MCA 2: Pulmonary Exam Questions and
Correct Answers
Question 1
A nurse is caring for a patient with a pulmonary embolism who reports sudden
dyspnea, chest pain, and a sense of impending doom. Which action is most
appropriate?
A. Place the patient flat to increase venous return
B. Initiate IV fluids and place the patient in Semi-Fowler's
C. Immediately prepare the patient for embolectomy
D. Withhold anticoagulants until ABGs are completed
Correct Answer
B
Rationale: Management includes IVF and Semi-Fowler's positioning to support
perfusion and oxygenation.
Question 2
Which lab/diagnostic findings are consistent with advanced COPD?
• A. Decreased PaO₂
• B. Elevated PaCO₂
• C. Increased bicarbonate (late stage)
• D. Normal chest x-ray
• E. Increased FRC
Correct Answer
A, B, C, E
Rationale: COPD causes hypoxemia, hypercapnia, increased bicarb (compensatory),
increased FRC, and abnormal chest x-ray.
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,Question 3
A patient with asthma has a PEFR of 350 (normal >400). What is the most appropriate
nursing action?
A. Document the result and reassess in 24 hours
B. Administer a short-acting beta agonist (SABA) and repeat peak flow
C. Provide an anticholinergic inhaler only
D. Order a chest x-ray immediately
Correct Answer
B
Rationale: Notes specify that when PEFR is low, the nurse should administer SABA
and redo peak flow.
Question 4
Which finding indicates cor pulmonale secondary to COPD?
A. Right-sided heart failure
B. Pulmonary embolism
C. Left-sided heart failure
D. Pleural effusion
Correct Answer
A. Right-sided heart failure
Rationale: Cor pulmonale is right-sided heart failure due to pulmonary hypertension
caused by COPD.
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, Question 5
The nurse is preparing to give propranolol to a patient with a history of asthma.
Which action is most appropriate?
A. Administer the drug as ordered
B. Hold the dose and notify the provider
C. Give the medication with a SABA
D. Substitute with a leukotriene modifier
Correct Answer
B
Rationale: Propranolol is a nonselective beta blocker. Notes warn it may worsen
asthma because it affects both beta-1 and beta-2 receptors, leading to
bronchoconstriction.
Question 6
The review notes that "dead space" is the volume of air inhaled that does not
participate in gas exchange. Which of the following patient conditions are examples
of increased dead space ventilation? SATA
A. Pulmonary embolism
B. COPD
C. Pneumonia
D. ARDs
E. Pulmonary edema
Correct Answer
A, B
Rationale: Dead space occurs when alveoli are ventilated but poorly perfused.
Pulmonary embolism and COPD are examples. Pneumonia, ARDs, and pulmonary
edema are associated with shunting, not dead space.
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Correct Answers
Question 1
A nurse is caring for a patient with a pulmonary embolism who reports sudden
dyspnea, chest pain, and a sense of impending doom. Which action is most
appropriate?
A. Place the patient flat to increase venous return
B. Initiate IV fluids and place the patient in Semi-Fowler's
C. Immediately prepare the patient for embolectomy
D. Withhold anticoagulants until ABGs are completed
Correct Answer
B
Rationale: Management includes IVF and Semi-Fowler's positioning to support
perfusion and oxygenation.
Question 2
Which lab/diagnostic findings are consistent with advanced COPD?
• A. Decreased PaO₂
• B. Elevated PaCO₂
• C. Increased bicarbonate (late stage)
• D. Normal chest x-ray
• E. Increased FRC
Correct Answer
A, B, C, E
Rationale: COPD causes hypoxemia, hypercapnia, increased bicarb (compensatory),
increased FRC, and abnormal chest x-ray.
Page 1 of 28
,Question 3
A patient with asthma has a PEFR of 350 (normal >400). What is the most appropriate
nursing action?
A. Document the result and reassess in 24 hours
B. Administer a short-acting beta agonist (SABA) and repeat peak flow
C. Provide an anticholinergic inhaler only
D. Order a chest x-ray immediately
Correct Answer
B
Rationale: Notes specify that when PEFR is low, the nurse should administer SABA
and redo peak flow.
Question 4
Which finding indicates cor pulmonale secondary to COPD?
A. Right-sided heart failure
B. Pulmonary embolism
C. Left-sided heart failure
D. Pleural effusion
Correct Answer
A. Right-sided heart failure
Rationale: Cor pulmonale is right-sided heart failure due to pulmonary hypertension
caused by COPD.
Page 2 of 28
, Question 5
The nurse is preparing to give propranolol to a patient with a history of asthma.
Which action is most appropriate?
A. Administer the drug as ordered
B. Hold the dose and notify the provider
C. Give the medication with a SABA
D. Substitute with a leukotriene modifier
Correct Answer
B
Rationale: Propranolol is a nonselective beta blocker. Notes warn it may worsen
asthma because it affects both beta-1 and beta-2 receptors, leading to
bronchoconstriction.
Question 6
The review notes that "dead space" is the volume of air inhaled that does not
participate in gas exchange. Which of the following patient conditions are examples
of increased dead space ventilation? SATA
A. Pulmonary embolism
B. COPD
C. Pneumonia
D. ARDs
E. Pulmonary edema
Correct Answer
A, B
Rationale: Dead space occurs when alveoli are ventilated but poorly perfused.
Pulmonary embolism and COPD are examples. Pneumonia, ARDs, and pulmonary
edema are associated with shunting, not dead space.
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