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Oxygenation

Total questions: 72

Worksheet time: 2hrs 28mins

Name
Class
Date
1.

While caring for a patient with respiratory disease, the nurse observes that the patient’s SpO2 drops from 93% to 88% while the patient is ambulating in the hallway. What is the priorityaction of the nurse?

a)

Notify the health care provider.

b)

Document the response to exercise.

c)

Administer the PRN supplemental O2.

d)

Encourage the patient to pace activity.

2.
The nurse is caring for a client with orders for oxygen at 5 L/min. Approximately how much FiO2 is the client receiving?
a)
24%
b)
28%
c)
36%
d)
40%
3.
A client who is receiving continuous oxygen therapy by nasal cannula for an acute respiratory problem is becoming increasingly confused. What does the nurse do first?
a)
Notify the health care provider.
b)
Assess the client’s pulse oximetry.
c)
Document the observation.
d)
Raise the head of the bed.
4.
The nurse assesses a client who is receiving oxygen via a partial rebreather mask. Which assessment finding does the nurse intervene to correct?
a)
The bag is two thirds inflated during inhalation.
b)
The client’s pulse oximetry reading is 93%.
c)
The oxygen flow rate is 2 L/min.
d)
The arterial oxygen level is 90%.
5.
A client is 24 hours postoperative after a tracheostomy has been performed. The nurse finds the client cyanotic, with the tracheostomy tube lying on his chest. Which action by the nurse takes priority?
a)
Auscultate breath sounds bilaterally.
b)
Ventilate with a resuscitation bag and mask.
c)
Call a code or the Rapid Response Team.
d)
Insert a new obturator into the neck.
6.
While suctioning a client who had a tracheostomy placed 4 days ago, the nurse notes particles of food in the tracheal secretions. Which action by the nurse is most appropriate?
a)
Increase the inflation pressure in the tracheostomy cuff.
b)
Add blue dye to a beverage to assess for aspiration.
c)
Make the client NPO and notify the health care provider.
d)
Perform a more thorough assessment of the client.
7.
The nurse observes a nursing student suctioning a client. Which intervention by the student nurse requires the supervising nurse to intervene?
a)
Checking oxygen saturation post suctioning
b)
Hyperoxygenating the client after removal of the catheter
c)
Applying intermittent suction during catheter removal
d)
Applying suction when the catheter is inserted
8.
The nurse assesses a client during suctioning. Which finding indicates that the procedure should be stopped?
a)
Heart rate increases from 86 to 102 beats/min.
b)
Respiratory rate increases from 16 to 20 breaths/min.
c)
Blood pressure increases from 110/70 to 120/80 mm Hg.
d)
Heart rate decreases from 78 to 40 beats/min.
9.
A client receiving high-flow oxygen has new crackles and diminished breath sounds since the last assessment 1 hour ago. Which action by the nurse is most appropriate?
a)
Call respiratory therapy and request a bronchodilator treatment.
b)
Instruct the client to use the spirometer and to cough and deep breathe.
c)
Consult with the health care provider and request an order for diuretics.
d)
Ensure that the ordered FiO2 is what is being provided.
10.
The nurse is preparing to receive a postoperative client who just had a tracheostomy. Which action by the nurse takes priority?
a)
Obtain report from the postanesthesia care unit.
b)
Place a second tracheostomy tube and obturator at the bedside.
c)
Review orders for postoperative pain medications.
d)
Order supplies for tracheostomy care for 24 hours.
11.
The nurse is caring for an older adult client with a pulmonary infection. Which nursing action is a priority with this client?
a)
Encouraging the client to increase fluid intake
b)
Assessing the client’s level of consciousness
c)
Raising the head of the bed to at least 45 degrees
d)
Providing the client with humidified oxygen
12.
A client has a long-standing history of chronic obstructive pulmonary disease (COPD). Which laboratory finding does the nurse correlate with this condition?
a)
White blood cell count, 7500/mm3
b)
Hemoglobin, 22 g/dL
c)
Neutrophils, 6000/ mm3
d)
Monocytes, 600/mm3
13.
A client with a history of chronic obstructive pulmonary disease (COPD) presents to the clinic with increased cough and low-grade temperature. Which question by the nurse elicits the most useful information?
a)
“How long have you been sick?”
b)
“Has your sputum changed color?”
c)
“Is anyone else in your house sick?”
d)
“Do you take any medications?”
14.
 A client says to the nurse, “It’s hard for me to breathe; I feel winded all the time.” The nurse would record this subjective feeling on the chart as
a)
