Chapter 24 Oxygenation

Chapter 24 Oxygenation

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)A student nurse is caring for a client with a chest tube with a water-seal chest drainage systemconnected to suction. Which of the following actions by the student nurse indicate a lack ofunderstanding of the principles of this kind of system? (Select all that apply.)1)A)Fluctuation is observed in the water seal chamber with respirations and is not reported.B)The chest tube is clamped close to the chest when the client is ambulating.C)The dressing at the insertion site of the chest tube is inspected for drainage and intactness.D)Gentle range-of-motion exercises are done with the arm on the side of the chest tube.E)Chest tube drainage is emptied, measured, and recorded at the end of the shift.F)The tubing is secured in a way that prevents dependent looping.Answer:B, EExplanation:A)The question asks for incorrect actions. Chest tubes should not be clamped when aclient ambulates. Clamping a chest tube may trap air in the pleural cavity, andlead to a tension pneumothorax. The water seal drainage system is a closed systemand drainage should be measured and recorded, not emptied. The other answerchoices are correct actions when caring for a client with a chest tube. Fluid in thewater seal chamber will fluctuate with respiration until the lung has reexpanded.Occasional bubbling may also be observed when the tube is connected to suction.An increase in frequency of bubbling in the water seal chamber should bereported. Gentle range-of-motion exercises on the affected side helps to preventankylosis of the shoulder joint.EvaluationSafe, Effective Care Environment-Safety and Infection ControlAnalysisB)The question asks for incorrect actions. Chest tubes should not be clamped when aclient ambulates. Clamping a chest tube may trap air in the pleural cavity, andlead to a tension pneumothorax. The water seal drainage system is a closed systemand drainage should be measured and recorded, not emptied. The other answerchoices are correct actions when caring for a client with a chest tube. Fluid in thewater seal chamber will fluctuate with respiration until the lung has reexpanded.Occasional bubbling may also be observed when the tube is connected to suction.An increase in frequency of bubbling in the water seal chamber should bereported. Gentle range-of-motion exercises on the affected side helps to preventankylosis of the shoulder joint.EvaluationSafe, Effective Care Environment-Safety and Infection ControlAnalysis1
C)The question asks for incorrect actions. Chest tubes should not be clamped when aclient ambulates. Clamping a chest tube may trap air in the pleural cavity, andlead to a tension pneumothorax. The water seal drainage system is a closed systemand drainage should be measured and recorded, not emptied. The other answerchoices are correct actions when caring for a client with a chest tube. Fluid in thewater seal chamber will fluctuate with respiration until the lung has reexpanded.Occasional bubbling may also be observed when the tube is connected to suction.An increase in frequency of bubbling in the water seal chamber should bereported. Gentle range-of-motion exercises on the affected side helps to preventankylosis of the shoulder joint.EvaluationSafe, Effective Care Environment-Safety and Infection ControlAnalysisD)The question asks for incorrect actions. Chest tubes should not be clamped when aclient ambulates. Clamping a chest tube may trap air in the pleural cavity, andlead to a tension pneumothorax. The water seal drainage system is a closed systemand drainage should be measured and recorded, not emptied. The other answerchoices are correct actions when caring for a client with a chest tube. Fluid in thewater seal chamber will fluctuate with respiration until the lung has reexpanded.Occasional bubbling may also be observed when the tube is connected to suction.An increase in frequency of bubbling in the water seal chamber should bereported. Gentle range-of-motion exercises on the affected side helps to preventankylosis of the shoulder joint.EvaluationSafe, Effective Care Environment-Safety and Infection ControlAnalysisE)The question asks for incorrect actions. Chest tubes should not be clamped when aclient ambulates. Clamping a chest tube may trap air in the pleural cavity, andlead to a tension pneumothorax. The water seal drainage system is a closed systemand drainage should be measured and recorded, not emptied. The other answerchoices are correct actions when caring for a client with a chest tube. Fluid in thewater seal chamber will fluctuate with respiration until the lung has reexpanded.Occasional bubbling may also be observed when the tube is connected to suction.An increase in frequency of bubbling in the water seal chamber should bereported. Gentle range-of-motion exercises on the affected side helps to preventankylosis of the shoulder joint.EvaluationSafe, Effective Care Environment-Safety and Infection ControlAnalysisF)The question asks for incorrect actions. Chest tubes should not be clamped when aclient ambulates. Clamping a chest tube may trap air in the pleural cavity, andlead to a tension pneumothorax. The water seal drainage system is a closed systemand drainage should be measured and recorded, not emptied. The other answerchoices are correct actions when caring for a client with a chest tube. Fluid in thewater seal chamber will fluctuate with respiration until the lung has reexpanded.Occasional bubbling may also be observed when the tube is connected to suction.An increase in frequency of bubbling in the water seal chamber should bereported. Gentle range-of-motion exercises on the affected side helps to preventankylosis of the shoulder joint.EvaluationSafe, Effective Care Environment-Safety and Infection ControlAnalysis2
