NURS (FUNDAMENTAL): NCLEX OXYGENATION AND
PERFUSION WITH COMPLETE SOLUTIONS
GUARANTEED PASS
A nurse caring for a patient with chronic obstructive
pulmonary disease (COPD) knows that hypoxia may occur
in patients with respiratory problems. What are signs of
this serious condition? Select all answers that apply.
a) Dyspnea
b) Hypotension
c) Small pulse pressure
d) Decreased respiratory rate
e) Pallor
f) Increased pulse rate - ANSWER ->a, c, e, f
If a problem exists in ventilation, respiration, or
perfusion, hypoxia may occur. Hypoxia is a condition in
which an inadequate amount of oxygen is available to
cells. The most common symptoms of hypoxia are
dyspnea (difficulty breathing), an elevated blood
pressure with a small pulse pressure, increased
respiratory and pulse rates, pallor, and cyanosis.
,A nurse is suctioning the nasopharyngeal airway of a
patient to maintain a patent airway. For which condition
would the nurse anticipate the need for a nasal trumpet?
a) The patient vomits during suctioning.
b) The secretions appear to be stomach contents.
c) The catheter touches an unsterile surface.
d) Epistaxis is noted with continued suctioning. -
ANSWER ->d) Epistaxis is noted with continued
suctioning.
When epistaxis is noted with continued suctioning, the
nurse should notify the physician and anticipate the need
for a nasal trumpet. The nasal trumpet will protect the
nasal mucosa from further trauma related to suctioning.
A nurse is inserting an oropharyngeal airway for a patient
who vomits when it is inserted. Which action would be
the first that should be taken by the nurse related to this
occurrence?
a) Quickly position the patient on his or her side.
b) Put on disposable gloves and remove the oral airway.
c) Check that the airway is the appropriate size for the
patient.
,d) Put on sterile gloves and suction the airway. - ANSWER
->a) Quickly position the patient on his or her side.
A nurse is choosing a catheter to use to suction a
patient's endotracheal tube via an open system. On
which variable would the nurse base the size of the
catheter to use?
a) The age of the patient
b) The size of the endotracheal tube
c) The type of secretions to be suctioned
d) The height and weight of the patient - ANSWER ->b)
The size of the endotracheal tube
A nurse is caring for a 16-year-old male patient who has
been hospitalized for an acute asthma exacerbation.
Which testing methods might the nurse use to measure
the patient's oxygen saturation? Select all that apply.
a) Thoracentesis
b) Spirometry
c) Pulse oximetry
d) Peak expiratory flow rate
e) Diffusion capacity
f) Maximal respiratory pressure - ANSWER ->b, c, d
, Spirometers are used to monitor the health status of
patients with respiratory disorders, such as asthma. Pulse
oximetry is used to obtain baseline information about
the patient's oxygen saturation level and is also
performed for patients with asthma, along with PEFR to
monitor airflow. These three tests may be administered
by the nurse.
A patient with COPD is unable to perform activities of
daily living (ADLs) without becoming exhausted. Which
nursing diagnosis best describes this alteration in
oxygenation as the etiology?
a) Decreased Cardiac Output related to difficulty
breathing
b) Impaired Gas Exchange related to use of
bronchodilators
c) Fatigue related to impaired oxygen transport system
d) Ineffective Airway Clearance related to fatigue -
ANSWER ->c) Fatigue related to impaired oxygen
transport system
A nurse working in a long-term care facility is providing
teaching to patients with altered oxygenation due to
conditions such as asthma and COPD. Which measures
would the nurse recommend? Select all that apply.
PERFUSION WITH COMPLETE SOLUTIONS
GUARANTEED PASS
A nurse caring for a patient with chronic obstructive
pulmonary disease (COPD) knows that hypoxia may occur
in patients with respiratory problems. What are signs of
this serious condition? Select all answers that apply.
a) Dyspnea
b) Hypotension
c) Small pulse pressure
d) Decreased respiratory rate
e) Pallor
f) Increased pulse rate - ANSWER ->a, c, e, f
If a problem exists in ventilation, respiration, or
perfusion, hypoxia may occur. Hypoxia is a condition in
which an inadequate amount of oxygen is available to
cells. The most common symptoms of hypoxia are
dyspnea (difficulty breathing), an elevated blood
pressure with a small pulse pressure, increased
respiratory and pulse rates, pallor, and cyanosis.
,A nurse is suctioning the nasopharyngeal airway of a
patient to maintain a patent airway. For which condition
would the nurse anticipate the need for a nasal trumpet?
a) The patient vomits during suctioning.
b) The secretions appear to be stomach contents.
c) The catheter touches an unsterile surface.
d) Epistaxis is noted with continued suctioning. -
ANSWER ->d) Epistaxis is noted with continued
suctioning.
When epistaxis is noted with continued suctioning, the
nurse should notify the physician and anticipate the need
for a nasal trumpet. The nasal trumpet will protect the
nasal mucosa from further trauma related to suctioning.
A nurse is inserting an oropharyngeal airway for a patient
who vomits when it is inserted. Which action would be
the first that should be taken by the nurse related to this
occurrence?
a) Quickly position the patient on his or her side.
b) Put on disposable gloves and remove the oral airway.
c) Check that the airway is the appropriate size for the
patient.
,d) Put on sterile gloves and suction the airway. - ANSWER
->a) Quickly position the patient on his or her side.
A nurse is choosing a catheter to use to suction a
patient's endotracheal tube via an open system. On
which variable would the nurse base the size of the
catheter to use?
a) The age of the patient
b) The size of the endotracheal tube
c) The type of secretions to be suctioned
d) The height and weight of the patient - ANSWER ->b)
The size of the endotracheal tube
A nurse is caring for a 16-year-old male patient who has
been hospitalized for an acute asthma exacerbation.
Which testing methods might the nurse use to measure
the patient's oxygen saturation? Select all that apply.
a) Thoracentesis
b) Spirometry
c) Pulse oximetry
d) Peak expiratory flow rate
e) Diffusion capacity
f) Maximal respiratory pressure - ANSWER ->b, c, d
, Spirometers are used to monitor the health status of
patients with respiratory disorders, such as asthma. Pulse
oximetry is used to obtain baseline information about
the patient's oxygen saturation level and is also
performed for patients with asthma, along with PEFR to
monitor airflow. These three tests may be administered
by the nurse.
A patient with COPD is unable to perform activities of
daily living (ADLs) without becoming exhausted. Which
nursing diagnosis best describes this alteration in
oxygenation as the etiology?
a) Decreased Cardiac Output related to difficulty
breathing
b) Impaired Gas Exchange related to use of
bronchodilators
c) Fatigue related to impaired oxygen transport system
d) Ineffective Airway Clearance related to fatigue -
ANSWER ->c) Fatigue related to impaired oxygen
transport system
A nurse working in a long-term care facility is providing
teaching to patients with altered oxygenation due to
conditions such as asthma and COPD. Which measures
would the nurse recommend? Select all that apply.
