1.
Which of the following is the correct "normal range" levels for PaO2
Correct Answer
B. 80 to 100
Explanation
The correct "normal range" levels for PaO2 are 80 to 100. This range indicates the normal partial pressure of oxygen in arterial blood, which is typically measured in millimeters of mercury (mmHg). PaO2 levels outside of this range may indicate a respiratory or circulatory issue.
2.
Which of the following represent the range for "normal" levels for HCO3 in the blood?
Correct Answer
B. 22 - 26
Explanation
The range for "normal" levels of HCO3 in the blood is typically 22 - 26. HCO3, also known as bicarbonate, is an important electrolyte that helps maintain the acid-base balance in the body. Levels outside of this range may indicate an imbalance in the body's pH levels and can be a sign of certain medical conditions.
3.
Which of the following represent the correct "normal" range for PCO2 in the blood?
Correct Answer
C. 35 - 45
Explanation
The correct "normal" range for PCO2 in the blood is 35 - 45. PCO2 refers to the partial pressure of carbon dioxide in the blood, and this range represents the typical levels of carbon dioxide that are considered normal in the bloodstream. Levels below 35 or above 45 may indicate an imbalance in the body's respiratory system.
4.
You should assess for what complication in the client whose main respiratory drive is hypoxia (hypoxic drive), such as the patient with chronic lung disease who also has carbon monoxide retention?
Correct Answer
A. Oxygen Induced Hypoventilation
Explanation
When a client's main respiratory drive is hypoxia (hypoxic drive), providing supplemental oxygen can suppress their respiratory drive and cause hypoventilation. This is known as oxygen-induced hypoventilation. In clients with chronic lung disease and carbon monoxide retention, their hypoxic drive is already compromised, and providing too much oxygen can further decrease their respiratory effort. Therefore, assessing for oxygen-induced hypoventilation is important in these clients to prevent respiratory complications.
5.
You are treating a client with oxygen therapy at 2L/min. While watching for signs of hypoventilation during the first 30 minutes, which manifestation should alert you that the client is at riskf for either apnea or respiratory arrest from loss of Hypoxic Drive?
Correct Answer
A. Patient's color improves from ashen or gray to pink
Explanation
If the patient's color improves from ashen or gray to pink, it indicates that the oxygen therapy is effective and the client's oxygen saturation levels are increasing. This suggests that the client's respiratory drive is not solely dependent on the hypoxic drive, which is the backup mechanism that stimulates breathing in individuals with chronic respiratory conditions. Therefore, this manifestation indicates that the client is not at risk for apnea or respiratory arrest from loss of Hypoxic Drive.
6.
A client receiving oxygen therapy for 32 hours, complains of a cough, substernal chest pain, upset stomach and show signs of difficulty breathing. Later, at 34 hours of continuous oxygen greater than 50%, hyaline membrane formation results. This client was more than likely experiencing which complication of oxygen therapy?
Correct Answer
D. Oxygen Toxicity
Explanation
Initial symptoms include nonproductive cough, substernal chest pain, GI upset, and dyspnea. As exposure to high levels of oxygen continues, the symptoms become more severe with decreased vital capacity, decreased compliance (which results in more dyspnea), crackles, and hypoxemia. Prolonged exposure to high oxygen levels damages lung tissues. Atelectasis, pulmonary edema, hemorrhage, and hyaline membrane formation result.
7.
While treating a client who recently experienced oxygen toxicity, you notice their PaO2 levels are 92mm Hg. What should your next action be?
Correct Answer
B. Notify the pHysician immediately
Explanation
The toxic effects of oxygen are difficult to treat, making prevention a priority. The lowest level of oxygen needed to maintain oxygenation and prevent oxygen toxicity is prescribed. Closely monitor arterial blood gases (ABGs) during oxygen therapy, and notify the physician of PaO2 levels greater than 90 mm Hg. Also monitor the prescribed oxygen level and length of therapy to identify the patient at higher risk. High oxygen levels are avoided unless absolutely necessary.
8.
When high oxygen levels are delivered, ________ is diluted. This causes the oxygen to diffuse from the alveoli into the circulation and the alveoli collapse.
Correct Answer
A. Nitrogen
Explanation
Nitrogen in the air normally helps maintain patent airways and alveoli. Making up 79% of room air, nitrogen prevents alveolar collapse. When high oxygen levels are delivered, nitrogen is diluted, oxygen diffuses from the alveoli into the circulation, and the alveoli collapse. Collapsed alveoli cause atelectasis (called absorption atelectasis), which is detected by auscultation. Monitor the patient closely for crackles and decreased breath sounds every 1 to 2 hours when oxygen therapy is started and as often as needed thereafter.
9.
Which of the following factors determine the type of oxygen delivery system used for a client? (Select all that apply)
Correct Answer(s)
A. Oxygen concentration required by the patient
B. Importance of accuracy and control of the oxygen concentration
C. Patient comfort
D. Patient mobility
E. Importance of humidity
Explanation
The type of oxygen delivery system used for a client is determined by several factors. First, the oxygen concentration required by the patient is important in determining the appropriate delivery system. Some patients may require a higher concentration of oxygen, which may necessitate the use of a different system. The importance of accuracy and control of the oxygen concentration is also a factor, as some delivery systems may offer more precise control over the oxygen levels. Patient comfort is another consideration, as certain delivery systems may be more comfortable for the patient to use. Patient mobility is also important, as some systems may be more portable and allow for greater freedom of movement. Finally, the importance of humidity may also play a role, as certain systems may offer options for adding humidity to the delivered oxygen.