2)A student nurse is to obtain a pulse oximetry measurement as part of an elderly client’s respiratoryassessment. The client is recovering from pneumonia and is receiving oxygen by nasal cannula.Which action by the student nurse indicates a lack of understanding of this procedure?2)A)The student nurse makes sure that all measurements are done after the client has beenreceiving oxygen by nasal cannula for at least five minutes.B)The sensor is placed on the index finger of one hand.C)The client is asked to breathe normally during the measurement.D)The client’s arm and hand are resting on the bed during the measurement.Answer:AExplanation:A)The most accurate information about the client’s respiratory efficiency is obtainedwith the client on room air. The pulse oximetry reading is likely to be higher whenthe client is concomitantly receiving oxygen therapy. In reality the client may bemonitored both with and without oxygen. It is very important for the nurse todocument the circumstances of the pulse oximetry readings, such as with orwithout oxygen and before, during, or after activity. The other actions by thestudent nurse are correct. There must be consistency in how the procedure is done.EvaluationHealth Promotion and MaintenanceAnalysisB)The most accurate information about the client’s respiratory efficiency is obtainedwith the client on room air. The pulse oximetry reading is likely to be higher whenthe client is concomitantly receiving oxygen therapy. In reality the client may bemonitored both with and without oxygen. It is very important for the nurse todocument the circumstances of the pulse oximetry readings, such as with orwithout oxygen and before, during, or after activity. The other actions by thestudent nurse are correct. There must be consistency in how the procedure is done.EvaluationHealth Promotion and MaintenanceAnalysisC)The most accurate information about the client’s respiratory efficiency is obtainedwith the client on room air. The pulse oximetry reading is likely to be higher whenthe client is concomitantly receiving oxygen therapy. In reality the client may bemonitored both with and without oxygen. It is very important for the nurse todocument the circumstances of the pulse oximetry readings, such as with orwithout oxygen and before, during, or after activity. The other actions by thestudent nurse are correct. There must be consistency in how the procedure is done.EvaluationHealth Promotion and MaintenanceAnalysisD)The most accurate information about the client’s respiratory efficiency is obtainedwith the client on room air. The pulse oximetry reading is likely to be higher whenthe client is concomitantly receiving oxygen therapy. In reality the client may bemonitored both with and without oxygen. It is very important for the nurse todocument the circumstances of the pulse oximetry readings, such as with orwithout oxygen and before, during, or after activity. The other actions by thestudent nurse are correct. There must be consistency in how the procedure is done.EvaluationHealth Promotion and MaintenanceAnalysis3
3)A client has a right upper anterior chest tube. The primary purpose for placing a chest tube in thislocation is to:3)A)Remove blood from the intrapulmonic space.B)Restore the negative intrapulmonic pressure.C)Restore the negative intrapleural pressure.D)Remove blood from the intrapleural space.Answer:CExplanation:A)A chest tube is inserted to restore the negative pressure inside the pleural cavity,which then restores the positive pressure inside the lungs. When a chest tube isplaced high in the pleural cavity, it is intended to remove air, not blood or otherfluid. Air will rise in the pleural cavity; heavier fluids will settle to the lowerspaces.AssessmentPhysiological Integrity-Physiological AdaptationApplicationB)A chest tube is inserted to restore the negative pressure inside the pleural cavity,which then restores the positive pressure inside the lungs. When a chest tube isplaced high in the pleural cavity, it is intended to remove air, not blood or otherfluid. Air will rise in the pleural cavity; heavier fluids will settle to the lowerspaces.AssessmentPhysiological Integrity-Physiological AdaptationApplicationC)A chest tube is inserted to restore the negative pressure inside the pleural cavity,which then restores the positive pressure inside the lungs. When a chest tube isplaced high in the pleural cavity, it is intended to remove air, not blood or otherfluid. Air will rise in the pleural cavity; heavier fluids will settle to the lowerspaces.AssessmentPhysiological Integrity-Physiological AdaptationApplicationD)A chest tube is inserted to restore the negative pressure inside the pleural cavity,which then restores the positive pressure inside the lungs. When a chest tube isplaced high in the pleural cavity, it is intended to remove air, not blood or otherfluid. Air will rise in the pleural cavity; heavier fluids will settle to the lowerspaces.AssessmentPhysiological Integrity-Physiological AdaptationApplication