# A hospitalized client with COPD has the oxygen target shown and receives an opioid for procedural pain. Click the reassessment that most strongly supports an immediate breathing and responsiveness assessment, even though the oxygen-saturation value alone might appear acceptable.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=581197&lang=en  
> language: en  
> subject: Physiological Adaptation  
> category: PA

## Question

A hospitalized client with COPD has the oxygen target shown and receives an opioid for procedural pain. Click the reassessment that most strongly supports an immediate breathing and responsiveness assessment, even though the oxygen-saturation value alone might appear acceptable.

![](https://mymerci.kr/data/nclex/hotspot/regen_20260908_2350/HSR534.svg)

## Explanation

D shows only eight breaths/min and difficulty arousing the client despite an SpO2 of 91%.

## In-depth explanation

Quick answer
D. D shows only eight breaths/min and difficulty arousing the client despite an SpO2 of 91%.
Why this is the best choice
Oxygen saturation does not directly measure ventilation. Integrate the marked fall in respiratory rate, new reduced responsiveness and recent opioid exposure. Prompt airway and breathing assessment and escalation take priority over accepting an in-range saturation.
Clinical picture
The observations are fictional teaching data. Apply the stated context; the selected feature does not by itself replace a complete bedside assessment.
Memory hook
Interpret saturation together with respiratory effort, rate and level of consciousness.
Decision rule
Interpret saturation together with respiratory effort, rate and level of consciousness.
Why the other regions do not fit
A has saturation just below the ordered range but preserved respiratory effort and alertness. B is within range with similar effort. C is above the oxygen target and needs titration assessment, but the client remains alert and breathing 20/min; D adds a new immediate ventilation concern.
**Sources**
- Supplemental oxygen can delay saturation-based recognition of opioid-related ventilatory impairment.

## Key concepts

- **Ventilation deterioration masked by saturation** — Interpret saturation together with respiratory effort, rate and level of consciousness.
- **Comparison with context** — C is outside the target, while D is inside it but has new ventilatory and consciousness deterioration.

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