Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Medical & Surgical Nursing
Easy
Highest concentration of O2 is with:
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- The rebreathing mask system includes both partial and non-rebreather masks, which are designed to deliver high concentrations of oxygen.
- A non-rebreather mask, a type of rebreathing mask, uses a reservoir bag and one-way valves.
- These features prevent the patient from inhaling room air or their own exhaled air, allowing for the delivery of the highest possible oxygen concentration (up to 95%) among simple mask systems.
- This makes it the ideal choice for patients with severe hypoxemia who are breathing spontaneously.
Why Other Options Were Wrong
- Option A: A simple face mask delivers a moderate oxygen concentration, typically between 40% and 60%. Vents on the side of the mask allow a significant amount of room air to be inhaled, which dilutes the oxygen.
- Option B: A nasal prong (nasal cannula) delivers the lowest concentration of oxygen among the options, typically 24% to 44%. The final concentration is influenced by the patient's respiratory rate and pattern.
- Option C: A Venturi mask is designed to deliver a precise and reliable oxygen concentration (e.g., 24%, 28%, 40%), but its maximum deliverable concentration (up to 60%) is lower than that of a rebreathing mask.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Oxygen Delivery Devices and FiO2 Concentration as background academic context rather than a clinical decision trigger.
- Selecting the correct oxygen delivery device is a critical nursing skill that directly impacts patient outcomes. The choice depends on the patient's clinical condition, the required oxygen concentration, and the need for precision.
- For a patient in acute respiratory distress with severe hypoxemia, a non-rebreather mask is the initial device of choice to provide high FiO2 quickly.
- Nurses must monitor the reservoir bag on a rebreathing mask to ensure it remains at least two-thirds full during inspiration. A collapsing bag indicates the flow rate is too low and the patient may be rebreathing excess CO2.
How to Approach the Question
- First, understand the question is asking for the device that can deliver the highest oxygen concentration.
- Recall the common types of oxygen delivery systems used in clinical practice: nasal cannula, simple mask, Venturi mask, and rebreather masks (partial and non-rebreather).
- Mentally or on paper, list the approximate maximum FiO2 (fraction of inspired oxygen) for each device.
- Compare these maximum values: Nasal Cannula (44%), Simple Mask (60%), Venturi Mask (60%), Rebreathing Mask (95%).
- Identify that the rebreathing mask system offers the highest potential FiO2.
- Select the corresponding option.
Concept Tested & Keywords
- Concept Tested: Oxygen Delivery Devices and FiO2 Concentration
- Stem keywords: Highest concentration, O2, oxygen
- Lead-in keywords: Highest
- Negative lead-in flag: false
Question ID
QwxbMZGR64hvGVMgxp3D5n
Reference Book
E6 Nursing Fundamentals Taylor p. 731-733
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 7-9
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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