NCLEX Respiratory System Disorders Practice Exam Quiz
Which of the following is the primary function of the respiratory system?
Transport of nutrients
B. Gas exchange
C. Regulation of electrolytes
D. Blood circulation
A patient with chronic obstructive pulmonary disease (COPD) is most likely to exhibit which of the following symptoms?
Sudden chest pain
B. Productive cough and dyspnea
C. Hemoptysis
D. Bradypnea
Which of the following is a priority intervention for a patient experiencing an asthma attack?
Administer a corticosteroid
B. Place the patient in a supine position
C. Administer a short-acting bronchodilator
D. Initiate chest physiotherapy
A patient with pneumonia is experiencing difficulty breathing. What is the best position to improve oxygenation?
Supine
B. Prone
C. High Fowler’s
D. Trendelenburg
What is the hallmark sign of acute respiratory distress syndrome (ARDS)?
Wheezing
B. Hypoxemia unresponsive to oxygen therapy
C. Hypercapnia
D. Pleural effusion
A nurse is educating a patient about using a metered-dose inhaler. What is the correct technique?
Exhale completely, press the inhaler, and inhale deeply
B. Press the inhaler and exhale quickly
C. Inhale deeply and press the inhaler simultaneously
D. Hold the inhaler 2 feet away from the mouth and inhale slowly
Which of the following diagnostic tests is the gold standard for diagnosing pulmonary embolism?
Chest X-ray
B. D-dimer test
C. Ventilation-perfusion (V/Q) scan
D. CT pulmonary angiography
Which type of lung sounds are typically heard in a patient with pulmonary edema?
Wheezing
B. Crackles
C. Rhonchi
D. Pleural friction rub
A patient with tuberculosis is prescribed isoniazid. What is the most important patient teaching point?
Avoid dairy products
B. Take the medication with meals
C. Monitor for signs of liver toxicity
D. Limit fluid intake
Which of the following is the priority nursing diagnosis for a patient with a tracheostomy?
Impaired physical mobility
B. Risk for infection
C. Ineffective airway clearance
D. Altered nutrition
Which acid-base imbalance is commonly seen in patients with respiratory failure?
Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
What is a common early symptom of lung cancer?
Persistent cough
B. Chest pain
C. Hemoptysis
D. Shortness of breath
A nurse auscultates diminished breath sounds in the left lower lung field of a postoperative patient. What is the likely cause?
Atelectasis
B. Pneumothorax
C. Bronchitis
D. Pulmonary embolism
Which of the following is an expected finding in a patient with emphysema?
Barrel-shaped chest
B. Cyanosis
C. Frequent infections
D. Clubbing of the fingers
What should the nurse monitor for in a patient with a chest tube?
Continuous bubbling in the water seal chamber
B. Fluctuation in the water seal chamber with respirations
C. Absence of drainage for 24 hours
D. Drainage greater than 100 mL per hour
Which condition is commonly associated with wheezing?
Pleural effusion
B. Asthma
C. Pneumonia
D. Pulmonary fibrosis
What is the priority assessment for a patient receiving oxygen therapy?
Skin integrity
B. Level of consciousness
C. Respiratory rate and effort
D. Nutritional status
A patient with cystic fibrosis is at increased risk for which complication?
Pneumothorax
B. Pulmonary hypertension
C. Respiratory infections
D. Pulmonary embolism
Which medication is used as a first-line treatment for pulmonary tuberculosis?
Rifampin
B. Amoxicillin
C. Ciprofloxacin
D. Prednisone
What does a SpO2 level below 90% indicate?
Hypoxia
B. Hypercapnia
C. Acidosis
D. Bradycardia
A patient reports shortness of breath after surgery. What is the nurse’s first action?
Assess oxygen saturation
B. Administer oxygen
C. Notify the provider
D. Position the patient supine
What is the primary cause of pneumothorax?
Fluid accumulation in the pleural space
B. Air in the pleural space
C. Infection in the lung tissue
D. Inflammation of the alveoli
What dietary advice is appropriate for a patient with COPD?
Low-calorie, low-fat diet
B. High-protein, high-calorie diet
C. High-fiber diet
D. Low-sodium diet
What symptom differentiates bronchitis from pneumonia?
Fever
B. Productive cough
C. Rales
D. Chest pain
Which intervention is most appropriate for a patient with obstructive sleep apnea?
Administer diuretics
B. Use of continuous positive airway pressure (CPAP)
C. Chest physiotherapy
D. Avoiding protein in the diet
Which symptom is most characteristic of pleuritis?
Sharp chest pain with breathing
B. Dry cough
C. Wheezing
D. Fever
Which of the following is a common trigger for asthma?
Alcohol consumption
B. Cold air
C. High salt intake
D. Exercise
In patients with COPD, why is it important to limit oxygen flow to 2-3 L/min?
To prevent oxygen toxicity
B. To avoid suppressing the hypoxic drive
C. To conserve oxygen supplies
D. To prevent hyperventilation
What is the purpose of pursed-lip breathing in COPD patients?
Increase lung capacity
B. Promote deep breathing
C. Prevent airway collapse
D. Reduce bronchospasm
What is the most common cause of community-acquired pneumonia?
