1. Oxygenation & Ostomy Review

2. #1 The highest need on Maslow’s Hiearchy is: a. Self esteem b. Oxygen c. Water d. Food

3. Answer #1 B. oxygen

4. #2 The exchange of oxygen and carbon dioxide is known as: a. Inspiration b. Expiration c. Respiration d. ventilation

5. Answer #2 C. respiration

6. Question # 3 Insufficient oxygen within the arterial blood is known as: a. Cyanosis b. Hypoxia c. Hypoxemia d. Clubbing

7. Answer #3 C. Hypoxemia Hypoxemia – When oxygen levels drop below normal range, it is referred to as hypoxemia. In the event of hypoxemia the blood cannot take adequate amounts of oxygen in the tissues, causing hypoxia.

8. Question #4 Signs and symptoms of inadequate oxygenation include: (choose all that apply) a. Cyanosis of skin b. Restlessness c. Rapid heart rate d. Nasal flaring

9. Answer #4 a. Cyanosis of skin b. Restlessness c. Rapid heart rate d. Nasal flaring

10. Question #5 The lab test that uses arterial blood to assess oxygenation, ventilation and acid- base balance is: a. BUN b. Oxygenation saturation c. Chemistry d. Arterial blood gases

11. Answer #5 d. Arterial blood gases

12. Question # 6 The noninvasive technique for periodically or continuously monitoring the O2 saturation of blood is: a. Arterial blood gases b. Nebulizer c. Pulse oximetry d. Incentive spirometry

13. Answer #6 c. Pulse oximetry

14. Question #7 Normal O2 saturation should be: a. 80-90% b. 95-100% c. 70-80% d. 90-95%

15. Answer #7 b. 95-100%

16. #8 The best position for a patient who has poor oxygenation is: a. Semi-fowler’s b. High-fowler’s c. Flat in bed d. Side lying position

17. Answer #8 b. High-fowler’s

18. #9 The position where the patient is seated with arms supported on pillows or arm rests of the chair and leans forward over the bedside table for maximum vertical and lateral chest expansion is known as: a. High-fowler’s position b. Orthopedic position c. Orthopneic position d. Vertical position

19. Answer #9 c. Orthopneic position

20. Question #10 The calibrated deep breathing device that encourages patients to reach a goal- directed volume of inspired air is: a. Pulse oximeter b. Incentive spirometry c. Oxygen d. Nebulizer

21. Answer #10 b. Incentive spirometry

22. Question #11 The form of controlled ventilation in which the client consciously prolongs the expiration phase of breathing is known as: a. Deep breathing b. Shallow breathing c. Pursed-Lip breathing d. Diaphramatic breathing

23. Answer #11 C. Pursed-Lip Breathing

24. Question #12 An intervention for administering more oxygen than is present in the atmosphere to prevent or relieve hypoxia is: a. Nebulizer treatment b. Oxygen analyzer c. BiPap d. Oxygen therapy

25. Answer #12 d. Oxygen therapy

26. Question #13 True or False: A physician’s order is needed to administer oxygen.

27. Answer #13 True, a physician’s order is necessary to administer O2 to a patient.

28. Question #14 Oxygen sources include(Choose all that apply): a. Oxygen concentrator b. Portable tank c. Liquid oxygen unit d. Wall outlet

29. Question Answer #14 Oxygen sources include: a. Oxygen concentrator b. Portable tank c. Liquid oxygen unit d. Wall outlet

30. Question #15 Oxygen is measured in: a. Units b. Liters c. Quarts d. Pints

31. Answer #15 Oxygen is measured in liters.

32. Question #16 A hollow tube with ½ inch prongs placed in the nostrils to administer a low concentration of O2 is: a. O2 mask b. Partial rebreather mask c. Nasal cannula d. Ventilator

33. Answer #16 c. Nasal cannula

34. #17 Question Disadvantages to administering O2 via nasal cannula are: (Choose all that apply): a. Increased mucosal secretions b. Irritation of cheeks and ears c. Dries nasal mucosa d. Metallic taste in mouth

35. Answer #17 b. Irritation of cheeks and ears c. Dries nasal mucosa

36. #18 Question The device that measures the concentration of O2 being received by the patient: a. O2 nebulizer b. O2 concentrator c. O2 analyzer d. O2 tank

37. Answer #18 c. O2 analyzer

38. Question #19 The device used for a patient to inhale a mixture of atmospheric air and oxygen from its source, and o2 contained within a reservoir bag is: a. Nasal cannula b. Simple mask c. Oxygen tent d. Partial rebreather mask

