Nclexrn Quiz: Oxygen Therapy Indications And Device Selection

What this quiz covers

This quiz focuses on Oxygen Therapy Indications And Device Selection, giving you a quick way to practice the rules, question types, and explanations that matter most for Nclexrn.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

Question 1

1. Apply nasal cannula at 1–2 L/min and titrate to oxygen saturation 88%–92% (correct answer)
2. Apply a simple face mask at 10 L/min to maintain oxygen saturation above 98%
3. Apply a nonrebreather mask at 15 L/min and do not titrate until a provider evaluates the client
4. Start high-flow nasal cannula at 60 L/min because it provides the most oxygen

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a COPD client in a long-term care setting with worsening symptoms. Key assessment data include oxygen saturation of 82% on room air, respiratory rate of 32/min, PaCO2 of 62 mm Hg, PaO2 of 48 mm Hg, mild confusion, and increased cough, signifying acute decompensation. Applying a nasal cannula at 1–2 L/min titrated to 88%–92% is the best initial action as it provides low-flow oxygen suitable for COPD to correct hypoxemia without abolishing hypoxic drive. A simple face mask at 10 L/min delivers higher FiO2 risking CO2 retention; a nonrebreather at 15 L/min without titration is excessive; and high-flow nasal cannula at 60 L/min is not initial for stable COPD exacerbations. A key decision-making principle in oxygen therapy is to start with conservative flows in COPD and titrate based on saturation targets. Another principle is to avoid high-concentration oxygen to prevent respiratory acidosis worsening. A transferable strategy for selecting oxygen devices is to prioritize client comfort and disease-specific guidelines when initiating therapy in non-acute settings.

Question 2

1. Nonrebreather mask at 15 L/min (correct answer)
2. Nasal cannula at 1–2 L/min
3. Venturi mask set to deliver 24% oxygen
4. Simple face mask at 4 L/min

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a COPD client in severe distress. Key assessment data include oxygen saturation of 78% on room air, respiratory rate of 36/min, PaCO2 of 70 mm Hg, PaO2 of 44 mm Hg, and audible wheezing, indicating life-threatening hypoxemia. The nonrebreather mask at 15 L/min is most appropriate as an immediate, short-term intervention to rapidly correct severe hypoxemia while preparing for ventilation support. Nasal cannula at 1–2 L/min is too low for acute severity; Venturi at 24% provides insufficient FiO2; and simple face mask at 4 L/min delivers variable low oxygen inadequate for crisis. A key decision-making principle in oxygen therapy is to prioritize high-flow devices in emergent hypoxemia even in COPD, with close monitoring for hypercapnia. Another principle is to transition to advanced support like BiPAP promptly after stabilization. A transferable strategy for selecting oxygen devices is to escalate to high-concentration options temporarily in critical situations while planning for definitive respiratory interventions.

Question 3

1. Nonrebreather mask at 15 L/min
2. Nasal cannula at 6 L/min
3. Continuous positive airway pressure (CPAP) using the client's prescribed settings if available per facility protocol (correct answer)
4. Venturi mask set to deliver 24% oxygen

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a post-operative client with obstructive sleep apnea. Key assessment data include respiratory rate of 10/min, oxygen saturation of 89% on room air, rising end-tidal CO2, drowsiness, and shallow respirations, suggesting hypoventilation due to OSA. Continuous positive airway pressure (CPAP) using prescribed settings is most appropriate as it maintains airway patency and improves oxygenation in OSA clients post-operatively. A nonrebreather at 15 L/min provides high oxygen but does not address airway obstruction; nasal cannula at 6 L/min is inadequate for hypoventilation; and Venturi at 24% offers low FiO2 without positive pressure support. A key decision-making principle in oxygen therapy for OSA is to integrate positive airway pressure to prevent apneic events. Another principle is to adhere to home settings if available to ensure continuity of care. A transferable strategy for selecting oxygen devices is to consider underlying conditions like OSA that require combined oxygenation and ventilatory support post-operatively.

