Deck 7: Oxygen Therapy Management

Question 1

The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD)who is prescribed 24% oxygen at 2 L/min.Which is the best method for the nurse to use in order to administer oxygen to this patient?

A) Face mask
B) Venturi mask
C) Nasal cannula
D) Nonrebreather mask

Answer 1

Nasal cannula

Question 2

Which nursing action determines the accuracy of the detected waveform when monitoring a patient's oxygen saturation via oximetry?

A) Using a site with adequate perfusion
B) Ensuring the any nail polish is removed
C) Leaving the sensor in place for a minimum of ten seconds
D) Assessing the heart rate and comparing it with the displayed pulse

Answer 2

Assessing the heart rate and comparing it with the displayed pulse

Question 3

Which did the nurse auscultate when conducting a patient's respiratory assessment if wheezing is documented?

A) Snoring sounds
B) Gurgling sounds
C) Low-pitched bubbling
D) High-pitched squeaking

Answer 3

High-pitched squeaking

Question 4

When conducting in-line suctioning on a patient,which amount of time should the nurse allow as a rest period between suction procedures?

A) 5 to 15 seconds
B) 10 to 20 seconds
C) 15 to 25 seconds
D) 20 to 30 seconds

Question 5

When conducting in-line suctioning,which is the maximum amount of time for each suctioning event?

A) 10 seconds
B) 30 seconds
C) 45 seconds
D) 60 seconds

Question 6

Which did the nurse auscultate when conducting a patient's respiratory assessment if rhonchi is documented?

A) Snoring sounds
B) Gurgling sounds
C) Low-pitched bubbling
D) High-pitched squeaking

Question 7

Which position should the nurse place a patient prior to performing in-line suctioning?

A) Prone
B) Supine
C) Fowler's
D) Semi-Fowler's

Question 8

The nurse is providing care to a patient,diagnosed with asthma,with a respiratory rate of 28 at rest who is experiencing audible wheezing during inspiration.Which nursing diagnosis should the nurse use when planning care for this patient?

A) Activity Intolerance
B) Impaired Tissue Perfusion
C) Ineffective Airway Clearance
D) Ineffective Breathing Pattern

Question 9

The nurse is performing in-line suctioning when the patient experiences a drop in oxygen saturation and bradycardia.Which nursing action is appropriate?

A) Continue suctioning and administer 50% oxygen
B) Discontinue suctioning and prepare for resuscitation
C) Discontinue suctioning and administer 100% oxygen
D) Continue suctioning and administer prescribed epinephrine

Question 10

The nurse is providing care for a patient admitted with smoke inhalation injury who is developing acute respiratory distress syndrome (ARDS).Which course of action regarding oxygen therapy does the nurse anticipate for this patient?

A) Oxygen via a facial mask
B) Oxygen via a Venturi mask
C) Oxygen via a nasal cannula
D) Oxygen via mechanical ventilation

Question 11

The nurse is providing care to an infant diagnosed with respiratory syncytial virus (RSV).The infant is grunting with expiration.Which action by the nurse is appropriate?

A) Limit fluid intake
B) Place the infant in a supine position
C) Perform chest physiotherapy to clear the nasal passages
D) Suction the airway to relieve the current obstruction that is noted

Question 12

The nurse is providing care to a patient who is mechanically ventilated.The high-pressure alarm beeps and the nurse notes the patient is biting down on the endotracheal (ET)tube.Which action by the nurse is appropriate?

A) Suction,as needed
B) Insert an oral airway
C) Assess for asymmetric chest rise
D) Empty water from the ventilator tubing

Question 13

The nurse is providing care to a patient who is mechanically ventilated.The high-pressure alarm beeps and the nurse notes a collection of moisture in the ventilator tubing.Which action by the nurse is appropriate?

A) Empty the water
B) Suction,as needed
C) Insert an oral airway
D) Assess for asymmetric chest rise

Question 14

The nurse is providing care to a patient who has a tracheostomy.The loss of which protective mechanism does the nurse plan to monitor this patient for during the respiratory assessment process?

