RESPIRATORY NCLEX STYLE EXAM
2025 QUESTIONS AND ANSWERS
1. The client is asking the nurse a question regarding the Mantoux test for tuberculosis. The
nurse should base her response on the fact that the:
A. area of redness is measured in 3 days and determines whether tuberculosis is present.
B. skin test doesn't differentiate between active and dormant tuberculosis infection.
C. presence of a wheal at the injection site in 2 days indicates active tuberculosis.
D. test stimulates a reddened response in some clients and requires a second test in 3 months. -
ANS 1. ANSWER: B
The Mantoux test doesn't differentiate between active and dormant infections. If a positive
reaction occurs, a sputum smear and culture as well as a chest X-ray are necessary to provide
more information. Although the area of redness is measured in 3 days, a second test may be
needed; neither test indicates that tuberculosis is active. In the Mantoux test, an induration 5
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,to 9 mm in diameter indicates a borderline reaction; a larger induration indicates a positive
reaction. The presence of a wheal within 2 days doesn't indicate active tuberculosis.
2. A client hospitalized with a pneumothorax has the following arterial blood gas (ABG) analysis:
pH, 7.19; partial pressure of arterial carbon dioxide (PaCO2), 63 mm Hg; and HCO3-, 22 mEq/L.
A chest tube was inserted and oxygen administered at 4 L/minute by nasal cannula. One hour
after the initiation of treatment, ABG analysis reveals: pH, 7.28; PaCO2, 52 mm Hg; and HCO3-,
22 mEq/L. This change in ABG analysis indicates:
A. respiratory alkalosis.
B. impending respiratory arrest.
C. the need for intubation.
D. improved respiratory status. - ANS 2. ANSWER: D
The original ABG analysis reveals respiratory acidosis commonly seen with a pneumothorax.
After chest tube insertion, the client's respiratory status has improved, pH is increasing toward
normal, and the PaCO2 is decreasing. ABG analysis in respiratory alkalosis shows an elevated pH
and a low PaCO2. Assessment findings are more important than ABG analysis in determining
whether the client requires intubation or if respiratory arrest is imminent.
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2
,3. A client is admitted to the intensive care unit with pulmonary edema. When performing the
admission assessment, the nurse should expect:
A. A decreased blood pressure
B. Radiating anterior chest pain
C. A pulse that is weak and rapid
D. Crackles at the base of each lung - ANS 3. ANSWER: D
Crackles are the sound of air passing through fluid in the alveolar spaces; in pulmonary edema,
fluid moves from the intravascular compartment into the alveoli.
A: The blood pressure is usually increased with hypervolemia.
B: This would occur with angina or a myocardial infarction.
C: The pulse would be bounding with hypervolemia.
5. For a client with COPD who has trouble raising respiratory secretions, which of the following
nursing measures would help reduce the tenacity of secretions?
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, A. Ensuring that the client's diet is low in salt.
B. Ensuring that the client's oxygen therapy is continuous.
C. Helping the client maintain a high fluid intake.
D. Keeping the client in a semi-sitting position as much as possible. - ANS 5. ANSWER: C
A fluid intake of 2 to 3 L/day, providing that the client does not have cardiovascular or renal
disease, helps liquefy bronchial secretions. 1
A: A low-salt diet does not help reduce the viscosity of mucus.
B: Continuous oxygen therapy does not help reduce the viscosity of mucus.
D: Maintaining a semi-sitting position does not help reduce the viscosity of mucus.
6. A chronically ill, elderly female client tells the home care nurse that the daughter with whom
she lives seems run-down and disinterested in her own health as well as the health of her
children, ages 2, 5, 7, and 12. The client tells the nurse that her daughter coughs a good deal
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4
2025 QUESTIONS AND ANSWERS
1. The client is asking the nurse a question regarding the Mantoux test for tuberculosis. The
nurse should base her response on the fact that the:
A. area of redness is measured in 3 days and determines whether tuberculosis is present.
B. skin test doesn't differentiate between active and dormant tuberculosis infection.
C. presence of a wheal at the injection site in 2 days indicates active tuberculosis.
D. test stimulates a reddened response in some clients and requires a second test in 3 months. -
ANS 1. ANSWER: B
The Mantoux test doesn't differentiate between active and dormant infections. If a positive
reaction occurs, a sputum smear and culture as well as a chest X-ray are necessary to provide
more information. Although the area of redness is measured in 3 days, a second test may be
needed; neither test indicates that tuberculosis is active. In the Mantoux test, an induration 5
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED
1
,to 9 mm in diameter indicates a borderline reaction; a larger induration indicates a positive
reaction. The presence of a wheal within 2 days doesn't indicate active tuberculosis.
2. A client hospitalized with a pneumothorax has the following arterial blood gas (ABG) analysis:
pH, 7.19; partial pressure of arterial carbon dioxide (PaCO2), 63 mm Hg; and HCO3-, 22 mEq/L.
A chest tube was inserted and oxygen administered at 4 L/minute by nasal cannula. One hour
after the initiation of treatment, ABG analysis reveals: pH, 7.28; PaCO2, 52 mm Hg; and HCO3-,
22 mEq/L. This change in ABG analysis indicates:
A. respiratory alkalosis.
B. impending respiratory arrest.
C. the need for intubation.
D. improved respiratory status. - ANS 2. ANSWER: D
The original ABG analysis reveals respiratory acidosis commonly seen with a pneumothorax.
After chest tube insertion, the client's respiratory status has improved, pH is increasing toward
normal, and the PaCO2 is decreasing. ABG analysis in respiratory alkalosis shows an elevated pH
and a low PaCO2. Assessment findings are more important than ABG analysis in determining
whether the client requires intubation or if respiratory arrest is imminent.
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED
2
,3. A client is admitted to the intensive care unit with pulmonary edema. When performing the
admission assessment, the nurse should expect:
A. A decreased blood pressure
B. Radiating anterior chest pain
C. A pulse that is weak and rapid
D. Crackles at the base of each lung - ANS 3. ANSWER: D
Crackles are the sound of air passing through fluid in the alveolar spaces; in pulmonary edema,
fluid moves from the intravascular compartment into the alveoli.
A: The blood pressure is usually increased with hypervolemia.
B: This would occur with angina or a myocardial infarction.
C: The pulse would be bounding with hypervolemia.
5. For a client with COPD who has trouble raising respiratory secretions, which of the following
nursing measures would help reduce the tenacity of secretions?
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3
, A. Ensuring that the client's diet is low in salt.
B. Ensuring that the client's oxygen therapy is continuous.
C. Helping the client maintain a high fluid intake.
D. Keeping the client in a semi-sitting position as much as possible. - ANS 5. ANSWER: C
A fluid intake of 2 to 3 L/day, providing that the client does not have cardiovascular or renal
disease, helps liquefy bronchial secretions. 1
A: A low-salt diet does not help reduce the viscosity of mucus.
B: Continuous oxygen therapy does not help reduce the viscosity of mucus.
D: Maintaining a semi-sitting position does not help reduce the viscosity of mucus.
6. A chronically ill, elderly female client tells the home care nurse that the daughter with whom
she lives seems run-down and disinterested in her own health as well as the health of her
children, ages 2, 5, 7, and 12. The client tells the nurse that her daughter coughs a good deal
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED
4
