1. Dr.

Jones prescribes albuterol sulfate (Proventil)

for a patient with newly diagnose asthma. When
teaching the patient about this drug, the nurse should
explain that it may cause:
A. Nasal congestion
B. Nervousness
C. Lethargy
D. Hyperkalemia
2. Miriam, a college student with acute rhinitis sees
the campus nurse because of excessive nasal
drainage. The nurse asks the patient about the color
of the drainage. In a acute rhinitis, nasal drainage
normally is:
A. Yellow
B. Green
C. Clear
D. Gray
3. A male adult patient hospitalized for treatment of a
pulmonary embolism develops respiratory alkalosis.
Which clinical findings commonly accompany
respiratory alkalosis?
A. Nausea or vomiting
B. Abdominal pain or diarrhea
C. Hallucinations or tinnitus
D. Lightheadedness or paresthesia
4. Before administering ephedrine, Nurse Tony
assesses the patients history. Because of ephedrines
central nervous system (CNS) effects, it is not
recommended for:
A. Patients with an acute asthma attack
B. Patients with narcolepsy
C. Patients under age 6
D. Elderly patients
5. A female patient suffers adult respiratory distress
syndrome as a consequence of shock. The patients
condition deteriorates rapidly, and endotracheal
intubation and mechanical ventilation are initiated.
When the high pressure alarm on the mechanical

ventilator, alarm sounds, the nurse starts to check for

the cause. Which condition triggers the high pressure
alarm?
A. Kinking of the ventilator tubing
B. A disconnected ventilator tube
C. An endotracheal cuff leak
D. A change in the oxygen concentration without resetting
the oxygen level alarm
6. A male adult patient on mechanical ventilation is
receiving pancuronium bromide (Pavulon), 0.01
mg/kg I.V. as needed. Which assessment finding
indicates that the patient needs another pancuronium
dose?
A. Leg movement
B. Finger movement
C. Lip movement
D. Fighting the ventilator
7. On auscultation, which finding suggests a right
pneumothorax?
A. Bilateral inspiratory and expiratory crackles
B. Absence of breaths sound in the right thorax
C. Inspiratory wheezes in the right thorax
D. Bilateral pleural friction rub.
8. Rhea, confused and short breath, is brought to the
emergency department by a family member. The
medical history reveals chronic bronchitis and
hypertension. To learn more about the current
respiratory problem, the doctor orders a chest x-ray
and arterial blood gas (ABG) analysis. When reviewing
the ABG report, the nurses sees many abbreviations.
What does a lowercase a in ABG value present?
A. Acid-base balance
B. Arterial Blood
C. Arterial oxygen saturation
D. Alveoli
9. A male patient is admitted to the health care facility
for treatment of chronic obstructive pulmonary
disease. Which nursing diagnosis is most important

for this patient?

A. Activity intolerance related to fatigue
B. Anxiety related to actual threat to health status
C. Risk for infection related to retained secretions
D. Impaired gas exchange related to airflow obstruction
10. Nurse Ruth assessing a patient for tracheal
displacement should know that the trachea will
deviate toward the:
A. Contralateral side in a simple pneumothorax
B. Affected side in a hemothorax
C. Affected side in a tension pneumothorax
D. Contralateral side in hemothorax
11. After undergoing a left pneumonectomy, a female
patient has a chest tube in place for drainage. When
caring for this patient, the nurse must:
A. Monitor fluctuations in the water-seal chamber
B. Clamp the chest tube once every shift
C. Encourage coughing and deep breathing
D. Milk the chest tube every 2 hours
12. When caring for a male patient who has just had a
total laryngectomy, the nurse should plan to:
A. Encourage oral feeding as soon as possible
B. Develop an alternative communication method
C. Keep the tracheostomy cuff fully inflated
D. Keep the patient flat in bed
13. A male patient has a sucking stab wound to the
chest. Which action should the nurse take first?
A. Drawing blood for a hematocrit and hemoglobin level
B. Applying a dressing over the wound and taping it on three
sides
C. Preparing a chest tube insertion tray
D. Preparing to start an I.V. line
14. For a patient with advance chronic obstructive
pulmonary disease (COPD), which nursing action best
promotes adequate gas exchange?
A. Encouraging the patient to drink three glasses of fluid
daily
B. Keeping the patient in semi-fowlers position

