LPN Respiratory Care and Oxygenation 2 — Questions and Answers
Question 1: A patient with asthma is having an acute attack. Which medication should the LPN anticipate administering first?
- Inhaled corticosteroid (budesonide)
- Short-acting beta-2 agonist (albuterol) (Correct answer)
- Long-acting beta-2 agonist (salmeterol)
- Leukotriene modifier (montelukast)
Correct answer: Short-acting beta-2 agonist (albuterol)
Short-acting beta-2 agonists like albuterol cause rapid bronchodilation and are the first-line rescue medication for acute asthma attacks.
Question 2: Why is it important to maintain a flow rate of at least 5 L/min when using a simple face mask?
- To prevent skin breakdown from the mask
- To prevent CO2 rebreathing (Correct answer)
- To maintain proper humidity levels
- To prevent barotrauma
Correct answer: To prevent CO2 rebreathing
A simple face mask must have a flow rate of at least 5 L/min to flush exhaled CO2 out of the mask reservoir; lower rates allow CO2 to accumulate and be rebreathed.
Question 3: Which assessment finding is most indicative of pneumonia?
- Decreased tactile fremitus
- Hyperresonance on percussion
- Bronchial breath sounds over peripheral lung fields (Correct answer)
- Decreased respiratory rate with deep breaths
Correct answer: Bronchial breath sounds over peripheral lung fields
Bronchial breath sounds heard over peripheral lung fields (where vesicular sounds are normal) indicate consolidation of lung tissue, a hallmark of pneumonia.
Question 4: A patient with a spontaneous pneumothorax would most likely exhibit which assessment finding on the affected side?
- Bilateral crackles
- Absent or markedly decreased breath sounds (Correct answer)
- Diffuse wheezing throughout both lung fields
- Increased chest wall movement
Correct answer: Absent or markedly decreased breath sounds
A pneumothorax causes air to enter the pleural space and collapse the lung, resulting in absent or markedly decreased breath sounds on the affected side.
Question 5: Which principle should the LPN follow when performing oropharyngeal suctioning?
- Apply suction continuously during catheter insertion
- Limit each suctioning pass to no longer than 10-15 seconds (Correct answer)
- Insert the catheter with suction already applied
- Suction every 30 minutes on a fixed schedule regardless of need
Correct answer: Limit each suctioning pass to no longer than 10-15 seconds
Limiting each suction pass to 10-15 seconds prevents hypoxia and tracheal mucosal trauma; suction is only applied while withdrawing the catheter.
Question 6: A patient's ABG results show pH 7.28, PaCO2 58 mmHg, HCO3 24 mEq/L. How should the LPN interpret this?
- Respiratory alkalosis
- Metabolic acidosis
- Respiratory acidosis (Correct answer)
- Metabolic alkalosis
Correct answer: Respiratory acidosis
A low pH (7.28) with elevated PaCO2 (58 mmHg) and normal bicarbonate indicates respiratory acidosis from hypoventilation and CO2 retention.
Question 7: When should postural drainage therapy be scheduled to reduce the risk of aspiration?
- Immediately after meals
- 30 minutes after meals
- 1-2 hours before or after meals (Correct answer)
- Only at bedtime regardless of meal timing
Correct answer: 1-2 hours before or after meals
Postural drainage should be performed 1-2 hours before or after meals to reduce the risk of aspiration and prevent nausea or vomiting during the procedure.
LPN Respiratory Care and Oxygenation 2
A patient with asthma is having an acute attack.
Which medication should the LPN anticipate administering first?