apnea
b)
dyspnea
c)
respiratory fatigue
d)
tachypnea
15.
A 44-year-old man with active pulmonary tuberculosis is experiencing hemoptysis, which the nurse understands describes
a)
bloody sputum.
b)
chest pain.
c)
constant cough.
d)
dyspnea.
16.
The nurse would explain to a client with complaints of wheezing and chest tightness that wheezing occurs when
a)
air is passing through a narrowed airway.
b)
air is trapped in the alveoli.
c)
an allergic reaction is taking place.
d)
sputum production is increased.
17.
 The nurse clinician performing percussion of the chest on a client assesses a low-pitched, hollow sound over the middle lobe. The nurse would record this finding as
a)
dull, and refer the client to an allergist.
b)
hyperresonant, and refer to a physician for work-up.
c)
resonant and document the finding, taking no other action.
d)
tympany, and refer the client to radiology for a chest x-ray.
18.
A patient with chronic obstructive pulmonary disease requires low flow oxygen. How will the oxygen be administered?
a)
Nasal cannula
b)
Simple oxygen mask
c)
Venturi mask
d)
Partial rebreather mask
19.
The home care nurse visits a patient with compromised lung function. She has greenish-yellow sputum with a musty odor. This is indicative of
a)
allergy
b)
congestive heart failure
c)
asthma
d)
infection
20.
Which of the following medications are administered in the home or the hospital to relieve inflammation in the lung tissue?
a)
Antibiotics
b)
Bronchodilators
c)
Expectorants
d)
Corticosteroids
21.
Which of the following dietary guidelines would be appropriate for the elderly homebound patient with advanced respiratory disease who informs the nurse that she has no energy to eat?
a)
Snack on high-carbohydrate foods frequently
b)
Eat smaller meals that are high in protein
c)
Contact the physician for Ensure
d)
Eat one large meal at noon
22.
The nurse is assessing a newborn in the nursery. The nurse notes the infant has episodes in which breathing ceased for 20 seconds on  . The nurse correctly recognizes this condition as which of the following?
a)
dyspnea
b)
apnea
c)
orthopnea
d)
hypercapnia
23.
When the nurse observes a newborn infant demonstrating an irregular abdominal breathing pattern, with a respiratory rate of 50 breaths/minute with occasional pauses in breathing of 5-second durations, the most appropriate action by the nurse is to
a)
Begin resuscitation efforts
b)
Elevate the head of the crib
c)
Continue to assess the infant
d)
Position the infant side-lying
24.
Oxygen and carbon dioxide move between the alveoli and the blood by
a)
Osmosis
b)
Hyperosmolar pressure
c)
Diffusion
d)
Negative pressure
25.
The nurse is reviewing the results of a patient’s pulmonary function tests. Which result describes the air remaining in lungs after normal expiration?
a)
Tidal volume
b)
Expiratory reserve
c)
Forced vital capacity
d)
Functional residual capacity
26.
The nurse is reviewing the exchange of gases in the blood stream with a patient prescribed oxygen therapy. How should the nurse explain the transport of carbon dioxide in the blood?
a)
As CO2 in plasma
b)
As bicarbonate ions in plasma
c)
As hydrogen ions in red blood cells
d)
As part of hemoglobin in red blood cells
27.
A patient is having problems with oxygenation of body tissues. What is important for the nurse to consider about the transport of oxygen in the blood?
a)
It is in blood plasma as free oxygen.
b)
It travels on red blood cell membranes.
c)
It is bonded to hemoglobin in blood plasma.
d)
It is bonded to hemoglobin in red blood cells.
28.
A patient has a low oxygen level. Which body structure should the nurse consider as being responsible for this low level?
a)
larynx
b)
alveoli
c)
bronchi
d)
nasal passages
29.
While providing care for a patient with asthma, the nurse notes the patient’s shoulders are rising with each breath. What should the nurse realize this action represents?
a)
Hyperinflation of the chest
b)
The use of accessory muscles to aid breathing
c)
Shoulder muscle fatigue related to difficulty breathing
d)
Effective use of a breathing exercise to increase ventilation
30.
An adult patient has a respiratory rate of 36 breaths per minute. Which term should the nurse use to document this finding?
a)
apnea
b)
bradypnea
c)
tachypnea
d)
within normal limits
31.
A patient with pulmonary edema has moist, bubbling lung sounds. How should the nurse describe this finding?
a)
wheezing
b)
fine crackles
c)
coarse crackles
d)
pleural friction rub
32.
A patient is making a loud crowing sound caused by an obstruction of the airways by a foreign body. How should the nurse document this patient’s lung sound?
a)
stridor
b)
wheeze
c)
crackles
d)
