©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
NRSG 2630 Exam 1 – Respiratory Questions
And Answers 2025 Update.
What is the correct sequence of structures in the respiratory system? - Answer✔Nostrils/mouth
Trachea
Bronchi
Bronchioles
Alveoli
What is the primary defense mechanism in the alveoli? - Answer✔Alveolar macrophages
Give six examples of abnormal breathing sounds. - Answer✔Fine crackles: short, high-pitched
crackling sounds
Coarse crackles: long, low-pitched bubbling sounds
Rhonchi: continuous rumbling or rattling
Wheezing: high-pitching squeaking or musical vibration
Stridor: continuous crowing at a constant pitch
Pleural friction rub: creaking or grating sound from rough, inflammed tissue rubbing together
What acid/base imbalance does a shift to the left on the oxygen-hemoglobin dissociation curve
indicate? - Answer✔Alkalosis
1
,©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
High O2 affinity - hgb attaches to O2 but does not let go because it does not want to pick up
and get rid of CO2, an acid
What acid/base imbalance does a shift to the right on the oxygen-hemoglobin dissociation
curve indicate? - Answer✔Acidosis
Low O2 affinity - hgb does not want to pick up O2 because it will have to release and get rid of
CO2, an acid
A patient with metabolic alkalosis has an SpO2 of 93% and a shift to the left in the oxygen-
hemoglobin dissociation curve. Which action by the nurse is appropriate?
A. Administer supplemental oxygen because less oxygen is dissolved in the blood
B. Discontinue supplemental oxygen because more oxygen is released to the tissues
C. Administer supplemental oxygen because oxygen is not readily released to the tissues
D. Discontinue supplemental oxygen because more oxygen is dissolved in the blood -
Answer✔C
When the oxygen dissociation curve shifts to the left, blood picks up oxygen more readily in the
lungs but delivers oxygen less readily to the tissues. Alkalosis can cause a shift to the left.
Patients may be given higher concentrations of oxygen until alkalosis normalizes. This helps to
compensate for decreased oxygen unloading in the tissues.
A patient's arterial blood gas (ABG) results include the following: pH 7.32, PaO2 84 mm Hg,
PaCO2 49 mm Hg, and SaO2 84%. For what should the nurse assess the patient?
A. Tetany
B. Tachypnea
C. Pleural friction rub
D. Kussmaul respirations - Answer✔B
The arterial blood gas analysis indicates respiratory acidosis. Tachypnea is defined as a rapid
respiratory rate and indicates respiratory distress. Tetany occurs in metabolic alkalosis. A
pleural friction rub is a creaking or grating sound heard during auscultation of the lungs and
indicates inflamed pleural surfaces that are rubbing together. Kussmaul respirations are
commonly seen in metabolic acidosis and are abnormally deep, very rapid sighing respirations.
The nurse would interpret an induration of 5 mm resulting from tuberculin skin testing as a
positive finding in which patient?
2
,©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
A. A patient with a history of illegal IV drug use
B. A patient with diabetes and end-stage kidney disease
C. A patient who immigrated from India 3 months ago
D. A patient who is HIV positive - Answer✔D
Induration of 5 mm in an HIV-infected person is considered a positive reaction.
What are possible complications of a nasal fracture? - Answer✔- *airway obstruction*
- epistaxis
- meningeal tears
- septal hematoma
- deformity
How do we test for or diagnose a meningeal tear? - Answer✔CSF fluid is present and can be
seen as
- a "halo" appearance around blood on gauze or other absorbant surfaces
- the presence of glucose in snot or other fluids from the nasal cavity
What are s/s used to diagnose a nasal fracture? - Answer✔- local pain
- crepitus
- swelling
- epistaxis
- ecchymosis around the eyes
- deformity
- difficulty breathing
In the case of a nasal fracture, ecchymosis under one or both eyes may indicate what? -
Answer✔Orbital or basilar skull fracture
What are priority goals for a patient with a nasal fracture? - Answer✔- *maintain airway*
- reduce edema/pain
- ice (15 on, 15 off)
- analgesics
- nasal decongestants
3
, ©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
- humidifier
- surgery (rhinoplasty) may be necessary as a last resort for repair
What is epistaxis? - Answer✔Nose bleed
What are possible local causes of epistaxis? - Answer✔- nasal trauma
- allergic, chronic, or infection rhinitis
- chemical irritants
- topical medications
- drying of the nasal mucosa
- deviation of nasal septum or septal perforation
- bleeding polyp of the septum or lateral nasal wall
- neoplasms of the nose or sinuses
- tumors
- vascular malformation (ex: aneurysm)
What are possible systemic causes of epistaxis? - Answer✔- systemic arterial hypertension
- endocrine changes (ex: pregnancy, pheochromocytoma)
- hereditary hemorrhagic telangectasias
- Osler Rendu Weber syndrome
- anticoagulants
- hepatic diseases
- blood diseases
- platelet dysfunction
What are components of a physical exam for epistaxis? - Answer✔- measure BP and other vital
signs
- apply direct pressure to external nose to decrease bleeding
- use vasoconstricting spray mixed with tetracaine in a 1:1 ratio for topical anesthesia
- *identify the bleeding source*
A nose bleed after which surgical procedure is considered a medical emergency? -
Answer✔Tonsilectomy
What are the differences between anterior and posterior nose bleeds? - Answer✔Anterior
4
NRSG 2630 Exam 1 – Respiratory Questions
And Answers 2025 Update.
