HESI RN OXYGENATION ACCURATE
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
Helpful
Question 1
A client with chronic obstructive pulmonary disease (COPD) has an
arterial blood gas (ABG) result showing a pH of 7.30, PaCO2 of 58 mm
Hg, and HCO3- of 30 mEq/L. Which of the following is the most
appropriate nursing intervention?
A. Administer a high-flow oxygen mask at 100%
B. Prepare for immediate intubation
C. Administer oxygen via nasal cannula at 2 L/min
D. Place the client in a Trendelenburg position
Correct Answer: C
Rationale: This client is experiencing compensated respiratory
acidosis, as indicated by the low pH, elevated PaCO2, and elevated
bicarbonate. In COPD, the hypoxic drive is the primary stimulus to
breathe. Administering high-flow oxygen can eliminate this drive and
lead to respiratory arrest. The safest intervention is to administer low-
,flow oxygen at 1-2 L/min via nasal cannula to maintain an oxygen
saturation of 88-92%. Intubation is not immediately indicated as the
client is compensating. Trendelenburg position would worsen
dyspnea.
Question 2
The nurse is caring for a client with a chest tube. Which finding indicates
that the chest tube system is functioning properly?
A. Continuous bubbling in the water seal chamber
B. Fluctuation (tidaling) of the fluid in the water seal chamber with
respiration
C. Absence of drainage in the collection chamber for 4 hours
D. Constant bubbling in the suction control chamber
Correct Answer: B
Rationale: Fluctuation or tidaling in the water seal chamber is a
normal finding and indicates that the chest tube is patent and the
system is functioning correctly. It reflects pressure changes in the
pleural space during respiration. Continuous bubbling in the water
seal chamber indicates an air leak. Absence of drainage is not
necessarily a sign of proper function but should be monitored. The
suction control chamber should have gentle bubbling, not constant,
vigorous bubbling which would indicate high suction pressure.
Question 3
A client is admitted with a pulmonary embolism. Which assessment
finding is most concerning and requires immediate intervention?
A. Respiratory rate of 24 breaths per minute
B. Heart rate of 102 beats per minute
C. Sudden onset of chest pain and hemoptysis
D. Oxygen saturation of 91% on room air
Correct Answer: C
Rationale: Sudden onset of chest pain and hemoptysis are classic signs
,of a pulmonary infarction due to a large or massive pulmonary
embolism. This indicates a significant obstruction and requires
immediate intervention to prevent cardiovascular collapse. While
tachypnea, tachycardia, and mild hypoxemia are common findings
with a pulmonary embolism, the presence of chest pain and
hemoptysis signifies a more critical and emergent situation.
Question 4
The nurse is preparing to administer a dose of furosemide to a client
with pulmonary edema. Which laboratory value should the nurse assess
prior to administration?
A. Serum sodium
B. Serum potassium
C. Serum glucose
D. Serum calcium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of potassium. Therefore, it can cause
hypokalemia. The nurse should assess the client's serum potassium
level before administration to ensure it is within normal range and to
monitor for potential complications of hypokalemia.
Question 5
The nurse is caring for a client with asthma who is using a metered-dose
inhaler (MDI) containing albuterol. Which instruction is most important
to include in the teaching plan?
A. "Hold the inhaler upside down while spraying."
B. "Inhale rapidly and deeply after the spray is released."
C. "Wait 1 to 2 minutes between puffs if two puffs are prescribed."
D. "Use the inhaler only when you are feeling short of breath."
Correct Answer: C
, Rationale: Waiting 1 to 2 minutes between puffs allows for maximal
bronchodilation and better absorption of the second dose. The inhaler
should be held upright, not upside down. The client should inhale
slowly and deeply to facilitate the medication reaching the lower
airways. Albuterol is a rescue bronchodilator and should be used as
prescribed, not just when feeling short of breath.
Question 6
A client with pneumonia is receiving oxygen via nasal cannula at 4
L/min. The nurse notes that the client's oxygen saturation is 88%. What
is the priority action?
A. Increase the oxygen flow rate to 6 L/min
B. Assess the client's respiratory effort and lung sounds
C. Notify the healthcare provider immediately
D. Apply a non-rebreather mask at 15 L/min
Correct Answer: B
Rationale: Before making any changes, the nurse must first assess the
client's clinical status. The low oxygen saturation could be due to
several factors, such as a mucus plug, worsening infection, or
equipment malfunction. The nurse should assess the client's
respiratory rate, effort, breath sounds, and the integrity of the oxygen
delivery system. Notifying the provider may be necessary after a
thorough assessment, but it is not the priority. Increasing the oxygen
flow or changing the device without assessment could be premature
and is not the best first step.
Question 7
The nurse is assessing a client with heart failure who has been receiving
digoxin. Which finding would indicate a potential adverse effect of the
medication related to oxygenation?