Question 4

1. Increase nasal cannula to 6 L/min and reassess in 1 hour
2. Apply CPAP per protocol and notify the provider/anesthesia team (correct answer)
3. Switch to a simple face mask at 3 L/min to avoid drying the nasal mucosa
4. Apply a Venturi mask set to deliver 50% oxygen to correct hypoxemia quickly

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a post-operative client with sleep apnea receiving opioids. Key assessment data include respiratory rate of 8/min, oxygen saturation of 86% on 2 L/min nasal cannula, snoring, difficult arousal, and breathing pauses, indicating opioid-induced respiratory depression in OSA. Applying CPAP per protocol and notifying the provider is the best initial action as it provides positive pressure to maintain airway and oxygenation. Increasing nasal cannula to 6 L/min does not address airway issues; simple face mask at 3 L/min lacks pressure support; and Venturi at 50% risks masking underlying hypoventilation. A key decision-making principle in oxygen therapy is to prioritize devices that support ventilation in clients with OSA and sedation. Another principle is to act promptly on signs of respiratory compromise post-operatively. A transferable strategy for selecting oxygen devices is to escalate to specialized equipment like CPAP when standard oxygen fails to correct desaturation in at-risk clients.

Question 5

1. Portable oxygen concentrator with nasal cannula at 2 L/min as prescribed (correct answer)
2. Nonrebreather mask at 15 L/min during ambulation
3. Venturi mask set to deliver 50% oxygen while walking
4. High-flow nasal cannula system at 40 L/min for home use

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a home care patient with chronic heart failure experiencing exertional hypoxemia. The key assessment data influencing the decision include the client's CHF diagnosis, exertional dyspnea, desaturation with activity (84%), adequate resting saturation (90%), mild pulmonary congestion on x-ray, and home care setting. A portable oxygen concentrator with nasal cannula at 2 L/min is the best choice because it provides appropriate supplemental oxygen for activity-related hypoxemia, is practical for home use, allows mobility, and matches the prescribed therapy. Nonrebreather mask (B) is impractical and excessive for home ambulation; Venturi mask at 50% (C) is unnecessarily high and cumbersome for home use; high-flow nasal cannula (D) requires specialized equipment not typically available for home care. The principle is to provide the minimum oxygen needed to maintain SpO2 ≥90% during activities of daily living while promoting independence. When selecting oxygen devices for home care, prioritize portable, user-friendly systems that meet the patient's activity needs while maintaining safety and quality of life.

Question 6

1. Oxygen saturation is 98% and work of breathing has improved (correct answer)
2. Heart rate remains above 110/min after bronchodilator therapy
3. Child reports being thirsty
4. Temperature is 37.1°C (98.8°F)

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection by identifying when adjustment is needed in a pediatric asthma client. Key assessment data post-treatment include improved wheezing, decreased retractions, respiratory rate of 26/min, and oxygen saturation of 98% on simple face mask at 8 L/min. The finding of 98% saturation and improved work of breathing indicates the need to adjust, as it suggests opportunity to wean oxygen to prevent hyperoxia. Heart rate above 110/min may relate to bronchodilators; thirst is unrelated; normal temperature does not require change. A key decision-making principle in oxygen therapy is to de-escalate support when clinical improvement occurs. Another principle is to monitor for over-oxygenation in resolving exacerbations. A transferable strategy for selecting oxygen devices is to reassess and titrate downward based on saturation and respiratory effort to optimize therapy in pediatrics.

