Penn State University
2 MAXE 152 SRUN
PSU
Ross and Carol Nese College of Nursing · BSN Program
NURSING
MAKING LIFE BETTER
EST. 1855
NURS 251 — Exam 2: Oxygenation, Medications, Elimination
& Patient Education
R E S P I R ATO R Y C A R E · P H A R M A CO LO G Y · I V T H E R A P Y · U R I N A R Y/ B O W E L E L I M I N AT I O N · H E A LT H
TEACHING
INSTITUTION Penn State University COURSE CODE NURS 251
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE NURS 251 — Exam 2: Oxygenation, TOTAL QUESTIONS 40 Questions
Pharmacology, Elimination & Patient
Education
COURSE TITLE Foundations of Professional Nursing · FORMAT Multiple Choice — Select the Single Best
Clinical Skills & Patient Education Answer
EXAMINATION INSTRUCTIONS
▸ Questions cover oxygenation, medication administration, IV therapy, urinary/bowel elimination, patient education, and the
nursing process.
▸ Select the single best answer based on nursing fundamentals and NCLEX prioritization frameworks.
▸ Pay careful attention to medication safety, oxygen therapy for COPD patients, and the six rights of medication administration.
▸ Correct answers and detailed rationales appear below each question for comprehensive exam preparation.
OXYGENATION · PHARMACOLOGY · IV THERAPY · ELIMINATION · PATIENT Questions
EDUCATION · NURSING PROCESS 1 – 40
1. What is the priority problem for a 72-year-old patient with pneumonia, RR 24, SpO₂ 90%, and dyspnea?
A. Chronic hypoxia
B. Mild hypoxia
C. Acute respiratory distress
D. Respiratory acidosis
CORRECT ANSWER B. Mild hypoxia
RATIONALE SpO₂ 90% indicates mild hypoxia (normal ≥94%). The patient has pneumonia with increased RR (24—
compensating) and dyspnea. Mild hypoxia is treated with supplemental oxygen via nasal cannula or simple
face mask. Acute respiratory distress would present with SpO₂ <85%, accessory muscle use, and severe
dyspnea. COPD-related chronic hypoxia typically presents with lower baseline SpO₂ (88–92%).
, 2. What is the first nursing action for a patient with mild hypoxia (SpO₂ 90%)?
A. Call a code blue
B. Administer supplemental oxygen
C. Place the patient in Trendelenburg position
D. Document the finding and continue monitoring
CORRECT ANSWER B. Administer supplemental oxygen
RATIONALE For mild hypoxia (SpO₂ 90%), the priority intervention is to improve oxygenation by administering
supplemental oxygen per protocol or standing orders. Elevate the head of bed (high Fowler's) first, then apply
oxygen. Documentation alone is insufficient—intervention is required. A code blue is for respiratory or cardiac
arrest, not hypoxia with a pulse.
3. Should you increase oxygen for a COPD patient whose SpO₂ is now 90%?
A. Yes, increase to maintain SpO₂ >95%
B. No, avoid increasing oxygen to prevent CO₂ retention
C. Yes, apply a non-rebreather mask
D. Discontinue oxygen therapy immediately
CORRECT ANSWER B. No, avoid increasing oxygen to prevent CO₂ retention
RATIONALE COPD patients have a hypoxic drive to breathe—their respiratory center adapts to chronic hypercapnia and
relies on low oxygen levels to stimulate breathing. Over-oxygenating (SpO₂ >92%) can suppress the
respiratory drive, leading to CO₂ retention, respiratory acidosis, and potential respiratory failure. Target SpO₂
for COPD patients is typically 88–92%. Use the lowest oxygen flow to maintain this range.
4. What finding indicates that oxygen therapy is effective?
A. SpO₂ 88%
B. SpO₂ 95%
C. Respiratory rate 28
D. Patient reports continued dyspnea
CORRECT ANSWER B. SpO₂ 95%
RATIONALE Normal SpO₂ is 94–100%. A value of 95% indicates oxygen therapy is effective—the patient is adequately
oxygenated. SpO₂ 88% indicates continued hypoxia requiring intervention. RR 28 is tachypnea (abnormal).
Continued dyspnea despite oxygen suggests inadequate therapy or worsening condition. Always trend SpO₂
values to evaluate oxygen therapy effectiveness.
5. What are the six rights of medication administration?
A. Right patient, medication, dose, route, time, documentation
B. Right patient, medication, dose, route, time, diagnosis
C. Right patient, medication, dose, route, time, provider
D. Right patient, medication, dose, route, time, pharmacy
CORRECT ANSWER A. Right patient, medication, dose, route, time, documentation
RATIONALE The six rights are the foundation of safe medication administration: (1) Right patient—verify with two
identifiers; (2) Right medication—check label against MAR three times; (3) Right dose—calculate and verify; (4)
Right route—oral, IV, IM, etc.; (5) Right time—within 30 minutes of scheduled time; (6) Right documentation—
record immediately after administration. Some sources add right reason, right response, and right to refuse.
