Socraties Quiz Oxygenation

Question 1

________refers to the amount of air remaining in the lungs at the end of a full, forced exhalation. It is one of the lung volumes measured during pulmonary function tests

Answer 1

Residual volume

Question 2

The epiglottis serves which function?

Answer 2

Prevents food from entering the trachea

Question 3

Which condition would the nurse suspect in a patient with an eosinophil count of 700/mm3?

Answer 3

Asthma

Question 4

Normal Values
pH, PCO2, PO2, HCO3
Base excess or deficit:

Answer 4

pH: 7.35–7.45

PCO2 (Partial Pressure of Carbon Dioxide): 35–45 mm Hg

PO2 (Partial Pressure of Oxygen): 80–100 mm Hg

HCO3 (Bicarbonate): 22–26 mEq/L

Base excess or deficit: –2–+2 mmol/L

Question 5

Arterial blood gas analysis assesses

Answer 5

gas exchange and perfusion by measuring oxygenation (PaO2), alveolar ventilation (PaCO2), and acid-base balance

Question 6

An increased partial pressure of arterial carbon dioxide (PaCO2) is known as

Answer 6

hypercarbia or hypercapnia

Question 7

Chronic respiratory acidosis results from

Answer 7

increased arterial carbon dioxide (PaCO2)

Question 8

*Metabolic alkalosis is described as a compensatory mechanism that occurs in the context of ____

*Characterised by _____

*Occurs as compensation

*This compensatory change is seen on arterial blood gases (ABGs) as an elevation of _________

*Even with this compensation, in the setting of chronic respiratory acidosis, the pH _________

Answer 8

*chronic respiratory acidosis
*increased arterial bicarbonate
*by kidney retention of bicarbonate
*HCO3-
*remains lower than normal

Question 9

In late-stage emphysema, carbon dioxide retention and chronic respiratory acidosis result because

Answer 9

the alveoli are affected, reducing the functional area for gas exchange

Question 10

In chronic bronchitis, impaired airflow and gas exchange due to mucus plugs and inflammation narrowing the airways lead to increased

Answer 10

arterial carbon dioxide (PaCO2) levels and respiratory acidosis.

Question 11

When chronic respiratory acidosis is present_____

Answer 11

*Metabolic alkalosis can occur as a compensatory mechanism. This involves the kidneys retaining bicarbonate.
*On ABG studies, this compensation is seen as an elevation of HCO3-.
*However, even with this metabolic compensation, the pH remains lower than normal

Question 12

Acidosis-Alkalosis Scale

Answer 12

Question 13

Which clinical findings wil priompt the nurse to evaluate the patient as a priority?

A. Sore throat and fever (102.2 F) (39 C) taken orally
B. SOB after walking up a flight of stairs
C. Soreness of arm after receiving PPD skin test
D. Speaking in three-word sentences with a saturated peripheral O2 (SpO2) of 90% by pulse oximetry

Answer 13

D. Speaking in three-word sentences with a saturated peripheral O2 (SpO2) of 90% by pulse oximetry

This patient is showing signs of respiratory distress and potential hypoxia:

Three-word sentences indicate severe dyspnea (the patient can’t speak full sentences without becoming short of breath).

SpO2 of 90% is below the normal range (typically ≥ 95%) and may signal impaired oxygenation.

This is a priority finding because airway and breathing are the highest priorities in nursing (ABC: Airway, Breathing, Circulation).

Question 14

Which rationale is appropriate for prescribing a mucolytic for a patient diagnosed with chronic bronchitis?

A. Mucolytics decrease secretion production
B. Mucolytics increase gas exchange in the lower airways
C. Mucolytics thin secretions, making them easier to expectorate
D. Mucolytics provide bronchodilation in pts with COPD

Answer 14

C. Mucolytics thin secretions, making them easier to expectorate

Question 15

A patient with status asthmaticus has the following assessment findings: a respiratory rate of 35 breathes per minute, a HR of 110 bpm high-pitches wheezes in all lung fields, and marked assessory muscles to breathe. The patient is receiving an IV steroid and a continuous nebulized bronchodilator medication. Which assessment reveals a worsening of this patient’s condition?

A. Absense of wheezing
B. Tremors in both hands
C. Heart rate decreased to 90 bpm
D. Decreases respiratory rate to 20 breaths/min.