Question 7

1. Respiratory rate is 9/min with signs of hypoventilation despite oxygen (correct answer)
2. Oxygen saturation improves from 88% to 90% after oxygen is applied
3. Client reports mild throat dryness
4. Blood pressure remains stable compared with baseline

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection by identifying adjustment needs in a post-operative client with sleep apnea. Key assessment data include respiratory rate of 9/min, oxygen saturation of 90% on 2 L/min nasal cannula, increasing somnolence, shallow breathing, and capnography showing hypoventilation. The respiratory rate of 9/min with hypoventilation despite oxygen indicates the need to adjust, as it suggests inadequate ventilation requiring positive pressure support. Oxygen saturation improvement to 90% is positive but insufficient alone; mild throat dryness is a minor side effect; and stable blood pressure does not necessitate change. A key decision-making principle in oxygen therapy is to assess for hypoventilation signs beyond saturation in sedated clients. Another principle is to escalate to CPAP when low-flow oxygen fails to correct respiratory depression. A transferable strategy for selecting oxygen devices is to integrate ventilatory monitoring like capnography to guide adjustments in high-risk post-operative scenarios.

Question 8

1. Apply a nonrebreather mask at 15 L/min and keep oxygen saturation at 100%
2. Decrease nasal cannula to 1 L/min to reduce anxiety
3. Switch to a Venturi mask at 24% oxygen to prevent carbon dioxide retention
4. Switch to a simple face mask at 6–10 L/min and titrate to keep oxygen saturation at least 94% (correct answer)

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a pediatric asthma client with persistent symptoms. Key assessment data include oxygen saturation of 90% on 2 L/min nasal cannula with continued retractions, indicating inadequate response. Switching to a simple face mask at 6–10 L/min titrated to at least 94% is most appropriate to provide higher FiO2 for better support in distress. Decreasing to 1 L/min could worsen; Venturi at 24% is low for asthma; nonrebreather at 15 L/min is for severe cases. A key decision-making principle in oxygen therapy is to escalate delivery when low-flow fails in pediatric exacerbations. Another principle is to target normoxemia while treating underlying bronchospasm. A transferable strategy for selecting oxygen devices is to progress to higher-flow masks based on ongoing assessment of saturation and effort in children.

Question 9

1. Keep oxygen at least 10 feet (3 meters) away from open flames and do not smoke while using oxygen (correct answer)
2. Use petroleum jelly inside the nostrils to prevent dryness
3. Store the oxygen cylinder lying flat on the bed for easy access
4. Turn the oxygen flow rate up when feeling short of breath without contacting the provider

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection with a focus on safety education for home use. Key assessment data include the client's use of nasal cannula at 2 L/min and inquiry about fire risk reduction in chronic heart failure. Keeping oxygen at least 10 feet from flames and no smoking is most appropriate to prevent combustion hazards associated with oxygen. Petroleum jelly can be flammable; storing cylinders flat risks damage; self-adjusting flow without provider input is unsafe. A key decision-making principle in oxygen therapy is to emphasize fire safety in home education. Another principle is to promote adherence to prescribed use to avoid complications. A transferable strategy for selecting oxygen devices is to integrate safety instructions with device choice to ensure safe long-term home therapy.

Question 10

1. Nasal cannula at 1–2 L/min
2. Nonrebreather mask at 15 L/min
3. Simple face mask at 6–10 L/min (correct answer)
4. Venturi mask set to deliver 24% oxygen

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a pediatric client with asthma in acute distress. Key assessment data include oxygen saturation of 89% on room air, respiratory rate of 40/min, wheezing, nasal flaring, intercostal retractions, and peak flow at 45% of personal best, indicating moderate to severe exacerbation. The simple face mask at 6–10 L/min is most appropriate as it delivers moderate FiO2 (35%–60%) and is tolerated by children in distress. Nasal cannula at 1–2 L/min provides low FiO2 insufficient for hypoxemia; nonrebreather at 15 L/min is for severe cases and may be intimidating; Venturi at 24% offers low precise oxygen but not ideal for acute high needs. A key decision-making principle in oxygen therapy for pediatric asthma is to aim for saturation above 94% while addressing bronchospasm. Another principle is to select child-friendly devices that balance oxygen delivery with comfort. A transferable strategy for selecting oxygen devices is to escalate FiO2 based on severity of respiratory distress and hypoxemia in acute pediatric conditions.

