NCLEX NGN EAQ RESPIRATORY
SYSTEM QUESTIONS AND ANSWERS
1. A nurse is caring for a client with a history of COPD who is receiving oxygen at 2 L/min via
nasal cannula. The nurse notes the client’s oxygen saturation is 91%. What is the most
appropriate action?
A. Increase the oxygen flow to 4 L/min.
B. Notify the healthcare provider immediately.
C. Switch the client to a non-rebreather mask.
D. Document the finding as normal for this client.
Answer: D
Conceptual Explanation: For clients with COPD, an oxygen saturation between 88% and
92% is often acceptable because a high oxygen concentration can suppress the hypoxic
drive to breathe.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a client with acute
respiratory failure?
A. pH 7.50, PaCO2 30 mmHg
,B. pH 7.35, PaCO2 40 mmHg
C. pH 7.45, PaCO2 35 mmHg
D. pH 7.25, PaCO2 60 mmHg
Answer: D
Conceptual Explanation: Acute respiratory failure is characterized by respiratory acidosis
(low pH) and hypercapnia (high PaCO2) due to the inability to remove CO2.
3. A client is scheduled for a bronchoscopy. Which nursing intervention is essential following
the procedure?
A. Encourage the client to drink fluids immediately.
B. Place the client in a prone position.
C. Administer an oral bronchodilator.
D. Check for the return of the gag reflex before feeding.
Answer: D
Conceptual Explanation: The client’s throat is numbed for a bronchoscopy; therefore, the
nurse must ensure the gag reflex has returned to prevent aspiration before allowing oral
intake.
4. A nurse observes a client using an incentive spirometer. Which action by the client
indicates a need for further teaching?
A. Exhaling forcefully into the device.
, B. Holding the breath for 3 to 5 seconds after inhalation.
C. Inhaling slowly and deeply through the mouthpiece.
D. Performing 10 repetitions every hour while awake.
Answer: A
Conceptual Explanation: Incentive spirometry measures inspiratory volume. The client
should inhale through the device, not exhale into it.
5. The nurse is assessing a client with a chest tube. The nurse notes tidaling in the water seal
chamber. How should the nurse interpret this finding?
A. The system has an air leak.
B. The lung has fully re-expanded.
C. The chest tube is functioning normally.
D. The suction pressure is too high.
Answer: C
Conceptual Explanation: Tidaling (the rise and fall of water with respiration) indicates
that the chest tube system is patent and functioning correctly.
6. A client with tuberculosis (TB) is prescribed Rifampin. What side effect should the nurse
instruct the client to expect?
A. Dizziness and hearing loss.
B. Severe muscle aches and joint pain.
SYSTEM QUESTIONS AND ANSWERS
1. A nurse is caring for a client with a history of COPD who is receiving oxygen at 2 L/min via
nasal cannula. The nurse notes the client’s oxygen saturation is 91%. What is the most
appropriate action?
A. Increase the oxygen flow to 4 L/min.
B. Notify the healthcare provider immediately.
C. Switch the client to a non-rebreather mask.
D. Document the finding as normal for this client.
Answer: D
Conceptual Explanation: For clients with COPD, an oxygen saturation between 88% and
92% is often acceptable because a high oxygen concentration can suppress the hypoxic
drive to breathe.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a client with acute
respiratory failure?
A. pH 7.50, PaCO2 30 mmHg
,B. pH 7.35, PaCO2 40 mmHg
C. pH 7.45, PaCO2 35 mmHg
D. pH 7.25, PaCO2 60 mmHg
Answer: D
Conceptual Explanation: Acute respiratory failure is characterized by respiratory acidosis
(low pH) and hypercapnia (high PaCO2) due to the inability to remove CO2.
3. A client is scheduled for a bronchoscopy. Which nursing intervention is essential following
the procedure?
A. Encourage the client to drink fluids immediately.
B. Place the client in a prone position.
C. Administer an oral bronchodilator.
D. Check for the return of the gag reflex before feeding.
Answer: D
Conceptual Explanation: The client’s throat is numbed for a bronchoscopy; therefore, the
nurse must ensure the gag reflex has returned to prevent aspiration before allowing oral
intake.
4. A nurse observes a client using an incentive spirometer. Which action by the client
indicates a need for further teaching?
A. Exhaling forcefully into the device.
, B. Holding the breath for 3 to 5 seconds after inhalation.
C. Inhaling slowly and deeply through the mouthpiece.
D. Performing 10 repetitions every hour while awake.
Answer: A
Conceptual Explanation: Incentive spirometry measures inspiratory volume. The client
should inhale through the device, not exhale into it.
5. The nurse is assessing a client with a chest tube. The nurse notes tidaling in the water seal
chamber. How should the nurse interpret this finding?
A. The system has an air leak.
B. The lung has fully re-expanded.
C. The chest tube is functioning normally.
D. The suction pressure is too high.
Answer: C
Conceptual Explanation: Tidaling (the rise and fall of water with respiration) indicates
that the chest tube system is patent and functioning correctly.
6. A client with tuberculosis (TB) is prescribed Rifampin. What side effect should the nurse
instruct the client to expect?
A. Dizziness and hearing loss.
B. Severe muscle aches and joint pain.