Staphylococcus aureus
B. Streptococcus pneumoniae
C. Pseudomonas aeruginosa
D. Klebsiella pneumoniae
What is the primary goal of oxygen therapy in a patient with hypoxemia?
Prevent oxygen toxicity
B. Reduce hypercapnia
C. Maintain adequate tissue oxygenation
D. Increase hemoglobin levels
Which of the following is a key symptom of a pleural effusion?
Dry cough
B. Decreased breath sounds over the affected area
C. Cyanosis
D. Expiratory wheezing
What is the most effective way to prevent ventilator-associated pneumonia (VAP)?
Administer prophylactic antibiotics
B. Perform frequent oral care
C. Keep the patient supine
D. Change ventilator tubing daily
Which diagnostic test confirms tuberculosis (TB)?
Chest X-ray
B. Sputum culture
C. Mantoux skin test
D. Complete blood count
Which nursing intervention is most effective for promoting airway clearance in a patient with pneumonia?
Limiting fluid intake
B. Administering antipyretics
C. Encouraging coughing and deep breathing
D. Restricting physical activity
Which of the following medications is used to treat acute bronchospasm?
Ipratropium
B. Salmeterol
C. Albuterol
D. Montelukast
A patient with ARDS is placed on mechanical ventilation. What is the priority nursing assessment?
Fluid balance
B. Ventilator settings and alarms
C. Neurological status
D. Skin integrity
What is the primary treatment for obstructive sleep apnea?
Weight loss and lifestyle changes
B. Diuretics and fluid restriction
C. Surgery to remove tonsils
D. Oxygen therapy
Which condition is characterized by chronic productive cough lasting at least 3 months in 2 consecutive years?
Emphysema
B. Chronic bronchitis
C. Asthma
D. Bronchiectasis
A patient is admitted with a pulmonary embolism. Which symptom is most commonly reported?
Hemoptysis
B. Sudden onset of chest pain and dyspnea
C. Fever
D. Wheezing
Which nursing intervention is most important after bronchoscopy?
Monitor for hemoptysis
B. Assess for fever
C. Ensure the patient remains NPO until the gag reflex returns
D. Monitor oxygen saturation
Which condition involves the collapse of alveoli in the lungs?
Pneumonia
B. Atelectasis
C. Emphysema
D. Bronchitis
Which sign indicates that a patient with asthma is deteriorating?
Increased peak expiratory flow rate
B. Loud wheezing
C. Silent chest with no audible wheezing
D. Respiratory rate of 12 breaths per minute
What is the purpose of chest physiotherapy in a patient with cystic fibrosis?
To prevent airway obstruction
B. To strengthen respiratory muscles
C. To improve oxygen saturation
D. To prevent infection
Which condition is characterized by fluid-filled alveoli leading to impaired gas exchange?
ARDS
B. Asthma
C. Pleural effusion
D. Pneumothorax
A nurse is teaching a patient about the use of a peak flow meter. What should the patient do?
Blow into the device slowly and steadily
B. Inhale deeply before exhaling forcefully into the device
C. Use the device only when feeling short of breath
D. Measure peak flow before taking any medications
A patient with COPD is prescribed tiotropium. What is the correct method of administration?
Oral tablet
B. Intravenous injection
C. Inhalation via a dry powder inhaler
D. Subcutaneous injection
Which statement by a patient with a new diagnosis of asthma indicates a need for further teaching?
“I should use my rescue inhaler during an asthma attack.”
B. “I should avoid triggers like dust and smoke.”
C. “I can stop taking my medications if I feel better.”
D. “I need to use my peak flow meter daily.”
What is the most common cause of acute respiratory failure?
Hyperventilation
B. Impaired gas exchange
C. Dehydration
D. Sepsis
Which of the following conditions is associated with a tracheal shift?
Pleural effusion
B. Pulmonary embolism
C. Pneumothorax
D. Bronchitis
Which medication is most commonly used to reduce inflammation in asthma patients?
Montelukast
B. Prednisone
C. Theophylline
D. Epinephrine
What symptom indicates the need for suctioning in a patient with a tracheostomy?
Clear breath sounds
B. Decreased oxygen saturation
C. Tachycardia
D. Patient request
What is the priority intervention for a patient with suspected pulmonary embolism?
Initiate oxygen therapy
B. Administer IV antibiotics
C. Perform a chest X-ray
D. Elevate the patient’s legs
Which complication is a patient with COPD most at risk for?
Myocardial infarction
B. Cor pulmonale
C. Sepsis
D. Stroke
Which of the following best describes clubbing of the fingers?
Enlargement of the fingertips due to chronic hypoxemia
B. Brittle nails due to vitamin deficiency
C. Curving of the nails caused by fungal infection
D. Discoloration of the nails due to cyanosis
Which respiratory condition is commonly associated with a barrel-shaped chest?
Asthma
B. Chronic bronchitis
C. Emphysema
D. Pneumonia
A nurse is caring for a patient with a chest tube. Which finding requires immediate intervention?
Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber during respiration
C. Drainage of 50 mL per hour
D. Chest tube dressing intact
Which breathing technique is recommended for a patient with COPD to promote airway clearance?