Answer 15

A. Absense of wheezing

Rationale:
In a patient with status asthmaticus (a severe, life-threatening asthma attack), the sudden absence of wheezing can indicate a critical worsening of the condition — not improvement. This usually means:

Airflow is so restricted that not enough air is moving to produce wheezing sounds.

This is a sign of impending respiratory failure and requires immediate intervention.

Why the others are not signs of worsening:
B. Tremors in both hands: Likely a side effect of bronchodilators (e.g., albuterol), not necessarily a sign of clinical deterioration.

C. Heart rate decreased to 90 bpm: A decrease from tachycardia (110 bpm) to normal HR (90 bpm) can be a positive sign — unless it’s accompanied by other signs of collapse.

D. Decreased respiratory rate to 20 breaths/min: If this is without signs of fatigue or hypoxia, it might seem like improvement — but if paired with silent chest or mental status changes, it would be concerning. However, by itself, it’s not as immediately alarming as absence of wheezing

Question 16

🚨 Red Flags (Signs of Worsening or Impending Respiratory Failure):

Answer 16

Silent Chest (Absence of Wheezing)

No air movement means the airway is severely obstructed.

This is an emergency.

Inability to Speak in Full Sentences

Often limited to 1–3 words per breath.

Indicates severe respiratory effort.

Drowsiness, Confusion, or Lethargy

Suggests CO₂ retention and hypoxia — a very late and dangerous sign.

Use of Accessory Muscles/Retractions

Indicates the patient is working very hard to breathe.

Neck, chest, and abdominal muscles may visibly contract.

Respiratory Rate that Suddenly Drops

If RR decreases with other signs of fatigue or reduced LOC, it’s not good — it can mean the patient is tiring out.

O2 Saturation Below 90%

Hypoxemia is dangerous and must be corrected promptly.

⚠️ Other Concerning Signs:
Pulsus paradoxus (drop in systolic BP during inspiration >10 mmHg)

Peak flow <50% of personal best or <100 L/min

Cyanosis (bluish lips or nail beds)

✨ Summary Mnemonic: “TIREDD”
Tachypnea/Tachycardia

Inability to speak

Retractions/accessory muscle use

Exhaustion

Drowsiness/confusion

Decreased or absent breath sounds

Question 17

Whihc information would the nurse include when educating an older patient and family about pneumnia prevention. Select all that apply.

A. Avoiding dehydration
B. Monitoring blood pressure
C. Avoiding crowded public places
D. Decreasing exposure to air pollutants
E. Receiving an annual influenza vaccine

Answer 17

The correct answers are:
A. Avoiding dehydration
C. Avoiding crowded public places
D. Decreasing exposure to air pollutants
E. Receiving an annual influenza vaccine

Question 18

Which factor may cause hypoxia in a patient with a tracheostomy? Select all that apply.

A. Frequent Suctioning
B. Use of 14 Fr catheter
C. Limited suctioning time
D. Excessive suction pressure
E. Ineffective oxygenation before suctioning

Answer 18

The correct answers are:
A. Frequent suctioning
D. Excessive suction pressure
E. Ineffective oxygenation before suctioning

✅ Rationale:
A. Frequent suctioning
✔️ Correct – Frequent suctioning can cause mucosal trauma, airway irritation, and removal of oxygen from the airway, leading to hypoxia.

B. Use of 14 Fr catheter
❌ Incorrect – The size of the catheter must be appropriate for the tracheostomy tube, and a 14 Fr catheter is often appropriate for adult patients. It’s not inherently a cause of hypoxia unless it’s too large or causes obstruction.

C. Limited suctioning time
❌ Incorrect – Short suction duration (≤10–15 seconds) is actually recommended to prevent hypoxia, not cause it.

D. Excessive suction pressure
✔️ Correct – High suction pressure can remove too much air and damage tissue, leading to hypoxemia.

E. Ineffective oxygenation before suctioning
✔️ Correct – Patients should be preoxygenated before suctioning to reduce the risk of oxygen desaturation during the procedure.

Question 19

Which of the following is a primary reason to teach pursed-lip breathing to clients with emphysema?

