NURS 441 Concepts: Exam 1 LATEST 2025-2026 Q &
A NEW VERSION GRADED A+
ANS: D
Effects of nicotine on blood vessels and lung tissue have been proven to increase pathological
changes, leading to heart disease and lung cancer. - answer--A patient who started smoking in
adolescence and continues to smoke 40 years later comes to the clinic. The nurse understands
that this patient has an increased risk for being diagnosed with which disorder:
a. Alcoholism and hypertension
b. Obesity and diabetes
c. Stress-related illnesses
d. Cardiopulmonary disease and lung cancer
ANS: D
Hypoxia occurs because of decreased circulating blood volume, which leads to decreased
oxygen to muscles, causing fatigue, decreased activity tolerance, and a feeling of shortness of
breath. - answer--A patient has been diagnosed with severe iron deficiency anemia. During
physical assessment for which of the following symptoms would the nurse assess to determine
the patient's oxygen status?
a. Increased breathlessness but increased activity tolerance
b. Decreased breathlessness and decreased activity tolerance
c. Increased activity tolerance and decreased breathlessness
d. Decreased activity tolerance and increased breathlessness
ANS: B
Carbon monoxide strongly binds to hemoglobin, making it unavailable for oxygen binding and
transport. - answer--A patient is admitted to the emergency department with suspected carbon
monoxide poisoning. Even though the patient's color is ruddy, not cyanotic, the nurse
understands that the patient is at a risk for decreased oxygen-carrying capacity of blood
because carbon monoxide does which of the following:
,a. Stimulates hyperventilation, causing respiratory alkalosis
b. Forms a strong bond with hemoglobin, creating a functional anemia.
c. Stimulates hypoventilation, causing respiratory acidosis
d. Causes alveoli to overinflate, leading to atelectasis
ANS: A
When the body cannot meet the increased oxygenation need, the increased metabolic rate
causes breakdown of protein and wasting of respiratory muscles, increasing the work of
breathing. - answer--A 6-year-old boy is admitted to the pediatric unit with chills and a fever of
104°F (40°C). What physiological process explains why the child is at risk for developing
dyspnea?
a. Fever increases metabolic demands, requiring increased oxygen need.
b. Blood glucose stores are depleted, and the cells do not have energy to use oxygen.
c. Carbon dioxide production increases as result of hyperventilation.
d. Carbon dioxide production decreases as a result of hypoventilation.
ANS: D
Decreased effective contraction of left side of heart leads to back up of fluid in the lungs,
increasing hydrostatic pressure and causing pulmonary edema, resulting in crackles in lung
bases. - answer--A patient is admitted with the diagnosis of severe left-sided heart failure. The
nurse expects to auscultate which adventitious lung sounds?
a. Sonorous wheezes in the left lower lung
b. Rhonchi midsternum
c. Crackles only in apex of lungs
d. Inspiratory crackles in lung bases
ANS: B
,Movement not only mobilizes secretions but helps strengthen respiratory muscles by impacting
the effectiveness of gas exchange processes. - answer--The nurse is caring for a patient who has
decreased mobility. Which intervention is a simple and cost-effective method for reducing the
risks of stasis of pulmonary secretions and decreased chest wall expansion?
a. Antibiotics
b. Frequent change of position
c. Oxygen humidification
d. Chest physiotherapy
ANS: C
Impaired ability to cough up mucus caused by weakness or very thick secretions indicates a
need for suctioning when you know the patient has pneumonia. - answer--A patient is admitted
with severe lobar pneumonia. Which of the following assessment findings would indicate that
the patient needs airway suctioning?
a. Coughing up thick sputum only occasionally
b. Coughing up thin, watery sputum easily after nebulization
c. Decreased independent ability to cough
d. Lung sounds clear only after coughing
ANS: A
When the lung collapses, the thoracic space fills with air on each inspiration, and the
atmospheric air irritates the parietal pleura, causing pain. - answer--A patient was admitted
after a motor vehicle accident with multiple fractured ribs. Respiratory assessment includes
signs/symptoms of secondary pneumothorax, which includes which of the following?
a. Sharp pleuritic pain that worsens on inspiration
b. Crackles over lung bases of affected lung
c. Tracheal deviation toward the affected lung
d. Increased diaphragmatic excursion on side of rib fractures
, ANS: D
Hypoxia is the drive to breathe in a patient with chronic obstructive pulmonary disease who has
become used to acidic pH and elevated CO2 levels. Turning up to 6 L/min increases the oxygen
level, which turns off the drive to breathe. - answer--A patient has been newly diagnosed with
emphysema. In discussing his condition with the nurse, which of his statements would indicate
a need for further education?
a. "I'll make sure that I rest between activities so I don't get so short of breath."
b. "I'll rest for 30 minutes before I eat my meal."
c. "If I have trouble breathing at night, I'll use two to three pillows to prop up."
d. "If I get short of breath, I'll turn up my oxygen level to 6 L/min."
ANS: A
Raising the head of the bed brings the diaphragm down and allows for better chest expansion,
thus improving ventilation. - answer--The nurse goes to assess a new patient and finds him lying
supine in bed. The patient tells the nurse that he feels short of breath. Which nursing action
should the nurse perform first?
a. Raise the head of the bed to 45 degrees.
b. Take his oxygen saturation with a pulse oximeter.
c. Take his blood pressure and respiratory rate.
d. Notify the health care provider of his shortness of breath.
ANS: D
Saline has been found to cause more side effects when suctioning and does not increase the
amount of secretions removed. - answer--Which of the following statements made by a student
nurse indicates the need for further teaching about suctioning a patient with an endotracheal
tube?
a. "Suctioning the patient requires sterile technique."
b. "I'll apply suction while rotating and withdrawing the suction catheter."
c. "I'll suction the mouth after I suction the endotracheal tube."