Diaphragmatic breathing
B. Rapid, shallow breathing
C. Pursed-lip breathing
D. Deep breathing and holding the breath
Which symptom is an early sign of hypoxia?
Cyanosis
B. Bradycardia
C. Restlessness
D. Clubbing of the fingers
Which laboratory finding is consistent with respiratory acidosis?
Low PaCO2 and high pH
B. High PaCO2 and low pH
C. Low PaO2 and normal pH
D. High HCO3 and high pH
A patient with tuberculosis is started on isoniazid (INH). What is the most important teaching point?
Avoid alcohol during therapy
B. Expect orange discoloration of urine
C. Take with meals to avoid stomach upset
D. Discontinue if symptoms improve
Which of the following is the best indicator of effective gas exchange?
SpO2 of 95%
B. Respiratory rate of 22 breaths per minute
C. Absence of cyanosis
D. Clear breath sounds
Which patient is at greatest risk for developing a pulmonary embolism?
A patient with asthma who uses an inhaler
B. A postoperative patient with a deep vein thrombosis
C. A patient with community-acquired pneumonia
D. A patient with COPD who smokes
What is the hallmark symptom of status asthmaticus?
Persistent hypoxemia despite treatment
B. Sudden resolution of wheezing
C. Excessive mucus production
D. Productive cough
In a patient with acute respiratory distress syndrome (ARDS), what is the purpose of prone positioning?
To prevent pressure ulcers
B. To improve ventilation-perfusion matching
C. To reduce oxygen consumption
D. To enhance pulmonary perfusion to the dependent areas
Which medication is used as a long-term controller in asthma management?
Albuterol
B. Prednisone
C. Fluticasone
D. Epinephrine
A nurse suspects a tension pneumothorax in a trauma patient. What is the most critical finding?
Hypotension
B. Tachycardia
C. Tracheal deviation
D. Diminished breath sounds
Which respiratory condition is characterized by foul-smelling sputum and recurrent infections?
Asthma
B. Bronchiectasis
C. COPD
D. Tuberculosis
What is the priority intervention for a patient experiencing an asthma exacerbation?
Administer IV corticosteroids
B. Provide nebulized albuterol
C. Encourage deep breathing exercises
D. Administer oxygen via nasal cannula
Which dietary advice is most appropriate for a patient with COPD?
Consume high-carbohydrate meals
B. Focus on small, frequent high-calorie meals
C. Increase fluid intake during meals
D. Avoid foods high in protein
Which symptom is most concerning in a patient with pneumonia?
Productive cough with green sputum
B. Fever of 101°F (38.3°C)
C. Confusion or altered mental status
D. Fatigue and weakness
Which condition is associated with a “ground-glass” appearance on a chest X-ray?
ARDS
B. Tuberculosis
C. Chronic bronchitis
D. Pulmonary embolism
What is the main goal of pulmonary rehabilitation in patients with COPD?
Improve oxygenation levels
B. Prevent disease progression
C. Enhance quality of life and functional capacity
D. Reduce the need for oxygen therapy
A nurse observes that a patient with COPD is using accessory muscles to breathe. What does this indicate?
Hyperventilation
B. Increased work of breathing
C. Improved oxygenation
D. Decreased airway resistance
What is the first-line diagnostic test for pulmonary embolism?
Chest X-ray
B. D-dimer test
C. CT pulmonary angiography
D. Ventilation-perfusion (V/Q) scan
What is a key teaching point for a patient using a dry powder inhaler (DPI)?
Shake the inhaler before use
B. Exhale into the inhaler to load the dose
C. Rinse the mouth after each use
D. Use a spacer for better delivery
A patient presents with hemothorax following chest trauma. What is the primary treatment?
Bronchodilator therapy
B. Chest tube insertion
C. Thoracentesis
D. Intubation and mechanical ventilation
Which type of hypoxia is caused by decreased oxygen-carrying capacity of the blood?
Histotoxic hypoxia
B. Anemic hypoxia
C. Stagnant hypoxia
D. Hypoxemic hypoxia
What is the classic sign of carbon monoxide poisoning?
Cyanosis
B. Cherry-red skin color
C. Decreased SpO2 levels
D. Bradycardia
What is the purpose of incentive spirometry after surgery?
Reduce postoperative pain
B. Promote alveolar expansion and prevent atelectasis
C. Clear mucus from the airways
D. Improve oxygen delivery to tissues
What is the most appropriate position for a patient with severe dyspnea?
Supine with head flat
B. Trendelenburg position
C. High Fowler’s position
D. Prone position
What is the primary goal of oxygen therapy for a patient with hypoxemia?
Decrease heart rate
B. Improve tissue oxygenation
C. Reverse metabolic acidosis
D. Lower blood pressure
Which complication is most associated with long-term oxygen therapy?
Hypercapnia
B. Oxygen toxicity
C. Respiratory alkalosis
D. Pulmonary embolism
What is the best way to confirm placement of an endotracheal tube?
Observing chest rise and fall
B. Auscultating breath sounds bilaterally
C. Performing a chest X-ray
D. Monitoring oxygen saturation
A patient with acute bronchitis asks why antibiotics are not prescribed. What is the nurse’s best response?
