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OXYGENATION AND PERFUSION NUR
111 (NCLEX QUESTIONS) Questions and
Correct Answers/ Latest Update / Already
Graded
Which of the following assessment findings would suggest to the
nurse that a Patient is at risk for alterations in perfusion?
1. Blood pressure 110/68 mmHg
2. Apical heart rate 80; radial beats per minute 68
3. Respiratory rate 20 per minute
4. Temperature 98.8°F
Ans: Answer
2. Apical heart rate 80; radial beats per minute 68.
• Rationale:
• The number of radial beats per minute is 12 beats slower than
the apical rate of 80 per minute. This indicates weak
contractions of the left ventricle and could lead to alterations in
perfusion. The other assessment findings are within normal
limits.
• Nursing Process: Assessment
• Cognitive Level: Analyzing
• Client Need: Physiological Integrity
All rights reserved © 2025/ 2026 |
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A Patient is admitted with complaints of shortness of breath of 2
weeks duration. Which of the following laboratory findings would
support the finding that the Patient is at risk for an alteration in
perfusion?
1. Increased hematocrit
2. Decreased BUN
3. Increased blood sugar
4. Increased sedimentation rate
Ans: 1. Increased hematocrit.
• Rationale:
• Hematocrit is the percentage of the blood that is
erythrocytes, which contain the hemoglobin that carries
oxygen. Long-term hypoxia may result in the body's attempt to
increase oxygen-carrying capacity by increasing erythrocyte
production. This can lead to an alteration in the client's
perfusion. BUN is a measure of blood urea nitrogen, not
oxygen-carrying capacity. Increases in blood sugar and
sedimentation rate are not directly a measure of oxygenation.
• Nursing Process: Assessment
• Cognitive Level: Analyzing
• Client Need: Physiological Integrity
All rights reserved © 2025/ 2026 |
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• Learning Outcome: 5. Outline diagnostic and laboratory tests
to determine the individual's perfusion status.
A Patient tells the nurse that he does not want to develop the same
heart problems that his parents experienced. Which of the following
should the nurse instruct this client?
1. Avoid cigarette smoking
2. Limit fluid intake
3. Wear elastic hose
4. Limit exercise to 15 minutes a day
Ans: • • Answer
1. Avoid cigarette smoking
Rationale:
• The one intervention that would help the client prevent the
onset of cardiovascular disease would be to avoid cigarette
smoking. Limiting fluids and wearing elastic hose are not
known to prevent the onset of cardiovascular disease. Limiting
exercise to 15 minutes a day may also not be enough exercise to
prevent the onset of cardiovascular disease.
• Nursing Process: Implementation
• Cognitive Level: Applying
All rights reserved © 2025/ 2026 |
OXYGENATION AND PERFUSION NUR
111 (NCLEX QUESTIONS) Questions and
Correct Answers/ Latest Update / Already
Graded
Which of the following assessment findings would suggest to the
nurse that a Patient is at risk for alterations in perfusion?
1. Blood pressure 110/68 mmHg
2. Apical heart rate 80; radial beats per minute 68
3. Respiratory rate 20 per minute
4. Temperature 98.8°F
Ans: Answer
2. Apical heart rate 80; radial beats per minute 68.
• Rationale:
• The number of radial beats per minute is 12 beats slower than
the apical rate of 80 per minute. This indicates weak
contractions of the left ventricle and could lead to alterations in
perfusion. The other assessment findings are within normal
limits.
• Nursing Process: Assessment
• Cognitive Level: Analyzing
• Client Need: Physiological Integrity
All rights reserved © 2025/ 2026 |
, Page |2
A Patient is admitted with complaints of shortness of breath of 2
weeks duration. Which of the following laboratory findings would
support the finding that the Patient is at risk for an alteration in
perfusion?
1. Increased hematocrit
2. Decreased BUN
3. Increased blood sugar
4. Increased sedimentation rate
Ans: 1. Increased hematocrit.
• Rationale:
• Hematocrit is the percentage of the blood that is
erythrocytes, which contain the hemoglobin that carries
oxygen. Long-term hypoxia may result in the body's attempt to
increase oxygen-carrying capacity by increasing erythrocyte
production. This can lead to an alteration in the client's
perfusion. BUN is a measure of blood urea nitrogen, not
oxygen-carrying capacity. Increases in blood sugar and
sedimentation rate are not directly a measure of oxygenation.
• Nursing Process: Assessment
• Cognitive Level: Analyzing
• Client Need: Physiological Integrity
All rights reserved © 2025/ 2026 |
, Page |3
• Learning Outcome: 5. Outline diagnostic and laboratory tests
to determine the individual's perfusion status.
A Patient tells the nurse that he does not want to develop the same
heart problems that his parents experienced. Which of the following
should the nurse instruct this client?
1. Avoid cigarette smoking
2. Limit fluid intake
3. Wear elastic hose
4. Limit exercise to 15 minutes a day
Ans: • • Answer
1. Avoid cigarette smoking
Rationale:
• The one intervention that would help the client prevent the
onset of cardiovascular disease would be to avoid cigarette
smoking. Limiting fluids and wearing elastic hose are not
known to prevent the onset of cardiovascular disease. Limiting
exercise to 15 minutes a day may also not be enough exercise to
prevent the onset of cardiovascular disease.
• Nursing Process: Implementation
• Cognitive Level: Applying
All rights reserved © 2025/ 2026 |