What is the correct sequence of structures in the respiratory system? - Answer✔Nostrils/mouth
Trachea
Bronchi
Bronchioles
Alveoli
What is the primary defense mechanism in the alveoli? - Answer✔Alveolar macrophages
Give six examples of abnormal breathing sounds. - Answer✔Fine crackles: short, high-pitched
crackling sounds
Coarse crackles: long, low-pitched bubbling sounds
Rhonchi: continuous rumbling or rattling
Wheezing: high-pitching squeaking or musical vibration
Stridor: continuous crowing at a constant pitch
Pleural friction rub: creaking or grating sound from rough, inflammed tissue rubbing together
What acid/base imbalance does a shift to the left on the oxygen-hemoglobin dissociation curve
indicate? - Answer✔Alkalosis
1
,©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
High O2 affinity - hgb attaches to O2 but does not let go because it does not want to pick up
and get rid of CO2, an acid
What acid/base imbalance does a shift to the right on the oxygen-hemoglobin dissociation
curve indicate? - Answer✔Acidosis
Low O2 affinity - hgb does not want to pick up O2 because it will have to release and get rid of
CO2, an acid
A patient with metabolic alkalosis has an SpO2 of 93% and a shift to the left in the oxygen-
hemoglobin dissociation curve. Which action by the nurse is appropriate?
A. Administer supplemental oxygen because less oxygen is dissolved in the blood
B. Discontinue supplemental oxygen because more oxygen is released to the tissues
C. Administer supplemental oxygen because oxygen is not readily released to the tissues
D. Discontinue supplemental oxygen because more oxygen is dissolved in the blood -
Answer✔C
When the oxygen dissociation curve shifts to the left, blood picks up oxygen more readily in the
lungs but delivers oxygen less readily to the tissues. Alkalosis can cause a shift to the left.
Patients may be given higher concentrations of oxygen until alkalosis normalizes. This helps to
compensate for decreased oxygen unloading in the tissues.
A patient's arterial blood gas (ABG) results include the following: pH 7.32, PaO2 84 mm Hg,
PaCO2 49 mm Hg, and SaO2 84%. For what should the nurse assess the patient?
A. Tetany
B. Tachypnea
C. Pleural friction rub
D. Kussmaul respirations - Answer✔B
The arterial blood gas analysis indicates respiratory acidosis. Tachypnea is defined as a rapid
respiratory rate and indicates respiratory distress. Tetany occurs in metabolic alkalosis. A
pleural friction rub is a creaking or grating sound heard during auscultation of the lungs and
indicates inflamed pleural surfaces that are rubbing together. Kussmaul respirations are
commonly seen in metabolic acidosis and are abnormally deep, very rapid sighing respirations.
The nurse would interpret an induration of 5 mm resulting from tuberculin skin testing as a
positive finding in which patient?
2
,©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
A. A patient with a history of illegal IV drug use
B. A patient with diabetes and end-stage kidney disease
C. A patient who immigrated from India 3 months ago
D. A patient who is HIV positive - Answer✔D
Induration of 5 mm in an HIV-infected person is considered a positive reaction.
What are possible complications of a nasal fracture? - Answer✔- *airway obstruction*
- epistaxis
- meningeal tears
- septal hematoma
- deformity
How do we test for or diagnose a meningeal tear? - Answer✔CSF fluid is present and can be
seen as
- a "halo" appearance around blood on gauze or other absorbant surfaces
- the presence of glucose in snot or other fluids from the nasal cavity
What are s/s used to diagnose a nasal fracture? - Answer✔- local pain
- crepitus
- swelling
- epistaxis
- ecchymosis around the eyes
- deformity
- difficulty breathing
In the case of a nasal fracture, ecchymosis under one or both eyes may indicate what? -
Answer✔Orbital or basilar skull fracture
What are priority goals for a patient with a nasal fracture? - Answer✔- *maintain airway*
- reduce edema/pain
- ice (15 on, 15 off)
- analgesics
- nasal decongestants
3
, ©THEBRIGHT 2025 ALL RIGHTS RESERVED 11:11PM.
- humidifier
- surgery (rhinoplasty) may be necessary as a last resort for repair
What is epistaxis? - Answer✔Nose bleed
What are possible local causes of epistaxis? - Answer✔- nasal trauma
- allergic, chronic, or infection rhinitis
- chemical irritants
- topical medications
- drying of the nasal mucosa
- deviation of nasal septum or septal perforation
- bleeding polyp of the septum or lateral nasal wall
- neoplasms of the nose or sinuses
- tumors
- vascular malformation (ex: aneurysm)
What are possible systemic causes of epistaxis? - Answer✔- systemic arterial hypertension
- endocrine changes (ex: pregnancy, pheochromocytoma)
- hereditary hemorrhagic telangectasias
- Osler Rendu Weber syndrome
- anticoagulants
- hepatic diseases
- blood diseases
- platelet dysfunction
What are components of a physical exam for epistaxis? - Answer✔- measure BP and other vital
signs
- apply direct pressure to external nose to decrease bleeding
- use vasoconstricting spray mixed with tetracaine in a 1:1 ratio for topical anesthesia
- *identify the bleeding source*
A nose bleed after which surgical procedure is considered a medical emergency? -
Answer✔Tonsilectomy
What are the differences between anterior and posterior nose bleeds? - Answer✔Anterior
4
