ATI MED SURG RESPIRATORY PHARM 2025 With
Correct Answers
1. A Nurse Is Reviewing The Laboratory Results Of A Client Who Has Metabolic Alkalosis. Which Of The Following
Laboratory Values Should The Nurse Expect?
A. Ph 7.31, HCO3- 22 Meq/L, Paco2 50 Mmhg
B. Ph 7.48, HCO3- 23 Meq/L, Paco2 25 Mmhg
C. Ph 7.32, HCO3- 18 Meq/L, Paco2 40 Mmhg
D. Ph 7.49, HCO3- 32 Meq/L, Paco2 40 Mmhg
ANS
D. Ph 7.49, HCO3- 32 Meq/L, Paco2 40 Mmhg
These Laboratory Values Reflect Metabolic Alkalosis. The Ph And The Bicarbonate Are Greater Than The Expected
Reference Range, And The Paco2 Is Within The Expected Reference Range.
2. A Nurse Is Caring For A Client Who Has Pneumonia And Is Experiencing Thick Oral Secretions. Which Of The
Following Actions Should The Nurse Take First?
A. Provide Chest Physiotherapy For The Client
B. Perform Oropharyngeal Suction
C. Encourage Deep-Breathing And Coughing
D. Assist The Client To Ambulate
ANS
C. Encourage Deep-Breathing And Coughing
The First Action The Nurse Should Take When Using The Airway, Breathing, And Circulation (ABC) Approach To Client
Care Is Encourage The Client To Deep-Breathe And Cough To Clear Secretions From The Airway.
3. A Nurse Is Reinforcing Teaching About Pursed-Lip Breathing With A Client Who Has Chronic Obstructive Pulmonary
Disease (COPD) And Emphysema. The Nurse Should Explain That This Breathing Technique Does Which Of The
Following?
A. Increases Oxygen Intake
B. Keeps The Airways Open On Exhalation
C. Uses The Intercostal Muscles
D. Strengthens The Diaphragm Check Answer Question Feedback Close Explanation
,ANS
B. Keeps The Airways Open On Exhalation
This Client Who Has COPD With Emphysema Should Use Pursed-Lip Breathing When Experiencing Dyspnea. This Simple
Way To Control Dyspnea Slows The Client’s Pace Of Breathing And Keeps The Airway Open On Exhalation, Making Each
Breath More Effective. Pursed-Lip Breathing Releases Trapped Air In The Lungs And Prolongs Exhalation To Slow The
Breathing Rate.
This Improved Breathing Pattern Moves Carbon Dioxide Out Of The Lungs More Efficiently.
4. A Nurse Is Caring For A Client Who Has A 20-Year History Of COPD And Is Receiving Oxygen At 2 L/Min Via Nasal
Cannula. The Client Is Dyspneic And Has An Oxygen Saturation Via Pulse Oximetry Of 85%. Which Of The Following
Actions Should The Nurse Take? A
A. Place A Nonrebreather Mask On The Client And Increase The Oxygen Flow To 3 L/Min
B. Prepare The Client For The Possibility Of Endotracheal Intubation And Mechanical Ventilation
C. Increase The Oxygen Flow And Request An Arterial Blood Gas Determination
D. Position The Client Supine And Administer An Antianxiety Medication
ANS
C. Increase The Oxygen Flow And Request An Arterial Blood Gas Determination
The Client Requires Oxygen Therapy At A Rate That Will Keep The Oxygen Saturation Between 88% And 92%. The Nurse
Should Increase The Client's Oxygen Flow And Evaluate Its Effectiveness With ABG Results And Oxygen Saturation Via
Pulse Oximetry Measurements.
5. A Nurse Is Caring For An Older Adult Client Who Has Chronic Obstructive Pulmonary Disease (COPD) And
Pneumonia. The Nurse Should Monitor The Client For Which Of The Following Acid-Base Imbalances? A.
Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
ANS
B. Respiratory Acidosis
Respiratory Acidosis Is A Common Complication Of COPD. This Complication Occurs Because Clients Who Have COPD Are
Unable To Exhale Carbon Dioxide Due To A Loss Of Elastic Recoil In The Lungs.
6 . A Nurse Is Caring For A Client Who Is Postoperative Following A Rhinoplasty. Which Of The Following Findings
Should The Nurse Report To The Surgeon?
A. Nasal Edema
B. Mouth Breathing
C. Periorbital Ecchymosis
D. Frequent Swallowing
ANS
,D. Frequent Swallowing
Frequent Swallowing Indicates Posterior Nasal Bleeding And Possibly Hemorrhage. The Nurse Should Notify The Surgeon
Promptly About This Finding.
