Oxygen Therapy NCLEX Review: Devices & Safety

bolt The 60-second version

check_circleOxygen requires an order (except in emergencies per protocol) and is titrated to a target SpO₂.
check_circleNasal cannula: 1–6 L/min; simple face mask: at least 5 L/min to flush exhaled CO₂.
check_circleNon-rebreather mask: about 10–15 L/min with the reservoir bag kept inflated; delivers the highest FiO₂ of standard low-flow devices.
check_circleVenturi mask delivers a precise FiO₂, useful in COPD.
check_circleEarly hypoxia signs: restlessness, anxiety, confusion, tachycardia, tachypnea; cyanosis is late.
check_circleFire safety: no smoking or open flames, avoid petroleum-based products on the face, secure tanks upright.

target What you'll be able to do · aligned to NCLEX-RN Test Plan · Physiological Integrity; Safety and Infection Prevention and Control

PHYS ADAPTSelect oxygen delivery devices and flow rates appropriately.
PHYS ADAPTRecognize early and late signs of hypoxia.
SAFETYApply oxygen fire and equipment safety measures.
BASIC CAREPrevent device-related pressure injury and dryness.

How oxygen therapy is tested on the NCLEX-RN

Items fall under Physiological Adaptation, Safety, and Basic Care.

Devices. Approximate ranges as commonly taught; follow manufacturer and facility guidance.

Recognize hypoxia

Behavioral changes often come before a falling SpO₂ is noticed.

Hypoxia cues. A newly confused older client should have oxygenation checked.

SpO₂ factor	Effect
Poor perfusion, cold fingers	Unreliable reading; try earlobe or forehead probe
Dark nail polish, artificial nails	Can interfere with reading
Carbon monoxide poisoning	Falsely normal SpO₂
Darker skin pigmentation	Pulse oximeters can overestimate saturation; correlate with ABGs and clinical signs
Motion	Artifact

Treat the client, not only the number.

Take action: titration and positioning

Match the device to the need and reassess.

Low SpO₂ workflow. Check that tubing is connected and flowing before escalating.

Usual target is often 92–96% for many adults; for clients at risk of CO₂ retention (some COPD), often 88–92%, as ordered.
Humidification may be used at higher flows to reduce dryness.
Encourage deep breathing, incentive spirometry, and coughing as appropriate.

Safety and skin care

Oxygen supports combustion and devices can cause pressure injuries.

Risk	Nursing action
Fire	No smoking, candles, or open flames; post signs; avoid petroleum jelly on the face (use water-based lubricant)
Tank safety	Secure cylinders upright; store away from heat
Pressure injury	Pad tubing over ears; check nares and bridge of nose
Dryness	Mouth care; humidify as ordered
Oxygen toxicity	Avoid prolonged high FiO₂ beyond what is needed

Home oxygen clients also need teaching on flow settings and when to call.

NGN-style case

Device selection and troubleshooting.

functions Clinical judgment case — non-rebreather

A client on a non-rebreather mask at 15 L/min has SpO₂ 84%. The nurse notices the reservoir bag collapses completely when the client inhales. What should the nurse do?

Recognize cues: low SpO₂ and a collapsing reservoir bag.
Analyze: the bag is not staying inflated, so the client is not receiving the intended high FiO₂.
Check the connection and flow; ensure the bag stays at least partly inflated on inhalation.
Reassess SpO₂ and work of breathing; escalate to the rapid response team if not improving.

Answer. Check the oxygen connection and flow so the reservoir bag stays inflated, then reassess and escalate if hypoxemia persists.

Next in the roadmap

DVT & PE

arrow_forward

quiz Test yourself