“Your symptoms are not severe enough for antibiotics.”
B. “Bronchitis is usually caused by a virus.”
C. “Antibiotics may worsen your cough.”
D. “Antibiotics are only given for asthma-related symptoms.”
What is a priority nursing action during a thoracentesis procedure?
Encourage the patient to take deep breaths
B. Position the patient supine
C. Monitor the patient for signs of pneumothorax
D. Check oxygen saturation every 30 minutes
What is the purpose of a peak flow meter for a patient with asthma?
Monitor oxygen saturation levels
B. Detect early signs of airflow obstruction
C. Measure the effectiveness of bronchodilators
D. Predict episodes of hypoxemia
Which intervention is most important for preventing ventilator-associated pneumonia (VAP)?
Administering prophylactic antibiotics
B. Elevating the head of the bed 30–45 degrees
C. Performing chest physiotherapy every shift
D. Suctioning the endotracheal tube every hour
Which lung sound is most characteristic of a pneumothorax?
Crackles
B. Rhonchi
C. Diminished or absent breath sounds
D. Wheezing
What is the most important initial action for a nurse caring for a patient with suspected pulmonary edema?
Administer a bronchodilator
B. Position the patient in a high Fowler’s position
C. Start chest physiotherapy
D. Prepare for intubation
Which diagnostic test is most definitive for confirming a diagnosis of tuberculosis?
Chest X-ray
B. Sputum culture for acid-fast bacilli
C. Tuberculin skin test (Mantoux test)
D. Interferon-gamma release assay (IGRA)
A patient with cystic fibrosis is admitted for pulmonary exacerbation. Which intervention is the highest priority?
Administering pancreatic enzyme supplements
B. Providing chest physiotherapy
C. Encouraging high-calorie meals
D. Offering psychological support
What is the expected finding in arterial blood gases for a patient with respiratory alkalosis?
Low pH, high PaCO2
B. High pH, low PaCO2
C. Low pH, normal HCO3
D. High pH, high PaO2
Which intervention is most appropriate for a patient with pleural effusion?
Administering a bronchodilator
B. Performing thoracentesis
C. Providing humidified oxygen
D. Encouraging fluid intake
Which finding suggests worsening status in a patient with asthma?
Decreased wheezing
B. Use of accessory muscles
C. SpO2 of 94%
D. Respiratory rate of 20 breaths/minute
A patient is prescribed montelukast for asthma management. What is the nurse’s priority teaching?
Take the medication only during an asthma attack
B. Take the medication daily in the evening
C. Avoid taking with bronchodilators
D. Stop taking if symptoms improve
Which condition is most associated with pink, frothy sputum?
Chronic bronchitis
B. Pulmonary edema
C. Tuberculosis
D. Asthma
Which patient is most likely experiencing respiratory failure?
PaCO2 of 40 mm Hg and PaO2 of 80 mm Hg
B. PaCO2 of 55 mm Hg and PaO2 of 50 mm Hg
C. PaCO2 of 30 mm Hg and PaO2 of 90 mm Hg
D. PaCO2 of 45 mm Hg and PaO2 of 75 mm Hg
Which assessment finding indicates effective treatment of a pleural effusion?
Clear breath sounds
B. Increased respiratory rate
C. Use of accessory muscles
D. Paradoxical chest wall movement
What is the first-line treatment for a patient with bacterial pneumonia?
Oxygen therapy
B. Bronchodilator therapy
C. Antibiotic therapy
D. Corticosteroids
Which intervention is most appropriate for a patient with a pulmonary embolism?
Administering IV heparin
B. Encouraging ambulation
C. Positioning the patient in a supine position
D. Providing humidified oxygen
Which nursing intervention helps prevent atelectasis in a postoperative patient?
Encouraging use of an incentive spirometer
B. Administering bronchodilators
C. Limiting fluid intake
D. Placing the patient in a supine position
What is a critical nursing action for a patient with acute epiglottitis?
Insert a nasogastric tube for feeding
B. Assess for a barking cough
C. Prepare for emergency airway management
D. Administer an oral corticosteroid
A patient with a history of smoking has a persistent productive cough and clubbing of the fingers. Which condition is most likely?
Tuberculosis
B. Chronic bronchitis
C. Emphysema
D. Pulmonary embolism
Which medication is used to reverse opioid-induced respiratory depression?
Flumazenil
B. Naloxone
C. Albuterol
D. Morphine sulfate
What is the primary goal of chest physiotherapy for a patient with cystic fibrosis?
Reduce lung inflammation
B. Improve oxygen saturation
C. Mobilize and remove secretions
D. Increase lung volume
Which clinical finding is most characteristic of pulmonary embolism?
Sudden onset of chest pain and dyspnea
B. Persistent productive cough with green sputum
C. Gradual onset of hemoptysis
D. Wheezing and diminished breath sounds
A patient is receiving albuterol for asthma. Which side effect should the nurse monitor for?
Bradycardia
B. Hypoglycemia
C. Tachycardia
D. Hypertension
What is the most reliable method for assessing oxygenation in a patient?
