CNA Oxygen Therapy and Respiratory Support — Questions and Answers
Question 1: A resident is receiving oxygen via nasal cannula. The nurse aide notices the tubing has become kinked. The nurse aide should:
- Remove the cannula and notify the nurse at the next scheduled check
- Straighten the tubing immediately to restore oxygen flow and report the finding to the nurse (Correct answer)
- Increase the oxygen flow rate to compensate for the kink
- Replace the cannula with an oxygen mask without a nurse's order
Correct answer: Straighten the tubing immediately to restore oxygen flow and report the finding to the nurse
A kinked tube interrupts oxygen delivery, which can rapidly cause hypoxia. The nurse aide should correct the kink immediately — this is within scope — and inform the nurse. Changing flow rates or switching delivery devices requires a nurse's or physician's order.
Question 2: Which safety rule is most important when oxygen is in use in a resident's room?
- Keep the oxygen tank as full as possible at all times
- Post 'No Smoking / Oxygen in Use' signs and eliminate all open flames and sparks (Correct answer)
- Limit the number of people allowed in the room to two
- Store extra oxygen tanks directly next to heat vents for easy access
Correct answer: Post 'No Smoking / Oxygen in Use' signs and eliminate all open flames and sparks
Oxygen dramatically accelerates combustion. Open flames, smoking, electric sparks, and petroleum-based products (like Vaseline) are serious fire hazards in oxygen-enriched environments. Posting warnings and removing ignition sources is the top safety priority.
Question 3: A nurse aide checks a resident's pulse oximetry reading and finds it is 88%. The nurse aide should:
- Record the reading and report it at the next nursing handoff
- Tell the resident to breathe more deeply and recheck in an hour
- Report the low reading to the nurse immediately, as it may indicate inadequate oxygenation (Correct answer)
- Adjust the resident's oxygen flow rate to correct the low reading
Correct answer: Report the low reading to the nurse immediately, as it may indicate inadequate oxygenation
A normal pulse oximetry reading is typically 95–100%. A reading of 88% indicates significantly low blood oxygen saturation (hypoxia) and must be reported to the nurse immediately for assessment and intervention. The nurse aide must not adjust oxygen independently.
Question 4: Which position is generally most helpful for a resident who is having difficulty breathing?
- Supine (flat on the back)
- Prone (lying face down)
- Fowler's or semi-Fowler's position (head of bed elevated 30–90 degrees) (Correct answer)
- Trendelenburg position (head lower than feet)
Correct answer: Fowler's or semi-Fowler's position (head of bed elevated 30–90 degrees)
Elevating the head of the bed in Fowler's or semi-Fowler's position uses gravity to lower the diaphragm and allow the lungs to expand more fully. Flat or head-down positions compress the diaphragm and worsen breathing difficulty.
Question 5: Which of the following signs would indicate a resident may be experiencing hypoxia (low blood oxygen)?
- Pink, warm skin and a regular, slow breathing rate
- Confusion, bluish color of the lips or fingertips (cyanosis), and labored breathing (Correct answer)
- Increased appetite and high energy level
- A blood pressure reading higher than normal
Correct answer: Confusion, bluish color of the lips or fingertips (cyanosis), and labored breathing
Hypoxia causes cyanosis (bluish discoloration from deoxygenated blood), altered mental status, shortness of breath, and restlessness. These are emergency signs requiring immediate nurse notification.
Question 6: A resident on continuous oxygen therapy wants to smoke in the outdoor smoking area. The nurse aide should:
- Allow it as long as the resident turns off the oxygen tank first
- Reduce the oxygen flow rate to the lowest setting before the resident goes outside
- Inform the resident that smoking while on oxygen is extremely dangerous and notify the nurse (Correct answer)
- Accompany the resident to the smoking area to supervise
Correct answer: Inform the resident that smoking while on oxygen is extremely dangerous and notify the nurse
Smoking while on or near supplemental oxygen creates an extreme fire and explosion risk, as oxygen accelerates combustion. The nurse aide must explain the danger and immediately notify the nurse. Allowing smoking with oxygen in any form — even 'turned off' nearby — is unsafe.
