NURS 120 – Introduction to Medical Surgical
Nursing (WCU) | Quiz 6 | 2026/2027 Update |
Verified Questions & Answers
TOPIC 1 – Oxygenation & Respiratory Care (Q1-8)
Question 1
A client with COPD (PaCO₂ 58 mmHg chronic) is admitted with acute exacerbation. Current
SpO₂ 86% on 2 L/min NC. The nurse’s priority intervention is:
A. Increase oxygen to 6 L/min to achieve SpO₂ 96%
B. Maintain 2 L/min and titrate to SpO₂ 88-92%
C. Apply BiPAP immediately
D. Place client on 100% non-rebreather mask
Answer: B
Rationale: COPD clients are chronic CO₂ retainers and rely on hypoxic drive. High-flow O₂ can
suppress respiratory drive, causing CO₂ narcosis and respiratory arrest (ATS/ERS 2026 COPD
Guideline). Target SpO₂ 88-92% (not 94-98%) in known retainers.
Question 2
The nurse is assessing a client receiving oxygen via Venturi mask at 40%. Which statement
indicates correct client understanding?
A. “This mask delivers exactly 40% oxygen no matter how I breathe.”
B. “I can increase the oxygen by breathing faster.”
C. “This is the same as a simple face mask.”
D. “The oxygen percentage changes with my respiratory rate.”
Answer: A
Rationale: Venturi masks use the Bernoulli principle to entrain room air at a fixed ratio, delivering
precise FiO₂ (24-50%) regardless of respiratory pattern (Lewis 12th ed., 2026 update). Essential
for COPD to prevent hyperoxia.
Question 3
A client with pulmonary edema is on 6 L/min simple face mask. SpO₂ remains 89%. The most
appropriate next oxygen delivery device is:
A. Non-rebreather mask
, B. Nasal cannula at 10 L/min
C. Venturi mask at 50%
D. CPAP at 10 cm H₂O
Answer: A
Rationale: Pulmonary edema requires high FiO₂ (>60-90%). Non-rebreather can deliver up to
90-100% with tight seal (AACN 2026). CPAP (D) is therapeutic but requires physician order and
equipment.
Question 4
The nurse notes a high-pressure alarm on a client receiving oxygen via nasal cannula at 4 L/min
connected to a humidifier. The most likely cause is:
A. Water condensed in tubing
B. Kink in oxygen tubing
C. Client mouth-breathing
D. Humidifier bubble set too low
Answer: A
Rationale: Condensation (“rain-out”) in tubing increases resistance and triggers high-pressure
alarms. Drain water periodically (Lewis 2026).
Question 5
A client with a tracheostomy has thick secretions. The most effective nursing intervention to thin
secretions is:
A. Increase oxygen flow rate
B. Administer heated humidification
C. Suction every hour
D. Encourage coughing only
Answer: B
Rationale: Heated humidification (≥37°C) adds moisture to inspired gas, thinning secretions and
preventing mucus plugging (AACN Procedure Manual 2026). Oxygen alone dries airways.
Question 6
Which client is at highest risk for oxygen-induced hypoventilation?
A. 35-year-old with asthma exacerbation
B. 72-year-old with chronic CO₂ retention (baseline PaCO₂ 55)
C. 50-year-old postoperative with pain
D. 28-year-old with pneumonia
Nursing (WCU) | Quiz 6 | 2026/2027 Update |
Verified Questions & Answers
TOPIC 1 – Oxygenation & Respiratory Care (Q1-8)
Question 1
A client with COPD (PaCO₂ 58 mmHg chronic) is admitted with acute exacerbation. Current
SpO₂ 86% on 2 L/min NC. The nurse’s priority intervention is:
A. Increase oxygen to 6 L/min to achieve SpO₂ 96%
B. Maintain 2 L/min and titrate to SpO₂ 88-92%
C. Apply BiPAP immediately
D. Place client on 100% non-rebreather mask
Answer: B
Rationale: COPD clients are chronic CO₂ retainers and rely on hypoxic drive. High-flow O₂ can
suppress respiratory drive, causing CO₂ narcosis and respiratory arrest (ATS/ERS 2026 COPD
Guideline). Target SpO₂ 88-92% (not 94-98%) in known retainers.
Question 2
The nurse is assessing a client receiving oxygen via Venturi mask at 40%. Which statement
indicates correct client understanding?
A. “This mask delivers exactly 40% oxygen no matter how I breathe.”
B. “I can increase the oxygen by breathing faster.”
C. “This is the same as a simple face mask.”
D. “The oxygen percentage changes with my respiratory rate.”
Answer: A
Rationale: Venturi masks use the Bernoulli principle to entrain room air at a fixed ratio, delivering
precise FiO₂ (24-50%) regardless of respiratory pattern (Lewis 12th ed., 2026 update). Essential
for COPD to prevent hyperoxia.
Question 3
A client with pulmonary edema is on 6 L/min simple face mask. SpO₂ remains 89%. The most
appropriate next oxygen delivery device is:
A. Non-rebreather mask
, B. Nasal cannula at 10 L/min
C. Venturi mask at 50%
D. CPAP at 10 cm H₂O
Answer: A
Rationale: Pulmonary edema requires high FiO₂ (>60-90%). Non-rebreather can deliver up to
90-100% with tight seal (AACN 2026). CPAP (D) is therapeutic but requires physician order and
equipment.
Question 4
The nurse notes a high-pressure alarm on a client receiving oxygen via nasal cannula at 4 L/min
connected to a humidifier. The most likely cause is:
A. Water condensed in tubing
B. Kink in oxygen tubing
C. Client mouth-breathing
D. Humidifier bubble set too low
Answer: A
Rationale: Condensation (“rain-out”) in tubing increases resistance and triggers high-pressure
alarms. Drain water periodically (Lewis 2026).
Question 5
A client with a tracheostomy has thick secretions. The most effective nursing intervention to thin
secretions is:
A. Increase oxygen flow rate
B. Administer heated humidification
C. Suction every hour
D. Encourage coughing only
Answer: B
Rationale: Heated humidification (≥37°C) adds moisture to inspired gas, thinning secretions and
preventing mucus plugging (AACN Procedure Manual 2026). Oxygen alone dries airways.
Question 6
Which client is at highest risk for oxygen-induced hypoventilation?
A. 35-year-old with asthma exacerbation
B. 72-year-old with chronic CO₂ retention (baseline PaCO₂ 55)
C. 50-year-old postoperative with pain
D. 28-year-old with pneumonia
