ATI Medical Surgical Respiratory Retake Exam
with NGN Questions and Verified Rationalized Answers,
100% A+ Graded Guarantee (2024/2025)
With 52 multiple choices questions and answers
1. A patient with acute shortness of breath is admitted to the hospital. Whichaction
should the nurse take during the initial assessment of the patient?
a. Ask the patient to lie down to complete a full physical assessment.
b. Briefly ask specific questions about this episode of respiratory distress.
c. Complete the admission database to check for allergies before treatment.
d. Delay the physical assessment to first complete pulmonary function tests.-
: ANS: B
When a patient has severe respiratory distress, only information pertinent to the current
episode is obtained, and a more thorough assessment is deferred until later. Obtaining a
comprehensive health history or full physical examination is unnecessary until the acute
distress has resolved. Brief questioning and a focusedphysical assessment should be done
rapidly to help determine the cause of the distress and suggest treatment. Checking for
allergies is important, but it is not appropriate to complete the entire admission database at
,this time. The initial respi-ratory assessment must be completed before any diagnostic
tests or interventionscan be ordered.
2. The nurse prepares a patient with a left-sided pleural effusion for a thora-centesis.
How should the nurse position the patient?
a. Supine with the head of the bed elevated 30 degrees
b. In a high-Fowler's position with the left arm extended
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table: ANS: D
The upright position with the arms supported increases lung expansion, allows fluidto
collect at the lung bases, and expands the intercostal space so that access to thepleural
space is easier. The other positions would increase the work of breathing for the patient
and make it more difficult for the health care provider performing thethoracentesis.
3. A diabetic patient's arterial blood gas (ABG) results are pH 7.28; PaCO2 34mm Hg;
PaO2 85 mm Hg; HCO3- 18 mEq/L. The nurse would expect which finding?
a. Intercostal retractions
b. Kussmaul respirations
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure: ANS: B
Kussmaul (deep and rapid) respirations are a compensatory mechanism for meta-bolic
acidosis. The low pH and low bicarbonate result indicate metabolic acidosis. Intercostal
retractions, a low oxygen saturation rate, and a decrease in venous O2pressure would not
be caused by acidosis.
,4. On auscultation of a patient's lungs, the nurse hears low-pitched, bubblingsounds
during inhalation in the lower third of both lungs. How should the nurse document this
finding?
a. Inspiratory crackles at the bases
b. Expiratory wheezes in both lungs
c. Abnormal lung sounds in the apices of both lungs
d. Pleural friction rub in the right and left lower lobes: ANS: A
Crackles are low-pitched, bubbling sounds usually heard on inspiration. Wheezes are high-
pitched sounds. They can be heard during the expiratory or inspiratory phase of the
respiratory cycle.The lower third of both lungs are the bases, not apices.Pleural friction rubs ar
grating sounds that are usually heard during both inspirationand expiration.
5. The nurse palpates the posterior chest while the patient says "99" and notesabsent
fremitus. Which action should the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep breathe.
c. Review the chest x-ray report for evidence of pneumonia.
d. Auscultate anterior and posterior breath sounds bilaterally.: ANS: D To assess
for tactile fremitus, the nurse should use the palms of the hands toassess for
vibration when the patient repeats a word or phrase such as "99."
After noting absent fremitus, the nurse should then auscultate the lungs to assessfor the
presence or absence of breath sounds. Absent fremitus may be noted
with pneumothorax or atelectasis. The vibration is increased in conditions such as
pneumonia, lung tumors, thick bronchial secretions, and pleural effusion. Turning,
coughing, and deep breathing is an appropriate intervention for atelectasis, but the nurse
, needs to first assess breath sounds. Fremitus is decreased if the hand is farther from the
lung or the lung is hyperinflated (barrel chest).The anterior of the chest is more difficult to
palpate for fremitus because of the presence of largemuscles and breast tissue.