Monitoring respiratory rate
B. Measuring oxygen saturation via pulse oximetry
C. Observing skin color
D. Analyzing arterial blood gases
Which sign indicates a positive reaction to the Mantoux tuberculin skin test?
Erythema of 10 mm or more
B. Induration of 5 mm or more
C. Induration of 15 mm or more
D. Purulent drainage at the injection site
Which statement indicates a patient understands the purpose of pursed-lip breathing?
“It will help improve oxygen saturation immediately.”
B. “It helps me eliminate carbon dioxide buildup.”
C. “It strengthens my diaphragm.”
D. “It allows me to breathe faster during activity.”
A nurse is caring for a patient with a chest tube. What is the most critical action?
Clamping the chest tube to prevent air leakage
B. Ensuring continuous bubbling in the water seal chamber
C. Keeping the drainage system below chest level
D. Frequently irrigating the chest tube
Which medication is most commonly used to treat an acute asthma exacerbation?
Salmeterol
B. Ipratropium
C. Albuterol
D. Montelukast
What is the best indicator of effective gas exchange in a patient with COPD?
Normal skin color
B. Respiratory rate of 20 breaths per minute
C. Absence of accessory muscle use
D. Arterial blood gases within normal limits
Which intervention is most effective for preventing pneumonia in postoperative patients?
Administering prophylactic antibiotics
B. Encouraging deep breathing and coughing exercises
C. Providing humidified oxygen therapy
D. Restricting fluid intake
What is the primary purpose of administering corticosteroids to a patient with COPD?
Prevent bronchospasm
B. Reduce airway inflammation
C. Decrease mucus production
D. Improve oxygen exchange
A patient with sleep apnea is prescribed continuous positive airway pressure (CPAP). What is the nurse’s primary responsibility?
Teach the patient to perform respiratory exercises
B. Explain the importance of using the device during naps
C. Ensure proper fit of the CPAP mask
D. Monitor for signs of hypercapnia
Which assessment finding is most concerning in a patient with a pneumothorax?
Oxygen saturation of 94%
B. Asymmetrical chest wall movement
C. Respiratory rate of 22 breaths/min
D. Subcutaneous emphysema near the chest wall
What is the most appropriate initial intervention for a patient experiencing an acute asthma attack?
Administering oxygen therapy
B. Administering a bronchodilator
C. Initiating IV corticosteroid therapy
D. Positioning the patient in the Trendelenburg position
Which factor increases a patient’s risk for developing pneumonia?
Recent travel history
B. Advanced age
C. Regular aerobic exercise
D. High carbohydrate diet
A nurse is educating a patient with COPD about nutrition. What is the best dietary recommendation?
High-carbohydrate, low-protein diet
B. Small, frequent, high-calorie meals
C. Restricting all fats to reduce respiratory effort
D. Encouraging large, hearty meals
Which is the most common early symptom of pulmonary tuberculosis?
Hemoptysis
B. Persistent cough
C. Chest pain
D. Sudden weight gain
A patient receiving mechanical ventilation develops increased peak airway pressures. What should the nurse assess for?
Anxiety
B. Bronchospasm or obstruction
C. Pneumonia
D. Hyperventilation
What is the primary purpose of administering heparin to a patient with a pulmonary embolism?
Dissolve the existing clot
B. Prevent future clot formation
C. Decrease pulmonary hypertension
D. Relieve chest pain
What intervention is most appropriate for a patient with carbon monoxide poisoning?
Administering 100% oxygen
B. Initiating bronchodilator therapy
C. Encouraging deep breathing and coughing
D. Preparing for intubation and mechanical ventilation
What is a critical nursing consideration for a patient receiving ribavirin therapy for respiratory syncytial virus (RSV)?
Ensure the patient is NPO during therapy
B. Monitor for worsening respiratory symptoms
C. Protect pregnant healthcare workers from exposure
D. Administer the medication with food
Which finding suggests acute respiratory distress syndrome (ARDS)?
Bilateral pulmonary infiltrates on chest X-ray
B. Sudden onset of hemoptysis
C. Tracheal deviation
D. Wheezing and stridor
Which laboratory result would most concern the nurse for a patient with COPD?
PaO2 of 80 mm Hg
B. PaCO2 of 50 mm Hg
C. HCO3 of 24 mEq/L
D. SpO2 of 87%
Which nursing intervention is most appropriate for a patient with pleuritis?
Administering pain medication as prescribed
B. Encouraging vigorous coughing exercises
C. Restricting fluid intake
D. Placing the patient in a supine position
A patient with pneumonia is prescribed levofloxacin. What should the nurse prioritize in patient education?
“You may stop the medication when you feel better.”
B. “Take the medication with antacids to avoid stomach upset.”
C. “Complete the full course of antibiotics as prescribed.”
D. “Avoid taking the medication with dairy products.”
What is the most common side effect of using inhaled corticosteroids in asthma management?
Tachycardia
B. Oral candidiasis
C. Hypokalemia
D. Persistent cough
Which symptom is most indicative of hypoxia?
Cyanosis
B. Decreased urine output
C. Hypertension
D. Tachypnea
A patient with COPD is prescribed ipratropium bromide. What is the primary action of this medication?