Question 11

1. Nasal cannula at 1 L/min
2. Nonrebreather mask at 10 L/min
3. Simple face mask at 6–10 L/min (correct answer)
4. Venturi mask set to deliver 24% oxygen

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a pediatric patient experiencing an acute asthma exacerbation. The key assessment data influencing the decision include the child's asthma history, smoke exposure trigger, significant respiratory distress (wheezing, nasal flaring, retractions), tachypnea (RR 38/min), hypoxemia (SpO2 89%), and severely reduced peak flow (45% of personal best). A simple face mask at 6-10 L/min is the best choice because it provides adequate oxygen delivery (35-60%) to correct hypoxemia while allowing concurrent nebulizer treatments, which are essential for asthma management. Nasal cannula at 1 L/min (A) is insufficient for moderate hypoxemia; nonrebreather mask (B) may interfere with nebulizer treatments and is unnecessarily high; Venturi mask at 24% (D) provides too low a concentration for this degree of hypoxemia. The principle in pediatric asthma is to provide sufficient oxygen to maintain SpO2 ≥94% while facilitating bronchodilator delivery. When selecting oxygen devices for pediatric asthma, choose systems that correct hypoxemia while allowing simultaneous administration of inhaled medications.

Question 12

1. Venturi mask set to deliver 24%–28% oxygen (correct answer)
2. Nasal cannula at 6 L/min
3. Nonrebreather mask at 15 L/min
4. Face tent at 10 L/min

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a client with COPD in acute exacerbation. Key assessment data include oxygen saturation of 86% on room air, respiratory rate of 28/min, PaCO2 of 55 mm Hg, and PaO2 of 50 mm Hg, reflecting hypoxemia with hypercapnia. The Venturi mask set to 24%–28% oxygen is the best choice as it delivers a precise, low FiO2, which is essential for COPD clients to prevent suppression of hypoxic drive. A nasal cannula at 6 L/min provides variable FiO2 and higher oxygen than needed; a nonrebreather mask at 15 L/min delivers near 100% FiO2, risking CO2 retention; and a face tent at 10 L/min offers imprecise oxygen delivery unsuitable for precise control. A key decision-making principle in oxygen therapy is to select devices that allow accurate FiO2 control in clients at risk for hypercapnic respiratory failure. Another principle is to reassess arterial blood gases and clinical status frequently to guide adjustments. A transferable strategy for selecting oxygen devices is to consider the need for precision in FiO2 delivery, especially in conditions where high oxygen concentrations may be detrimental.

Question 13

1. Venturi mask set to deliver 24%–28% oxygen
2. Nasal cannula at 6 L/min
3. Nonrebreather mask at 15 L/min (correct answer)
4. Simple face mask at 5 L/min

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a COPD patient in severe respiratory distress. The key assessment data influencing the decision include severe hypoxemia (PaO2 44 mm Hg, SpO2 78%), cyanosis, severe respiratory acidosis (pH 7.26, PaCO2 66 mm Hg), tachypnea (RR 34/min), and signs of impending respiratory failure. Despite the COPD diagnosis, a nonrebreather mask at 15 L/min is appropriate because this is a life-threatening emergency where correcting severe hypoxemia takes priority over concerns about CO2 retention. Venturi mask at 24-28% (A) would be insufficient for this degree of hypoxemia; nasal cannula at 6 L/min (B) is inadequate; simple face mask at 5 L/min (D) delivers unpredictable, insufficient oxygen. The principle in severe hypoxemia with impending respiratory failure is that oxygenation takes precedence, even in COPD patients, while preparing for likely intubation. When selecting oxygen devices for critically hypoxemic COPD patients, use high-concentration oxygen temporarily to prevent cardiac arrest while rapidly preparing for mechanical ventilation.