pleural friction rub
33.
A patient’s oxygen saturation value is 92% on room air. What does this value mean to the nurse?
a)
The percentage of oxygen in the lungs
b)
The partial pressure of the oxygen in the blood
c)
The amount of oxygen saturating the lymphocytes
d)
The percentage of hemoglobin that is saturated with oxygen
34.
A patient’s oxygen saturation is 89%. Which actions should the nurse take first?
a)
Raise the head of the patient’s bed.
b)
Call the respiratory therapist STAT.
c)
Place the patient in a supine position.
d)
No action; this is a normal oxygen saturation.
35.
The nurse is assigned to monitor a patient with chronic lung disease who is receiving oxygen via a non-rebreathing mask. Which observation indicates to the nurse that the system is functioning as expected?
a)
Both side vents open, reservoir bag inflated
b)
Both side vents open, reservoir bag deflated
c)
Both side vents closed, reservoir bag inflated
d)
Both side vents closed, reservoir bag deflated
36.
A postoperative patient is taking shallow breaths because of fear of incisional pain. Which action should the nurse take first?
a)
Instruct the patient on the use of an incentive spirometer.
b)
Measure peak expiratory flow rate with a peak flow meter.
c)
Call respiratory therapy to provide a metered-dose inhaler (MDI).
d)
Contact the physician to request nebulized mist treatments (NMTs).
37.
After providing chest physiotherapy, the nurse notes the patient has loose secretions and a slight rattle with expiration. Which action should the nurse take first?
a)
Administer an expectorant.
b)
Suction the patient’s airway.
c)
Keep the patient on bedrest for 4 hours.
d)
Encourage the patient to cough and deep breathe.
38.
The nurse explains that the purpose of mucus is to:
a)
warm the air entering the lungs.
b)
trap particles and bacteria.
c)
protect the cilia.
d)
clean the sinus cavity.
39.
The nurse uses a visual aid to show the mechanics of inhaling which correctly illustrates:
a)
the diaphragm moves down.
b)
the negative pressure of the lung converts to positive pressure.
c)
muscles contract, pulling the rib cage down.
d)
bronchi enlarge.
40.
 The nurse explains that the substance that decreases the surface tension of the alveolar walls is:
a)
plasma
b)
surfactant
c)
cilia
d)
mucus
41.
Using animation, the nurse demonstrates how most of the inspired oxygen is carried to the tissues by the:
a)
plasma
b)
lymphatic system
c)
red blood cells
d)
white blood cells
42.
When the nurse places the diaphragm of the stethoscope over one of the main bronchi, the expected normal breath sound heard is:
a)
bronchovesicular
b)
bronchial
c)
rhonchi
d)
vesicular
43.
The nurse performing tracheal suctioning of the patient with a respiratory disorder should suction no longer than _____ seconds.
a)
2 to 5
b)
5 to 10
c)
10 to 15
d)
15 to 20
44.
While reviewing the results of the pulmonary functions test, the nurse is aware that the maximum amount of gas that can be displaced (expired) from the lung is called:
a)
Vital capacity (VC)
b)
Total lung capacity
c)
Functional capacity
d)
Residual volume
45.
A patient requires a precise concentration of 40% oxygen. Which of the following devices would best allow for this?
a)
A simple face mask
b)
A non-rebreather mask
c)
A partial rebreathing mask
d)
Venturi mask
took five deep breaths slowly every 4 hours.A Venturi mask
46.
The nurse recognizes that a post-operative patient who can breathe independently but has trouble maintaining an airway because of the tongue falling back into the throat would be best benefited by a(n):
a)
pharyngeal airway.
b)
endotracheal tube.
c)
tracheostomy.
d)
partial rebreather oxygen mask.
47.
A nurse caring for a patient with a tracheostomy should determine whether the patient needs suctioning by:
a)
monitoring the rate of respirations.
b)
determining the last time the patient was suctioned.
c)
examining the character of the sputum.
d)
auscultating the breath sounds.
48.
The nurse takes into consideration that while caring for a patient on oxygen therapy, safety precautions should be observed, which include:
a)
using clothing of synthetic cloth for the patient.
b)
removing any adhesive from the patient’s skin with acetone.
c)
assessing equipment in room for frayed cords.
d)
reducing humidification on the oxygen delivery device.
49.
The nurse would determine that this patient is aware of how to use the incentive spirometer device properly when the patient:
a)
took 10 slow, deep breaths every hour.
b)
took five quick “huffs” and then coughed vigorously.
c)
exhaled deeply and then inhaled quickly and forcefully three times.
d)
took five deep breaths slowly every 4 hours.
50.