Reduce airway inflammation
B. Thin pulmonary secretions
C. Promote bronchodilation
D. Decrease respiratory rate
Which diagnostic test confirms a diagnosis of tuberculosis?
Chest X-ray
B. Mantoux skin test
C. Sputum culture for acid-fast bacilli
D. Complete blood count
Which is the priority nursing intervention for a patient experiencing a severe asthma attack?
Administering a long-acting bronchodilator
B. Administering oxygen via nasal cannula
C. Positioning the patient in high Fowler’s position
D. Administering an inhaled beta-agonist
A nurse is monitoring a patient with a chest tube. Continuous bubbling in the water seal chamber indicates which complication?
Normal functioning
B. Pneumothorax resolution
C. Air leak in the system
D. Blocked drainage tubing
Which medication is most effective for long-term management of persistent asthma?
Inhaled corticosteroids
B. Short-acting beta-agonists
C. Leukotriene modifiers
D. Oral theophylline
A patient with cystic fibrosis is prescribed pancreatic enzymes. What is the rationale for this medication?
To reduce pulmonary secretions
B. To improve digestion and nutrient absorption
C. To prevent intestinal obstruction
D. To decrease sweat sodium levels
What is the most critical nursing intervention for a patient with a suspected pulmonary embolism?
Administering anticoagulant therapy
B. Encouraging ambulation
C. Performing chest physiotherapy
D. Preparing the patient for thoracentesis
Which finding indicates early respiratory distress in a patient with COPD?
Cyanosis
B. Increased respiratory rate
C. Diminished breath sounds
D. Clubbing of the fingers
What is the primary purpose of using a peak flow meter in asthma management?
To measure oxygen saturation
B. To monitor airway obstruction
C. To assess lung volume
D. To evaluate response to bronchodilators
Which intervention is most effective for preventing ventilator-associated pneumonia (VAP)?
Elevating the head of the bed
B. Administering prophylactic antibiotics
C. Using a closed suction system
D. Performing routine chest X-rays
A patient with a tracheostomy becomes restless and exhibits decreased oxygen saturation. What is the nurse’s priority action?
Increase oxygen flow rate
B. Suction the tracheostomy tube
C. Assess for bilateral breath sounds
D. Administer a bronchodilator
Which complication is most likely in a patient with a history of chronic bronchitis?
Pneumothorax
B. Pulmonary hypertension
C. Lung cancer
D. Pleural effusion
A patient presents with a tension pneumothorax. What is the nurse’s priority intervention?
Administering high-flow oxygen
B. Preparing for needle decompression
C. Initiating IV fluid therapy
D. Positioning the patient in Trendelenburg
What is the primary purpose of administering diuretics to a patient with pulmonary edema?
To reduce fluid overload and improve oxygenation
B. To decrease pulmonary inflammation
C. To promote vasodilation and improve perfusion
D. To prevent electrolyte imbalances
A patient with severe acute respiratory distress syndrome (ARDS) is placed on mechanical ventilation. Which ventilator setting is most critical to monitor?
Tidal volume
B. Respiratory rate
C. FiO2
D. Positive end-expiratory pressure (PEEP)
Which statement indicates the patient understands the use of a spacer with an inhaler?
“It helps me use my inhaler less often.”
B. “It prevents the medication from irritating my mouth.”
C. “It ensures the medication is delivered more effectively to my lungs.”
D. “It allows me to take the medication without inhaling deeply.”
Which dietary recommendation is most appropriate for a patient with emphysema?
High-protein, high-calorie diet
B. Low-fat, high-carbohydrate diet
C. High-sodium, low-protein diet
D. Low-calorie, high-fiber diet
A nurse is caring for a patient with pneumonia who has developed pleuritic pain. What is the best intervention to relieve this symptom?
Encourage ambulation
B. Provide a heating pad to the chest
C. Administer prescribed analgesics
D. Position the patient supine
Which type of oxygen delivery device is most appropriate for a patient requiring a precise FiO2?
Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
What is the primary goal of treatment for a patient with acute bronchitis?
Cure the infection
B. Relieve symptoms and improve airway clearance
C. Prevent progression to pneumonia
D. Reduce the risk of chronic disease
What assessment finding is most concerning in a patient with pneumonia?
Productive cough
B. Fever of 101.3°F (38.5°C)
C. Respiratory rate of 30 breaths/min
D. Inspiratory crackles
Which intervention is most appropriate for a patient with a pulmonary embolism?
Initiating thrombolytic therapy
B. Positioning the patient supine
C. Administering IV antibiotics
D. Performing chest physiotherapy
Which sign is most indicative of chronic hypoxemia?
Tachypnea
B. Clubbing of the fingers
C. Cyanosis
D. Restlessness
Answer: B. Clubbing of the fingers
Questions and Answers for Study Guide
Question:
Describe the pathophysiology of chronic obstructive pulmonary disease (COPD) and explain how it differs from asthma.
