FUNDIES II: Chapter 39- Oxygen and Perfusion

A client with a history of chronic obstructive pulmonary disease (COPD) has been ordered oxygen at 3 L/min as needed for treatment of dyspnea. What delivery mode is most appropriate to this client's needs? A: Nasal cannula B: Simple mask C: Partial rebreather mask D: Nonrebreather mask

A: nasal cannula

A nurse is delivering 3 L/min oxygen to a client via nasal cannula. What percentage of delivered oxygen is the client receiving? A: 23% B: 28% C: 32% D: 47%

C: 32%

When a nurse observes that an older client's skin is dry and shiny and his nails are thickened, the nurse determines that the client is most likely experiencing A: Anemia B: Malnutrition C: Poor tissue perfusion D: Congestive heart failure

C: poor tissue perfusion

Which diagnostic procedure measures lung size and airway patency, producing graphic representations of lung volumes and flows? A: Chest x-ray B: Bronchoscopy C: Skin tests D: Pulmonary function tests

D: pulmonary function tests

A client's primary care provider has informed the nurse that the client will require thoracentesis. The nurse should suspect that the client has developed which disorder of lung function. A: Pleural effusion B: Tachypnea C: Wheezes D: Pneumonia

A: pleural effusion

The nurse is assessing a newborn in the nursery. The nurse notes the infant has episodes in which breathing ceased for 20 seconds on 2 occasions. The nurse correctly recognizes this condition as: A: dyspnea. B: apnea. C: orthopnea. D: hypercapnia.

B: apnea

When the nurse observes a newborn infant demonstrating an irregular abdominal breathing pattern, with a respiratory rate of 40 breaths/minute with occasional pauses in breathing of 5-second duration. What is the most appropriate action by the nurse? A: Begin resuscitation efforts. B: Elevate the head of the crib. C: Continue to assess the infant. D: Position the infant side-lying.

C: continue to assess the infant

The nurse assesses a client and detects the following findings: difficulty breathing, increased respiratory and pulse rates, and pale skin with regions of cyanosis. What condition would the nurse suspect as causing these respiratory alterations? A: Hyperventilation B: Hypoxia C: Perfusion D: Atelectasis

B: Hypoxia

An older resident at a long-term care facility has been placed on oxygen via a partial rebreather mask due to COVID-19. While helping the resident prepare for sleep, the nurse notices the mask is no longer fitting properly. Which question should the nurse prioritize? A: "Did you remove your dentures?" B: "Is your mask causing discomfort?" C: "Did someone take your mask off?" D: "Did someone loosen the straps on your mask?"

B: is your mask causing discomfort?

While auscultating a client's chest, the nurse auscultates crackles in the lower lung bases. What condition does the nurse identify the client is experiencing? A: presence of sputum in the trachea B: presence of fluid in the lungs C: air passing through narrowed airways D: inflammation of pleural surfaces

B: presence of fluid in the lungs

Which dietary guideline would be appropriate for the older adult homebound client with advanced respiratory disease who informs the nurse that she has no energy to eat? A: Snack on high-carbohydrate foods frequently. B: Eat smaller meals that are high in protein. C: Contact the physician for nutrition shake. D: Eat one large meal at noon.

B: smaller meals that are high in protein

A nurse assessing a client's respiratory status gets a weak signal from the pulse oximeter. The client's other vital signs are within reference ranges. What is the nurse's best action? A: Warm the client's hands and try again. B: Place the probe on the client's earlobe. C: Shine available light on the equipment to facilitate accurate reading. D: Use a blood pressure cuff to increase circulation to the site.

