NURS 104L Oxygen Therapy & Respiratory Care Comprehensive Exam
2026 |WCU
1. A nurse is assessing a patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min via nasal cannula. Which of the
following findings is the most critical early indicator of hypoxia?
A. Cyanosis of the nail beds and mucous membranes
B. Bradypnea and hypotension
C. Restlessness and apprehension
D. Decreased level of consciousness
Answer: C
Rationale: Restlessness, anxiety, and apprehension are the earliest clinical manifestations
of hypoxia. Cyanosis and decreased consciousness are late signs.
2. When performing tracheostomy suctioning, which action by the student
nurse requires immediate intervention by the clinical instructor?
A. Applying suction while inserting the catheter into the tracheostomy
B. Hyperoxygenating the patient with 100% oxygen before the procedure
C. Limiting the suctioning pass to no more than 10 to 15 seconds
D. Rotating the catheter while withdrawing it from the airway
Answer: A
Rationale: Suction should never be applied during insertion as it causes trauma to the
tracheal mucosa and depletes oxygen. Suction should only be applied intermittently or
continuously during withdrawal.
,3. A patient requires a precise concentration of oxygen at 35% FiO2. Which
oxygen delivery device is most appropriate for this patient?
A. Venturi mask
B. Nasal cannula
C. Simple face mask
D. Non-rebreather mask
Answer: A
Rationale: The Venturi mask is the most accurate delivery device for providing a specific,
constant concentration of oxygen regardless of the patient’s breathing pattern.
4. What is the recommended suction pressure range for an adult patient when
performing oropharyngeal or tracheal suctioning?
A. 60–80 mmHg
B. 80–100 mmHg
C. 160–200 mmHg
D. 100–150 mmHg
Answer: D
Rationale: For adults, the safe and effective suction pressure range is typically 100 to 150
mmHg to prevent mucosal damage while effectively removing secretions.
5. During tracheostomy care, the nurse prepares to clean the inner cannula.
Which solution is most commonly used for cleaning a non-disposable inner
cannula?
A. Half-strength hydrogen peroxide and sterile saline
B. Sterile water only
C. Chlorhexidine gluconate
D. Povidone-iodine
Answer: A
, Rationale: A mixture of half-strength hydrogen peroxide is used to loosen secretions,
followed by a rinse with sterile normal saline.
6. A patient is instructed on the use of an incentive spirometer. Which
statement by the patient indicates a need for further teaching?
A. ‘I will hold my breath for 3 to 5 seconds at the end of my inhalation.’
B. ‘I will try to keep the indicator at the target level as long as possible.’
C. ‘I should use this device 5 to 10 times every hour while I am awake.’
D. ‘I should take a deep breath in through my nose before blowing into the mouthpiece.’
Answer: D
Rationale: Incentive spirometry involves a slow, deep inhalation through the mouthpiece
(not blowing into it) to expand the alveoli.
7. A nurse is preparing to perform nasotracheal suctioning. Which position is
most appropriate for a conscious patient with a functional gag reflex?
A. Supine
B. Semi-Fowler’s with the head hyperextended
C. Prone position
D. High-Fowler’s with the neck slightly flexed (sniffing position)
Answer: D
Rationale: High-Fowler’s or Semi-Fowler’s helps with lung expansion; for nasotracheal
insertion, the ‘sniffing’ position helps the catheter enter the trachea rather than the
esophagus.
8. Which safety precaution is essential when oxygen is in use in a home setting?
A. Using petroleum-based ointments for dry lips
B. Maintaining a distance of at least 10 feet from open flames or heat sources
C. Ensuring the oxygen tank is stored horizontally under the bed
D. Using wool blankets to keep the patient warm
Answer: B
2026 |WCU
1. A nurse is assessing a patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min via nasal cannula. Which of the
following findings is the most critical early indicator of hypoxia?
A. Cyanosis of the nail beds and mucous membranes
B. Bradypnea and hypotension
C. Restlessness and apprehension
D. Decreased level of consciousness
Answer: C
Rationale: Restlessness, anxiety, and apprehension are the earliest clinical manifestations
of hypoxia. Cyanosis and decreased consciousness are late signs.
2. When performing tracheostomy suctioning, which action by the student
nurse requires immediate intervention by the clinical instructor?
A. Applying suction while inserting the catheter into the tracheostomy
B. Hyperoxygenating the patient with 100% oxygen before the procedure
C. Limiting the suctioning pass to no more than 10 to 15 seconds
D. Rotating the catheter while withdrawing it from the airway
Answer: A
Rationale: Suction should never be applied during insertion as it causes trauma to the
tracheal mucosa and depletes oxygen. Suction should only be applied intermittently or
continuously during withdrawal.
,3. A patient requires a precise concentration of oxygen at 35% FiO2. Which
oxygen delivery device is most appropriate for this patient?
A. Venturi mask
B. Nasal cannula
C. Simple face mask
D. Non-rebreather mask
Answer: A
Rationale: The Venturi mask is the most accurate delivery device for providing a specific,
constant concentration of oxygen regardless of the patient’s breathing pattern.
4. What is the recommended suction pressure range for an adult patient when
performing oropharyngeal or tracheal suctioning?
A. 60–80 mmHg
B. 80–100 mmHg
C. 160–200 mmHg
D. 100–150 mmHg
Answer: D
Rationale: For adults, the safe and effective suction pressure range is typically 100 to 150
mmHg to prevent mucosal damage while effectively removing secretions.
5. During tracheostomy care, the nurse prepares to clean the inner cannula.
Which solution is most commonly used for cleaning a non-disposable inner
cannula?
A. Half-strength hydrogen peroxide and sterile saline
B. Sterile water only
C. Chlorhexidine gluconate
D. Povidone-iodine
Answer: A
, Rationale: A mixture of half-strength hydrogen peroxide is used to loosen secretions,
followed by a rinse with sterile normal saline.
6. A patient is instructed on the use of an incentive spirometer. Which
statement by the patient indicates a need for further teaching?
A. ‘I will hold my breath for 3 to 5 seconds at the end of my inhalation.’
B. ‘I will try to keep the indicator at the target level as long as possible.’
C. ‘I should use this device 5 to 10 times every hour while I am awake.’
D. ‘I should take a deep breath in through my nose before blowing into the mouthpiece.’
Answer: D
Rationale: Incentive spirometry involves a slow, deep inhalation through the mouthpiece
(not blowing into it) to expand the alveoli.
7. A nurse is preparing to perform nasotracheal suctioning. Which position is
most appropriate for a conscious patient with a functional gag reflex?
A. Supine
B. Semi-Fowler’s with the head hyperextended
C. Prone position
D. High-Fowler’s with the neck slightly flexed (sniffing position)
Answer: D
Rationale: High-Fowler’s or Semi-Fowler’s helps with lung expansion; for nasotracheal
insertion, the ‘sniffing’ position helps the catheter enter the trachea rather than the
esophagus.
8. Which safety precaution is essential when oxygen is in use in a home setting?
A. Using petroleum-based ointments for dry lips
B. Maintaining a distance of at least 10 feet from open flames or heat sources
C. Ensuring the oxygen tank is stored horizontally under the bed
D. Using wool blankets to keep the patient warm
Answer: B