Answer:
Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease characterized by airflow obstruction that is not fully reversible. The primary causes include long-term exposure to irritants such as cigarette smoke, air pollution, and occupational dust. Pathophysiologically, COPD involves chronic inflammation of the airways, alveoli, and pulmonary blood vessels. This leads to narrowing of the airways, destruction of alveolar walls (emphysema), and increased mucus production (chronic bronchitis). Over time, these changes result in reduced elastic recoil, air trapping, and hyperinflation of the lungs, causing difficulty in exhalation.
Asthma, on the other hand, is a reversible airway obstruction primarily caused by hypersensitivity to triggers like allergens, exercise, or respiratory infections. It is characterized by bronchoconstriction, airway inflammation, and increased mucus production, leading to episodic symptoms such as wheezing, dyspnea, and chest tightness. Unlike COPD, asthma is typically managed with anti-inflammatory drugs like corticosteroids and bronchodilators, and its symptoms are often reversible with proper treatment.
Question:
Explain the nursing interventions and rationale for managing a patient with pneumonia.
Answer:
Managing a patient with pneumonia requires a comprehensive approach to address the infection, promote oxygenation, and prevent complications. Key nursing interventions include:
- Monitoring Vital Signs: Frequent assessment of temperature, respiratory rate, heart rate, and oxygen saturation helps identify signs of respiratory distress or sepsis.
- Administering Prescribed Medications: Antibiotics or antivirals are given to treat the underlying infection, while antipyretics and analgesics help manage fever and pain.
- Oxygen Therapy: Supplemental oxygen is provided to maintain adequate oxygenation, especially if the patient’s SpO2 falls below 90%.
- Encouraging Fluid Intake: Adequate hydration helps thin mucus secretions, making them easier to expectorate.
- Promoting Airway Clearance: Techniques like deep breathing exercises, incentive spirometry, and chest physiotherapy facilitate mucus removal and improve lung function.
- Positioning: Keeping the patient in an upright position enhances lung expansion and prevents pooling of secretions.
The rationale for these interventions is to ensure effective treatment of the infection, maintain adequate oxygen delivery to tissues, and prevent complications such as atelectasis or respiratory failure.
Question:
Discuss the role of patient education in the management of obstructive sleep apnea (OSA).
Answer:
Patient education is crucial in managing obstructive sleep apnea (OSA) as it empowers patients to make lifestyle changes and adhere to treatment regimens. Education focuses on:
- Understanding the Condition: Patients should be informed about the causes of OSA, including upper airway obstruction during sleep, and its consequences, such as daytime fatigue, cardiovascular complications, and poor quality of life.
- Lifestyle Modifications: Weight loss is emphasized for overweight patients, as obesity is a significant risk factor. Avoiding alcohol and sedatives before bedtime, quitting smoking, and adopting regular sleep patterns are also recommended.
- Use of CPAP Devices: Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA. Patients should receive training on using, cleaning, and maintaining the device to ensure adherence and effectiveness.
- Follow-Up Care: Regular follow-ups with healthcare providers help monitor the effectiveness of interventions and make necessary adjustments.
By understanding their condition and the importance of adherence, patients can reduce the severity of symptoms, prevent complications, and improve their overall health outcomes.
Question:
Analyze the complications of untreated pulmonary embolism and the importance of early intervention.
Answer:
Pulmonary embolism (PE) is a life-threatening condition that occurs when a blood clot obstructs a pulmonary artery, impairing blood flow to the lungs. If left untreated, PE can lead to several complications:
- Right Ventricular Failure: The obstruction increases pulmonary vascular resistance, causing strain on the right ventricle and potentially leading to failure.
- Pulmonary Infarction: Reduced blood flow can cause tissue necrosis in the lungs, leading to chest pain, hemoptysis, and impaired gas exchange.
- Hypoxemia: The obstruction prevents adequate oxygenation of blood, resulting in systemic hypoxia.
- Cardiac Arrest: Massive PE can obstruct blood flow to the heart, leading to sudden cardiac arrest.
Early intervention is critical to prevent these complications. Administering anticoagulants, such as heparin or warfarin, dissolves existing clots and prevents new ones from forming. In severe cases, thrombolytic therapy or surgical embolectomy may be required. Prompt diagnosis and treatment improve survival rates and reduce the risk of long-term sequelae.
Question:
Evaluate the impact of smoking cessation on the progression of respiratory disorders such as COPD.
Answer:
Smoking cessation has a profound impact on slowing the progression of respiratory disorders like chronic obstructive pulmonary disease (COPD). Cigarette smoke is the primary cause of COPD, leading to chronic inflammation, airway remodeling, and destruction of alveolar walls. Quitting smoking provides several benefits:
- Reduced Inflammation: Smoking cessation decreases airway inflammation and oxidative stress, which are key contributors to COPD progression.
- Improved Lung Function: Although damage caused by COPD is irreversible, quitting smoking slows the decline in lung function and improves overall respiratory efficiency.
- Decreased Exacerbations: Smokers who quit experience fewer acute exacerbations of COPD, reducing hospitalizations and improving quality of life.
- Lower Mortality Risk: Smoking cessation reduces the risk of complications such as lung cancer, cardiovascular disease, and respiratory failure, which are common in COPD patients.
Healthcare providers play a vital role in supporting smoking cessation through counseling, nicotine replacement therapy, and medications like varenicline or bupropion. The benefits of quitting smoking are immediate and long-lasting, emphasizing its importance in managing respiratory disorders.