39. Answer #19 d. Partial rebreather mask

40. Question #20 One of the most serious complications for a patient using a partial rebreather mask is: a. Risk for choking b. Risk for aspiration c. Risk for suffocation d. Risk for respiratory arrest

41. Answer #20 c. Risk for suffocation

42. Question #21 The device that allows for all of the exhaled air to leave the mask rather than partially entering the reservoir bag: a. Simple mask b. Partial rebreather mask c. Non-rebreather mask d. Venturi mask

43. Question Answer #21 c. Non-rebreather mask

44. Question #22 The main disadvantage of using the non- rebreather mask is: a. Risk for suffocation b. Risk for O2 toxicity c. Risk for aspiration d. Risk for increased secretions

45. Question Answer #22 b. Risk for O2 toxicity

46. Question #23 The device with a large ringed tube extending from it that has adapters within the tube that are color-coded permitting only a specific amount of room air to mix with oxygen: a. Simple mask b. Venturi Mask c. Partial rebreather mask d. Non-rebreather mask

47. Answer #23 b. Venturi Mask

48. #24Question A disadvantage of the Venturi Mask is: a. O2 toxicity b. Nasal dryness c. Condensation in the tubing d. Risk for aspiration

49. Answer #24 c. Permits condensation to form in the tubing which diminishes O2 flow.

50. Question #25 O2 device that is used for a patient with facial trauma and burns is the: a. Nasal cannula b. Face tent c. Simple mask d. Partial rebreather mask

51. Answer #25 b. Face tent

52. Question #26 The surgical opening that is made between the first and second cartilage ring is a: a. Trachectomy b. Tracheotomy c. Ostomy d. illeostomy

53. Answer #26 b. Tracheotomy

54. Question #27 A flexible plastic tube inserted into the trachea to maintain an open airway is known as: a. Tracheostomy b. Endotrachial intubation c. Endotrachial suction d. tracheotomy

55. Answer #27 b. Endotrachial Intubation

56. #28 Question True or False: Oxygen does not burn, but supports combustion.

57. Answer #28 True-oxygen does not burn but supports combustion.

58. Question #29 Signs and symptoms of oxygen toxicity include (choose all that apply): a. Nausea and vomiting b. Elevated temp. c. Nasal stuffiness d. Headache

59. Answer #29 a. nausea and vomiting c. Nasal stuffiness d. headache

60. Question #30 True or False: A patient who is using O2 may smoke occasionally.

61. Answer #30 False, instruct patients never to smoke around oxygen.

62. #31Question A surgically created opening into the abdominal wall that serves as an exit site from the bowel or the ureter is: a. Colostomy b. Tracheostomy c. Illeostomy d. Ostomy

63. Answer #31 d. ostomy

64. Question #32 A surgically created opening from the small intestines to the abdominal wall allowing the passage of feces: a. Colostomy b. Illeostomy c. Tracheostomy d. ostomy

65. Answer to 32 b. Illeostomy

66. Question #33 A surgical procedure creating an opening from the ureter to the abdominal cavity is known as: a. Nephrostomy b. Ureterostomy c. Urostomy d. illeostomy

67. Answer #33 b. ureterostomy

68. Question #34 The portion of the bowel or ureter that is surgically opened and brought out through the abdominal wall is known as the: a. Ostomy b. Ureter c. Stoma d. pouch

69. Answer #34 c. Stoma

70. Question #35 The stool from an illeostomy is usually: a. Mushy b. Formed c. Liquid d. Solid

71. Answer #35 c. liquid

72. Question #36 Stool from a transverse colostomy is usually: a. Solid b. Mushy c. Solid d. liquid

73. Answer #36 b. mushy

74. Question #37 A permanent colostomy is usually located at the : a. Transverse colon b. Descending colon c. Ascending colon

75. Answer #37 b. Descending colon

76. Question #38 The name of the drainage from an ostomy is known as: a. Feces b. Effulent c. Stomadhesive d. contents

77. Question #39 Post-op complications for the nurse to assess the patient for are (choose all that apply): a. Excessive bleeding b. Drying of the stoma c. Stoma dark in color d. Stoma pink to red

78. Answer #39 a. Excessive bleeding b. Drying of the stoma c. Stoma dark in color

79. Question #40 When the ureter is transplanted into a closed off portion of the ileum with an opening to the outer abdomen creating a stoma: a. Colostomy b. Illeostomy c. Tracheostomy d. Urinary diversion

80. Answer #40 d. Urinary diversion or ileal conduit

81. Question #41 You listen to a patients lung sounds bilaterally. You note a frequent productive cough of thick yellow sputum. Which other assessments will you need to quickly make? a.Perform pulse oximetry to determine SaO2 b.Assess color of the lips, nailbeds, and mucous membranes c.Assess respiratory rate, character, and quality. d.Palpate for crepitus e.Determine how much fluid intake the patient has had in the past 24 hours?