10.
While monitoring a client using a Low Flow System for their oxygen therapy, you're aware that the total level of oxygen inspired is dependent upon ___________.
Correct Answer
A. Respiratory Rate & Tidal Volume
Explanation
The total level of oxygen inspired in a Low Flow System for oxygen therapy is dependent upon the respiratory rate and tidal volume. The respiratory rate refers to the number of breaths taken per minute, while tidal volume refers to the volume of air inhaled and exhaled with each breath. By adjusting the respiratory rate and tidal volume, the amount of oxygen delivered to the client can be controlled.
11.
Obtain a presciption for humidification if oxygen is being delivered at ___L/min or more.
Correct Answer
B. 4L/min
Explanation
When an oxygen flow rate higher than 4 L/min is needed, humidity is added to the delivery system.
12.
Which of the following demonstrate the proper way to cleanse the cannula or mask of a client receiving oxygen therapy?
Correct Answer
A. Cleanse with clear, warm water every 4 to 8 hours or as needed
Explanation
The proper way to cleanse the cannula or mask of a client receiving oxygen therapy is to cleanse it with clear, warm water every 4 to 8 hours or as needed. This helps to remove any dirt, debris, or secretions that may have accumulated on the cannula or mask, ensuring that the client receives clean and effective oxygen therapy. Using sterile saline or clear, cool water is not necessary for routine cleansing of the cannula or mask.
13.
Nasal Cannulas are used at flow rates of ____ to ____L/min. Flow rates greater than the latter number do not increase oxygenation because the anatomic dead space is full.
Correct Answer
B. 1 to 6L/min
Explanation
The nasal cannula, or nasal prongs, is used at flow rates of 1 to 6 L/min. Oxygen concentrations of 24% (at 1 L/min) to 44% (at 6 L/min) can be achieved. Flow rates greater than 6 L/min do not increase oxygenation because the anatomic dead space (places where air flows but the structures are too thick for gas exchange) is full. In addition, high flow rates increase mucosal irritation.
14.
A client with COPD is _______ going to be prescribed to received oxygen at a rate higher than 2 to 3 L/min because of the risk of losing the drive to breath, thereby increasing the risk for apnea or respiratory arrest
Correct Answer
B. Rarely
Explanation
The patient who retains carbon dioxide rarely is prescribed to receive oxygen at a rate higher than 2 to 3 L/min because of the risk for losing the drive to breathe, thereby increasing the risk for apnea or respiratory arrest.
15.
While treating a client with a Partial Rebreather Mask, you notice that the bag is deflated. Deflation results in:
Correct Answer
A. Rebreathing of exhaled air
Explanation
Make sure that the reservoir does not twist or kink, which results in a deflated bag. Deflation results in decreased oxygen delivered and rebreathing of exhaled air.
16.
Simple Facemasks are used to deliver concentrations of 40% to 60% for short-term oxygen therapy or in an emergency. A minimum flow rate of ____ L/min is needed to prevent the rebreathing of exhaled air.
Correct Answer
D. 5L/min
Explanation
A minimum flow rate of 5 L/min is needed to prevent the rebreathing of exhaled air.
17.
Which of the following oxygen delivery systems is best for a client with chronic lung disease?
Correct Answer
C. Venturi Mask (Venti Mask)
Explanation
The Venturi Mask is best for the patient with chronic lung disease because it delivers a more precise oxygen concentration.
18.
Humidification is needed in all of the following High Flow Oxygen Delivery Systems except for...
Correct Answer
A. Venturi Mask
Explanation
Humidification is not needed in a Venturi Mask because this type of oxygen delivery system provides a precise and fixed concentration of oxygen to the patient. It works by mixing oxygen with room air through a series of small ports, creating a specific oxygen concentration. Since the oxygen is not delivered at a high flow rate, there is no need for humidification to prevent drying of the airways. In contrast, the other options (Aerosol Mask, Face Tent, Tracheostomy Collar) deliver oxygen at high flow rates, which can cause drying of the airways, and therefore require humidification to add moisture to the delivered oxygen.
19.
This high flow system mask is not tight fitting, making it useful for facial trauma or burns.
Correct Answer
C. Face Tent
Explanation
The face tent is a high flow system mask that is not tight fitting, which makes it suitable for patients with facial trauma or burns. The loose fit of the mask allows for better comfort and less pressure on the affected areas, while still delivering a high flow of oxygen or aerosol therapy to the patient. This helps to ensure adequate oxygenation and healing while minimizing discomfort and potential damage to the injured facial tissues.
20.
__________ delivers a set positive airway pressure throughout each cycle of inhalation and exhalation. The effect is to open collapsed alveoli. Patients who may benefit from this form of oxygen or air delivery include those with atelectasis after surgery or cardiac-induced pulmonary edema. This technique is also used for sleep apnea. The effect of this use is to hold open the upper airways
Correct Answer
C. CPAP
Explanation
CPAP stands for Continuous Positive Airway Pressure. It delivers a set positive airway pressure throughout each cycle of inhalation and exhalation. This helps to open collapsed alveoli, making it beneficial for patients with atelectasis after surgery or cardiac-induced pulmonary edema. CPAP is also used for sleep apnea, as it holds open the upper airways, allowing for better breathing during sleep.