Question:
Explain the diagnostic methods and management strategies for acute respiratory distress syndrome (ARDS).
Answer:
Acute respiratory distress syndrome (ARDS) is a severe condition characterized by rapid-onset respiratory failure due to widespread inflammation and increased permeability of the alveolar-capillary membrane.
Diagnostic Methods:
- Clinical Assessment: Symptoms such as severe dyspnea, hypoxemia unresponsive to oxygen therapy, and bilateral infiltrates on chest imaging.
- Arterial Blood Gas (ABG): Indicates hypoxemia and respiratory acidosis.
- Chest X-Ray/CT Scan: Shows bilateral pulmonary infiltrates consistent with pulmonary edema, without cardiac failure.
- Exclusion of Cardiac Causes: Echocardiography or pulmonary artery catheterization rules out left heart failure.
Management Strategies:
- Ventilatory Support: Use of low tidal volume ventilation and positive end-expiratory pressure (PEEP) to prevent alveolar collapse and maintain oxygenation.
- Prone Positioning: Enhances lung perfusion and oxygenation by redistributing alveolar pressures.
- Fluid Management: Conservative fluid strategies reduce pulmonary edema.
- Treatment of Underlying Cause: Addressing sepsis, trauma, or other triggers.
- Pharmacological Interventions: Use of sedatives, analgesics, and, in some cases, corticosteroids to manage inflammation.
Prompt and multidisciplinary management improves ARDS outcomes, but it remains a condition with high morbidity and mortality.
Question:
Discuss the nursing considerations in the care of a patient with a tracheostomy.
Answer:
Nursing care for a patient with a tracheostomy involves maintaining airway patency, preventing infections, and ensuring patient comfort and safety.
Key Nursing Considerations:
- Airway Patency: Regular suctioning to remove secretions and prevent blockages. Suction should be performed aseptically to reduce infection risk.
- Stoma Care: Cleaning the stoma site with sterile saline to prevent infection and skin breakdown.
- Humidification: Providing humidified air or oxygen to prevent drying of tracheal mucosa.
- Communication: Facilitating communication using writing boards, hand signals, or tracheostomy-speaking valves.
- Emergency Preparedness: Keeping spare tracheostomy tubes and suction equipment at the bedside in case of accidental decannulation.
- Monitoring for Complications: Observing for signs of infection, bleeding, or subcutaneous emphysema.
Education is also critical, teaching patients and caregivers how to perform tracheostomy care at home, including recognizing signs of complications.
Question:
Analyze the effects of pulmonary hypertension on the cardiovascular system.
Answer:
Pulmonary hypertension (PH) is a condition characterized by elevated pressure in the pulmonary arteries, leading to significant cardiovascular complications.
Effects on the Cardiovascular System:
- Right Ventricular Hypertrophy: The increased resistance in pulmonary circulation forces the right ventricle to work harder, leading to hypertrophy and eventual failure (cor pulmonale).
- Reduced Cardiac Output: As the right ventricle fails, it cannot adequately pump blood to the lungs, reducing oxygenation and systemic perfusion.
- Systemic Venous Congestion: Right heart failure causes blood to back up into systemic circulation, resulting in edema, hepatomegaly, and jugular vein distension.
- Arrhythmias: Strain on the heart increases the risk of atrial and ventricular arrhythmias.
Early diagnosis and treatment with vasodilators, oxygen therapy, and anticoagulation are essential to manage PH and prevent severe complications.
Question:
Discuss the significance of early mobilization in patients with post-operative respiratory complications.
Answer:
Early mobilization plays a vital role in preventing and managing post-operative respiratory complications such as atelectasis and pneumonia.
Benefits of Early Mobilization:
- Improves Lung Expansion: Encourages deep breathing and prevents alveolar collapse.
- Promotes Airway Clearance: Mobilizes secretions, reducing the risk of pneumonia.
- Enhances Circulation: Improves blood flow, reducing the risk of pulmonary embolism and venous thromboembolism.
- Boosts Recovery: Strengthens respiratory muscles and overall physical function.
Nurses should encourage patients to engage in activities like sitting up in bed, ambulating, and performing incentive spirometry as part of a comprehensive post-operative care plan.
Question:
Evaluate the impact of environmental factors on the prevalence of respiratory disorders.
Answer:
Environmental factors significantly influence the prevalence and severity of respiratory disorders by affecting air quality and individual susceptibility.
Key Environmental Factors:
- Air Pollution: Exposure to particulate matter (PM2.5), nitrogen oxides, and ozone exacerbates conditions like asthma, COPD, and lung cancer.
- Occupational Hazards: Inhalation of dust, chemicals, and fumes in workplaces increases the risk of pneumoconiosis and other respiratory illnesses.
- Climate Change: Rising temperatures and extreme weather events worsen air quality and increase the prevalence of allergens, triggering respiratory conditions.
- Indoor Pollution: Tobacco smoke, mold, and biomass fuel exposure contribute to chronic respiratory diseases, especially in low-income populations.
Addressing these factors through public health initiatives and individual preventive measures can reduce the global burden of respiratory diseases.