Chapter 37. Oxygenation
MULTIPLE CHOICE
1. A client in labor after 32 weeks’ gestation is eager to deliver. Which client statement indicates
that teaching provided about fetal development was effective?
1) “The baby’s lungs are well developed now, but he will be at increased risk for
SIDS if I deliver early.”
2) “We should try to stop this labor now because the baby will be born with sleep
apnea if I deliver this early.”
3) “If I deliver this early my baby is at risk for respiratory distress syndrome, a
condition that can be life threatening.”
4) “Thanks for reassuring me; I was pretty sure there isn’t much risk to the baby this
far along in my pregnancy.”
ANS: 3
Chapter number and title: 37, Oxygenation
Chapter learning objective: Describe the structure and function of the respiratory system.
Chapter page reference: 1365
Heading: Developmental Stage
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive level: Analysis [Analyzing]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 A premature infant’s lungs are not well developed.
2 A premature infant is not at risk for developing sleep apnea.
3 Premature infants (younger than 33 weeks’ gestation) are born before the
alveolar surfactant system is fully developed. Therefore, they are at high risk for
respiratory distress syndrome (RDS). RDS is characterized by widespread
atelectasis (collapse of alveoli), usually related to a deficiency of surfactant that
keeps air sacs open.
4 There is a risk that the infant’s lungs will not be mature.
PTS: 1 CON: Oxygenation
2. The nurse is caring for a patient who is experiencing dyspnea. Which position would be most
effective if incorporated into the patient’s care?
1) Supine
2) Head of bed elevated 80°
3) Head of bed elevated 30°
4) Lying on left side
ANS: 2
Chapter number and title: 37, Oxygenation
Chapter learning objective: Plan outcomes and interventions for maintaining and improving
oxygenation.
Chapter page reference: 1375
, Heading: Assessing Breathing Patterns
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive level: Application [Applying]
Concept: Oxygenation
Difficulty: Easy
Feedback
1 Most patients with dyspnea cannot tolerate lying down.
2 Position affects ventilation. An upright or elevated position pulls abdominal
organs down, thus allowing maximum diaphragm excursion and lung expansion.
3 The head of the bed should be higher to facilitate breathing.
4 Lying on the left side will not help with this patient’s dyspnea.
PTS: 1 CON: Oxygenation
3. While a patient is receiving hygiene care, the chest tube becomes disconnected from the
water-seal chest drainage system (CDU). Which action should the nurse take immediately?
1) Clamp the chest tube close to the insertion site.
2) Set up a new drainage system and connect it to the chest tube.
3) Have the patient take and hold a deep breath while the nurse reconnects the tube to
the CDU.
4) Place the disconnected end nearest the patient into a bottle of sterile water.
ANS: 4
Chapter number and title: 37, Oxygenation
Chapter learning objective: Safely and correctly perform common nursing procedures related
to oxygenation, breathing, and gas exchange.
Chapter page reference: 1394
Heading: Clinical Insight 37-5 Managing Chest Tubes
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 Do not clamp the chest tube because this can rapidly lead to a tension
pneumothorax.
2 A new drainage system should be set up to decrease the risk of infection, but the
immediate action is to place the disconnected end into a bottle of sterile water.
3 The new drainage system needs to be in place before asking the patient to take
and hold a deep breath.
4 Recollapse of the lung can occur because of loss of negative pressure within the
system. This is commonly caused by air leaks, disconnections, or cracks in the
bottles or chambers. If any of these occur, the nurse should immediately place
the disconnected end nearest the patient into a bottle of sterile water or saline to
a depth of 2 cm to serve as an emergency water seal until a new system can be
connected.
PTS: 1 CON: Oxygenation
, 4. The nurse administers an antitussive/expectorant cough preparation to a patient with
bronchitis. Which response indicates to the nurse that the medication is effective?
1) The amount of sputum decreases with each dose administered.
2) Cough is completely suppressed, and the patient is able to sleep through the night.
3) Dry, unproductive cough is reduced, but voluntary coughing is more productive.
4) Involuntary coughing produces large amounts of thick yellow sputum.
ANS: 3
Chapter number and title: 37, Oxygenation
Chapter learning objective: Recognize medications used to enhance pulmonary function.
Chapter page reference: 1368
Heading: Table 37-1 Respiratory Medications That Promote Ventilation and Oxygenation
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive level: Analysis [Analyzing]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 An antitussive does not reduce the amount of sputum produced.
2 An antitussive is not a cough suppressant.
3 Antitussives are cough suppressants that reduce the frequency of an involuntary,
dry, nonproductive cough. Antitussives are useful for adults when coughing is
unproductive and frequent, leading to throat irritation or interrupted sleep.
4 Expectorants help make coughing more productive.
PTS: 1 CON: Oxygenation
5. A client with pulmonary hypertension and right-sided heart failure has conversational dyspnea
and shortness of breath. What is the first action the nurse should take?
1) Review and implement the primary care provider’s prescriptions for treatments.
2) Perform a quick physical examination of breathing, circulation, and oxygenation.
3) Gather a thorough medical history, including current symptoms, from the family.
4) Administer oxygen to the patient through a nasal cannula.
ANS: 2
Chapter number and title: 37, Oxygenation
Chapter learning objective: Assess oxygenation, breathing, and gas exchange.
Chapter page reference: 1375
Heading: Assessing Breathing Patterns
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive level: Application [Applying]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 Following a quick assessment, the nurse should then review and implement
physician’s orders.
