition is their report of a decrease in exertional dyspnea (Option C). Decreased dyspnea signifies improved pulmonary artery pressure and oxygenation, which are key treatment goals in IPAH management. This symptom directly reflects how well the medication is working to alleviate the pressure on the pulmonary arteries, allowing for improved oxygen exchange in the lungs. Option A, the chest x-ray indicating clear lung fields, while important, may not always directly correlate with the patient's symptomatic improvement or the effectiveness of the medication in managing IPAH. Option B, heart rate between 60 and 100 beats/minute, is a general parameter for heart rate control but does not specifically address the improvement in pulmonary hypertension or oxygenation in IPAH. Option D, blood pressure less than 140/90 mm Hg, is a parameter for blood pressure control and is not directly related to the improvement in IPAH symptoms, such as dyspnea. Educationally, understanding the rationale behind selecting the most appropriate assessment parameter in monitoring patients with IPAH on nifedipine is crucial for nurses and healthcare providers. It highlights the importance of focusing on specific symptoms related to the condition being treated and how they can be used to evaluate the effectiveness of the therapy provided. This knowledge enhances the quality of patient care by ensuring that assessments are tailored to monitor the relevant aspects of the patient's condition accurately.
Question 4 of 5
The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus (combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that teaching about medication administration has been successful?
Correct Answer: B
Rationale: The correct answer to this NCLEX question is option B: "The patient rapidly inhales the medication." This action indicates successful teaching about the administration of Advair Diskus. Rapid inhalation is crucial for this dry powder inhaler to ensure proper delivery of the medication into the lungs. Unlike metered-dose inhalers (MDIs) that require slow inhalation to coordinate with the release of the medication, dry powder inhalers like Advair Diskus require a quick, forceful inhalation to effectively disperse the medication for optimal absorption. Option A, shaking the device before use, is incorrect because Advair Diskus does not require shaking before administration. Shaking the device can actually disrupt the consistency of the medication inside. Option C, attaching a spacer to the Diskus, is also incorrect because spacers are not used with dry powder inhalers like Advair Diskus. Spacers are typically used with MDIs to help improve medication delivery and coordination. Option D, performing huff coughing after inhalation, is not a step associated with the administration of Advair Diskus and does not indicate successful teaching. In an educational context, it is essential for nurses to understand the proper administration techniques for different types of inhalers to effectively teach patients with respiratory conditions. By ensuring patients understand the correct inhalation techniques for medications like Advair Diskus, nurses can help improve patient outcomes and medication efficacy. Understanding these nuances can help nurses provide comprehensive education and support to patients managing chronic respiratory conditions like chronic bronchitis.
Question 5 of 5
A 55-yr-old patient with increasing dyspnea is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease (COPD). When teaching a patient about pulmonary spirometry for this condition, what is the most important question the nurse should ask?
Correct Answer: C
Rationale: In this scenario, the most important question the nurse should ask the patient undergoing pulmonary spirometry for a possible COPD diagnosis is whether they have taken any bronchodilators that day (Option C). This is the correct choice because bronchodilators can affect the spirometry results by altering airway tone and potentially providing a false representation of the patient's baseline lung function. Option A, asking about claustrophobia, is incorrect because it is not directly related to the accuracy of the spirometry test. Option B, inquiring about shellfish allergies, is irrelevant to pulmonary function testing. Option D, asking about metal implants, is also not as crucial as ensuring the patient has not taken bronchodilators prior to spirometry. Educationally, understanding the impact of medications on diagnostic tests is crucial for nurses and healthcare providers. It highlights the need for thorough patient assessment and history-taking to ensure the accuracy of diagnostic procedures. By asking the right questions, healthcare professionals can guarantee reliable test results and provide appropriate care based on accurate assessments. This rationale emphasizes the importance of clinical knowledge and critical thinking skills in nursing practice.