Chapter 38: Oxygenation and Tissue Perfusion

Chapter 38: Oxygenation and Tissue Perfusion

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse finds the patient in cardiopulmonary arrest with no pulse or respirations. Which oxygen delivery device will the nurse use for this patient?

a.	Non-rebreather mask
b.	Bag-valve-mask unit
c.	Continuous positive airway pressure (CPAP)
d.	High-flow nasal cannula

 

 

ANS:  B

The priority of the nurse is to ventilate the patient manually using an Ambu bag-valve-mask unit. This allows air to be forced into the patient’s lungs when there are no spontaneous respirations. The non-rebreather mask and nasal cannula require the patient to breathe on his own. CPAP is used for patients who are awake, oriented, and in respiratory failure.

 

DIF:    Understanding                                 REF:   p. 960 | p. 964

TOP:   Implementation

MSC:  NCLEX Client Needs Category: Physiological Adaptation: Medical Emergencies

NOT:  Concepts: Gas Exchange

 

2. The nurse is caring for a patient who is slow to awaken following general anesthesia. The patient is breathing spontaneously but is minimally responsive and having difficulty maintaining a patent airway. Which intervention is the most appropriate for the patient to improve oxygenation?

a.	Insert an oral airway.
b.	Lower the head of the bed.
c.	Turn the patient’s head to the side.
d.	Monitor the patient’s pulse oximetry.

 

 

ANS:  A

An oral airway will prevent the patient’s tongue from falling back and occluding the airway. Lowering the head of the bed will only increase airway occlusion and risk of aspiration. Turning the patient’s head to the side will not clear the back of the patient’s tongue from the airway. Monitoring the patient’s pulse oximetry will not improve oxygenation or clear the airway.

 

DIF:    Applying        REF:   pp. 964-965    TOP:   Implementation

MSC:  NCLEX Client Needs Category: Reduction of Risk Potential: Potential for Complications from Surgical Procedures                NOT:  Concepts: Gas Exchange

 

3. The nurse is caring for a patient with a history of left-sided congestive heart failure who is acutely short of breath. The nurse hears fine crackles throughout both lung fields and notes that the patient’s pulse oximetry is only 88% on 4 L of oxygen. What is the priority intervention of the nurse?

a.	Administer the ordered intravenous diuretic.
b.	Prepare for insertion of a chest tube.
c.	Suction secretions from the patient’s respiratory tract.
d.	Have the patient use the ordered incentive spirometer.

 

 

ANS:  A

The patient’s respiratory distress is due to pulmonary edema and fluid overload from left-sided congestive heart failure. A diuretic will pull the excess fluid out of the body through the urine and relieve the patient’s distress. A chest tube is not needed as the fluid is within the alveoli rather than between the lung and chest wall. Suctioning and use of an incentive spirometer will not address fluid overload or improve the patient’s symptoms.

 

DIF:    Understanding                                 REF:   p. 966             TOP:   Implementation

MSC:  NCLEX Client Needs Category: Physiological Adaptation: Fluid and Electrolyte Imbalances

NOT:  Concepts: Fluid and Electrolyte Balance

 

4. The nurse is caring for a patient who has been intubated with an oral endotracheal tube for several weeks. The physicians predict that the patient will need to remain on a ventilator for at least several more weeks before he will be able to maintain his airway and breathe on his own. What procedure does the nurse anticipate will be planned for the patient to facilitate his recovery?

a.	Placement of a tracheostomy tube
b.	Diagnostic thoracentesis
c.	Pulmonary angiogram
d.	Lung transplantation surgery

 

 

ANS:  A

Placement of a tracheostomy tube will secure the patient’s airway directly through the trachea, eliminating the need for the endotracheal tube. This will make the patient more comfortable and may allow him to eat while minimizing damage to the oropharynx from the endotracheal tube.

 

DIF:    Understanding                                 REF:   p. 965             TOP:   Planning

MSC:  NCLEX Client Needs Category: Reduction of Risk Potential: Therapeutic Procedures

NOT:  Concepts: Gas Exchange