7. A Nurse Is Caring For A Client Who Is Experiencing Acute Opioid Toxicity. Which Of The Following Actions Should
The Nurse Identify As The Priority?
A. Insert A Large-Bore IV Catheter
B. Ensure An Adequate Airway
C. Obtain An Accurate Medication History
D. Prepare To Administer An Antagonist
ANS
B. Ensure An Adequate Airway
The First Action The Nurse Should Take When Using The Airway, Breathing, And Circulation (ABC) Approach To Client
Care Is To Ensure The Client's Airway Is Adequate Because Respiratory Depression Is A Manifestation Of Opioid Toxicity.
8. A Nurse Is Caring For A Client Who Had A Left Lower Lobectomy To Treat Lung Cancer. Which Of The Following
Factors Has A Significant Impact On The Plan Of Care For This Client?
A. The Client Will Need Intensive Smoking-Cessation Education.
B. After Surgery, The Prognosis For Clients With Lung Cancer Is Usually Good.
C. Lung Cancer Usually Has Metastasized Before The Client Has Symptoms.
D. Oxygen Therapy Is Ineffective Following A Lobectomy.
ANS
C. Lung Cancer Usually Has Metastasized Before The Client Has Symptoms.
The Nurse Should Be Aware That Lung Cancer Is Usually At An Advanced Stage Before The Client Has Any Manifestations.
This Has Implications For Both Short-Term And Long-Term Care Options For The Client.
9. A Nurse Is Reinforcing Preoperative Teaching With A Client Who Is Scheduled To Undergo A Pneumonectomy. The
Client States, "I Am Afraid That Coughing Will Hurt After The Surgery." Which Of The Following Responses Should The
Nurse Make?
A. "After The Surgeon Removes The Lung, You Will Not Need To Cough."
B. "I'll Make Sure You Get A Cough Suppressant To Keep You From Straining The Incision When You Cough."
C. "Don’t Worry. You Will Have A Pump That Delivers Pain Medication As You Need It, So You Will Have Very Little
Pain." D. "I Will Show You How To Splint Your Incision While Coughing."
ANS
D. "I Will Show You How To Splint Your Incision While Coughing."
A Client Who Had A Pneumonectomy Must Cough To Clear Secretions From The Remaining Lung. The Nurse Should Show
The Client How To Splint The Incision To Reduce Pain When Coughing.
, 10. A Nurse In An Urgent Care Clinic Is Collecting Data From A Client Who Reports Exposure To Anthrax. Which Of
The Following Findings Is An Indication Of The Prodromal Stage Of Inhalation Anthrax? A. Dry Cough
B. Rhinitis
C. Sore Throat
D. Swollen Lymph Nodes
ANS
A. Dry Cough
A Dry Cough Is A Clinical Manifestation Of The Prodromal Stage Of Inhalation Anthrax. During This Stage, It Is Difficult To
Distinguish From Influenza Or Pneumonia Because There Is No Sore Throat Or Rhinitis.
11. A Nurse On A Medical Unit Is Assisting With The Care Of A Client Who Aspirated Gastric Contents Prior To
Admission. The Provider Prescribed 100% Oxygen By Nonrebreather Mask After The Client Reported Severe Dyspnea.
Which Of The Following Findings Is A Clinical Manifestation Of Acute Respiratory Distress Syndrome (ARDS)? A.
Tympanic Temperature 38°C (100.4°F)
B. Pao2 50 Mmhg
C. Rhonchi
D. Hypopnea
Check Answer Question Feedback Close Explanation Correct Answer:
B. Pao2 50 Mmhg
A Client With Manifestations Of ARDS Has A Low Pao2 Level Even After The Administration Of Oxygen. Hypoxemia After
Treatment With Oxygen Is A Manifestation Of ARDS.
12. A Nurse On A Medical-Surgical Unit Is Collecting Data From A Client Who Recently Transferred From The ICU
Following Endotracheal Extubation. Which Of The Following Findings Should The Nurse Identify As A Possible
Manifestation Of Tracheal Stenosis And Report To The Charge Nurse?
A. Increased Coughing
B. Diaphragmatic Breathing
C. Hemoptysis
D. Kussmaul Respirations
ANS
A. Increased Coughing
The Nurse Should Identify Increased Coughing As A Manifestation Of Tracheal Stenosis. Other Manifestations Include An
Inability To Cough Up Secretions And Difficulty Talking Or Breathing.
13. A Nurse On A Medical-Surgical Unit Is Caring For 4 Clients. Which Of The Following Clients Should The Nurse
Monitor For Crepitus?