A. Increased urine output
B. Visual disturbances (yellow halos around lights)
COMPREHENSIVE PRACTICE EXAM WITH ALL
POSSIBLE APPROVED WELL ELABORATED
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS EXPERT ANSWER KEY (100% CORRECT
VERIFIED SOLUTIONS) 2026-2027 CURRENTLY
UPDATED VERSION Q&A GUARANTEED PASS A+
INSTANT DOWNLOAD PDF
Helpful
Question 1
A client with chronic obstructive pulmonary disease (COPD) has an
arterial blood gas (ABG) result showing a pH of 7.30, PaCO2 of 58 mm
Hg, and HCO3- of 30 mEq/L. Which of the following is the most
appropriate nursing intervention?
A. Administer a high-flow oxygen mask at 100%
B. Prepare for immediate intubation
C. Administer oxygen via nasal cannula at 2 L/min
D. Place the client in a Trendelenburg position
Correct Answer: C
Rationale: This client is experiencing compensated respiratory
acidosis, as indicated by the low pH, elevated PaCO2, and elevated
bicarbonate. In COPD, the hypoxic drive is the primary stimulus to
breathe. Administering high-flow oxygen can eliminate this drive and
lead to respiratory arrest. The safest intervention is to administer low-
,flow oxygen at 1-2 L/min via nasal cannula to maintain an oxygen
saturation of 88-92%. Intubation is not immediately indicated as the
client is compensating. Trendelenburg position would worsen
dyspnea.
Question 2
The nurse is caring for a client with a chest tube. Which finding indicates
that the chest tube system is functioning properly?
A. Continuous bubbling in the water seal chamber
B. Fluctuation (tidaling) of the fluid in the water seal chamber with
respiration
C. Absence of drainage in the collection chamber for 4 hours
D. Constant bubbling in the suction control chamber
Correct Answer: B
Rationale: Fluctuation or tidaling in the water seal chamber is a
normal finding and indicates that the chest tube is patent and the
system is functioning correctly. It reflects pressure changes in the
pleural space during respiration. Continuous bubbling in the water
seal chamber indicates an air leak. Absence of drainage is not
necessarily a sign of proper function but should be monitored. The
suction control chamber should have gentle bubbling, not constant,
vigorous bubbling which would indicate high suction pressure.
Question 3
A client is admitted with a pulmonary embolism. Which assessment
finding is most concerning and requires immediate intervention?
A. Respiratory rate of 24 breaths per minute
B. Heart rate of 102 beats per minute
C. Sudden onset of chest pain and hemoptysis
D. Oxygen saturation of 91% on room air
Correct Answer: C
Rationale: Sudden onset of chest pain and hemoptysis are classic signs
,of a pulmonary infarction due to a large or massive pulmonary
embolism. This indicates a significant obstruction and requires
immediate intervention to prevent cardiovascular collapse. While
tachypnea, tachycardia, and mild hypoxemia are common findings
with a pulmonary embolism, the presence of chest pain and
hemoptysis signifies a more critical and emergent situation.
Question 4
The nurse is preparing to administer a dose of furosemide to a client
with pulmonary edema. Which laboratory value should the nurse assess
prior to administration?
A. Serum sodium
B. Serum potassium
C. Serum glucose
D. Serum calcium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of potassium. Therefore, it can cause
hypokalemia. The nurse should assess the client's serum potassium
level before administration to ensure it is within normal range and to
monitor for potential complications of hypokalemia.
Question 5
The nurse is caring for a client with asthma who is using a metered-dose
inhaler (MDI) containing albuterol. Which instruction is most important
to include in the teaching plan?
A. "Hold the inhaler upside down while spraying."
B. "Inhale rapidly and deeply after the spray is released."
C. "Wait 1 to 2 minutes between puffs if two puffs are prescribed."
D. "Use the inhaler only when you are feeling short of breath."
Correct Answer: C
, Rationale: Waiting 1 to 2 minutes between puffs allows for maximal
bronchodilation and better absorption of the second dose. The inhaler
should be held upright, not upside down. The client should inhale
slowly and deeply to facilitate the medication reaching the lower
airways. Albuterol is a rescue bronchodilator and should be used as
prescribed, not just when feeling short of breath.
Question 6
A client with pneumonia is receiving oxygen via nasal cannula at 4
L/min. The nurse notes that the client's oxygen saturation is 88%. What
is the priority action?
A. Increase the oxygen flow rate to 6 L/min
B. Assess the client's respiratory effort and lung sounds
C. Notify the healthcare provider immediately
D. Apply a non-rebreather mask at 15 L/min
Correct Answer: B
Rationale: Before making any changes, the nurse must first assess the
client's clinical status. The low oxygen saturation could be due to
several factors, such as a mucus plug, worsening infection, or
equipment malfunction. The nurse should assess the client's
respiratory rate, effort, breath sounds, and the integrity of the oxygen
delivery system. Notifying the provider may be necessary after a
thorough assessment, but it is not the priority. Increasing the oxygen
flow or changing the device without assessment could be premature
and is not the best first step.
Question 7
The nurse is assessing a client with heart failure who has been receiving
digoxin. Which finding would indicate a potential adverse effect of the
medication related to oxygenation?
A. Increased urine output
B. Visual disturbances (yellow halos around lights)