A. To promote oxygen intake
B. To strengthen the diaphram
C. To strengthen the intercoastal muscles
D. To promote carbon dioxide elimination

Answer 19

D. To promote carbon dioxide elimination

✅ Rationale:
Pursed-lip breathing is taught to clients with emphysema primarily to:

Slow exhalation

Prevent airway collapse

Improve gas exchange

Promote elimination of trapped carbon dioxide (CO₂)

Why the other options are incorrect:
A. To promote oxygen intake
❌ Pursed-lip breathing mainly aids in exhalation, not oxygen intake. It helps keep airways open longer to allow trapped air (and CO₂) to escape.

B. To strengthen the diaphragm
❌ Diaphragmatic breathing does this more effectively, not pursed-lip breathing.

C. To strengthen the intercostal muscles
❌ Not the purpose of this technique.

Question 20

Which of the following outcomes would be appropriate for a client with COPD who has been discharged to home? The client:

A. Promises to do pursed lip breathing at home
B. States actions to reduce pain
C. States taht he will use oxygen via nasal cannula at 5 L/minute
D. Agrees to call the physician if dypsnea on exertion increases

Answer 20

D. Agrees to call the physician if dyspnea on exertion increases

✔️ This is the most appropriate and measurable outcome because it shows the client understands the importance of monitoring and reporting worsening symptoms, which is crucial in managing COPD at home. Early intervention can prevent hospitalization.

Why the others are not the best outcomes:
A. Promises to do pursed lip breathing at home
❌ A promise is not a measurable or reliable outcome. A better option would be: “Demonstrates or verbalizes understanding of how to perform pursed-lip breathing.”

B. States actions to reduce pain
❌ Pain is not typically a primary concern in COPD. The focus is on airway clearance, oxygenation, and managing dyspnea, not pain control.

C. States that he will use oxygen via nasal cannula at 5 L/minute
❌ This could be unsafe. In COPD patients, especially those with chronic CO₂ retention, high-flow oxygen can suppress their respiratory drive. Oxygen therapy must be prescribed and carefully titrated, often starting at 1–2 L/min.

Question 21

Which two major categoried are incliuded in asthma medications?
A. Control and reliever
B. Preventative and quick acting
C. Steroids and bronchodilators
D. Bronchodilators and anti-inflammatories

Answer 21

A. Control and reliever
Asthma medications are broadly classified into two major categories:

Control medications (also called long-term controllers or preventers)

Taken daily to prevent symptoms and attacks

Examples: Inhaled corticosteroids, long-acting beta-agonists (LABAs), leukotriene modifiers

Reliever medications (also called quick-relief or rescue medications)

Used to relieve acute symptoms

Examples: Short-acting beta-agonists (SABAs) like albuterol

Why the other choices are incorrect or less accurate:
B. Preventative and quick acting
❌ Descriptive but not the formal classification used in asthma guidelines.

C. Steroids and bronchodilators
❌ These are types of drugs, not categories of use.

D. Bronchodilators and anti-inflammatories
❌ Again, these are mechanisms of action, not the major clinical categories for asthma management.

Question 22

Which symptoms is specific for asthma compared with other chronic lung disorders?
A. The patiet is coughing
B. The patient has dypsnea
C. It affects only young people
D. The patient is symptom-free between exacerbations

Answer 22

The correct answer is:
D. The patient is symptom-free between exacerbations

✅ Rationale:
Asthma is characterized by reversible airway obstruction, meaning symptoms like wheezing, coughing, and shortness of breath come and go. A hallmark feature of asthma is that the patient often feels completely normal between exacerbations.

Why the others are incorrect:
A. The patient is coughing
❌ Coughing occurs in many lung disorders like COPD, bronchitis, pneumonia, etc. It’s not specific to asthma.

B. The patient has dyspnea
❌ Shortness of breath is also common in many chronic lung diseases, including COPD, interstitial lung disease, and heart failure.

C. It affects only young people
❌ Asthma can occur at any age — while it’s common in children, adults and older adults can develop or have persistent asthma.

Question 23

When providing suctioning through an endotracheal or tracheostomy tube, which finding would alert the nurse to stop suctioning?

