ATI MEDICAL SURGICAL RESPIRATORY ACTUAL
EXAM PAPER 2026 QUESTIONS SOLUTIONS
GRADED A+
◉ Respiratory Diagnostic and Therapeutic Procedures: Respiratory
diagnostic procedures. Answer: Respiratory diagnostic procedures
that nurses should be knowledgeable about include:
o Pulse oximetry
o ABGs
o Bronchoscopy
o Thoracentesis
◉ Respiratory Diagnostic and Therapeutic Procedures: CHEST
TUBES. Answer: • Chest tubes are a type of therapeutic procedure
inserted into the pleural space to drain fluid, blood, or air;
reestablish a negative pressure; facilitate lung expansion; and
restore normal intrapleural pressure.
• Chest tubes can be inserted in the emergency department, at the
client's bedside, or in the operating room through a thoracotomy
incision.
• Chest tubes are removed when the lungs have reexpanded and/or
there is no more fluid drainage.
,◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY. Answer: • Pulse Oximetry is a noninvasive measurement
of the oxygen saturation of the blood, but it is not a replacement for
ABG measurement.
o A pulse oximeter is a battery- or electric-operated device with a
sensor probe that is attached securely onto the client's fingertip, toe,
bridge of nose, earlobe, or forehead with a clip or band.
o Pulse oximetry measures arterial oxygen saturation (SaO2) via a
wave of infrared light that measures light absorption by oxygenated
and deoxygenated Hgb in arterial blood. SaO2 and SpO2 are used
interchangeably.
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Indications. Answer: o Pulse oximetry is indicated for
conditions or situations in which a client's respiratory status should
be monitored, such as during a continuous opioid epidural infusion.
o Client presentation
• The following signs and symptoms indicate that oxygen saturation
should be monitored in a client o Increased work of breathing
o Wheezing
o Coughing
o Cyanosis
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Interpretation of Findings. Answer: o The expected
,reference range for SaO2 is 95% to 100%. Acceptable levels may
range from 91% to 100%. Some illness states may even allow for an
SaO2 of 85% to 89%.
o Values may be slightly lower in the older adult client and those
with dark skin.
o Additional reasons for low readings include hypothermia, poor
peripheral blood flow, too much light (sun or infrared lamps), low
Hgb levels, client movement, edema, and nail polish.
o An SaO2 below 91 % requires interventions to help the client
regain acceptable SaO2 levels. An SaOz below 86% is an emergency.
An SaOz below 80% is life-threatening.
The lower the SaOz level, the less accurate the value.
o Values obtained by pulse oximetry are unreliable in cardiac arrest,
shock, and other states of low perfusion.
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Preprocedure. Answer: Nursing actions
• Perform hand hygiene and provide privacy.
• Find an appropriate probe site. It must be dry and have adequate
circulation.
• Be sure the client is in a comfortable position, supporting the arm
if a finger is
used as a probe site.
, ◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Intraprocedure. Answer: Nursing actions
• Apply the sensor probe to the site.
• Press the power switch on the oximeter.
• Note the pulse reading and compare it with the client's radial
pulse. Any discrepancy warrants further data collection.
• Allow time for the readout to stabilize, and then record this value
as the oxygen saturation.
• Remove the probe, tum off the Oximeter, and store it appropriately.
• If continuous monitoring is required, make sure the alarms are set
for a low and a high limit, they are functioning, and that the sound is
audible. Check the condition of the skin under the probe every 4
hour and move the sensor every 24 hour if indicated.
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Post procedure. Answer: o Nursing actions
• Document the findings and report abnormal findings to the
provider.
• If a client's SaO2 is less than 90% (indicating hypoxemia):
o Confirm that the sensor probe is properly placed.
o Confirm that the oxygen delivery system is functioning and that
the client is receiving prescribed oxygen levels.
o Place the client in a semi-Fowler's or Fowler's position to
maximize ventilation.
