AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES Q&A INSTANT DOWNLOAD PDF
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Analyze and interpret arterial blood gases and oxygenation indices
2 Evaluate and prioritize interventions for patients with oxygenation deficits
3 Apply current evidence-based guidelines in the management of respiratory conditions
4 Integrate knowledge of respiratory pharmacology and mechanical ventilation
5 NURS 3209 Oxygenation Exam Practice Questions And Correct Answers
6 Verified Answers
7 Plus Rationales Q&A Instant Download Pdf
8 Foundations of Nursing - Oxygenation
9 Applied Nursing - Oxygenation
10 Advanced Nursing - Oxygenation
11 Nursing - Oxygenation Review
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,Q1 ANALYZE AND INTERPRET ARTERIAL BLOOD GASES AND OXYGENATION INDICES
A patient with acute respiratory distress syndrome (ARDS) has a PaO2 of 58
mmHg on an FiO2 of 0.8 with a PEEP of 10 cm H2O. The patient is on
volume-controlled ventilation with a tidal volume of 6 mL/kg ideal body weight.
Which intervention is most likely to improve oxygenation while minimizing further
lung injury?
A. Increase PEEP to 15 cm H2O and recruit collapsed alveoli CORRECT
B. Increase tidal volume to 8 mL/kg to improve minute ventilation
C. Switch to pressure-controlled ventilation with higher inspiratory pressures
D. Decrease FiO2 to 0.5 to reduce oxygen toxicity
RATIONALE: In ARDS, increasing PEEP improves oxygenation by recruiting collapsed alveoli
and reducing intrapulmonary shunt, while maintaining low tidal volumes protects against
ventilator-induced lung injury. Higher tidal volumes (B) increase volutrauma; pressure-controlled
ventilation (C) may not improve oxygenation if mean airway pressure is unchanged; decreasing
FiO2 (D) would worsen hypoxemia.
Q2 ANALYZE AND INTERPRET ARTERIAL BLOOD GASES AND OXYGENATION INDICES
A patient with chronic obstructive pulmonary disease (COPD) and hypercapnia is
receiving oxygen at 2 L/min via nasal cannula. The arterial blood gas shows a
PaCO2 of 60 mmHg and a pH of 7.36. Which finding indicates that the oxygen
therapy is being titrated appropriately?
A. PaO2 of 60 mmHg and oxygen saturation of 90% CORRECT
B. PaO2 of 75 mmHg and oxygen saturation of 95%
C. PaO2 of 50 mmHg and oxygen saturation of 85%
D. PaO2 of 80 mmHg and oxygen saturation of 96%
RATIONALE: For patients with COPD and hypercapnia, the goal is to maintain PaO2 around 60
mmHg and SpO2 88-92% to avoid suppressing hypoxic drive and worsening hypercapnia. Option
A reflects this target. Options B and D show higher oxygenation that may increase CO2
retention; Option C indicates inadequate oxygenation.
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,Q3 ANALYZE AND INTERPRET ARTERIAL BLOOD GASES AND OXYGENATION INDICES
Which of the following best explains the physiological mechanism by which
positive end-expiratory pressure (PEEP) improves oxygenation in patients with
acute respiratory distress syndrome?
A. It increases cardiac output and oxygen delivery
B. It reduces pulmonary vascular resistance and improves perfusion
C. It prevents alveolar collapse at end-expiration and reduces shunt fraction CORRECT
D. It increases the fraction of inspired oxygen delivered to the alveoli
RATIONALE: PEEP prevents end-expiratory alveolar collapse, thereby reducing atelectasis and
intrapulmonary shunt, which is the primary mechanism of hypoxemia in ARDS. It does not
directly increase cardiac output (A), may increase pulmonary vascular resistance (B), and does
not change FiO2 (D).
Q4 ANALYZE AND INTERPRET ARTERIAL BLOOD GASES AND OXYGENATION INDICES
A patient with pulmonary embolism presents with sudden onset of dyspnea,
pleuritic chest pain, and tachycardia. Which arterial blood gas finding is most
consistent with this condition?
A. Hypoxemia with respiratory alkalosis CORRECT
B. Hypercapnia with respiratory acidosis
C. Normal PaO2 with metabolic acidosis
D. Hypoxemia with metabolic alkalosis
RATIONALE: Pulmonary embolism often causes hypoxemia due to ventilation-perfusion
mismatch, and the resulting tachypnea leads to respiratory alkalosis (decreased PaCO2,
increased pH). Hypercapnia (B) is more typical of hypoventilation; metabolic acidosis (C) is not a
primary feature; metabolic alkalosis (D) is not expected.
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, Q5 ANALYZE AND INTERPRET ARTERIAL BLOOD GASES AND OXYGENATION INDICES
A patient on mechanical ventilation has the following settings: assist-control
mode, tidal volume 500 mL, respiratory rate 14/min, FiO2 0.5, PEEP 5 cm H2O. The
patient's plateau pressure is 25 cm H2O, and peak inspiratory pressure is 45 cm
H2O. Which interpretation is correct?
A. The high peak pressure is due to decreased lung compliance
B. The high peak pressure is due to increased airway resistance CORRECT
C. The plateau pressure is elevated, indicating alveolar overdistention
D. The difference between peak and plateau pressures suggests a leak in the circuit
RATIONALE: A large difference between peak and plateau pressures (20 cm H2O) indicates
increased airway resistance (e.g., bronchospasm, secretions). Plateau pressure reflects alveolar
pressure and is normal at 25 cm H2O, ruling out decreased compliance (A) or overdistention (C).
A leak (D) would cause low pressures, not high.
Q6 ANALYZE AND INTERPRET ARTERIAL BLOOD GASES AND OXYGENATION INDICES
Which of the following ventilator settings is most appropriate for a patient with
acute respiratory distress syndrome (ARDS) to provide lung-protective
ventilation?
A. Tidal volume 12 mL/kg ideal body weight, plateau pressure < 30 cm H2O
B. Tidal volume 6 mL/kg ideal body weight, plateau pressure < 30 cm H2O CORRECT
C. Tidal volume 8 mL/kg ideal body weight, plateau pressure < 35 cm H2O
D. Tidal volume 10 mL/kg ideal body weight, PEEP 5 cm H2O
RATIONALE: Lung-protective ventilation for ARDS uses low tidal volumes (4-8 mL/kg ideal body
weight) and aims to keep plateau pressure 30 cm H2O to prevent ventilator-induced lung injury.
Higher tidal volumes (A, C, D) increase the risk of volutrauma and barotrauma.
Page 4