A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best?

“The client needs immediate intubation and mechanical ventilation."

"Maybe the client has respiratory distress syndrome."

"The client is breathing too slowly and it interferes with oxygenation."

"The blood clot interferes with perfusion in the lungs."

Answer and Explanation

The Correct Answer is D

A. “The client needs immediate intubation and mechanical ventilation.” Intubation may be required in severe respiratory failure, but not all clients with pulmonary embolism need mechanical ventilation. Suggesting intubation without assessment of the client’s respiratory effort or ABGs is premature.

B. "Maybe the client has respiratory distress syndrome." ARDS is can impair oxygenation, but it is not the most likely explanation for persistent low oxygen saturation in PE. PE more commonly causes ventilation-perfusion mismatch due to blocked blood flow.

C. "The client is breathing too slowly and it interferes with oxygenation." Slow breathing could impair ventilation, but in PE, oxygenation is impaired because blood flow to parts of the lung is blocked, not necessarily due to a respiratory rate issue.

D. "The blood clot interferes with perfusion in the lungs." Pulmonary embolism obstructs blood flow in the pulmonary arteries, resulting in areas of the lung being ventilated but not perfused. This causes a ventilation-perfusion mismatch and leads to reduced oxygenation despite supplemental oxygen.

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Correct Answer is B

Explanation

A. The client's sputum is white colored:White sputum may be normal for a client with COPD and often indicates chronic inflammation without infection. It does not signal an acute or emergent issue that requires immediate intervention.

B. The client's arterial blood gas CO₂ level is 76 mm Hg:A CO₂ level this high indicates significant hypercapnia, which can lead to respiratory acidosis and altered mental status. This finding reflects serious respiratory compromise and requires prompt intervention to prevent respiratory failure.

C. The client's pulse oximeter is 90%:While 90% is on the lower end of acceptable for clients with end-stage COPD, it is often tolerated due to their adapted baseline. It does not represent an immediate threat unless accompanied by other signs of deterioration.

D. The client has mild SOB when walking to the bathroom:Mild shortness of breath with exertion is expected in clients with advanced COPD. It reflects baseline activity tolerance and does not require urgent action unless symptoms worsen.

A. A venturi mask B. A nasal cannula C. High-flow oxygen via nasal cannula D. Adding humidification to the oxygen setup.

Correct Answer is D

Explanation

A. A venturi mask: The Venturi mask is often used in patients with COPD. However, it may cause dryness and irritation in the nasal passages and sinuses due to non-humidified, high-flow delivery, which could aggravate existing sinus conditions.

B. A nasal cannula: While nasal cannulas are less drying than masks and suitable for low-flow oxygen delivery, they can still cause mucosal dryness when used without humidification, particularly in patients with sinus issues.

C. High-flow oxygen via nasal cannula: High-flow nasal cannula therapy provides warmed, humidified oxygen, but at higher rates than needed for most patients starting oxygen therapy. It is more appropriate for acute respiratory failure than for routine use in sinus conditions.

D. Adding humidification to the oxygen setup: Humidifying oxygen helps prevent nasal and sinus mucosal dryness and irritation, making it beneficial for patients with sinus disorders. Moisture improves comfort and protects the integrity of the upper airway mucosa during oxygen therapy.

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A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is D

Explanation

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