C. Using a high-flow venture mask to deliver oxygen as

prescribe
D. Administering a sedative, as prescribe
15. A male patients X-ray result reveals bilateral
white-outs, indicating adult respiratory distress
syndrome (ARDS). This syndrome results from:
A. Cardiogenic pulmonary edema
B. Respiratory alkalosis
C. Increased pulmonary capillary permeability
D. Renal failure
16. For a female patient with chronic obstructive
pulmonary disease, which nursing intervention would
help maintain a patent airway?
A. Restricting fluid intake to 1,000 ml per day
B. Enforcing absolute bed rest
C. Teaching the patient how to perform controlled coughing
D. Administering prescribe sedatives regularly and in large
amounts
17. Nurse Lei caring for a client with a pneumothorax
and who has had a chest tube inserted notes
continues gentle bubbling in the suction control
chamber. What action is appropriate?
A. Do nothing, because this is an expected finding
B. Immediately clamp the chest tube and notify the
physician
C. Check for an air leak because the bubbling should be
intermittent
D. Increase the suction pressure so that the bubbling
becomes vigorous
18. Nurse Maureen has assisted a physician with the
insertion of a chest tube. The nurse monitors the
client and notes fluctuation of the fluid level in the
water seal chamber after the tube is inserted. Based
on this assessment, which action would be
appropriate?
A. Inform the physician
B. Continue to monitor the client
C. Reinforce the occlusive dressing

D. Encourage the client to deep-breathe

19. Nurse Reynolds caring for a client with a chest
tube turns the client to the side, and the chest tube
accidentally disconnects. The initial nursing action is
to:
A. Call the physician
B. Place the tube in bottle of sterile water
C. Immediately replace the chest tube system
D. Place a sterile dressing over the disconnection site
20. A nurse is assisting a physician with the removal
of a chest tube. The nurse should instruct the client
to:
A. Exhale slowly
B. Stay very still
C. Inhale and exhale quickly
D. Perform the Valsalva maneuver
21. While changing the tapes on a tracheostomy tube,
the male client coughs and tube is dislodged. The
initial nursing action is to:
A. Call the physician to reinsert the tube
B. Grasp the retention sutures to spread the opening
C. Call the respiratory therapy department to reinsert the
tracheotomy
D. Cover the tracheostomy site with a sterile dressing to
prevent infection
22. Nurse Oliver is caring for a client immediately
after removal of the endotracheal tube. The nurse
reports which of the following signs immediately if
experienced by the client?
A. Stridor
B. Occasional pink-tinged sputum
C. A few basilar lung crackles on the right
D. Respiratory rate 24 breaths/min
23. An emergency room nurse is assessing a male
client who has sustained a blunt injury to the chest
wall. Which of these signs would indicate the presence
of a pneumothorax in this client?
A. A low respiratory rate

B. Diminished breath sounds

C. The presence of a barrel chest
D. A sucking sound at the site of injury
24. Nurse Reese is caring for a client hospitalized with
acute exacerbation of chronic obstructive pulmonary
disease. Which of the following would the nurse
expect to note on assessment of this client?
A. Hypocapnia
B. A hyperinflated chest noted on the chest x-ray
C. Increased oxygen saturation with exercise
D. A widened diaphragm noted on the chest x-ray
25. An oxygen delivery system is prescribed for a male
client with chronic obstructive pulmonary disease to
deliver a precise oxygen concentration. Which of the
following types of oxygen delivery systems would the
nurse anticipate to be prescribed?
A. Face tent
B. Venturi mask
C. Aerosol mask
D. Tracheostomy collar
26. Blessy, a community health nurse is conducting an
educational session with community members
regarding tuberculosis. The nurse tells the group that
one of the first symptoms associated with tuberculosis
is:
A. Dyspnea
B. Chest pain
C. A bloody, productive cough
D. A cough with the expectoration of mucoid sputum
27. A nurse performs an admission assessment on a
female client with a diagnosis of tuberculosis. The
nurse reviews the result of which diagnosis test that
will confirm this diagnosis?
A. Bronchoscopy
B. Sputum culture
C. Chest x-ray
D. Tuberculin skin test
28. A nurse is caring for a male client with