A. The patient’s heart rate increases from 72 to 78 bpm
B. The patient’s coughs uncontrollably during suctioning
C. Oxygen saturation by pulse oximetry is less than 90%
D. Secretions are thich and occulding the suction catheter

Answer 23

✅ Rationale:
An SpO₂ below 90% indicates hypoxemia, which is a dangerous complication during suctioning. If this occurs, the nurse should immediately stop suctioning, reoxygenate the patient, and reassess. Preventing hypoxia is a top priority during airway management.

Why the other options are incorrect:
A. Heart rate increases from 72 to 78 bpm
❌ A small HR increase is expected and not concerning during suctioning.

B. The patient coughs uncontrollably during suctioning
❌ Coughing is a normal reflex and helps clear secretions; it’s not a reason to stop unless it’s causing distress or worsening oxygenation.

D. Secretions are thick and occluding the suction catheter
❌ While this indicates a need for possible saline instillation or changing the catheter, it’s not a reason to immediately stop suctioning unless the patient is in distress.

Question 24

Which interventions would the nurse use to prevent hypoxia during suctioning in the patient with a tracheostomy? Select all that apply.

A. Monitoring the heart rate
B. Monitoring the temperature
C. Monitoring the Respiratory Rate
D. Hyperoxigenating the pateint with 100% oxygen
E. Having the patient take a deep breathes before suctioning

Answer 24

✅ Rationale for the Correct Answers:
A. Monitoring the heart rate
✔️ Monitoring the heart rate can provide early indicators of hypoxia or distress, as an increased heart rate may occur when oxygen levels are low.

D. Hyperoxigenating the patient with 100% oxygen
✔️ Pre-oxygenating with 100% oxygen before suctioning helps ensure that the patient has adequate oxygen reserves to prevent desaturation during the procedure.

E. Having the patient take deep breaths before suctioning
✔️ Encouraging the patient to take deep breaths before suctioning can increase oxygen levels and prevent desaturation during the suctioning process.

Why B. Monitoring the temperature and C. Monitoring the respiratory rate are not as relevant:
B. Monitoring the temperature
❌ While monitoring temperature is important for infection control, it is not a direct intervention for preventing hypoxia during suctioning.

C. Monitoring the respiratory rate
❌ Although monitoring respiratory rate is important in assessing the patient’s overall condition, it is not as directly related to preventing hypoxia during suctioning as the other interventions.

Question 25

Which recommendation will the nurse give to a patient with asthma who reports being afraid to begin an aerobi exercise program because exercise sometiems triggers asthma symptoms. A. Participating in a stretching and light calisthenics program instead B. Avoiding aerobic exercise because it will make symptoms worse C. Using oral corticosteroids to prevent asthma symptoms D. Pre-medicating with a short-acting beta-adrenergic (SABA) medication before exercise

Answer 25

The correct answer is: D. Pre-medicating with a short-acting beta-adrenergic (SABA) medication before exercise ✅ Rationale: For a patient with asthma, exercise can sometimes trigger symptoms, but exercise-induced bronchoconstriction (EIB) can often be managed effectively by pre-medicating with a short-acting beta-adrenergic (SABA) inhaler (e.g., albuterol). This helps open the airways before exercise and reduces the risk of symptoms like wheezing or shortness of breath during physical activity. Why the other options are less appropriate: A. Participating in a stretching and light calisthenics program instead ❌ Stretching and light exercise might be helpful for general flexibility, but aerobic exercise is still an important part of a healthy lifestyle for patients with asthma. Avoiding exercise altogether is not usually recommended. B. Avoiding aerobic exercise because it will make symptoms worse ❌ Complete avoidance of aerobic exercise is not necessary for asthma management. Most people with asthma can safely engage in exercise with the right precautions, like pre-medicating with a SABA inhaler. C. Using oral corticosteroids to prevent asthma symptoms ❌ Oral corticosteroids are usually reserved for severe asthma exacerbations and are not appropriate for routine prevention of exercise-induced symptoms. Inhaled corticosteroids are used for long-term control but are not typically used just for exercise.