6. A patient with a chronic cough has a bronchoscopy. After the procedure,which
intervention by the nurse is most appropriate?
a. Elevate the head of the bed to 80 to 90 degrees.
b. Keep the patient NPO until the gag reflex returns.
c. Place on bed rest for at least 4 hours after bronchoscopy.
d. Notify the health care provider about blood-tinged mucus.: ANS: B
Risk for aspiration and maintaining an open airway is the priority. Because a local
anesthetic is used to suppress the gag/cough reflexes during bronchoscopy, the nurse
should monitor for the return of these reflexes before allowing the patient totake oral
fluids or food. Blood-tinged mucus is not uncommon after bronchoscopy.
with NGN Questions and Verified Rationalized Answers,
100% A+ Graded Guarantee (2024/2025)
With 52 multiple choices questions and answers
1. A patient with acute shortness of breath is admitted to the hospital. Whichaction
should the nurse take during the initial assessment of the patient?
a. Ask the patient to lie down to complete a full physical assessment.
b. Briefly ask specific questions about this episode of respiratory distress.
c. Complete the admission database to check for allergies before treatment.
d. Delay the physical assessment to first complete pulmonary function tests.-
: ANS: B
When a patient has severe respiratory distress, only information pertinent to the current
episode is obtained, and a more thorough assessment is deferred until later. Obtaining a
comprehensive health history or full physical examination is unnecessary until the acute
distress has resolved. Brief questioning and a focusedphysical assessment should be done
rapidly to help determine the cause of the distress and suggest treatment. Checking for
allergies is important, but it is not appropriate to complete the entire admission database at
,this time. The initial respi-ratory assessment must be completed before any diagnostic
tests or interventionscan be ordered.
2. The nurse prepares a patient with a left-sided pleural effusion for a thora-centesis.
How should the nurse position the patient?
a. Supine with the head of the bed elevated 30 degrees
b. In a high-Fowler's position with the left arm extended
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table: ANS: D
The upright position with the arms supported increases lung expansion, allows fluidto
collect at the lung bases, and expands the intercostal space so that access to thepleural
space is easier. The other positions would increase the work of breathing for the patient
and make it more difficult for the health care provider performing thethoracentesis.
3. A diabetic patient's arterial blood gas (ABG) results are pH 7.28; PaCO2 34mm Hg;
PaO2 85 mm Hg; HCO3- 18 mEq/L. The nurse would expect which finding?
a. Intercostal retractions
b. Kussmaul respirations
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure: ANS: B
Kussmaul (deep and rapid) respirations are a compensatory mechanism for meta-bolic
acidosis. The low pH and low bicarbonate result indicate metabolic acidosis. Intercostal
retractions, a low oxygen saturation rate, and a decrease in venous O2pressure would not
be caused by acidosis.
,4. On auscultation of a patient's lungs, the nurse hears low-pitched, bubblingsounds
during inhalation in the lower third of both lungs. How should the nurse document this
finding?
a. Inspiratory crackles at the bases
b. Expiratory wheezes in both lungs
c. Abnormal lung sounds in the apices of both lungs
d. Pleural friction rub in the right and left lower lobes: ANS: A
Crackles are low-pitched, bubbling sounds usually heard on inspiration. Wheezes are high-
pitched sounds. They can be heard during the expiratory or inspiratory phase of the
respiratory cycle.The lower third of both lungs are the bases, not apices.Pleural friction rubs ar
grating sounds that are usually heard during both inspirationand expiration.
5. The nurse palpates the posterior chest while the patient says "99" and notesabsent
fremitus. Which action should the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep breathe.
c. Review the chest x-ray report for evidence of pneumonia.
d. Auscultate anterior and posterior breath sounds bilaterally.: ANS: D To assess
for tactile fremitus, the nurse should use the palms of the hands toassess for
vibration when the patient repeats a word or phrase such as "99."
After noting absent fremitus, the nurse should then auscultate the lungs to assessfor the
presence or absence of breath sounds. Absent fremitus may be noted
with pneumothorax or atelectasis. The vibration is increased in conditions such as
pneumonia, lung tumors, thick bronchial secretions, and pleural effusion. Turning,
coughing, and deep breathing is an appropriate intervention for atelectasis, but the nurse
, needs to first assess breath sounds. Fremitus is decreased if the hand is farther from the
lung or the lung is hyperinflated (barrel chest).The anterior of the chest is more difficult to
palpate for fremitus because of the presence of largemuscles and breast tissue.
6. A patient with a chronic cough has a bronchoscopy. After the procedure,which
intervention by the nurse is most appropriate?
a. Elevate the head of the bed to 80 to 90 degrees.
b. Keep the patient NPO until the gag reflex returns.
c. Place on bed rest for at least 4 hours after bronchoscopy.
d. Notify the health care provider about blood-tinged mucus.: ANS: B
Risk for aspiration and maintaining an open airway is the priority. Because a local
anesthetic is used to suppress the gag/cough reflexes during bronchoscopy, the nurse
should monitor for the return of these reflexes before allowing the patient totake oral
fluids or food. Blood-tinged mucus is not uncommon after bronchoscopy.
