Progressive Care Nursing Certification (PCCN) Practice Exam

For a patient with COPD, respiratory distress, and an O2 saturation of 85%, which treatment is most appropriate?

1. Immediate intubation and mechanical ventilation

2. 100% non-rebreather mask and steroid administration

3. O2 via nasal cannula 2L and bronchodilators

4. Chest X-ray, blood cultures, and antibiotics

The correct answer is: O2 via nasal cannula 2L and bronchodilators

In managing a patient with COPD who is experiencing respiratory distress and has an oxygen saturation of 85%, the most appropriate treatment focuses on improving oxygenation and alleviating the underlying respiratory issue. Administering oxygen via nasal cannula at a low flow rate (2L) can be beneficial for patients with COPD because it provides supplemental oxygen without significantly altering their breathing drive, which may be sensitive to high levels of oxygen. This approach helps to increase the patient's oxygen saturation to a safer level while minimizing the risk of causing respiratory depression, which can occur with uncontrolled oxygen supplementation in certain COPD patients. Additionally, bronchodilators are critical in this scenario as they help to relieve airway constriction, improving airflow and reducing respiratory distress. By enhancing airway patency, bronchodilators can lead to a rapid clinical improvement in the patient’s ventilatory status and overall comfort. The other options, while not entirely inappropriate, do not represent the best immediate course of action for this situation. Immediate intubation and mechanical ventilation could be considered for life-threatening situations but is not typically the first response for a patient showing moderate hypoxemia unless they are also showing signs of severe respiratory failure. A non-rebreather mask might deliver high oxygen levels, but it could lead