Progressive Care Nursing Certification (PCCN) Practice Exam

To improve oxygenation in a patient with unilateral pneumonia, what is the recommended initial position?

1. Prone

2. High-fowler's

3. Side-lying on the unaffected side

4. Supine

The correct answer is: Side-lying on the unaffected side

In a patient with unilateral pneumonia, positioning on the unaffected side is recommended to improve oxygenation. This positioning strategy facilitates better lung expansion and promotes drainage of secretions from the affected lung, enhancing ventilation-perfusion matching. By lying on the unaffected side, gravity assists in improving the air exchange in the healthy lung, while allowing more room for the affected lung to potentially expand and recover. This approach is critical as it helps in maximizing the patient's overall respiratory function and minimizes the risk of further complications such as atelectasis in the affected lung. Other positions may not provide the same benefits; for example, lying supine could lead to increased pressure on the affected lung, potentially worsening the patient's respiratory status. High-fowler's may not be optimal as it could limit lung expansion on the affected side. Prone positioning, while beneficial in certain situations, is not commonly recommended for unilateral pneumonia as it could hinder accessibility and drainage from the affected lung. The side-lying position on the unaffected side is therefore the most favorable initial approach.