The nurse is reviewing the arterial blood gas results for a patient with a respiratory disorder. What should the nurse recognize as being the most important chemical regulator of respiration?

a)

The blood level of oxygen

b)

The blood level of nitrogen

c)

The blood level of carbon dioxide

d)

The amount of hemoglobin in red blood cells

51.

The nurse is providing care to a patient who experienced an ischemic stroke and now requires respiratory support with mechanical ventilation. The nurse realizes that the stroke most likely occurred in which part of the brain?

a)

Medulla

b)

Cerebrum

c)

Cerebellum

d)

Hypothalamus

52.

A patient with emphysema enters the emergency room with severe dyspnea; O2 saturation is 74%, pulse is 120, and respirations are 26. After positioning the patient in high Fowler’s, the nurse should:

a)

attempt to help the patient slow her respirations.

b)

coach in pursed-lip breathing.

c)

give oxygen at 5 L/min by nasal cannula.

d)

reposition patient in orthopneic position.

53.

The nurse uses a visual aid to show the mechanics of inhaling which correctly illustrates:

a)

the diaphragm moves down.

b)

the negative pressure of the lung converts to positive pressure.

c)

muscles contract, pulling the rib cage down.

d)

bronchi enlarge.

54.

The nurse explains that the substance that decreases the surface tension of the alveolar walls is:

a)

plasma.

b)

surfactant.

c)

cilia.

d)

mucus.

55.

Using animation, the nurse demonstrates how most of the inspired oxygen is carried to the tissues by the:

a)

plasma.

b)

lymphatic system.

c)

red blood cells.

d)

white blood cells.

56.

After auscultating a coarse low-pitched sonorous rattling in the left lower lobe, the nurse is concerned that the patient may be developing:

a)

an accumulation of secretions in the larger air passages.

b)

narrowing in the lower lobe of the lung.

c)

irritation in the pleurae.

d)

crackles in the left lower lobe.

