WKU NUR 102 EXAM 3 STUDY GUIDE 2026/2027 – NURSING PRACTICE
QUESTIONS, EXAM REVIEW & TEST PREP
1. Your patient has a chronic condition that makes breathing difficult. Name and describe nursing
interventions to promote adequate respiratory functioning. - correct answer ✔✔Positioning
(Fowler's/high Fowler's)
Maintaining adequate fluid intake (to break up secretions)
Provide oxygen
Provide humidified air
Incentive spirometry
Teach pursed-lip breathing
Ambulate, as appropriate
Teach diaphragmatic breathing
Admin pain meds as prescribed
Maintain a patent airway
Auscultate breath sounds, noting areas of decreased or absent ventilation and presence of adventitious
sounds.
Initiate a program of respiratory muscle strength and/or endurance training, as appropriate.
pg.1418-1420)
2. When patients have fluid, blood, or air in the pleural space they may require a chest tube. What are
the guidelines for caring for a patient with a chest tube? - correct answer ✔✔Nursing responsibilities
include assisting with insertion and removal of a chest tube. Once the tube is in place, monitor the
patient's respiratory status and vital signs, check the dressing, and maintain the patency and integrity of
the drainage system
Observe the dressing around the chest tube insertion site and ensure that it is occlusive. Gently palpate
around the insertion site, feeling for crepitus, a result of air or gas collecting under the skin
(subcutaneous emphysema). Tape all connections securely. Check that the drainage tube has no
dependent loops or kinks. Make sure the drainage collection device is positioned below the tube
insertion site to facilitate drainage. Observe the water-seal chamber for fluctuations of the water level
with the patient's inspiration and expiration (tidaling). If suction is used, temporarily disconnect the
suction to observe for fluctuation. Assess for the presence of bubbling in the water-seal chamber. Add
water, if necessary, to maintain the level at the 2-cm mark, or the mark recommended by the
manufacturer. Assess the suction control chamber if suction is in use. If water suction is used, ensure
that water is at the appropriate level; add water to ensure that suction is adequate. Gentle bubbling in
the suction chamber indicates that suction is being applied to assist drainage. Keep the drainage
collection device secure so that it does not tip over. Check that two padded Kelly clamps are available
and secured at the bedside. If the drainage unit requires changing, position one clamp 1½ to 2½ inches
from the insertion site; position the second clamp 1 inch down from the first one until the unit has been
switched. Alternately, many systems have integrated clamps on the tubing. The chest tube may be
clamped before its removal to observe the patient's tolerance when it is discon
3. When a patient is sick with pneumonia and her oxygen saturation is low, what does mean on a
physiological level? - correct answer ✔✔Hemoglobin carries less than normal amounts of oxygen,
carbonic acid levels go up.
, Incomplete lung expansion or the collapse of alveoli, known as atelectasis, prevents pressure changes
and the exchange of gas by diffusion in the lungs. Areas of the lung with atelectasis cannot fulfill the
function of respiration
(p. 1490, 1400)
4. Respiratory rates are different for various ages. What is a normal adult respiratory rate? Newborn?
Aged (old) adult? - correct answer ✔✔Birth - 1 year: 30-55 breaths/min
Normal adult: 12-20 breaths/min
Aged (old) adult: 16-24 breaths/min
(p. 1405)
5. Children get more routine colds and infections when they enter daycare or school. Why? Is this
considered normal? Should it be cause for concern? - correct answer ✔✔The preschool child's
eustachian tubes, bronchi, and bronchioles are elongated and less angular. Thus, the average number of
routine colds and infections decreases until the child enters daycare or school and is exposed more
frequently to pathogens. Young children who are not placed in daycare usually have not had the
opportunity to develop antibodies for the variety of viruses and bacteria they may encounter in a school
setting.
No cause for concern unless its more serious problems i.e. otitis media, bronchitis, and pneumonia.
6. Your patient is having respiratory distress. What interventions can you do to support his breathing? -
correct answer ✔✔Positioning (Fowler's/high Fowler's)
Maintaining adequate fluid intake (to break up secretions)
Provide oxygen
Provide humidified air
Incentive spirometry
Teach pursed-lip breathing
Ambulate, as appropriate
Teach diaphragmatic breathing
Admin pain meds as prescribed
Maintain a patent airway
Auscultate breath sounds, noting areas of decreased or absent ventilation and presence of adventitious
sounds.
Initiate a program of respiratory muscle strength and/or endurance training, as appropriate.
p.1418-1420)
7. What are the different types of adventitious breath sounds? Describe them and when in the cycle of
respiration would you expect to hear them. What conditions might they be associated with? - correct
answer ✔✔Wheezes are continuous, high-pitched squeak or musical sound, produced as air passes
through airways constricted by swelling, narrowing, secretions, or tumors. They are often heard in
patients with asthma, tumors, or a buildup of secretions.
Crackles, frequently heard on inspiration, are soft, high-pitched discontinuous (intermittent) popping
sounds. They are produced by fluid in the airways or alveoli and delayed reopening of collapsed alveoli.
