ATI - Medical Surgical - Unit 3 Nursing
Care of Clients with Respiratory
Disorders Exam With Detailed
Questions And Correct
Answers||Latest Exam 2026-
2027||Already Graded A+
Respiratory Diagnostic and Therapeutic Procedures: Overview -ANSWER Respiratory
diagnostic procedures are used to evaluate a client's respiratory status by checking
indicators such as the oxygenation of the blood, lung functioning, and the integrity of the
airway.
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.
o Encourage the client to deep-breathe.
o Report significant findings to the provider.
o Remain with the client and provide emotional support to decrease anxiety.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
ANSWER • An ABG sample reports the status of oxygenation and acid-base balance of
the blood.
o An ABG measures:
• pH - The amount of free hydrogen ions in the arterial blood (H+).
• PaOz- The partial pressure of oxygen.
• PaCOz - The partial pressure of carbon dioxide.
• HC03 - The concentration of bicarbonate in arterial blood.
• SaOz - Percentage of oxygen bound to Hgb as compared to the total amount that can
be possibly carried.
o ABGs can be obtained by an arterial puncture or through an arterial line.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Indications -ANSWER o Potential diagnoses
• Blood pH levels may be affected by any number of disease processes (respiratory,
endOcrine, or neurologic).
• These assessments are helpful in monitoring the effectiveness of various treatments
(such as acidosis interventions), in guiding oxygen therapy, and in evaluating client
responses to weaning from mechanical ventilation.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) - pH
normal range -ANSWER 7.35 to 7.45
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
PaO2 normal range -ANSWER 80 to 100 mm Hg
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
PaCO2 normal range -ANSWER 35 to 45 mm Hg
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
HCO3 normal range -ANSWER 22 to 26 mEq/L
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
SaO2 normal range -ANSWER 95 to 100%* (Older adult values may be slightly lower)
, Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Abnormal pH Values -ANSWER Blood pH levels below 7.35 reflect acidosis, while levels
above 7.45 reflect alkalosis.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Complications - Hematoma, arterial occlusion -ANSWER • A hematoma occurs when
blood accumulates under the skin at the IV site.
• Nursing Actions
o Observe the client for changes in temperature, swelling, color, loss of pulse, or pain.
o Notify the provider immediately if symptoms persist.
o Apply pressure to the hematoma site.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Complications - Air embolism -ANSWER • Air enters the arterial system during catheter
insertion.
• Nursing Actions
o Monitor the client for a sudden onset of shortness of breath, decreases in SaO2
levels, chest pain, anxiety, and air hunger.
o Notify the provider immediately if symptoms occur, administer oxygen therapy, and
obtain ABGs. Continue to assess the client's respiratory status for any deterioration.
Respiratory Diagnostic and Therapeutic Procedures: Bronchoscopy -ANSWER
Bronchoscopy permits visualization of the larynx, trachea, and bronchi through either a
flexible fiberoptic or a rigid bronchoscope.
o Bronchoscopy can be performed as an outpatient procedure, in a surgical suite under
general anesthesia, or at the bedside under local anesthesia and moderate sedation.
o Bronchoscopy can also be performed on clients who are receiving mechanical
ventilation by inserting the scope through the client's endotracheal tube.
Respiratory Diagnostic and Therapeutic Procedures: Bronchoscopy - Indications -
ANSWER o Potential diagnoses
• Visualization of abnormalities such as tumors, inflammation, and strictures
• Biopsy of suspicious tissue (lung cancer)
o Clients undergoing a bronchoscopy with biopsy have additional risks for bleeding
and/or perforation.
• Aspiration of deep sputum or lung abscesses for culture and sensitivity and/or cytology
(pneumonia)
o Note - Bronchoscopy is also performed for therapeutic reasons, such as removal of
foreign bodies and secretions from the tracheobronchial tree, treating postoperative
atelectasis, and to destroy and excise lesions.
Respiratory Diagnostic and Therapeutic Procedures: Bronchoscopy - Interpretation of
Findings -ANSWER A bronchoscopy can identify airway problems, cancer and lung
disease.