A: warm the clients hands and try again

The nurse is caring for a client receiving oxygen therapy via nasal cannula. The client suddenly becomes cyanotic with a pulse oximetry reading of 91%. What is the next most appropriate action the nurse should take? A: Assess lung sounds B: Reposition client C: Elevate head of the bed D: Assess oxygen tubing connection

D: assess oxygen tubing connection

The nurse is assessing a client with lung cancer. What manifestations may suggest that the client has chronic hypoxia? A: Edema b: Hemoptysis C: Diarrhea D: Clubbing

D: clubbing

The nurse is caring for a client with emphysema who has been prescribed portable oxygen, 2 L/min. Which action(s) does the nurse take to administer low concentrations of oxygen to the client? Select all that apply. Ensure that the oxygen concentrator is turned on Confirm that the nasal cannula is worn properly by the client Verify the oxygen concentrator is set on the prescribed flow rate Place the finger at the nasal cannula outlet to feel for the flow of oxygen Place the outlet of nasal cannula into a glass of water to ensure the flow of oxygen

Ensure that the oxygen concentrator is turned on Confirm that the nasal cannula is worn properly by the client Verify the oxygen concentrator is set on the prescribed flow rate

The nurse is caring for a client with emphysema. When teaching the client pursed-lip breathing, the nurse will include which instruction(s)? Select all that apply. Inhale slowly through the nose for a count of three. Keep abdominal muscles in a relaxed state. Shape the lips as if you were about to blow a whistle. Over time, begin to increase the length of the exhale. Exhale slowly through pursed lips. Ensure that the exhale lasts twice as long as the inhale

Inhale slowly through the nose for a count of three. Shape the lips as if you were about to blow a whistle. Over time, begin to increase the length of the exhale. Exhale slowly through pursed lips. Ensure that the exhale lasts twice as long as the inhale

The nurse is performing a check with an oxygen analyzer. Which oxygen analyzer assessment finding indicates that the device is working properly? A: reads 0.21 when checking oxygen in room air B: reads 0.25 when checking oxygen in room air C: reads 0.19 when positioned near oxygen device D: reads 0.20 when positioned near oxygen device

a: reads 0.21 (21%) when checking oxygen in room air

A nurse is caring for an asthmatic client who requires a low concentration of oxygen. Which delivery device should the nurse use in order to administer oxygen to the client? A: simple mask B: nasal cannula C: face tent D: nonrebreather mask

B :nasal cannula

The nurse is caring for a client with metabolic acidosis whose breathing rate is 28 breaths per minute. Which arterial blood gas data does the nurse anticipate finding? A: pH less than 7.35; HCO3 low; PaCO2 low B: pH greater than 7.45; HCO3 high; PaCO2 high D: pH less than 7.35; HCO3 high; PaCO2 high D: pH greater than 7.45; HCO3 low; PaCO2 low; hyperventilation

A: pH less than 7.35; HCO3 low; PaCO2 low

In which client should the nurse prioritize assessments for respiratory depression? A: A client taking a beta-adrenergic blocker for hypertension B: A client taking antibiotics for a urinary tract infection C: A client taking insulin for type 1 diabetes D:A client taking opioids for cancer pain

D: a client taking opioids for cancer pain

A nurse is volunteering at a day camp. A child is stung by a bee and develops wheezing in the upper airways. The child is experiencing: A: bronchospasm. B: bronchitis. C: bronchiectasis. D: bronchiolitis.

A: bronchospasm

During data collection, the nurse auscultates low-pitched, soft sounds over the lungs' peripheral fields. Which appropriate terminology would the nurse use to describe these lung sounds when documenting? A: Crackles B: Bronchovesicular C: Bronchial D: Vesicular

D: vesicular

The nurse auscultates a client with soft, high-pitched popping breath sounds on inspiration. The nurse documents the breath sounds heard as: A: crackles. B: vesicular. C: wheezes. D: bronchovesicular.

A: crackles

A client who uses portable home oxygen states, "I still like to smoke cigarettes every now and then." What is the appropriate nursing response? A: "An occasional cigarette will not hurt you." B: "You should never smoke when oxygen is in use." C: "I understand; I used to be a smoker also." D: "Oxygen is a flammable gas."