Question 14

1. Nonrebreather mask at 15 L/min
2. Nasal cannula at 2 L/min (correct answer)
3. Venturi mask set to deliver 50% oxygen
4. Simple face mask at 10 L/min

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a post-operative patient with obstructive sleep apnea. The key assessment data influencing the decision include the client's OSA diagnosis, recent surgery, mild hypoxemia (SpO2 92%), normal respiratory rate (18/min), clear lungs, controlled pain, and alert mental status. Nasal cannula at 2 L/min is the best choice because it provides gentle supplemental oxygen to correct mild hypoxemia without masking potential respiratory complications in this at-risk patient. Nonrebreather mask at 15 L/min (A) is excessive for mild hypoxemia; Venturi mask at 50% (C) is unnecessarily high; simple face mask at 10 L/min (D) delivers too much oxygen for this situation. The principle is to use minimal supplemental oxygen in stable post-operative OSA patients while maintaining close monitoring for respiratory events. When selecting oxygen devices for alert, stable post-operative patients with OSA, choose low-flow systems that correct hypoxemia without obscuring signs of hypoventilation or airway obstruction.

Question 15

1. Request an order for high-flow nasal cannula before making any changes
2. Apply a nonrebreather mask at 15 L/min to rapidly raise oxygen saturation above 98%
3. Switch to room air to avoid suppressing respiratory drive
4. Increase nasal cannula to 2 L/min and reassess oxygen saturation and work of breathing (correct answer)

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for titrating in a COPD client during exacerbation. Key assessment data include oxygen saturation of 86% on 1 L/min nasal cannula, respiratory rate of 28/min, heart rate of 106/min, and mild accessory muscle use, below the 88%–92% target. Increasing nasal cannula to 2 L/min and reassessing is the best action to gently titrate within low-flow guidelines for COPD. Nonrebreather at 15 L/min risks hyperoxia; switching to room air could worsen hypoxemia; high-flow cannula requires an order and is not initial. A key decision-making principle in oxygen therapy is to titrate conservatively in COPD to meet targets without excess. Another principle is to monitor respiratory effort alongside saturation. A transferable strategy for selecting oxygen devices is to adjust flow incrementally based on real-time saturation and symptoms in chronic lung disease.

Question 16

1. Tracheostomy collar at 10 L/min
2. Nonrebreather mask at 15 L/min secured tightly to prevent leaks
3. Venturi mask set to deliver 28% oxygen
4. Blow-by oxygen held near the child's face while calming the child and preparing additional therapy (correct answer)

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a distressed pediatric client intolerant of standard devices. Key assessment data include oxygen saturation of 86% on room air, respiratory rate of 44/min, crying, tachypnea, wheezing, and inability to tolerate a mask. Blow-by oxygen held near the face is most appropriate as it delivers oxygen non-invasively while calming the child and preparing for therapy. Nonrebreather at 15 L/min tightly secured could increase distress; Venturi at 28% requires a mask; tracheostomy collar is irrelevant without tracheostomy. A key decision-making principle in oxygen therapy for pediatrics is to prioritize tolerance and minimize agitation during delivery. Another principle is to use alternative methods like blow-by for young children refusing masks. A transferable strategy for selecting oxygen devices is to adapt delivery methods to the client's age, behavior, and comfort to ensure effective oxygenation without added stress.

Question 17

1. Apply nasal cannula at 2 L/min and reassess oxygen saturation (correct answer)
2. Apply nonrebreather mask at 15 L/min and keep the client supine
3. Apply Venturi mask at 50% oxygen to rapidly increase oxygen saturation
4. Start home continuous positive airway pressure (CPAP) immediately without further assessment

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a post-operative patient with obstructive sleep apnea experiencing hypoventilation. The key assessment data influencing the decision include the client's OSA diagnosis, post-anesthesia state, hypoventilation (RR 10/min with capnography confirmation), mild hypoxemia (SpO2 88%), recent pain medication administration, and drowsiness. Starting with nasal cannula at 2 L/min is the best initial action because it provides supplemental oxygen while allowing close monitoring for respiratory depression without masking hypoventilation. A nonrebreather mask at 15 L/min (B) could mask worsening hypoventilation and is excessive; Venturi mask at 50% (C) is too aggressive and could suppress respiratory drive; starting home CPAP (D) without assessment is inappropriate in the acute post-op setting. The principle is to use the lowest effective oxygen concentration while monitoring for opioid-induced respiratory depression in OSA patients. When selecting oxygen devices for post-operative OSA patients, start conservatively with low-flow oxygen while maintaining vigilant respiratory monitoring and considering the need for positive pressure support.