MULTIPLE CHOICE
1. A client in labor after 32 weeks’ gestation is eager to deliver. Which client statement indicates
that teaching provided about fetal development was effective?
1) “The baby’s lungs are well developed now, but he will be at increased risk for
SIDS if I deliver early.”
2) “We should try to stop this labor now because the baby will be born with sleep
apnea if I deliver this early.”
3) “If I deliver this early my baby is at risk for respiratory distress syndrome, a
condition that can be life threatening.”
4) “Thanks for reassuring me; I was pretty sure there isn’t much risk to the baby this
far along in my pregnancy.”
ANS: 3
Chapter number and title: 37, Oxygenation
Chapter learning objective: Describe the structure and function of the respiratory system.
Chapter page reference: 1365
Heading: Developmental Stage
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive level: Analysis [Analyzing]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 A premature infant’s lungs are not well developed.
2 A premature infant is not at risk for developing sleep apnea.
3 Premature infants (younger than 33 weeks’ gestation) are born before the
alveolar surfactant system is fully developed. Therefore, they are at high risk for
respiratory distress syndrome (RDS). RDS is characterized by widespread
atelectasis (collapse of alveoli), usually related to a deficiency of surfactant that
keeps air sacs open.
4 There is a risk that the infant’s lungs will not be mature.
PTS: 1 CON: Oxygenation
2. The nurse is caring for a patient who is experiencing dyspnea. Which position would be most
effective if incorporated into the patient’s care?
1) Supine
2) Head of bed elevated 80°
3) Head of bed elevated 30°
4) Lying on left side
ANS: 2
Chapter number and title: 37, Oxygenation
Chapter learning objective: Plan outcomes and interventions for maintaining and improving
oxygenation.
Chapter page reference: 1375
, Heading: Assessing Breathing Patterns
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive level: Application [Applying]
Concept: Oxygenation
Difficulty: Easy
Feedback
1 Most patients with dyspnea cannot tolerate lying down.
2 Position affects ventilation. An upright or elevated position pulls abdominal
organs down, thus allowing maximum diaphragm excursion and lung expansion.
3 The head of the bed should be higher to facilitate breathing.
4 Lying on the left side will not help with this patient’s dyspnea.
PTS: 1 CON: Oxygenation
3. While a patient is receiving hygiene care, the chest tube becomes disconnected from the
water-seal chest drainage system (CDU). Which action should the nurse take immediately?
1) Clamp the chest tube close to the insertion site.
2) Set up a new drainage system and connect it to the chest tube.
3) Have the patient take and hold a deep breath while the nurse reconnects the tube to
the CDU.
4) Place the disconnected end nearest the patient into a bottle of sterile water.
ANS: 4
Chapter number and title: 37, Oxygenation
Chapter learning objective: Safely and correctly perform common nursing procedures related
to oxygenation, breathing, and gas exchange.
Chapter page reference: 1394
Heading: Clinical Insight 37-5 Managing Chest Tubes
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive level: Application [Applying]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 Do not clamp the chest tube because this can rapidly lead to a tension
pneumothorax.
2 A new drainage system should be set up to decrease the risk of infection, but the
immediate action is to place the disconnected end into a bottle of sterile water.
3 The new drainage system needs to be in place before asking the patient to take
and hold a deep breath.
4 Recollapse of the lung can occur because of loss of negative pressure within the
system. This is commonly caused by air leaks, disconnections, or cracks in the
bottles or chambers. If any of these occur, the nurse should immediately place
the disconnected end nearest the patient into a bottle of sterile water or saline to
a depth of 2 cm to serve as an emergency water seal until a new system can be
connected.
PTS: 1 CON: Oxygenation
, 4. The nurse administers an antitussive/expectorant cough preparation to a patient with
bronchitis. Which response indicates to the nurse that the medication is effective?
1) The amount of sputum decreases with each dose administered.
2) Cough is completely suppressed, and the patient is able to sleep through the night.
3) Dry, unproductive cough is reduced, but voluntary coughing is more productive.
4) Involuntary coughing produces large amounts of thick yellow sputum.
ANS: 3
Chapter number and title: 37, Oxygenation
Chapter learning objective: Recognize medications used to enhance pulmonary function.
Chapter page reference: 1368
Heading: Table 37-1 Respiratory Medications That Promote Ventilation and Oxygenation
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive level: Analysis [Analyzing]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 An antitussive does not reduce the amount of sputum produced.
2 An antitussive is not a cough suppressant.
3 Antitussives are cough suppressants that reduce the frequency of an involuntary,
dry, nonproductive cough. Antitussives are useful for adults when coughing is
unproductive and frequent, leading to throat irritation or interrupted sleep.
4 Expectorants help make coughing more productive.
PTS: 1 CON: Oxygenation
5. A client with pulmonary hypertension and right-sided heart failure has conversational dyspnea
and shortness of breath. What is the first action the nurse should take?
1) Review and implement the primary care provider’s prescriptions for treatments.
2) Perform a quick physical examination of breathing, circulation, and oxygenation.
3) Gather a thorough medical history, including current symptoms, from the family.
4) Administer oxygen to the patient through a nasal cannula.
ANS: 2
Chapter number and title: 37, Oxygenation
Chapter learning objective: Assess oxygenation, breathing, and gas exchange.
Chapter page reference: 1375
Heading: Assessing Breathing Patterns
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive level: Application [Applying]
Concept: Oxygenation
Difficulty: Moderate
Feedback
1 Following a quick assessment, the nurse should then review and implement
physician’s orders.