B: you should never smoke when oxygen is in use

A nurse assessing a client's respiratory effort notes that the client's breaths are shallow and 8 per minute. Shortly after, the client's respirations cease. Which form of oxygen delivery should the nurse use for this client? A: Oxygen mask B: Nasal cannula C: Ambu bag D: Oxygen tent

C: ambu bag

The home care nurse is visiting a client who is totally oxygen dependent and using home oxygen. Upon noticing a gas stove in the kitchen, what teaching will the nurse provide? A: "It is important to eat at least five servings of vegetables daily." B: "Remove your oxygen before cooking near the gas stove." C: "An electric stove may be a safer choice for you." D: "Be careful not to trip over your oxygen tubing while cooking."

C: an electric stove may be a safer choice for you

The nurse is caring for a client who has been prescribed humidified oxygen at 6 L/minute. Which type of liquid will the nurse gather to set up the humidifier? A: tap water B: normal saline C: distilled water D: mineral oil

C: distilled water

A nurse assessing a client's respiratory effort notes that the client is breathing 8 shallow breaths/min. Which action best meets this client's immediate oxygenation needs? A: Suction the client's upper airway. B :Apply nasal cannula at 6 L/min c: Use a bag and mask. D: Establish an oxygen hood.

C: use a bag and mask

The nurse is caring for a client who has a compromised cardiopulmonary system and needs to assess the client's tissue oxygenation. The nurse would use which appropriate method to assess this client's oxygenation? A: Hematocrit values B: Hemoglobin levels C: Pulmonary function D: Arterial blood gas

D: arterial blood gas

A client has been put on oxygen therapy because of low oxygen saturation levels in the blood. What should the nurse use to regulate the amount of oxygen delivered to the client? A: oxygen analyzer B: nasal strip C: nasal cannula D: flow meter

D: flow meter

A nurse is caring for a client who breathes very shallowly and has been reporting severe back pain. What suggestion could the nurse make to help the client breathe efficiently? A:Encourage the client to take deep breaths. B: Instruct the client in the use of pursed-lip breathing technique. C: Inform the client about nasal strips. D: Teach the client diaphragmatic breathing.

A: encourage the client to take deep breaths

The nurse schedules a pulmonary function test to measure the amount of air left in a client's lungs at maximal expiration. What test does the nurse order? A: Tidal volume (TV) B: Total lung capacity (TLC) c: Forced Expiratory Volume (FEV) D: Residual Volume (RV)

D: residual volume

A nurse is admitting a 6-year-old child after a tonsillectomy to the surgical unit. The nurse obtains the client's weight and places electrocardiogram (EKG) leads on the chest and a pulse oximeter on the left finger. The client's heart rate reads 100 bpm and the pulse oximeter reads 99%. These readings best indicate: A: adequate tissue perfusion. B: diminished stroke volume. C: high cardiac output. D: heart failure.

A: adequate tissue perfusion

What assessments would a nurse make when auscultating the lungs? A: air flow through the respiratory passages B: abnormal chest structures C: presence of edema D: volume of air exhaled or inhaled

A: air flow through the respiratory passages

The nurse is assessing the vital signs of clients in a community health care facility. Which client respiratory results should the nurse report to the health care provider? A: An infant with a respiratory rate of 16 bpm B: A 4-year-old with a respiratory rate of 32 bpm C: A 12-year-old with a respiratory rate of 20 bpm D: A 70-year-old with a respiratory rate of 18 bpm

A: an infant with a respiratory rate of 19 bpm (The infant's normal respiratory rate is 20 to 40 breaths per minute.)

A client 57 years of age is recovering in a hospital following a bilateral mastectomy and breast reconstruction 2 days earlier. Since her surgery, the client has been unwilling to mobilize despite the nurse's education on the benefits of early mobilization following surgery. The nurse would recognize that the client's prolonged immobility creates a risk for: A: atelectasis. B: pneumothorax. C: hemothorax. D: tachypnea.