Question 26

Which disease of the lungs may occur as a result of exposure to occupational irritants? Select all that apply A. Asthma B. Lung Cancer C. Cystic Fibrosis D. Pulmonary Fibrosis D. COPD

Answer 26

The correct answers are: A. Asthma B. Lung Cancer D. Pulmonary Fibrosis E. COPD ✅ Rationale: Occupational exposure to irritants such as dust, fumes, chemicals, and other hazardous substances can lead to several lung diseases: A. Asthma ✔️ Occupational asthma is a well-known condition where workplace irritants trigger asthma symptoms or exacerbate existing asthma. B. Lung Cancer ✔️ Long-term exposure to carcinogens such as asbestos, radon, and chemical fumes in the workplace increases the risk of developing lung cancer. D. Pulmonary Fibrosis ✔️ Occupational pulmonary fibrosis (e.g., silicosis, asbestosis) occurs from inhaling fine particles in industries like mining, construction, and manufacturing. E. COPD ✔️ Chronic exposure to irritants such as cigarette smoke, dust, and chemical fumes can lead to the development of chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Why C. Cystic Fibrosis is incorrect: Cystic fibrosis is a genetic disorder, not caused by environmental exposure. It is a hereditary condition that affects the lungs and digestive system due to mutations in the CFTR gene.

Question 27

Which prescribed medication would the nurse adminster first to a patient with asthma who has pneumonia, is reporting increased SOB, and has inspiratory and ecpiratory wheezes? A. Albuterol 2 inhalations B. Salmeterol 2 inhalations C. Ipratropium 2 inhalations D. Flucasone 2 inhalations

Answer 27

✅ Rationale: For a patient with asthma who has increased shortness of breath (SOB) and wheezing (both inspiratory and expiratory), the first medication to administer is a short-acting beta-agonist (SABA) like albuterol. Albuterol works quickly to relax the smooth muscles of the airways, allowing the bronchioles to dilate and improving airflow. This is crucial in the acute setting of asthma exacerbation, especially when wheezing and difficulty breathing are present. Why the other options are less appropriate: B. Salmeterol 2 inhalations ❌ Salmeterol is a long-acting beta-agonist (LABA) used for maintenance therapy in asthma but is not effective in treating acute exacerbations. LABAs should never be used alone for immediate relief. C. Ipratropium 2 inhalations ❌ Ipratropium is an anticholinergic bronchodilator, and while it can help during an asthma attack, albuterol is generally preferred as the first-line treatment for rapid relief. Ipratropium may be used in combination with albuterol for severe cases. D. Fluticasone 2 inhalations ❌ Fluticasone is an inhaled corticosteroid used for long-term control and prevention of asthma symptoms, but it does not provide immediate relief during an asthma attack. It is not appropriate for acute management of symptoms.

Question 28

The nurse receives a change of shift report on the following patients with COPD. Which patient should the nurse assess first? A. A patient with loud exipratory wheezes B. A patient with a respiratory rate of 38/minutes C. A patient who has a cough productive of thick, green mucus D. A pateint with jugular venous distention and peripheral edema

Answer 28

B. A patient with a respiratory rate of 38/minutes ✅ Rationale: A respiratory rate of 38 breaths per minute is significantly elevated and indicates the patient is likely experiencing acute respiratory distress or hypoxia, both of which are life-threatening conditions in a patient with COPD. The nurse should assess this patient immediately to evaluate for signs of respiratory failure, hypoxia, or exacerbation of COPD, which may require interventions like supplemental oxygen, bronchodilators, or mechanical ventilation. Why the other options are less urgent: A. A patient with loud expiratory wheezes ❌ Expiratory wheezes are common in COPD and usually indicate airway obstruction or bronchospasm. Although this is important to assess, it is less urgent than severe respiratory distress (like a very high respiratory rate). C. A patient who has a cough productive of thick, green mucus ❌ Thick, green mucus suggests a potential respiratory infection, but it does not indicate an immediate life-threatening condition. This patient should still be assessed, but it is not as urgent as a patient with severe respiratory distress. D. A patient with jugular venous distention and peripheral edema ❌ Jugular venous distention (JVD) and peripheral edema suggest right-sided heart failure (cor pulmonale), which can be a complication of COPD. However, respiratory rate of 38/min suggests more immediate concern for respiratory failure or acute exacerbation.