EXAM PAPER 2026 QUESTIONS SOLUTIONS
GRADED A+
◉ Respiratory Diagnostic and Therapeutic Procedures: Respiratory
diagnostic procedures. Answer: Respiratory diagnostic procedures
that nurses should be knowledgeable about include:
o Pulse oximetry
o ABGs
o Bronchoscopy
o Thoracentesis
◉ Respiratory Diagnostic and Therapeutic Procedures: CHEST
TUBES. Answer: • Chest tubes are a type of therapeutic procedure
inserted into the pleural space to drain fluid, blood, or air;
reestablish a negative pressure; facilitate lung expansion; and
restore normal intrapleural pressure.
• Chest tubes can be inserted in the emergency department, at the
client's bedside, or in the operating room through a thoracotomy
incision.
• Chest tubes are removed when the lungs have reexpanded and/or
there is no more fluid drainage.
,◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY. Answer: • Pulse Oximetry is a noninvasive measurement
of the oxygen saturation of the blood, but it is not a replacement for
ABG measurement.
o A pulse oximeter is a battery- or electric-operated device with a
sensor probe that is attached securely onto the client's fingertip, toe,
bridge of nose, earlobe, or forehead with a clip or band.
o Pulse oximetry measures arterial oxygen saturation (SaO2) via a
wave of infrared light that measures light absorption by oxygenated
and deoxygenated Hgb in arterial blood. SaO2 and SpO2 are used
interchangeably.
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Indications. Answer: o Pulse oximetry is indicated for
conditions or situations in which a client's respiratory status should
be monitored, such as during a continuous opioid epidural infusion.
o Client presentation
• The following signs and symptoms indicate that oxygen saturation
should be monitored in a client o Increased work of breathing
o Wheezing
o Coughing
o Cyanosis
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Interpretation of Findings. Answer: o The expected
,reference range for SaO2 is 95% to 100%. Acceptable levels may
range from 91% to 100%. Some illness states may even allow for an
SaO2 of 85% to 89%.
o Values may be slightly lower in the older adult client and those
with dark skin.
o Additional reasons for low readings include hypothermia, poor
peripheral blood flow, too much light (sun or infrared lamps), low
Hgb levels, client movement, edema, and nail polish.
o An SaO2 below 91 % requires interventions to help the client
regain acceptable SaO2 levels. An SaOz below 86% is an emergency.
An SaOz below 80% is life-threatening.
The lower the SaOz level, the less accurate the value.
o Values obtained by pulse oximetry are unreliable in cardiac arrest,
shock, and other states of low perfusion.
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Preprocedure. Answer: Nursing actions
• Perform hand hygiene and provide privacy.
• Find an appropriate probe site. It must be dry and have adequate
circulation.
• Be sure the client is in a comfortable position, supporting the arm
if a finger is
used as a probe site.
, ◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Intraprocedure. Answer: Nursing actions
• Apply the sensor probe to the site.
• Press the power switch on the oximeter.
• Note the pulse reading and compare it with the client's radial
pulse. Any discrepancy warrants further data collection.
• Allow time for the readout to stabilize, and then record this value
as the oxygen saturation.
• Remove the probe, tum off the Oximeter, and store it appropriately.
• If continuous monitoring is required, make sure the alarms are set
for a low and a high limit, they are functioning, and that the sound is
audible. Check the condition of the skin under the probe every 4
hour and move the sensor every 24 hour if indicated.
◉ Respiratory Diagnostic and Therapeutic Procedures: PULSE
OXIMETRY - Post procedure. Answer: o Nursing actions
• Document the findings and report abnormal findings to the
provider.
• If a client's SaO2 is less than 90% (indicating hypoxemia):
o Confirm that the sensor probe is properly placed.
o Confirm that the oxygen delivery system is functioning and that
the client is receiving prescribed oxygen levels.
o Place the client in a semi-Fowler's or Fowler's position to
maximize ventilation.