A. A Client Who Has A Chest Tube Following A Pneumothorax
B. A Client Who Has An Acute Exacerbation Of Crohn's Disease
Correct Answers
1. A Nurse Is Reviewing The Laboratory Results Of A Client Who Has Metabolic Alkalosis. Which Of The Following
Laboratory Values Should The Nurse Expect?
A. Ph 7.31, HCO3- 22 Meq/L, Paco2 50 Mmhg
B. Ph 7.48, HCO3- 23 Meq/L, Paco2 25 Mmhg
C. Ph 7.32, HCO3- 18 Meq/L, Paco2 40 Mmhg
D. Ph 7.49, HCO3- 32 Meq/L, Paco2 40 Mmhg
ANS
D. Ph 7.49, HCO3- 32 Meq/L, Paco2 40 Mmhg
These Laboratory Values Reflect Metabolic Alkalosis. The Ph And The Bicarbonate Are Greater Than The Expected
Reference Range, And The Paco2 Is Within The Expected Reference Range.
2. A Nurse Is Caring For A Client Who Has Pneumonia And Is Experiencing Thick Oral Secretions. Which Of The
Following Actions Should The Nurse Take First?
A. Provide Chest Physiotherapy For The Client
B. Perform Oropharyngeal Suction
C. Encourage Deep-Breathing And Coughing
D. Assist The Client To Ambulate
ANS
C. Encourage Deep-Breathing And Coughing
The First Action The Nurse Should Take When Using The Airway, Breathing, And Circulation (ABC) Approach To Client
Care Is Encourage The Client To Deep-Breathe And Cough To Clear Secretions From The Airway.
3. A Nurse Is Reinforcing Teaching About Pursed-Lip Breathing With A Client Who Has Chronic Obstructive Pulmonary
Disease (COPD) And Emphysema. The Nurse Should Explain That This Breathing Technique Does Which Of The
Following?
A. Increases Oxygen Intake
B. Keeps The Airways Open On Exhalation
C. Uses The Intercostal Muscles
D. Strengthens The Diaphragm Check Answer Question Feedback Close Explanation
,ANS
B. Keeps The Airways Open On Exhalation
This Client Who Has COPD With Emphysema Should Use Pursed-Lip Breathing When Experiencing Dyspnea. This Simple
Way To Control Dyspnea Slows The Client’s Pace Of Breathing And Keeps The Airway Open On Exhalation, Making Each
Breath More Effective. Pursed-Lip Breathing Releases Trapped Air In The Lungs And Prolongs Exhalation To Slow The
Breathing Rate.
This Improved Breathing Pattern Moves Carbon Dioxide Out Of The Lungs More Efficiently.
4. A Nurse Is Caring For A Client Who Has A 20-Year History Of COPD And Is Receiving Oxygen At 2 L/Min Via Nasal
Cannula. The Client Is Dyspneic And Has An Oxygen Saturation Via Pulse Oximetry Of 85%. Which Of The Following
Actions Should The Nurse Take? A
A. Place A Nonrebreather Mask On The Client And Increase The Oxygen Flow To 3 L/Min
B. Prepare The Client For The Possibility Of Endotracheal Intubation And Mechanical Ventilation
C. Increase The Oxygen Flow And Request An Arterial Blood Gas Determination
D. Position The Client Supine And Administer An Antianxiety Medication
ANS
C. Increase The Oxygen Flow And Request An Arterial Blood Gas Determination
The Client Requires Oxygen Therapy At A Rate That Will Keep The Oxygen Saturation Between 88% And 92%. The Nurse
Should Increase The Client's Oxygen Flow And Evaluate Its Effectiveness With ABG Results And Oxygen Saturation Via
Pulse Oximetry Measurements.
5. A Nurse Is Caring For An Older Adult Client Who Has Chronic Obstructive Pulmonary Disease (COPD) And
Pneumonia. The Nurse Should Monitor The Client For Which Of The Following Acid-Base Imbalances? A.
Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
ANS
B. Respiratory Acidosis
Respiratory Acidosis Is A Common Complication Of COPD. This Complication Occurs Because Clients Who Have COPD Are
Unable To Exhale Carbon Dioxide Due To A Loss Of Elastic Recoil In The Lungs.
6 . A Nurse Is Caring For A Client Who Is Postoperative Following A Rhinoplasty. Which Of The Following Findings
Should The Nurse Report To The Surgeon?
A. Nasal Edema
B. Mouth Breathing
C. Periorbital Ecchymosis
D. Frequent Swallowing
ANS
,D. Frequent Swallowing
Frequent Swallowing Indicates Posterior Nasal Bleeding And Possibly Hemorrhage. The Nurse Should Notify The Surgeon
Promptly About This Finding.