Question 29

A nurse is caring for a patient who is orally intubated and being mechanically ventillated. Which factor regarding an artificial airway increases the patient's risk for developing ventilator-associated pneumonia? Sata A. Bypassing the protective airway mechanisms B. Altering and decreasing the body's immune responses C. Preventing adequate gas exchange at the cellular level D. Causing a hyperactive reaction of mucocilliary clearance E. Allowing aspiration of secretions from the oropharynx

Answer 29

The correct answers are: A. Bypassing the protective airway mechanisms E. Allowing aspiration of secretions from the oropharynx ✅ Rationale: Patients with an artificial airway such as an oral endotracheal tube are at high risk for developing ventilator-associated pneumonia (VAP) due to the following key factors: A. Bypassing the protective airway mechanisms ✔️ Correct – The natural defenses like the epiglottis, gag reflex, and mucociliary clearance are bypassed with intubation, allowing pathogens easier access to the lower respiratory tract. E. Allowing aspiration of secretions from the oropharynx ✔️ Correct – Secretions can pool above the cuff of the endotracheal tube and leak into the lungs, carrying bacteria from the mouth and throat and increasing VAP risk. ❌ Incorrect choices explained: B. Altering and decreasing the body's immune responses Not specific to artificial airways. Immune suppression may increase infection risk, but it is not a direct result of intubation. C. Preventing adequate gas exchange at the cellular level This is a consequence of poor ventilation, not a mechanism that contributes to VAP specifically. D. Causing a hyperactive reaction of mucociliary clearance Actually, mucociliary clearance is reduced or bypassed, not hyperactive, due to the tube and dryness of gases.

Question 30

Which assessment finding would the nurse anticipate for the patient suspected of having pneumonia? Select all that apply. A. Myalgia B. Dyspnea C. Bradypnea D. Bradycardia E. Hemoptysis

Answer 30

The correct answers are: A. Myalgia B. Dyspnea E. Hemoptysis ✅ Rationale: In pneumonia, inflammation and infection of the lung tissue lead to a range of systemic and respiratory symptoms. Here's what to expect: A. Myalgia ✔️ Yes – Body aches (myalgia) are common due to the systemic infection response. B. Dyspnea ✔️ Yes – Shortness of breath is a classic sign due to impaired gas exchange from alveolar inflammation and fluid. E. Hemoptysis ✔️ Yes – Coughing up blood-tinged sputum may occur from irritation and damage to lung tissue or blood vessels. ❌ Incorrect choices: C. Bradypnea ✘ No – Patients with pneumonia typically exhibit tachypnea (rapid breathing), not slow breathing. D. Bradycardia ✘ No – Infection and hypoxia usually cause tachycardia (increased heart rate), not a slow heart rate.

Question 31

Laboratory test results for COPD

Answer 31

Increased hematocrit level due to low oxygenation levels Use sputum cultures and WBC counts to diagnose acute respiratory infections Arterial blood gasses -Hypoxemia (decreased PaO2 less than 80 mm Hg) -Hypercarbia (increased PaCO2 greater than 45 mm Hg) Blood electrolytes

Question 32

As COPD advances

Answer 32

The FEV-to-FVC ration decreases. The expected reference range is 100%. For mild COPD, the FEV/FVC ration is decreased to less than 70%. As the disease progresses to severe, the ration decreases less than 50%

Question 33

Chest X-ray on late stage emphasema

Answer 33

Hyperinflation of alveoli and flattened diaphragm

Question 34

Alpha1, antitrypsin level

Answer 34

Used to assess for deficiency in AAT, an enzyme produced in the liver that helps regulate other enzymes (which help break down pollutants) from attacking lung tissue

Question 35

Right sided heart failure in relation to COPD

Answer 35

Question 36

Side effects of prednisone

Answer 36

Hypokalemia Fluid retention Black tarry stools

Question 37

What is a pulse oximetry reading of 89% for a patient with COPD?

Answer 37

This is within the acceptable range for a COPD patient ## Footnote COPD patients often have lower baseline oxygen saturation levels.

Question 38

Which characteristic is associated with a restrictive respiratory disorder?

Answer 38

High recoil ## Footnote Restrictive disorders are characterized by reduced lung expansion.

Question 39

During chest physiotherapy, which area should the nurse avoid when performing percussion?

Answer 39

Sternum ## Footnote Percussion should not be performed over bony structures.

Question 40

What is a common presentation for a patient with emphysema?

Answer 40

Barrel chest ## Footnote This occurs due to hyperinflation of the lungs.

Question 41

What is the recommended limit for suctioning a patient with a tracheostomy?

Answer 41

10-15 seconds ## Footnote This limit helps prevent hypoxia and trauma.