emphysema who is receiving oxygen. The nurse

assesses the oxygen flow rate to ensure that it does
not exceed:
A. 1 L/min
B. 2 L/min
C. 6 L/min
D. 10 L/min
29. A nurse instructs a female client to use the
pursed-lip method of breathing and the client asks the
nurse about the purpose of this type of breathing. The
nurse responds, knowing that the primary purpose of
pursed-lip breathing is to:
A. Promote oxygen intake
B. Strengthen the diaphragm
C. Strengthen the intercostal muscles
D. Promote carbon dioxide elimination
30. A nurse is caring for a male client with acute
respiratory distress syndrome. Which of the following
would the nurse expect to note in the client?
A. Pallor
B. Low arterial PaO2
C. Elevated arterial PaO2
D. Decreased respiratory rate
31. A nurse is preparing to obtain a sputum specimen
from a male client. Which of the following nursing
actions will facilitate obtaining the specimen?
A. Limiting fluid
B. Having the client take deep breaths
C. Asking the client to spit into the collection container
D. Asking the client to obtain the specimen after eating
32. Nurse Joy is caring for a client after a
bronchoscopy and biopsy. Which of the following
signs, if noticed in the client, should be reported
immediately to the physician?
A. Dry cough
B. Hermaturia
C. Bronchospasm
D. Blood-streaked sputum

33. A nurse is suctioning fluids from a male client via

a tracheostomy tube. When suctioning, the nurse
must limit the suctioning time to a maximum of:
A. 1 minute
B. 5 seconds
C. 10 seconds
D. 30 seconds
34. A nurse is suctioning fluids from a female client
through an endotracheal tube. During the suctioning
procedure, the nurse notes on the monitor that the
heart rate is decreasing. Which if the following is the
appropriate nursing intervention?
A. Continue to suction
B. Notify the physician immediately
C. Stop the procedure and reoxygenate the client
D. Ensure that the suction is limited to 15 seconds
35. A male adult client is suspected of having a
pulmonary embolus. A nurse assesses the client,
knowing that which of the following is a common
clinical manifestation of pulmonary embolism?
A. Dyspnea
B. Bradypnea
C. Bradycardia
D. Decreased respirations
36. A slightly obese female client with a history of
allergy-induced asthma, hypertension, and mitral
valve prolapse is admitted to an acute care facility for
elective surgery. The nurse obtains a complete history
and performs a thorough physical examination, paying
special attention to the cardiovascular and respiratory
systems. When percussing the clients chest wall, the
nurse expects to elicit:
A. Resonant sounds.
B. Hyperresonant sounds.
C. Dull sounds.
D. Flat sounds.
37. A male client who weighs 175 lb (79.4 kg) is
receiving aminophylline (Aminophyllin) (400 mg in