A) The ability to cough
B) The filtration and humidification of inspired air
C) A decrease in the oxygen-carrying capacity of the trachea
D) The sneeze reflex initiated by irritants in the nasal passages

Question 15

The nurse is providing care to a patient who is diagnosed with chronic obstructive pulmonary disease (COPD).The patient's pulse oximetry is 93% on room air with a current respiratory rate of 35 breaths per minute.The most recent chest x-ray indicates a flattened diaphragm with infiltrates.The patient is currently febrile with an increased number of white blood cells (WBCs)noted on the latest complete blood count (CBC).Which prescription does the nurse question for this patient based on the current data?

A) Antibiotic therapy
B) Nonsteroidal anti-inflammatory therapy
C) Oxygen therapy via nasal cannula at 3-4 L/min
D) Bronchodilators therapy with adrenergic stimulating drugs

Question 16

The nurse is providing education to a patient who is prescribed oxygen in the home environment.Which statement made by the patient indicates the need for further education?

A) "I will ensure that the oxygen is kept six feet away from the stove."
B) "I placed a no smoking sign on the door and several places within the house."
C) "I will store the oxygen on its side,per the instructions provided by the agency."
D) "I will keep a fire extinguisher in the house and keep it close to where the oxygen is stored."

Question 17

When conducting a respiratory assessment,the nurse notes a low-pitched sound that is continuous throughout inspiration.Which does this lung sound indicate to the nurse?

A) Narrow bronchi
B) Narrow trachea passages
C) Inflamed pleural surfaces
D) Blocked large airway passages

Question 18

The nurse is providing care to a patient who is diagnosed with chronic obstructive pulmonary disease (COPD).The nurse assesses the patient's breathing rate at 32 breaths per minute.The patient is also experiencing hypertension and fatigue.Which nursing diagnosis is a priority when planning care for this patient?

A) Anxiety
B) Ineffective Coping
C) Ineffective Breathing Pattern
D) Ineffective Airway Clearance

Question 19

The nurse is providing care to a patient admitted with a respiratory disorder.Which laboratory finding would be most significant?

A) Blood pH 7.32
B) Oxygen saturation 96%
C) Serum sodium 140 mg/dL
D) Hemoglobin level 12 mg/dL

Question 20

The nurse is providing care to a patient who is mechanically ventilated.The high-pressure alarm beeps and the nurse notes a mucous plug in the endotracheal (ET)tube.Which action by the nurse is appropriate?

A) Suction,as needed
B) Insert an oral airway
C) Assess for asymmetric chest rise
D) Empty water from the ventilator tubing

Question 21

The nurse is providing care to a patient who is being weaned from mechanical ventilation.Which finding would necessitate the continuation of mechanical ventilation if noted during the assessment process?

A) An FIO₂ less than or equal to 0.4-0.5
B) A PEEP less than or equal to 5-8 cm H₂O
C) A pH greater than 7.25 during spontaneous ventilation
D) A drop in blood pressure indicating a hypotensive state

Question 22

The nurse is providing care to a patient who is recovering from facial trauma who requires high-flow oxygen therapy.Which method of oxygen delivery should the nurse plan for when providing care?

A) Face tent
B) Nasal cannula
C) Venturi mask
D) Nonrebreather mask

Question 23

The nurse is providing care to a patient who is mechanically ventilated.In order to decrease the risk for aspiration,which action by the nurse is appropriate?

A) Elevate the head of the bed between 30 to 45 degrees
B) Limit each suctioning event to no more than 10 seconds
C) Perform chest physiotherapy as prescribed by the practitioner
D) Ensure an NPO status is maintained for the length of the prescribed treatment

Question 24

The nurse is providing care to a patient diagnosed with chronic obstructive pulmonary disease (COPD)who requires supplemental oxygen.Which is the anticipated flow rate range by nasal cannula (NC)when providing care for this patient?

A) 1-2 L/min
B) 2-3 L/min
C) 3-4 L/min
D) 4-5 L/min

Question 25

The nurse is providing education to a patient regarding the use of an incentive spirometer.Which patient statement indicates the need for further education?

A) "I should be in a sitting position when using this device."
B) "I will use this device 20 times per hour while I am awake each day."
C) "I will exhale completely prior to placing my lips around the mouthpiece."
D) "I will hold my breath for 3 seconds after I feel like I cannot inhale any more breath."