Question 42

What does the hypoxic drive in COPD patients refer to?

Answer 42

The body's response to low oxygen levels that stimulates breathing ## Footnote This mechanism can be impaired with high oxygen levels.

Question 43

What is the most appropriate position for a patient receiving tracheostomy care?

Answer 43

Semi-Fowler's or Fowler's ## Footnote These positions facilitate breathing and airway clearance.

Question 44

What should the oxygen saturation levels aim for in a COPD patient?

Answer 44

88-92% ## Footnote Higher levels may suppress the hypoxic drive.

Question 45

What is the purpose of vibration during chest physiotherapy?

Answer 45

Increase turbulence of exhaled air ## Footnote This helps in mobilizing secretions.

Question 46

What condition would a patient with pulmonary fibrosis likely have?

Answer 46

Decreased lung compliance ## Footnote Pulmonary fibrosis causes stiffening of lung tissue.

Question 47

When performing tracheal suctioning, what should the nurse do?

Answer 47

Apply intermittent suction during withdrawal ## Footnote This technique minimizes damage to the airway.

Question 48

The external diameter of a suction catheter should not exceed:

Answer 48

One-half the internal diameter of the tracheostomy tube ## Footnote This ensures proper suctioning without obstruction.

Question 49

Before performing postural drainage, what should the nurse check?

Answer 49

Check gastric residual if the patient is receiving tube feeding ## Footnote This prevents aspiration during the procedure.

Question 50

What is a typical presentation for a patient with chronic bronchitis?

Answer 50

Productive cough with copious secretions ## Footnote This is a hallmark symptom of chronic bronchitis.

Question 51

What is the primary difference between obstructive and restrictive lung diseases?

Answer 51

Obstructive diseases affect expiration, while restrictive diseases affect inspiration ## Footnote This distinction is crucial for diagnosis.

Question 52

What should be done during hyper-oxygenation before suctioning?

Answer 52

Administer 100% oxygen for 30-60 seconds ## Footnote This prepares the patient for the procedure.

Question 53

What would a patient with asthma in an acute exacerbation likely exhibit?

Answer 53

Wheezing ## Footnote Wheezing is due to narrowed airways.

Question 54

What is the purpose of incentive spirometry?

Answer 54

Promote lung expansion ## Footnote This helps prevent atelectasis postoperatively.

Question 55

A patient with pneumonia is classified as having what type of respiratory disorder?

Answer 55

A restrictive respiratory disorder ## Footnote Pneumonia leads to decreased lung compliance.

Question 56

When teaching pursed-lip breathing, the nurse instructs the patient to:

Answer 56

Inhale through the nose and exhale through pursed lips ## Footnote This technique helps improve ventilation.

Question 57

A patient with COPD is at risk for developing:

Answer 57

Cor pulmonale ## Footnote This is due to chronic hypoxia and pulmonary hypertension.

Question 58

What is the most accurate method to verify feeding tube placement?

Answer 58

X-ray ## Footnote X-ray confirmation is the gold standard.

Question 59

A patient with silicosis would be classified as having:

Answer 59

A restrictive respiratory disorder ## Footnote Silicosis causes lung stiffness.

Question 60

What position should a patient be in for postural drainage of the lower lobes?

Answer 60

In Trendelenburg position ## Footnote This position allows gravity to assist in drainage.

Question 61

A patient with COPD who develops respiratory acidosis would have:

Answer 61

Decreased pH, increased PaCO2 ## Footnote This indicates hypoventilation.

Question 62

What is the primary purpose of a tracheostomy?

Answer 62

Provide long-term airway support ## Footnote It is often used for patients requiring prolonged ventilation.

Question 63

What would a patient with emphysema be expected to have?

Answer 63

Destruction of alveolar walls ## Footnote This leads to decreased surface area for gas exchange.

Question 64

When performing chest physiotherapy, the nurse should:

Answer 64

Percuss each area for 3-5 minutes ## Footnote This duration is effective for mobilizing secretions.

Question 65

What is the action of an inhaled corticosteroid for a patient with asthma?

Answer 65

Reduces inflammation in the airways ## Footnote This helps control asthma symptoms.

Question 66

What is the nurse's priority when caring for a patient with a tracheostomy?