500 ml) at 50 ml/hour. The theophylline level is

reported as 6 mcg/ml. The nurse calls the physician
who instructs the nurse to change the dosage to 0.45
mg/kg/hour. The nurse should:
A. Question the order because its too low.
B. Question the order because its too high.
C. Set the pump at 45 ml/hour.
D. Stop the infusion and have the laboratory repeat the
theophylline measurement.
38. The nurse is teaching a male client with chronic
bronchitis about breathing exercises. Which of the
following should the nurse include in the teaching?
A. Make inhalation longer than exhalation.
B. Exhale through an open mouth.
C. Use diaphragmatic breathing.
D. Use chest breathing.
39. Which phrase is used to describe the volume of air
inspired and expired with a normal breath?
A. Total lung capacity
B. Forced vital capacity
C. Tidal volume
D. Residual volume
40. A male client abruptly sits up in bed, reports
having difficulty breathing and has an arterial oxygen
saturation of 88%. Which mode of oxygen delivery
would most likely reverse the manifestations?
A. Simple mask
B. Non-rebreather mask
C. Face tent
D. Nasal cannula
41. A female client must take streptomycin for
tuberculosis. Before therapy begins, the nurse should
instruct the client to notify the physician if which
health concern occurs?
A. Impaired color discrimination
B. Increased urinary frequency
C. Decreased hearing acuity
D. Increased appetite

42. A male client is asking the nurse a question

regarding the Mantoux test for tuberculosis. The nurse
should base her response on the fact that the:
A. Area of redness is measured in 3 days and determines
whether tuberculosis is present.
B. Skin test doesnt differentiate between active and
dormant tuberculosis infection.
C. Presence of a wheal at the injection site in 2 days
indicates active tuberculosis.
D. Test stimulates a reddened response in some clients and
requires a second test in 3 months.
43. A female adult client has a tracheostomy but
doesnt require continuous mechanical ventilation.
When weaning the client from the tracheostomy tube,
the nurse initially should plug the opening in the tube
for:
A. 15 to 60 seconds.
B. 5 to 20 minutes.
C. 30 to 40 minutes.
D. 45 to 60 minutes.
44. Nurse Oliver observes constant bubbling in the
water-seal chamber of a closed chest drainage
system. What should the nurse conclude?
A. The system is functioning normally
B. The client has a pneumothorax.
C. The system has an air leak.
D. The chest tube is obstructed.
45. A black client with asthma seeks emergency care
for acute respiratory distress. Because of this clients
dark skin, the nurse should assess for cyanosis by
inspecting the:
A. Lips.
B. Mucous membranes.
C. Nail beds.
D. Earlobes.
46. For a male client with an endotracheal (ET) tube,
which nursing action is most essential?
A. Auscultating the lungs for bilateral breath sounds

B. Turning the client from side to side every 2 hours

C. Monitoring serial blood gas values every 4 hours
D. Providing frequent oral hygiene
47. The nurse assesses a male clients respiratory
status. Which observation indicates that the client is
experiencing difficulty breathing?
A. Diaphragmatic breathing
B. Use of accessory muscles
C. Pursed-lip breathing
D. Controlled breathing
48. A female client is undergoing a complete physical
examination as a requirement for college. When
checking the clients respiratory status, the nurse
observes respiratory excursion to help assess:
A. Lung vibrations.
B. Vocal sounds.
C. Breath sounds.
D. Chest movements.
49. A male client comes to the emergency department
complaining of sudden onset of diarrhea, anorexia,
malaise, cough, headache, and recurrent chills. Based
on the clients history and physical findings, the
physician suspects legionnaires disease. While
awaiting diagnostic test results, the client is admitted
to the facility and started on antibiotic therapy. What
is the drug of choice for treating legionnaires
disease?
A. Erythromycin (Erythrocin)
B. Rifampin (Rifadin)
C. Amantadine (Symmetrel)
D. Amphotericin B (Fungizone)
50. A male client with chronic obstructive pulmonary
disease (COPD) is recovering from a myocardial
infarction. Because the client is extremely weak and
cant produce an effective cough, the nurse should
monitor closely for:
A. Pleural effusion.
B. Pulmonary edema.