A: atelectasis

An older adult client is visibly pale with a respiratory rate of 30 breaths per minute. Upon questioning, the client states to the nurse, "I can't seem to catch my breath." The nurse has responded by repositioning the client and measuring the client's oxygen saturation using pulse oximetry, yielding a reading of 90%. The nurse should interpret this oxygen saturation reading in light of the client's: A: hemoglobin level. B: age. C: blood pH. D: sodium and potassium levels

A: hemoglobin level

The nurse is obtaining a pulse oximetry reading for a client admitted with exacerbation of chronic obstructive pulmonary disease (COPD). When observing a reading of 89%, what action should the nurse perform? A: No action is required, because this may be normal for the client B: The nurse should prepare intubation equipment for the health care provider C: Administer oxygen at 6 L/m by nasal cannula D: Have the client breath into a paper bag

A: no action is required, because this may be normal for the client

A nurse is caring for a client who has spontaneous respirations and needs to have oxygen administered at a FiO2 of 100%. Which oxygen delivery system should the nurse use? A: nonrebreather mask B: Venturi mask C: nasal cannula D: simple mask

A: nonrebreather mask

The air quality index has rated it a red air quality day in the city. Which information will the nurse share with the client about promoting effective respiratory self-care? A: Stay indoors as much as possible. B: Cut down on smoking. C: Avoid exposure to large crowds. D: Practice good hand hygiene.

A: stay indoors as much as possible

A nurse takes a client's pulse oximetry reading and finds that it is normal. What does this finding indicate? A: The client's available hemoglobin is adequately saturated with oxygen. B: The client's oxygen demands are being met. C: The client's red blood cell (RBC) count is in the normal range. D: The client's respiratory rate is in the normal range.

A: the client's available hemoglobin is adequately saturated with oxygen

The nurse is suctioning a client's tracheostomy when the tracheostomy becomes dislodged and the nurse is unable to replace it easily. What is the nurse's most appropriate response? A: Page the respiratory therapist STAT. B: Maintain the client's oxygenation and alert the health care provider immediately. C: Cover the tracheostomy stoma and apply oxygen by nasal cannula D: Assess the client's respiratory status and check vital signs every 1 minute for the next hour.

B: Maintain the client's oxygenation and alert the health care provider immediately.

The nurse is teaching the client with a pulmonary disorder about deep breathing. The client asks, "Why is it important to start by breathing through my nose, then exhaling through my mouth?" Which appropriate response would the nurse give this client? A: "Breathing through your nose first encourages you to sit up straighter to increase the expansion of the lungs during inhalation." B: "Breathing through your nose first will warm, filter, and humidify the air you are breathing." C: "If you breathe through the mouth first, you will swallow germs into your stomach." D: "We are concerned about you developing a snoring habit, so we encourage nasal breathing first."

B: breathing through your nose first will warm, filter, and humidify the air you are breathing

The nurse auscultates the lungs of a client with asthma who reports shortness of breath, sore throat, and congestion. Which finding does the nurse expect to document? A: Stridor B: Crackles c: Wheezing D: Absent breath sounds in lower lobes

C: wheezing

A client who utilizes a portable oxygen device reports planning to attend an upcoming bonfire on the beach. What is the appropriate nursing response? A: "Have an enjoyable time." B: "You should not leave the house with portable oxygen." C: "When using portable oxygen, you should avoid any fire." D: "Saltwater can increase the potential for oxygen toxicity."

C: when using portable oxygen, you should avoid any fire

A client is admitted to the hospital with shortness of breath, cyanosis and an oxygen saturation of 82% (0.82) on room air. Which action should the nurse implement first? A: Assist with intubation B: Apply oxygen as prescribed c: Educate client on incentive spirometry D: Raise the head of the bed

b: apply oxygen as prescribed

The nurse is administering oxygen to an older adult client who has been assessed to have increased work of breathing. If the intervention has been effective, what finding(s) will the nurse expect on the evaluation of the client? Select all that apply. Respiratory rate is 33 breaths/min at rest. Heart rate is 64 beats/min. Oxygen saturation reads 88% on 5L of oxygen. Mucous membranes are pink and moist. The client is able to state the date, time, and location.

heart rate is 64 beats/min mucous membranes are pink and moist the client is able to state the date, time, and location