Question 18

1. Nonrebreather mask at 15 L/min
2. Nasal cannula at 1–2 L/min
3. Simple face mask at 10 L/min
4. Venturi mask set to deliver 24%–28% oxygen (correct answer)

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a client with COPD experiencing an acute exacerbation. The key assessment data influencing the decision include the client's COPD diagnosis, severe hypoxemia (PaO2 52 mm Hg, SpO2 84%), hypercapnia (PaCO2 58 mm Hg), respiratory acidosis (pH 7.31), and signs of respiratory distress (accessory muscle use, speaking in short phrases). The Venturi mask at 24%-28% oxygen is the best choice because it provides controlled, precise oxygen delivery that corrects hypoxemia without suppressing the hypoxic drive in COPD patients, which could worsen CO2 retention. A nonrebreather mask (A) delivers too high a concentration that could suppress respiratory drive; nasal cannula at 1-2 L/min (B) is insufficient for severe hypoxemia; and a simple face mask at 10 L/min (C) delivers unpredictable high concentrations. The principle for COPD exacerbations is to use controlled oxygen therapy targeting SpO2 88-92% to avoid CO2 narcosis. When selecting oxygen devices for COPD patients, prioritize precise, controlled delivery systems like Venturi masks over high-flow, uncontrolled devices.

Question 19

1. Oxygen saturation is 86% despite prescribed oxygen flow rate (correct answer)
2. Client reports the oxygen tubing is uncomfortable behind the ears
3. Heart rate is 102/min
4. Client has mild ankle swelling

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection by identifying adjustment needs in a home care client with heart failure. Key assessment data include oxygen saturation of 86% on 2 L/min nasal cannula, respiratory rate of 26/min, increasing fatigue, dyspnea, and basal crackles, suggesting worsening congestion. The low saturation despite prescribed flow indicates the need to adjust, as it reflects inadequate oxygenation requiring escalation or evaluation. Tubing discomfort is minor; heart rate of 102/min may relate to decompensation; mild ankle swelling is expected in heart failure. A key decision-making principle in oxygen therapy is to reassess home regimens when symptoms worsen. Another principle is to titrate based on saturation and clinical signs. A transferable strategy for selecting oxygen devices is to monitor home oxygen efficacy through symptoms and oximetry to guide timely changes.

Question 20

1. Portable oxygen concentrator with nasal cannula as prescribed (correct answer)
2. Nonrebreather mask at 15 L/min for ambulation
3. High-flow nasal cannula system for home use
4. Venturi mask set to deliver 50% oxygen during activity

Explanation: This question tests clinical judgment regarding oxygen therapy and device selection for a home care client with chronic heart failure. Key assessment data include oxygen saturation of 90% on room air dropping with activity, heart rate of 96/min, respiratory rate of 22/min, and ejection fraction of 30%, without lung disease. A portable oxygen concentrator with nasal cannula as prescribed is most appropriate for intermittent home use during activity to maintain mobility and oxygenation. Nonrebreather at 15 L/min is impractical for ambulation; high-flow nasal cannula is excessive for home; Venturi at 50% provides unnecessary precision. A key decision-making principle in oxygen therapy for heart failure is to target saturation above 92% during exertion. Another principle is to select portable, user-friendly devices for home settings. A transferable strategy for selecting oxygen devices is to consider lifestyle needs like mobility when prescribing home oxygen for chronic conditions.