Care of Clients with Respiratory
Disorders Exam With Detailed
Questions And Correct
Answers||Latest Exam 2026-
2027||Already Graded A+
Respiratory Diagnostic and Therapeutic Procedures: Overview -ANSWER Respiratory
diagnostic procedures are used to evaluate a client's respiratory status by checking
indicators such as the oxygenation of the blood, lung functioning, and the integrity of the
airway.
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.
o Encourage the client to deep-breathe.
o Report significant findings to the provider.
o Remain with the client and provide emotional support to decrease anxiety.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
ANSWER • An ABG sample reports the status of oxygenation and acid-base balance of
the blood.
o An ABG measures:
• pH - The amount of free hydrogen ions in the arterial blood (H+).
• PaOz- The partial pressure of oxygen.
• PaCOz - The partial pressure of carbon dioxide.
• HC03 - The concentration of bicarbonate in arterial blood.
• SaOz - Percentage of oxygen bound to Hgb as compared to the total amount that can
be possibly carried.
o ABGs can be obtained by an arterial puncture or through an arterial line.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Indications -ANSWER o Potential diagnoses
• Blood pH levels may be affected by any number of disease processes (respiratory,
endOcrine, or neurologic).
• These assessments are helpful in monitoring the effectiveness of various treatments
(such as acidosis interventions), in guiding oxygen therapy, and in evaluating client
responses to weaning from mechanical ventilation.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) - pH
normal range -ANSWER 7.35 to 7.45
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
PaO2 normal range -ANSWER 80 to 100 mm Hg
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
PaCO2 normal range -ANSWER 35 to 45 mm Hg
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
HCO3 normal range -ANSWER 22 to 26 mEq/L
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
SaO2 normal range -ANSWER 95 to 100%* (Older adult values may be slightly lower)
, Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Abnormal pH Values -ANSWER Blood pH levels below 7.35 reflect acidosis, while levels
above 7.45 reflect alkalosis.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Complications - Hematoma, arterial occlusion -ANSWER • A hematoma occurs when
blood accumulates under the skin at the IV site.
• Nursing Actions
o Observe the client for changes in temperature, swelling, color, loss of pulse, or pain.
o Notify the provider immediately if symptoms persist.
o Apply pressure to the hematoma site.
Respiratory Diagnostic and Therapeutic Procedures: ABGs (Arterial Blood Gases) -
Complications - Air embolism -ANSWER • Air enters the arterial system during catheter
insertion.
• Nursing Actions
o Monitor the client for a sudden onset of shortness of breath, decreases in SaO2
levels, chest pain, anxiety, and air hunger.
o Notify the provider immediately if symptoms occur, administer oxygen therapy, and
obtain ABGs. Continue to assess the client's respiratory status for any deterioration.
Respiratory Diagnostic and Therapeutic Procedures: Bronchoscopy -ANSWER
Bronchoscopy permits visualization of the larynx, trachea, and bronchi through either a
flexible fiberoptic or a rigid bronchoscope.
o Bronchoscopy can be performed as an outpatient procedure, in a surgical suite under
general anesthesia, or at the bedside under local anesthesia and moderate sedation.
o Bronchoscopy can also be performed on clients who are receiving mechanical
ventilation by inserting the scope through the client's endotracheal tube.
Respiratory Diagnostic and Therapeutic Procedures: Bronchoscopy - Indications -
ANSWER o Potential diagnoses
• Visualization of abnormalities such as tumors, inflammation, and strictures
• Biopsy of suspicious tissue (lung cancer)
o Clients undergoing a bronchoscopy with biopsy have additional risks for bleeding
and/or perforation.
• Aspiration of deep sputum or lung abscesses for culture and sensitivity and/or cytology
(pneumonia)
o Note - Bronchoscopy is also performed for therapeutic reasons, such as removal of
foreign bodies and secretions from the tracheobronchial tree, treating postoperative
atelectasis, and to destroy and excise lesions.
Respiratory Diagnostic and Therapeutic Procedures: Bronchoscopy - Interpretation of
Findings -ANSWER A bronchoscopy can identify airway problems, cancer and lung
disease.