7. A Nurse Is Caring For A Client Who Is Experiencing Acute Opioid Toxicity. Which Of The Following Actions Should
The Nurse Identify As The Priority?
A. Insert A Large-Bore IV Catheter
B. Ensure An Adequate Airway
C. Obtain An Accurate Medication History
D. Prepare To Administer An Antagonist
ANS
B. Ensure An Adequate Airway
The First Action The Nurse Should Take When Using The Airway, Breathing, And Circulation (ABC) Approach To Client
Care Is To Ensure The Client's Airway Is Adequate Because Respiratory Depression Is A Manifestation Of Opioid Toxicity.
8. A Nurse Is Caring For A Client Who Had A Left Lower Lobectomy To Treat Lung Cancer. Which Of The Following
Factors Has A Significant Impact On The Plan Of Care For This Client?
A. The Client Will Need Intensive Smoking-Cessation Education.
B. After Surgery, The Prognosis For Clients With Lung Cancer Is Usually Good.
C. Lung Cancer Usually Has Metastasized Before The Client Has Symptoms.
D. Oxygen Therapy Is Ineffective Following A Lobectomy.
ANS
C. Lung Cancer Usually Has Metastasized Before The Client Has Symptoms.
The Nurse Should Be Aware That Lung Cancer Is Usually At An Advanced Stage Before The Client Has Any Manifestations.
This Has Implications For Both Short-Term And Long-Term Care Options For The Client.
9. A Nurse Is Reinforcing Preoperative Teaching With A Client Who Is Scheduled To Undergo A Pneumonectomy. The
Client States, "I Am Afraid That Coughing Will Hurt After The Surgery." Which Of The Following Responses Should The
Nurse Make?
A. "After The Surgeon Removes The Lung, You Will Not Need To Cough."
B. "I'll Make Sure You Get A Cough Suppressant To Keep You From Straining The Incision When You Cough."
C. "Don’t Worry. You Will Have A Pump That Delivers Pain Medication As You Need It, So You Will Have Very Little
Pain." D. "I Will Show You How To Splint Your Incision While Coughing."
ANS
D. "I Will Show You How To Splint Your Incision While Coughing."
A Client Who Had A Pneumonectomy Must Cough To Clear Secretions From The Remaining Lung. The Nurse Should Show
The Client How To Splint The Incision To Reduce Pain When Coughing.
, 10. A Nurse In An Urgent Care Clinic Is Collecting Data From A Client Who Reports Exposure To Anthrax. Which Of
The Following Findings Is An Indication Of The Prodromal Stage Of Inhalation Anthrax? A. Dry Cough
B. Rhinitis
C. Sore Throat
D. Swollen Lymph Nodes
ANS
A. Dry Cough
A Dry Cough Is A Clinical Manifestation Of The Prodromal Stage Of Inhalation Anthrax. During This Stage, It Is Difficult To
Distinguish From Influenza Or Pneumonia Because There Is No Sore Throat Or Rhinitis.
11. A Nurse On A Medical Unit Is Assisting With The Care Of A Client Who Aspirated Gastric Contents Prior To
Admission. The Provider Prescribed 100% Oxygen By Nonrebreather Mask After The Client Reported Severe Dyspnea.
Which Of The Following Findings Is A Clinical Manifestation Of Acute Respiratory Distress Syndrome (ARDS)? A.
Tympanic Temperature 38°C (100.4°F)
B. Pao2 50 Mmhg
C. Rhonchi
D. Hypopnea
Check Answer Question Feedback Close Explanation Correct Answer:
B. Pao2 50 Mmhg
A Client With Manifestations Of ARDS Has A Low Pao2 Level Even After The Administration Of Oxygen. Hypoxemia After
Treatment With Oxygen Is A Manifestation Of ARDS.
12. A Nurse On A Medical-Surgical Unit Is Collecting Data From A Client Who Recently Transferred From The ICU
Following Endotracheal Extubation. Which Of The Following Findings Should The Nurse Identify As A Possible
Manifestation Of Tracheal Stenosis And Report To The Charge Nurse?
A. Increased Coughing
B. Diaphragmatic Breathing
C. Hemoptysis
D. Kussmaul Respirations
ANS
A. Increased Coughing
The Nurse Should Identify Increased Coughing As A Manifestation Of Tracheal Stenosis. Other Manifestations Include An
Inability To Cough Up Secretions And Difficulty Talking Or Breathing.
13. A Nurse On A Medical-Surgical Unit Is Caring For 4 Clients. Which Of The Following Clients Should The Nurse
Monitor For Crepitus?
A. A Client Who Has A Chest Tube Following A Pneumothorax
B. A Client Who Has An Acute Exacerbation Of Crohn's Disease
