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ATI MED SURG RESPIRATORY – SECTION ONE
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CORE DOMAINS
• Respiratory Assessment and Diagnostic Testing
• Oxygenation and Ventilation
• Airway Management and Mechanical Ventilation
• Asthma and Chronic Obstructive Pulmonary Disease
• Pneumonia and Respiratory Infections
• Pulmonary Embolism and Other Vascular Disorders
• Pleural, Thoracic, and Pulmonary Disorders
• Respiratory Medications and Pharmacologic Management
• Postoperative and Emergency Respiratory Care
• Patient Education, Safety, and Clinical Decision-Making
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INTRODUCTION
This comprehensive assessment is designed to strengthen knowledge and clinical reasoning
related to adult respiratory medical-surgical nursing. The questions evaluate respiratory
assessment, oxygenation, ventilation, airway management, diagnostic findings, common
pulmonary disorders, pharmacologic therapy, complications, safety priorities, and patient
education. Multiple-choice questions emphasize both foundational knowledge and practical
application, requiring the learner to recognize clinical patterns, prioritize interventions,
interpret findings, and distinguish between closely related concepts. Understanding the
underlying physiology and rationale for nursing actions is essential because respiratory
conditions can deteriorate rapidly. The assessment therefore combines recall, application,
analysis, and professional judgment to support preparation for examination-style questions
and clinical practice.
SECTION ONE: QUESTIONS 1–100
Question 1. Which assessment finding is most concerning for a client experiencing acute
respiratory compromise?
A. Respiratory rate of 20/min
B. Oxygen saturation of 96% on room air
C. New onset confusion and restlessness
D. Productive cough with clear sputum
,Correct Answer: C. New onset confusion and restlessness
Explanation: Acute changes in mental status can indicate inadequate cerebral oxygenation
and worsening hypoxemia. Restlessness and confusion may occur before more obvious signs
of respiratory failure and require prompt assessment and intervention.
Question 2. Which position should the nurse place a client in to promote lung expansion
during an episode of dyspnea?
A. High-Fowler's position
B. Supine position
C. Trendelenburg position
D. Flat side-lying position
Correct Answer: A. High-Fowler's position
Explanation: High-Fowler's positioning increases thoracic expansion and allows the
diaphragm to move more effectively. It is commonly used to improve ventilation in clients
experiencing respiratory distress.
Question 3. Which finding is expected in a client with chronic hypoxemia?
A. Clubbing of the fingers
B. Bradycardia
C. Decreased hematocrit
D. Sudden unilateral absent breath sounds
Correct Answer: A. Clubbing of the fingers
Explanation: Chronic hypoxemia can stimulate tissue changes that result in digital clubbing.
It is associated with prolonged oxygenation problems and should be interpreted in the
context of the client's overall respiratory history.
Question 4. A nurse is assessing a client with pneumonia. Which finding most strongly
supports the presence of alveolar consolidation?
A. Hyperresonance to percussion
B. Bronchial breath sounds over a peripheral lung field
C. Decreased tactile fremitus over the affected area
D. Silent chest with severe wheezing
Correct Answer: B. Bronchial breath sounds over a peripheral lung field
Explanation: Consolidated lung tissue transmits bronchial sounds more effectively than
normal air-filled lung tissue. Bronchial breath sounds heard over a normally peripheral
vesicular area can therefore suggest consolidation.
, Question 5. Which oxygen-delivery device provides the most precise concentration of
oxygen for a spontaneously breathing client?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
Correct Answer: C. Venturi mask
Explanation: A Venturi mask delivers a controlled and relatively precise fraction of inspired
oxygen. This makes it particularly useful when careful oxygen concentration control is
important.
Question 6. A client with chronic respiratory disease is receiving oxygen therapy. Which
assessment is the priority?
A. Skin temperature
B. Level of consciousness and respiratory status
C. Appetite
D. Bowel sounds
Correct Answer: B. Level of consciousness and respiratory status
Explanation: Oxygen therapy must be accompanied by close monitoring of respiratory status
and mental status. Changes can indicate worsening ventilation, hypoxemia, or other
respiratory complications.
Question 7. Which instruction should the nurse provide to a client using an incentive
spirometer?
A. Exhale forcefully into the device
B. Inhale slowly and deeply through the mouthpiece
C. Use the device only when shortness of breath occurs
D. Breathe rapidly to raise the indicator
Correct Answer: B. Inhale slowly and deeply through the mouthpiece
Explanation: Incentive spirometry promotes sustained maximal inspiration. The client should
inhale slowly and deeply through the mouthpiece to encourage alveolar expansion and help
prevent atelectasis.
Question 8. Which assessment finding is characteristic of a client experiencing an asthma
exacerbation?
A. Expiratory wheezing
B. Fixed bradycardia