Oxygenation Study Guide Q&A With Complete Solutions
A ________ occurs when air enters the pleural cavity through a
perforation in the pleura covering the lung, such as with the
rupture of an emphysematous bleb or superficial lung abscess.
Correct Answer closed pneumothorax
A ___________ is a collection of air in the pleural space causing
a collapse of lung tissue. Correct Answer pneumothorax
A discussion is taking place on the unit regarding the application
of lubricant to the suction catheter before passing it through the
nasal passage. Which statement is accurate?
a. "Water-soluble lubricant should be used because oil based
lubricants increase the risk for aspiration and pneumonia."
b. "If the patient's fluid status is sufficient, lubricating the
catheter is unnecessary."
c. "Petroleum jelly can be used to lubricate the catheter as long
as the patient is not on oxygen via nasal cannula."
d. "Applying water-soluble lubricant to the suction catheter
ensures that it is working properly prior to oropharyngeal or
nasotracheal suctioning." Correct Answer a. "Water-soluble
lubricant should be used because oil based lubricants increase
the risk for aspiration and pneumonia."
A nurse is trying to determine whether or not a patient's artificial
airway should be suctioned. Which of the following fails to be
an indication for suctioning?
a. Pulse oximetry 89%.
b. Pulmonary secretions.
c. 2 hours have elapsed since patient was last suctioned.
,d. Patient has audible gurgling and appears restless. Correct
Answer c. 2 hours have elapsed since patient was last suctioned.
A nursing student is helping care for a patient with a chest tube.
The nursing student asks you ( the staff nurse) what determines
the level of suction in the chest tube. What is your correct
response? (Select all that apply.)
a. "The depth of fluid in the suction control chamber of a water-
seal system determines the highest amount of negative pressure
that can be present within the system."
b. "The setting of the wall suction determines the amount of
negative pressure present within the water-seal system."
c. "The suction float ball indicates the amount of suction the
patient's intrapleural space is receiving in a waterless system."
d. "Whether it is a two-chamber or three-chamber system
determines the level of suction. Three-chamber systems have
more area to collect drainage, creating a greater negative
intrapleural pressure." Correct Answer a. "The depth of fluid in
the suction control chamber of a water-seal system determines
the highest amount of negative pressure that can be present
within the system."
c. "The suction float ball indicates the amount of suction the
patient's intrapleural space is receiving in a waterless system."
A patient has a chest tube inserted in his left third intercostal
space for treatment of a pneumothorax. Which of the following
indicates a tension pneumothorax may be developing in the
patient? (Select all that apply.)
a. Shift of trachea to unaffected side of chest
b. Decreased cardiac output
c. Tidaling in the water-seal chamber
,d. Change in color of drainage
e. Hypotension
f. Tachycardia Correct Answer a. Shift of trachea to unaffected
side of chest
b. Decreased cardiac output
e. Hypotension
f. Tachycardia
A patient has a pleural effusion caused by a malignancy in her
left lung. Following a needle aspiration, she experienced a 40%
collapse of her left lower lung. She had a chest tube inserted to
remove the excess fluid and air that collected in her pleural
space. She has a waterless drainage system with a diagnostic
indicator, which is attached to suction. How will the nurse best
determine whether the patient is developing an air leak?
a. By periodically lifting and draining the tube to the collection
device.
b. By clamping the tube and assessing the patient for signs of
respiratory distress.
c. The nurse notices the suction float ball fails to remain at the
prescribed setting.
d. The nurse observes bubbling in the diagnostic indicator
chamber. Correct Answer d. The nurse observes bubbling in
the diagnostic indicator chamber
A patient has an endotracheal tube inserted orally. When should
the nurse expect to perform endotracheal tube care?
a. Whenever the patient begins to cough.
b. On a routine schedule every 24 to 48 hours to reposition the
tube.
, c. Only when the depth of the tube has changed from its original
position (as indicated by a marking at the lip or gum line).
d. According to physician orders. Correct Answer b. On a
routine schedule every 24 to 48 hours to reposition the tube.
A patient has clear oral secretions that are extremely copious
and thick. What would be an appropriate response by the nurse?
a. Oropharyngeal suctioning.
b. Nasopharyngeal suctioning.
c. Nasotracheal suctioning.
d. Obtain a sputum specimen for culture and sensitivity. Correct
Answer a. Oropharyngeal suctioning
A patient has just had a chest tube removed. Prior to the
procedure the patient received pain medication. The patient's
vital signs at the time were as follows: BP 120/80, pulse rate 76,
respiratory rate 20, pulse oximetry 95%, and temperature 98.1°
F. The nurse reassesses the patient postprocedure. Which of the
following would require notifying the physician?
a. BP 100/60, pulse rate 96, respiratory rate 30, and pulse
oximetry 90%.
b. The patient exhibits facial grimacing and may require an
additional dose of pain medication.
c. It is standard procedure to notify the physician of vital sign
results regardless of their reading.
d. BP126/84, pulse rate 72, respiratory rate 16, pulse oximetry
95% and temperature 98.2° F. Correct Answer a. BP 100/60,
pulse rate 96, respiratory rate 30, and pulse oximetry 90%.