C. Atelectasis.
D. Oxygen toxicity.
51. The nurse in charge is teaching a client with
emphysema how to perform pursed-lip breathing. The
client asks the nurse to explain the purpose of this
breathing technique. Which explanation should the
nurse provide?
A. It helps prevent early airway collapse.
B. It increases inspiratory muscle strength.
C. It decreases use of accessory breathing muscles.
D. It prolongs the inspiratory phase of respiration.
52. After receiving an oral dose of codeine for an
intractable cough, the male client asks the nurse,
How long will it take for this drug to work? How
should the nurse respond?
A. In 30 minutes
B. In 1 hour
C. In 2.5 hours
D. In 4 hours
53. A male client suffers adult respiratory distress
syndrome as a consequence of shock. The clients
condition deteriorates rapidly, and endotracheal (ET)
intubation and mechanical ventilation are initiated.
When the high-pressure alarm on the mechanical
ventilator sounds, the nurse starts to check for the
cause. Which condition triggers the high-pressure
alarm?
A. Kinking of the ventilator tubing
B. A disconnected ventilator tube
C. An ET cuff leak
D. A change in the oxygen concentration without resetting
the oxygen level alarm
54. A female client with chronic obstructive
pulmonary disease (COPD) takes anhydrous
theophylline, 200 mg P.O. every 8 hours. During a
routine clinic visit, the client asks the nurse how the
drug works. What is the mechanism of action of
anhydrous theophylline in treating a nonreversible

obstructive airway disease such as COPD?

A. It makes the central respiratory center more sensitive to
carbon dioxide and stimulates the respiratory drive.
B. It inhibits the enzyme phosphodiesterase, decreasing
degradation of cyclic adenosine monophosphate, a
bronchodilator.
C. It stimulates adenosine receptors, causing
bronchodilation.
D. It alters diaphragm movement, increasing chest
expansion and enhancing the lungs capacity for gas
exchange.
55. A male client with pneumococcal pneumonia is
admitted to an acute care facility. The client in the
next room is being treated for mycoplasmal
pneumonia. Despite the different causes of the
various types of pneumonia, all of them share which
feature?
A. Inflamed lung tissue
B. Sudden onset
C. Responsiveness to penicillin.
D. Elevated white blood cell (WBC) count
56. A client with Guillain-Barr syndrome develops
respiratory acidosis as a result of reduced alveolar
ventilation. Which combination of arterial blood gas
(ABG) values confirms respiratory acidosis?
A. pH, 5.0; PaCO2 30 mm Hg
B. pH, 7.40; PaCO2 35 mm Hg
C. pH, 7.35; PaCO2 40 mm Hg
D. pH, 7.25; PaCO2 50 mm Hg
57. A male client admitted to an acute care facility
with pneumonia is receiving supplemental oxygen, 2
L/minute via nasal cannula. The clients history
includes chronic obstructive pulmonary disease
(COPD) and coronary artery disease. Because of these
history findings, the nurse closely monitors the
oxygen flow and the clients respiratory status. Which
complication may arise if the client receives a high
oxygen concentration?

A. Apnea
B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
58. At 11 p.m., a male client is admitted to the
emergency department. He has a respiratory rate of
44 breaths/minute. Hes anxious, and wheezes are
audible. The client is immediately given oxygen by
face mask and methylprednisolone (Depo-medrol) I.V.
At 11:30 p.m., the clients arterial blood oxygen
saturation is 86% and hes still wheezing. The nurse
should plan to administer:
A. Alprazolam (Xanax).
B. Propranolol (Inderal)
C. Morphine.
D. Albuterol (Proventil).
59. After undergoing a thoracotomy, a male client is
receiving epidural analgesia. Which assessment
finding indicates that the client has developed the
most serious complication of epidural analgesia?
A. Heightened alertness
B. Increased heart rate
C. Numbness and tingling of the extremities
D. Respiratory depression
60. The nurse in charge formulates a nursing
diagnosis of Activity intolerance related to inadequate
oxygenation and dyspnea for a client with chronic
bronchitis. To minimize this problem, the nurse
instructs the client to avoid conditions that increase
oxygen demands. Such conditions include:
A. Drinking more than 1,500 ml of fluid daily.
B. Being overweight.
C. Eating a high-protein snack at bedtime.
D. Eating more than three large meals a day