PN Comprehensive Predictor 2026 Exam 2

Total Questions : 10

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Questions Remaining : 10

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1100:

Temperature 36.6Β° C (97.9Β° F)

Heart rate 68/min

Respiratory rate 14/min

Blood pressure 110/68 mm Hg

Oxygen saturation 94% on 2 L/min via nasal cannula

1105:

Heart rate 70/min

Respiratory rate 16/min

Blood pressure 116/72 mm Hg

Oxygen saturation 92% on 2 L/min via nasal cannula

1110:

Heart rate 80/min

Respiratory rate 18/min

Blood pressure 126/78 mm Hg

Oxygen saturation 90% on 2 L/min via nasal cannula

1115:

Temperature 36.6Β° C (97.9Β° F)

Heart rate 84/min

Respiratory rate 20/min

Blood pressure 126/78 mm Hg

Oxygen saturation 90% on 4 L/min via nasal cannula

1100:

Client admitted to postanesthesia care unit following colonoscopy with sedation. Client arousable to name. Oriented to person and place. Client receiving oxygen 2 L/min via nasal cannula.

1112:

Client arousable to name. Oriented to person and place. Oxygen increased to 4 L/min via nasal cannula.

1117:

Client arousable to name. Oriented to person and place. Oxygen increased to 5 L/min via nasal cannula.

1100:

Oxygen 2 to 5 L/min via nasal cannula to maintain oxygen saturation greater than 92%

Which of the following actions should the nurse take during the management of oxygenation for this client? Select all that apply.

Answer Options

Hint : 🫁 Breathe deep & assess for signs of hypoxemia.

Correct Answers:

  • Encourage client to perform deep breathing exercises.
  • Examine the client's nail beds.

Rationale :

βœ” Encourage the client to perform deep breathing exercises.

β—† Following procedural sedation, clients commonly experience hypoventilation and shallow breathing, increasing the risk for atelectasis and impaired gas exchange.

β—† The client's oxygen saturation is progressively declining (94% β†’ 92% β†’ 90%) despite increasing oxygen flow, indicating that supplemental oxygen alone is not adequately correcting the underlying problem.

β—† Deep breathing exercises promote alveolar expansion, reopen collapsed alveoli, and improve ventilation-perfusion (V/Q) matching, leading to more effective oxygen exchange.

β—† Because the client is arousable and oriented to person and place, they are able to follow simple commands and participate in deep breathing exercises.

β—† Encouraging deep breathing is a first-line nursing intervention that helps prevent postoperative pulmonary complications such as atelectasis and pneumonia.

β—† Improving lung expansion may increase oxygen saturation without the need for more advanced oxygen delivery devices.

β—† This intervention is noninvasive, safe, and evidence-based, making it appropriate before escalating respiratory support.

β—† Early respiratory interventions are essential in the PACU because respiratory depression is one of the most common complications following sedation.

βœ” Examine the client's nail beds.

β—† Declining oxygen saturation requires not only intervention but also a thorough clinical assessment to determine the severity of hypoxemia.

β—† Examining the nail beds for cyanosis helps identify whether inadequate oxygenation is affecting peripheral tissues.

β—† Cyanosis is a late but important clinical sign of significant hypoxemia and should prompt immediate reassessment and intervention.

β—† Physical assessment findings should always be correlated with pulse oximetry readings, as factors such as poor circulation, movement, or equipment issues can affect monitor accuracy.

β—† Assessing the nail beds also provides information about peripheral perfusion, which is important when evaluating oxygen delivery to tissues.

β—† Continuous assessment allows the nurse to determine whether the client's oxygenation is improving or deteriorating despite increasing oxygen therapy.

β—† Recognizing early signs of worsening hypoxemia supports timely interventions and helps prevent respiratory compromise.

β—† Combining objective data (SpOβ‚‚) with physical findings reflects comprehensive nursing assessment and promotes safe postoperative care.

❌Place the client in the supine position.

β—† The supine position can reduce lung expansion and worsen ventilation.

β—† A semi-Fowler's or high-Fowler's position is preferred to promote optimal oxygenation.

❌Add a humidifier to the oxygen device.

β—† Oxygen delivered via a nasal cannula at 2–5 L/min does not routinely require humidification.

β—† Adding a humidifier will not correct the client's declining oxygen saturation.

❌Prepare to administer oxygen via Venturi face mask.

β—† A Venturi mask is primarily used when a precise oxygen concentration is required, such as for clients with COPD.

β—† The current provider prescription specifies oxygen via nasal cannula (2–5 L/min), making a Venturi mask unnecessary at this stage.

Distractor Analysis :

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