Answer 66

Maintaining a patent airway ## Footnote Ensuring airway patency is critical for patient safety.

Question 67

What is the primary purpose of chest physiotherapy (CPT)?

Answer 67

To loosen respiratory secretions and move them into central airways ## Footnote Reduces the risk for respiratory infections and atelectasis.

Question 68

Which area should be avoided during percussion in chest physiotherapy?

Answer 68

Sternum ## Footnote To prevent injury to structures such as the breasts, sternum, spinal column, and kidneys.

Question 69

How long should a client typically remain in each position during postural drainage?

Answer 69

10-15 minutes ## Footnote This time may be shorter initially and gradually increased as the client's tolerance improves.

Question 70

When is the best time to schedule postural drainage?

Answer 70

When the client's stomach is empty ## Footnote To avoid gastric reflux and vomiting.

Question 71

What technique is used after percussion to increase the turbulence of exhaled air?

Answer 71

Vibration

Question 72

What is the recommended duration for applying suction during airway suctioning?

Answer 72

10-15 seconds ## Footnote To minimize hypoxia.

Question 73

What is an advantage of a closed in-line suction system?

Answer 73

It reduces the risk of infection and oxygen desaturation ## Footnote Does not require disconnecting the ventilator or oxygen source.

Question 74

What is the current recommendation regarding instilling 0.9% sodium chloride prior to suctioning?

Answer 74

It is no longer recommended ## Footnote No conclusive evidence that it facilitates secretion removal and may increase infection risk.

Question 75

How long should you wait between suction passes?

Answer 75

At least one minute

Question 76

Which type of suction catheter is used to clear secretions from the mouth or oropharynx?

Answer 76

Yankauer tonsil tip

Question 77

What technique should be used during nasotracheal suctioning?

Answer 77

Surgical asepsis (sterile technique) ## Footnote Important because the trachea is considered sterile.

Question 78

When suctioning a client with both tracheal and oral secretions, which area should be suctioned last?

Answer 78

Mouth/oropharynx ## Footnote Considered clean, not sterile.

Question 79

What is the purpose of hyperinflating and/or hyperoxygenating a client prior to suctioning?

Answer 79

To prevent oxygen desaturation

Question 80

Which personal protective equipment (PPE) is necessary when performing suctioning?

Answer 80

Gloves, goggles or face shield

Question 81

When using a closed in-line suction system, when should suction be applied?

Answer 81

While withdrawing the catheter

Question 82

What indicates that the catheter is fully withdrawn in a closed in-line suction system?

Answer 82

A black mark on the catheter

Question 83

How much 0.9% sodium chloride should be used to rinse the inner lumen of a suction catheter?

Answer 83

5-10 mL

Question 84

What is a complication of suctioning?

Answer 84

Hypoxia

Question 85

What is the purpose of vibration during chest physiotherapy?

Answer 85

To increase turbulence of exhaled air

Question 86

How should your hands be positioned when performing percussion?

Answer 86

Cupped with fingers and thumb together

Question 87

Which of the following is NOT a component of chest physiotherapy?

Answer 87

Incentive spirometry

Question 88

What is the correct technique for vibration during chest physiotherapy?

Answer 88

Apply vibration during exhalation

Question 89

What is the primary purpose of an oropharyngeal airway?

Answer 89

To keep the upper airway patent

Question 90

Which type of airway does not stimulate the gag reflex?

Answer 90

Nasopharyngeal airway: NPAs are commonly used in situations where patients may have difficulty breathing, such as when they are unconscious, have a gag reflex, or have difficulty opening their mouth. They can also be used to facilitate bag-valve-mask ventilation ## Footnote Made of soft, flexible rubber material.

Question 91

What is a potential complication of tracheostomy tube placement?

Answer 91

Pneumothorax

Question 92

When using a closed in-line suction system, why is the catheter usually not rotated?

Answer 92

Due to the protective catheter sheet

Question 93

What is the primary nursing priority after tracheostomy tube placement?

Answer 93

Maintaining a patent airway

Question 94

Which of the following is a contraindication for postural drainage?

Answer 94

Recent meal

Question 95

How often is postural drainage commonly performed?

Answer 95

Two or three times a day

Question 96

What should be done before starting postural drainage?

Answer 96

Evaluate the client's tolerance of various positions