82. Answer # 41 a. Perform pulse oximetry to determine SaO2 b. Assess color of lips, nailbeds, and mucous membranes. c. Assess respiratory rate, character and quality.

83. Question # 42 A patient who has chronic lung disease is stimulated to breathe because the chemoreceptor's detect: a. Low oxygen in the blood b. High oxygen in the blood c. Low carbon dioxide in the blood d. High carbon dioxide in the blood.

84. Answer # 42 a. Low oxygen in the blood

85. Question # 43 You are caring for a patient who has lung disease. Yesterday the patient Was alert, cooperative and pleasant. Today the patient is irritable, restless, and a little confused. She is complaining of a headache. What concerns you the most about this situation?

86. Question #43 Cont. a. The patients complaint of headache, along with the other symptoms could b sign of a stoke. b. All of the symptoms concern you because they are early signs of early hypoxia c. The confusion concerns you the most because it could medicate the beginning Alzheimers Disease. d. None of theses symptoms concerns you greatly because the patient is probably just having a bad day.

87. Answer # 43 B. All of the symptoms concern you because they can be signs of early hypoxia.

88. Question # 44 Incentive spirometry is used to: a. Deliver moisture and medications deep into the lungs. b. Help prevent pneumonia and altelectasis. c. Measure the rate and amount of air in a forceful exhalation. d. Help the patient conserve energy when performing ADL’s.

89. Answer # 44 b. Help to prevent pneumonia and altectasis.

90. Question # 45 People who have severe chronic pulmonary disease gradually develop a different stimulus to breathe. a. True b. False

91. Answer # 45 True

92. Question # 46 Which is (are) true of chemical regulation of respirations? a. Chemoreceptor's are located in the carotid and aorta and the brain. b. The cerebellum is responsible for brain control of respirations. c. The chemoreceptors in the brain cause an increase in the rate and depth of respirations in response to changes in ph. d. If the oxygen level in the blood falls, this provides the stimulus to breath in people who do not have chronic lung disease. e. Chemoreceptors in the carotid and aorta respond to decrease oxygen in the blood and send the message to the medula.

93. Answer # 46 F. Chemorecptors in the carotid and aorta respond to decreased oxygen in the blood and send the message to the medulla. The medulla is the Respiratory center in the Brain

94. Answer # 46 Regulation of Respiration The Respiratory Center of the brain is the “Medulla”. The medulla is located in the Brainstem. This brain function automatically controls inhalation by sending impulses to the phrenic nerve, which causes the contraction of the diaphram and the intercostal muscles.

95. Question # 47 The following factors can interfere with an accurate pulse ox reading. Select all that apply. a. Movement of the sensor b. Poor circulation c. Nail polish d. sunlight

96. Answer # 47 a. Movement of the sensor b. Poor circulation c. Nail polish barrier to light, also acrylic nails and thick nails or toenails. d. Direct sunlight

97. Question # 48 What are appropriate nursing /treatment interventions for patients with impaired oxygenation? Select all that apply. a. Turning b. Cough and deep breathing c. Incentive spirometry d. Nebulizer treatment e. Supplemental oxygen f. Conservation of energy g. Assistance with ADL’s h. Lung assessment

98. Answer # 49 Correct answer is all the above

99. Question # 50 All of the following appliances are needed for ostomy care except: a. One or two piece appliances b. Irrigations c. Wafers d. Sealant and closure

100. Answer # 50 Irrigations are ordered specifically by the doctor and may not bee need for routine care on all patients. You may need water with an irrigation bottle for cleaning out the bag.

101. Question # 51 The patient is taught when applying a new wafer over the stoma, the cut should be no more than how much larger than the stoma? a. 1/2 to 3/4 inch b. 1/16 to 1/8 inch c. 1/8 to 1/4 inch d. 1/3 to 2/3 inch

102. Answer # 51 c. 1/8 to 1/4 inch

103. Question # 52 To decrease the oder from an ileostomy effluent, the nurse tells the patient to decrease intake of a. Bananas b. Chocolate c. Broccoli d. cheese

104. Answer # 52 c. Broccoli

105. Question # 53 The patient notices during the changing of the pouch post recent ileostomy that the stoma is pinkish red the nurse responds. A. “There isn’t anything to worry about now.” “This is normal and shows that the stoma is healing as it should “I am not sure why this is happening and I’ll ask the doctor. “You need to be much more careful when taking of the pouch.”

106. Answer #53 B. This is normal and shows the stoma is healing as it should.