They occur due to inflammation or congestion and are associated with pneumonia, heart failure,
bronchitis, and COPD
Friction Rub
QUESTIONS, EXAM REVIEW & TEST PREP
1. Your patient has a chronic condition that makes breathing difficult. Name and describe nursing
interventions to promote adequate respiratory functioning. - correct answer ✔✔Positioning
(Fowler's/high Fowler's)
Maintaining adequate fluid intake (to break up secretions)
Provide oxygen
Provide humidified air
Incentive spirometry
Teach pursed-lip breathing
Ambulate, as appropriate
Teach diaphragmatic breathing
Admin pain meds as prescribed
Maintain a patent airway
Auscultate breath sounds, noting areas of decreased or absent ventilation and presence of adventitious
sounds.
Initiate a program of respiratory muscle strength and/or endurance training, as appropriate.
pg.1418-1420)
2. When patients have fluid, blood, or air in the pleural space they may require a chest tube. What are
the guidelines for caring for a patient with a chest tube? - correct answer ✔✔Nursing responsibilities
include assisting with insertion and removal of a chest tube. Once the tube is in place, monitor the
patient's respiratory status and vital signs, check the dressing, and maintain the patency and integrity of
the drainage system
Observe the dressing around the chest tube insertion site and ensure that it is occlusive. Gently palpate
around the insertion site, feeling for crepitus, a result of air or gas collecting under the skin
(subcutaneous emphysema). Tape all connections securely. Check that the drainage tube has no
dependent loops or kinks. Make sure the drainage collection device is positioned below the tube
insertion site to facilitate drainage. Observe the water-seal chamber for fluctuations of the water level
with the patient's inspiration and expiration (tidaling). If suction is used, temporarily disconnect the
suction to observe for fluctuation. Assess for the presence of bubbling in the water-seal chamber. Add
water, if necessary, to maintain the level at the 2-cm mark, or the mark recommended by the
manufacturer. Assess the suction control chamber if suction is in use. If water suction is used, ensure
that water is at the appropriate level; add water to ensure that suction is adequate. Gentle bubbling in
the suction chamber indicates that suction is being applied to assist drainage. Keep the drainage
collection device secure so that it does not tip over. Check that two padded Kelly clamps are available
and secured at the bedside. If the drainage unit requires changing, position one clamp 1½ to 2½ inches
from the insertion site; position the second clamp 1 inch down from the first one until the unit has been
switched. Alternately, many systems have integrated clamps on the tubing. The chest tube may be
clamped before its removal to observe the patient's tolerance when it is discon
3. When a patient is sick with pneumonia and her oxygen saturation is low, what does mean on a
physiological level? - correct answer ✔✔Hemoglobin carries less than normal amounts of oxygen,
carbonic acid levels go up.
, Incomplete lung expansion or the collapse of alveoli, known as atelectasis, prevents pressure changes
and the exchange of gas by diffusion in the lungs. Areas of the lung with atelectasis cannot fulfill the
function of respiration
(p. 1490, 1400)
4. Respiratory rates are different for various ages. What is a normal adult respiratory rate? Newborn?
Aged (old) adult? - correct answer ✔✔Birth - 1 year: 30-55 breaths/min
Normal adult: 12-20 breaths/min
Aged (old) adult: 16-24 breaths/min
(p. 1405)
5. Children get more routine colds and infections when they enter daycare or school. Why? Is this
considered normal? Should it be cause for concern? - correct answer ✔✔The preschool child's
eustachian tubes, bronchi, and bronchioles are elongated and less angular. Thus, the average number of
routine colds and infections decreases until the child enters daycare or school and is exposed more
frequently to pathogens. Young children who are not placed in daycare usually have not had the
opportunity to develop antibodies for the variety of viruses and bacteria they may encounter in a school
setting.
No cause for concern unless its more serious problems i.e. otitis media, bronchitis, and pneumonia.
6. Your patient is having respiratory distress. What interventions can you do to support his breathing? -
correct answer ✔✔Positioning (Fowler's/high Fowler's)
Maintaining adequate fluid intake (to break up secretions)
Provide oxygen
Provide humidified air
Incentive spirometry
Teach pursed-lip breathing
Ambulate, as appropriate
Teach diaphragmatic breathing
Admin pain meds as prescribed
Maintain a patent airway
Auscultate breath sounds, noting areas of decreased or absent ventilation and presence of adventitious
sounds.
Initiate a program of respiratory muscle strength and/or endurance training, as appropriate.
p.1418-1420)
7. What are the different types of adventitious breath sounds? Describe them and when in the cycle of
respiration would you expect to hear them. What conditions might they be associated with? - correct
answer ✔✔Wheezes are continuous, high-pitched squeak or musical sound, produced as air passes
through airways constricted by swelling, narrowing, secretions, or tumors. They are often heard in
patients with asthma, tumors, or a buildup of secretions.
Crackles, frequently heard on inspiration, are soft, high-pitched discontinuous (intermittent) popping
sounds. They are produced by fluid in the airways or alveoli and delayed reopening of collapsed alveoli.
They occur due to inflammation or congestion and are associated with pneumonia, heart failure,
bronchitis, and COPD
Friction Rub
