NCLEX Test Bank: Respiratory NCLEX, Neuro NCLEX,
GI NCLEX, Orthopadic NCLEX, Cardio, GI NCLEX
1. A client with COPD has an ABG: pH 7.31, PaCO2 55, HCO3 30. The nurse interprets this as:
• A) Metabolic acidosis, uncompensated
• B) Respiratory acidosis, partially compensated
• C) Respiratory alkalosis, fully compensated
• D) Metabolic alkalosis, uncompensated
Answer: B
• Rationale: Low pH = acidosis. High PaCO2 = respiratory cause. High HCO3 = kidneys
trying to compensate, but pH is not normal → partially compensated.
• A: Wrong because primary issue is respiratory, not metabolic.
• C: Wrong because pH is low (acidosis), not high (alkalosis).
• D: Wrong because pH and PaCO2 indicate respiratory acidosis.
2. The nurse hears absent breath sounds on the left side in a post-op chest tube patient. What
is the priority action?
• A) Reposition the patient
• B) Notify the provider immediately
• C) Check the chest tube for kinks
• D) Increase oxygen flow
Answer: C
• Rationale: Absent breath sounds may indicate a pneumothorax or tube malfunction.
First check for kinks or disconnection.
• A: Repositioning may help but is not the first step.
• B: Notify after checking the tube.
• D: Oxygen doesn’t fix a mechanical issue.
,3. A client with a tracheostomy has thick, dry secretions. Which intervention is best?
• A) Suction every hour
• B) Increase water intake
• C) Instill normal saline into the trach
• D) Apply a trach collar with humidified oxygen
Answer: D
• Rationale: Humidified oxygen loosens thick secretions.
• A: Suctioning too often causes mucosal damage.
• B: May help but slower and less direct.
• C: No longer routine; can cause infection.
4. Which finding indicates a tension pneumothorax?
• A) Respiratory distress + tracheal deviation
• B) Bradycardia and hypotension
• C) Wheezing on expiration
• D) Productive cough with green sputum
Answer: A
• Rationale: Tension pneumothorax shifts mediastinum, causing tracheal deviation away
from the affected side.
• B: Tachycardia occurs first.
• C: Wheezing suggests asthma.
• D: Infection not pneumothorax.
5. The nurse teaches a TB patient. Which statement shows correct understanding?
• A) "I can stop my meds when I feel better."
, • B) "I will take meds for 6–12 months."
• C) "I only need to isolate until my cough stops."
• D) "I should take meds on an empty stomach."
Answer: B
• Rationale: TB treatment is 6–12 months.
• A: Incomplete treatment causes resistance.
• C: Isolation is until sputum cultures are negative.
• D: Some TB drugs (like rifampin) are better with food.
6. A patient on mechanical ventilation has a high-pressure alarm. What is the first action?
• A) Sedate the patient
• B) Listen for breath sounds
• C) Increase FiO2
• D) Call respiratory therapy
Answer: B
• Rationale: High-pressure alarms often mean secretions, kink, or bronchospasm—listen
to assess first.
• A: Sedation may be needed but not first.
• C: Not the priority.
• D: You can call after assessment.
7. Which oxygen delivery device delivers the most precise FiO2?
• A) Nasal cannula
• B) Simple face mask
• C) Venturi mask
• D) Non-rebreather mask
GI NCLEX, Orthopadic NCLEX, Cardio, GI NCLEX
1. A client with COPD has an ABG: pH 7.31, PaCO2 55, HCO3 30. The nurse interprets this as:
• A) Metabolic acidosis, uncompensated
• B) Respiratory acidosis, partially compensated
• C) Respiratory alkalosis, fully compensated
• D) Metabolic alkalosis, uncompensated
Answer: B
• Rationale: Low pH = acidosis. High PaCO2 = respiratory cause. High HCO3 = kidneys
trying to compensate, but pH is not normal → partially compensated.
• A: Wrong because primary issue is respiratory, not metabolic.
• C: Wrong because pH is low (acidosis), not high (alkalosis).
• D: Wrong because pH and PaCO2 indicate respiratory acidosis.
2. The nurse hears absent breath sounds on the left side in a post-op chest tube patient. What
is the priority action?
• A) Reposition the patient
• B) Notify the provider immediately
• C) Check the chest tube for kinks
• D) Increase oxygen flow
Answer: C
• Rationale: Absent breath sounds may indicate a pneumothorax or tube malfunction.
First check for kinks or disconnection.
• A: Repositioning may help but is not the first step.
• B: Notify after checking the tube.
• D: Oxygen doesn’t fix a mechanical issue.
,3. A client with a tracheostomy has thick, dry secretions. Which intervention is best?
• A) Suction every hour
• B) Increase water intake
• C) Instill normal saline into the trach
• D) Apply a trach collar with humidified oxygen
Answer: D
• Rationale: Humidified oxygen loosens thick secretions.
• A: Suctioning too often causes mucosal damage.
• B: May help but slower and less direct.
• C: No longer routine; can cause infection.
4. Which finding indicates a tension pneumothorax?
• A) Respiratory distress + tracheal deviation
• B) Bradycardia and hypotension
• C) Wheezing on expiration
• D) Productive cough with green sputum
Answer: A
• Rationale: Tension pneumothorax shifts mediastinum, causing tracheal deviation away
from the affected side.
• B: Tachycardia occurs first.
• C: Wheezing suggests asthma.
• D: Infection not pneumothorax.
5. The nurse teaches a TB patient. Which statement shows correct understanding?
• A) "I can stop my meds when I feel better."
, • B) "I will take meds for 6–12 months."
• C) "I only need to isolate until my cough stops."
• D) "I should take meds on an empty stomach."
Answer: B
• Rationale: TB treatment is 6–12 months.
• A: Incomplete treatment causes resistance.
• C: Isolation is until sputum cultures are negative.
• D: Some TB drugs (like rifampin) are better with food.
6. A patient on mechanical ventilation has a high-pressure alarm. What is the first action?
• A) Sedate the patient
• B) Listen for breath sounds
• C) Increase FiO2
• D) Call respiratory therapy
Answer: B
• Rationale: High-pressure alarms often mean secretions, kink, or bronchospasm—listen
to assess first.
• A: Sedation may be needed but not first.
• C: Not the priority.
• D: You can call after assessment.
7. Which oxygen delivery device delivers the most precise FiO2?
• A) Nasal cannula
• B) Simple face mask
• C) Venturi mask
• D) Non-rebreather mask