A patient has returned from the operating room with a chest tube
in his sixth intercostal space with orders to connect the patient to
A ________ occurs when air enters the pleural cavity through a
perforation in the pleura covering the lung, such as with the
rupture of an emphysematous bleb or superficial lung abscess.
Correct Answer closed pneumothorax
A ___________ is a collection of air in the pleural space causing
a collapse of lung tissue. Correct Answer pneumothorax
A discussion is taking place on the unit regarding the application
of lubricant to the suction catheter before passing it through the
nasal passage. Which statement is accurate?
a. "Water-soluble lubricant should be used because oil based
lubricants increase the risk for aspiration and pneumonia."
b. "If the patient's fluid status is sufficient, lubricating the
catheter is unnecessary."
c. "Petroleum jelly can be used to lubricate the catheter as long
as the patient is not on oxygen via nasal cannula."
d. "Applying water-soluble lubricant to the suction catheter
ensures that it is working properly prior to oropharyngeal or
nasotracheal suctioning." Correct Answer a. "Water-soluble
lubricant should be used because oil based lubricants increase
the risk for aspiration and pneumonia."
A nurse is trying to determine whether or not a patient's artificial
airway should be suctioned. Which of the following fails to be
an indication for suctioning?
a. Pulse oximetry 89%.
b. Pulmonary secretions.
c. 2 hours have elapsed since patient was last suctioned.
,d. Patient has audible gurgling and appears restless. Correct
Answer c. 2 hours have elapsed since patient was last suctioned.
A nursing student is helping care for a patient with a chest tube.
The nursing student asks you ( the staff nurse) what determines
the level of suction in the chest tube. What is your correct
response? (Select all that apply.)
a. "The depth of fluid in the suction control chamber of a water-
seal system determines the highest amount of negative pressure
that can be present within the system."
b. "The setting of the wall suction determines the amount of
negative pressure present within the water-seal system."
c. "The suction float ball indicates the amount of suction the
patient's intrapleural space is receiving in a waterless system."
d. "Whether it is a two-chamber or three-chamber system
determines the level of suction. Three-chamber systems have
more area to collect drainage, creating a greater negative
intrapleural pressure." Correct Answer a. "The depth of fluid in
the suction control chamber of a water-seal system determines
the highest amount of negative pressure that can be present
within the system."
c. "The suction float ball indicates the amount of suction the
patient's intrapleural space is receiving in a waterless system."
A patient has a chest tube inserted in his left third intercostal
space for treatment of a pneumothorax. Which of the following
indicates a tension pneumothorax may be developing in the
patient? (Select all that apply.)
a. Shift of trachea to unaffected side of chest
b. Decreased cardiac output
c. Tidaling in the water-seal chamber
,d. Change in color of drainage
e. Hypotension
f. Tachycardia Correct Answer a. Shift of trachea to unaffected
side of chest
b. Decreased cardiac output
e. Hypotension
f. Tachycardia
A patient has a pleural effusion caused by a malignancy in her
left lung. Following a needle aspiration, she experienced a 40%
collapse of her left lower lung. She had a chest tube inserted to
remove the excess fluid and air that collected in her pleural
space. She has a waterless drainage system with a diagnostic
indicator, which is attached to suction. How will the nurse best
determine whether the patient is developing an air leak?
a. By periodically lifting and draining the tube to the collection
device.
b. By clamping the tube and assessing the patient for signs of
respiratory distress.
c. The nurse notices the suction float ball fails to remain at the
prescribed setting.
d. The nurse observes bubbling in the diagnostic indicator
chamber. Correct Answer d. The nurse observes bubbling in
the diagnostic indicator chamber
A patient has an endotracheal tube inserted orally. When should
the nurse expect to perform endotracheal tube care?
a. Whenever the patient begins to cough.
b. On a routine schedule every 24 to 48 hours to reposition the
tube.
, c. Only when the depth of the tube has changed from its original
position (as indicated by a marking at the lip or gum line).
d. According to physician orders. Correct Answer b. On a
routine schedule every 24 to 48 hours to reposition the tube.
A patient has clear oral secretions that are extremely copious
and thick. What would be an appropriate response by the nurse?
a. Oropharyngeal suctioning.
b. Nasopharyngeal suctioning.
c. Nasotracheal suctioning.
d. Obtain a sputum specimen for culture and sensitivity. Correct
Answer a. Oropharyngeal suctioning
A patient has just had a chest tube removed. Prior to the
procedure the patient received pain medication. The patient's
vital signs at the time were as follows: BP 120/80, pulse rate 76,
respiratory rate 20, pulse oximetry 95%, and temperature 98.1°
F. The nurse reassesses the patient postprocedure. Which of the
following would require notifying the physician?
a. BP 100/60, pulse rate 96, respiratory rate 30, and pulse
oximetry 90%.
b. The patient exhibits facial grimacing and may require an
additional dose of pain medication.
c. It is standard procedure to notify the physician of vital sign
results regardless of their reading.
d. BP126/84, pulse rate 72, respiratory rate 16, pulse oximetry
95% and temperature 98.2° F. Correct Answer a. BP 100/60,
pulse rate 96, respiratory rate 30, and pulse oximetry 90%.
A patient has returned from the operating room with a chest tube
in his sixth intercostal space with orders to connect the patient to