A NEW VERSION GRADED A+
ANS: D
Effects of nicotine on blood vessels and lung tissue have been proven to increase pathological
changes, leading to heart disease and lung cancer. - answer--A patient who started smoking in
adolescence and continues to smoke 40 years later comes to the clinic. The nurse understands
that this patient has an increased risk for being diagnosed with which disorder:
a. Alcoholism and hypertension
b. Obesity and diabetes
c. Stress-related illnesses
d. Cardiopulmonary disease and lung cancer
ANS: D
Hypoxia occurs because of decreased circulating blood volume, which leads to decreased
oxygen to muscles, causing fatigue, decreased activity tolerance, and a feeling of shortness of
breath. - answer--A patient has been diagnosed with severe iron deficiency anemia. During
physical assessment for which of the following symptoms would the nurse assess to determine
the patient's oxygen status?
a. Increased breathlessness but increased activity tolerance
b. Decreased breathlessness and decreased activity tolerance
c. Increased activity tolerance and decreased breathlessness
d. Decreased activity tolerance and increased breathlessness
ANS: B
Carbon monoxide strongly binds to hemoglobin, making it unavailable for oxygen binding and
transport. - answer--A patient is admitted to the emergency department with suspected carbon
monoxide poisoning. Even though the patient's color is ruddy, not cyanotic, the nurse
understands that the patient is at a risk for decreased oxygen-carrying capacity of blood
because carbon monoxide does which of the following:
,a. Stimulates hyperventilation, causing respiratory alkalosis
b. Forms a strong bond with hemoglobin, creating a functional anemia.
c. Stimulates hypoventilation, causing respiratory acidosis
d. Causes alveoli to overinflate, leading to atelectasis
ANS: A
When the body cannot meet the increased oxygenation need, the increased metabolic rate
causes breakdown of protein and wasting of respiratory muscles, increasing the work of
breathing. - answer--A 6-year-old boy is admitted to the pediatric unit with chills and a fever of
104°F (40°C). What physiological process explains why the child is at risk for developing
dyspnea?
a. Fever increases metabolic demands, requiring increased oxygen need.
b. Blood glucose stores are depleted, and the cells do not have energy to use oxygen.
c. Carbon dioxide production increases as result of hyperventilation.
d. Carbon dioxide production decreases as a result of hypoventilation.
ANS: D
Decreased effective contraction of left side of heart leads to back up of fluid in the lungs,
increasing hydrostatic pressure and causing pulmonary edema, resulting in crackles in lung
bases. - answer--A patient is admitted with the diagnosis of severe left-sided heart failure. The
nurse expects to auscultate which adventitious lung sounds?
a. Sonorous wheezes in the left lower lung
b. Rhonchi midsternum
c. Crackles only in apex of lungs
d. Inspiratory crackles in lung bases
ANS: B
,Movement not only mobilizes secretions but helps strengthen respiratory muscles by impacting
the effectiveness of gas exchange processes. - answer--The nurse is caring for a patient who has
decreased mobility. Which intervention is a simple and cost-effective method for reducing the
risks of stasis of pulmonary secretions and decreased chest wall expansion?
a. Antibiotics
b. Frequent change of position
c. Oxygen humidification
d. Chest physiotherapy
ANS: C
Impaired ability to cough up mucus caused by weakness or very thick secretions indicates a
need for suctioning when you know the patient has pneumonia. - answer--A patient is admitted
with severe lobar pneumonia. Which of the following assessment findings would indicate that
the patient needs airway suctioning?
a. Coughing up thick sputum only occasionally
b. Coughing up thin, watery sputum easily after nebulization
c. Decreased independent ability to cough
d. Lung sounds clear only after coughing
ANS: A
When the lung collapses, the thoracic space fills with air on each inspiration, and the
atmospheric air irritates the parietal pleura, causing pain. - answer--A patient was admitted
after a motor vehicle accident with multiple fractured ribs. Respiratory assessment includes
signs/symptoms of secondary pneumothorax, which includes which of the following?
a. Sharp pleuritic pain that worsens on inspiration
b. Crackles over lung bases of affected lung
c. Tracheal deviation toward the affected lung
d. Increased diaphragmatic excursion on side of rib fractures
, ANS: D
Hypoxia is the drive to breathe in a patient with chronic obstructive pulmonary disease who has
become used to acidic pH and elevated CO2 levels. Turning up to 6 L/min increases the oxygen
level, which turns off the drive to breathe. - answer--A patient has been newly diagnosed with
emphysema. In discussing his condition with the nurse, which of his statements would indicate
a need for further education?
a. "I'll make sure that I rest between activities so I don't get so short of breath."
b. "I'll rest for 30 minutes before I eat my meal."
c. "If I have trouble breathing at night, I'll use two to three pillows to prop up."
d. "If I get short of breath, I'll turn up my oxygen level to 6 L/min."
ANS: A
Raising the head of the bed brings the diaphragm down and allows for better chest expansion,
thus improving ventilation. - answer--The nurse goes to assess a new patient and finds him lying
supine in bed. The patient tells the nurse that he feels short of breath. Which nursing action
should the nurse perform first?
a. Raise the head of the bed to 45 degrees.
b. Take his oxygen saturation with a pulse oximeter.
c. Take his blood pressure and respiratory rate.
d. Notify the health care provider of his shortness of breath.
ANS: D
Saline has been found to cause more side effects when suctioning and does not increase the
amount of secretions removed. - answer--Which of the following statements made by a student
nurse indicates the need for further teaching about suctioning a patient with an endotracheal
tube?
a. "Suctioning the patient requires sterile technique."
b. "I'll apply suction while rotating and withdrawing the suction catheter."
c. "I'll suction the mouth after I suction the endotracheal tube."