2 MAXE 152 SRUN
PSU
Ross and Carol Nese College of Nursing · BSN Program
NURSING
MAKING LIFE BETTER
EST. 1855
NURS 251 — Exam 2: Oxygenation, Medications, Elimination
& Patient Education
R E S P I R ATO R Y C A R E · P H A R M A CO LO G Y · I V T H E R A P Y · U R I N A R Y/ B O W E L E L I M I N AT I O N · H E A LT H
TEACHING
INSTITUTION Penn State University COURSE CODE NURS 251
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE NURS 251 — Exam 2: Oxygenation, TOTAL QUESTIONS 40 Questions
Pharmacology, Elimination & Patient
Education
COURSE TITLE Foundations of Professional Nursing · FORMAT Multiple Choice — Select the Single Best
Clinical Skills & Patient Education Answer
EXAMINATION INSTRUCTIONS
▸ Questions cover oxygenation, medication administration, IV therapy, urinary/bowel elimination, patient education, and the
nursing process.
▸ Select the single best answer based on nursing fundamentals and NCLEX prioritization frameworks.
▸ Pay careful attention to medication safety, oxygen therapy for COPD patients, and the six rights of medication administration.
▸ Correct answers and detailed rationales appear below each question for comprehensive exam preparation.
OXYGENATION · PHARMACOLOGY · IV THERAPY · ELIMINATION · PATIENT Questions
EDUCATION · NURSING PROCESS 1 – 40
1. What is the priority problem for a 72-year-old patient with pneumonia, RR 24, SpO₂ 90%, and dyspnea?
A. Chronic hypoxia
B. Mild hypoxia
C. Acute respiratory distress
D. Respiratory acidosis
CORRECT ANSWER B. Mild hypoxia
RATIONALE SpO₂ 90% indicates mild hypoxia (normal ≥94%). The patient has pneumonia with increased RR (24—
compensating) and dyspnea. Mild hypoxia is treated with supplemental oxygen via nasal cannula or simple
face mask. Acute respiratory distress would present with SpO₂ <85%, accessory muscle use, and severe
dyspnea. COPD-related chronic hypoxia typically presents with lower baseline SpO₂ (88–92%).
, 2. What is the first nursing action for a patient with mild hypoxia (SpO₂ 90%)?
A. Call a code blue
B. Administer supplemental oxygen
C. Place the patient in Trendelenburg position
D. Document the finding and continue monitoring
CORRECT ANSWER B. Administer supplemental oxygen
RATIONALE For mild hypoxia (SpO₂ 90%), the priority intervention is to improve oxygenation by administering
supplemental oxygen per protocol or standing orders. Elevate the head of bed (high Fowler's) first, then apply
oxygen. Documentation alone is insufficient—intervention is required. A code blue is for respiratory or cardiac
arrest, not hypoxia with a pulse.
3. Should you increase oxygen for a COPD patient whose SpO₂ is now 90%?
A. Yes, increase to maintain SpO₂ >95%
B. No, avoid increasing oxygen to prevent CO₂ retention
C. Yes, apply a non-rebreather mask
D. Discontinue oxygen therapy immediately
CORRECT ANSWER B. No, avoid increasing oxygen to prevent CO₂ retention
RATIONALE COPD patients have a hypoxic drive to breathe—their respiratory center adapts to chronic hypercapnia and
relies on low oxygen levels to stimulate breathing. Over-oxygenating (SpO₂ >92%) can suppress the
respiratory drive, leading to CO₂ retention, respiratory acidosis, and potential respiratory failure. Target SpO₂
for COPD patients is typically 88–92%. Use the lowest oxygen flow to maintain this range.
4. What finding indicates that oxygen therapy is effective?
A. SpO₂ 88%
B. SpO₂ 95%
C. Respiratory rate 28
D. Patient reports continued dyspnea
CORRECT ANSWER B. SpO₂ 95%
RATIONALE Normal SpO₂ is 94–100%. A value of 95% indicates oxygen therapy is effective—the patient is adequately
oxygenated. SpO₂ 88% indicates continued hypoxia requiring intervention. RR 28 is tachypnea (abnormal).
Continued dyspnea despite oxygen suggests inadequate therapy or worsening condition. Always trend SpO₂
values to evaluate oxygen therapy effectiveness.
5. What are the six rights of medication administration?
A. Right patient, medication, dose, route, time, documentation
B. Right patient, medication, dose, route, time, diagnosis
C. Right patient, medication, dose, route, time, provider
D. Right patient, medication, dose, route, time, pharmacy
CORRECT ANSWER A. Right patient, medication, dose, route, time, documentation
RATIONALE The six rights are the foundation of safe medication administration: (1) Right patient—verify with two
identifiers; (2) Right medication—check label against MAR three times; (3) Right dose—calculate and verify; (4)
Right route—oral, IV, IM, etc.; (5) Right time—within 30 minutes of scheduled time; (6) Right documentation—
record immediately after administration. Some sources add right reason, right response, and right to refuse.