57.

The nurse reminds a group of retirees that age may alter the respiratory systems by: (Select all that apply.)

a)

weakened cough.

b)

kyphosis.

c)

increased ciliary movement.

d)

decrease in body fluid.

e)

muscle weakness.

58.

The nurse is caring for an individual whose respiratory rate of 14 is even and easy; breath sounds are normal. Which terms should the nurse use in this patient’s narrative note? (Select all that apply.)

a)

Apnea

b)

Eupnea

c)

Rhonchi

d)

Bradypnea

e)

Clear to auscultation

59.

A licensed practical nurse (LPN) is helping prepare a patient for a thoracentesis. What should the nurse include in the teaching? (Select all that apply.)

a)

“You will need to be NPO for 6 hours.”

b)

“You will need to sign a consent form for the procedure.”

c)

“You will assume a sitting position at the side of the bed.”

d)

“This is a sterile procedure, so the site will be covered in a drape.”

e)

“You will need to take frequent deep breaths during the procedure.”

60.

The nurse is participating in the planning of care for a patient with a newly placed tracheostomy. Which interventions should the nurse identify as a priority for this patient? (Select all that apply.)

a)

Restrict fluids.

b)

Turn and reposition every shift.

c)

Assess lung sounds every 4 hours.

d)

Suction using sterile technique as needed.

e)

Perform tracheostomy care according to policy.

61.

The nurse is describing the movement of blood into and out of the capillary beds of the lungs to the body organs and tissues. What term should the nurse use to describe this process?

a)

Perfusion

b)

Ventilation

c)

Diffusion

d)

Circulation

62.

If an individual with respiratory difficulty were retaining too much carbon dioxide, which of the following compensatory responses would the nurse expect to be initiated?

a)

Increase in respiratory rate

b)

Decrease in ventilation rate

c)

Increase in tidal volume

d)

Vasodilation of the pulmonary arterioles

63.

A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition?

a)

Cyanosis

b)

Dyspnea

c)

Hyperpnea

d)

Orthopnea

64.

A 20-year-old male presents to his primary care provider reporting difficulty breathing when lying down. What term should the nurse use to document this condition?

a)

Dyspnea

b)

Orthopnea

c)

Apnea

d)

Tachypnea

65.

A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause?

a)

Hyperventilation

b)

Hypoventilation

c)

Apnea

d)

Cyanosis

66.

A nurse is reviewing the results of an ABG and finds reduced oxygenation of arterial blood. What term should the nurse use to describe this condition?

a)

Ischemia

b)

Hypoxia

c)

Hypoxemia

d)

Hypocapnia

67.

A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would the nurse expect?

a)

Electrolyte imbalances

b)

Elevated PaCO2

c)

Low hematocrit

d)

Elevated pH

68.

A 65-year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. The nurse assesses the patient for which complication?

a)

Pneumonia

b)

Bronchiectasis

c)

Pneumothorax

d)

Emphysema

69.

A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway hyper-responsiveness in asthma is related to:

a)

Increased sympathetic nervous system response

b)

The release of stress hormones

c)

Exposure to an allergen causing mast cell degranulation

d)

Hereditary decrease in IgE responsiveness

70.

A 30-year-old male prison inmate contracted tuberculosis during an outbreak. While planning interactions, the nurse realizes the patient can transmit this disease through:

a)

Skin contact

b)

Fecal-oral contact

c)

Airborne droplets

d)

Blood transfusions

71.

A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. The nurse realizes this embolus is composed of:

a)

Fat

b)

Air

c)

Tissue fragment

d)

Blood clot

72.

A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer. He was previously exposed to air pollution, asbestos, and radiation at his job. Which of the following should the nurse realize had the greatest impact on the development of his cancer?

a)

Radiation

b)

Cigarette smoke

c)

Asbestos

d)

Air pollution

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