1
NCLEX PN Exam Bank Respiratory Disorders
and Oxygen Therapy
Table of Contents
Subtopic 1: Respiratory Assessment and Early Recognition of Compromise ...................... 2
Subtopic 2: Oxygen Therapy Administration and Safety Protocols ..................................... 9
Subtopic 3: Common Respiratory Diseases – Asthma, COPD, and Pneumonia ................ 18
Subtopic 4: Tuberculosis, Influenza, and Other Infectious Respiratory Conditions ........... 26
Subtopic 5: Respiratory Pharmacology in Clinical Practice (Questions 81–100) ................ 34
Subtopic 6: Tracheostomy Care and Airway Management .............................................. 42
Subtopic 7: Acute and Chronic Respiratory Failure: Prioritization and Emergency
Management .............................................................................................................. 50
Subtopic 8: Nursing Considerations for Artificial Airways and Mechanical Ventilation ...... 57
, 2
Subtopic 1: Respiratory Assessment and Early
Recognition of Compromise
(Questions 1–20)
1. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which
assessment finding requires immediate intervention?
A. Clubbing of the fingers
B. Use of accessory muscles during respiration
C. Productive cough with white sputum
D. O2 saturation of 91% on room air
Correct Answer: B
Rationale: Use of accessory muscles indicates increased work of breathing and possible
respiratory distress, requiring immediate attention.
2. Which breath sound is most concerning and indicative of a medical emergency?
A. Crackles at lung bases
B. Diminished breath sounds in both lower lobes
C. Stridor heard over the neck and upper chest
D. Wheezes in all lung fields
Correct Answer: C
Rationale: Stridor is a high-pitched sound indicating upper airway obstruction and is a
medical emergency.
3. A nurse notes a client’s respiratory rate is 8 breaths/min after receiving morphine. What
is the priority action?
, 3
A. Reassess in 15 minutes
B. Notify the provider and prepare to administer naloxone
C. Encourage deep breathing
D. Increase IV fluid rate
Correct Answer: B
Rationale: Respiratory depression is a known opioid complication. Naloxone reverses
opioid effects.
4. Which sign indicates early hypoxia in a patient?
A. Cyanosis
B. Bradycardia
C. Restlessness and irritability
D. Decreased urine output
Correct Answer: C
Rationale: Restlessness and irritability are early neurologic signs of hypoxia due to reduced
oxygenation of brain tissue.
5. During respiratory assessment, what finding would suggest atelectasis?
A. Resonance on percussion
B. Diminished breath sounds and dullness on percussion
C. Inspiratory wheezing
D. Loud rhonchi
Correct Answer: B
, 4
Rationale: Diminished breath sounds and dullness suggest lung tissue collapse or
consolidation.
6. Which lab value is most relevant for evaluating respiratory function?
A. Hemoglobin A1C
B. Arterial blood gases (ABG)
C. Prothrombin time
D. Serum creatinine
Correct Answer: B
Rationale: ABG analysis provides detailed information on oxygenation, ventilation, and
acid-base balance.
7. What is the normal range for PaCO₂ in arterial blood gas (ABG)?
A. 20–30 mmHg
B. 35–45 mmHg
C. 50–60 mmHg
D. 60–70 mmHg
Correct Answer: B
Rationale: Normal PaCO₂ is 35–45 mmHg. Deviations may indicate respiratory acidosis or
alkalosis.
8. A client is experiencing dyspnea. Which nursing action is the priority?
A. Call respiratory therapy
B. Raise the head of the bed to high Fowler’s position
C. Check blood pressure
NCLEX PN Exam Bank Respiratory Disorders
and Oxygen Therapy
Table of Contents
Subtopic 1: Respiratory Assessment and Early Recognition of Compromise ...................... 2
Subtopic 2: Oxygen Therapy Administration and Safety Protocols ..................................... 9
Subtopic 3: Common Respiratory Diseases – Asthma, COPD, and Pneumonia ................ 18
Subtopic 4: Tuberculosis, Influenza, and Other Infectious Respiratory Conditions ........... 26
Subtopic 5: Respiratory Pharmacology in Clinical Practice (Questions 81–100) ................ 34
Subtopic 6: Tracheostomy Care and Airway Management .............................................. 42
Subtopic 7: Acute and Chronic Respiratory Failure: Prioritization and Emergency
Management .............................................................................................................. 50
Subtopic 8: Nursing Considerations for Artificial Airways and Mechanical Ventilation ...... 57
, 2
Subtopic 1: Respiratory Assessment and Early
Recognition of Compromise
(Questions 1–20)
1. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which
assessment finding requires immediate intervention?
A. Clubbing of the fingers
B. Use of accessory muscles during respiration
C. Productive cough with white sputum
D. O2 saturation of 91% on room air
Correct Answer: B
Rationale: Use of accessory muscles indicates increased work of breathing and possible
respiratory distress, requiring immediate attention.
2. Which breath sound is most concerning and indicative of a medical emergency?
A. Crackles at lung bases
B. Diminished breath sounds in both lower lobes
C. Stridor heard over the neck and upper chest
D. Wheezes in all lung fields
Correct Answer: C
Rationale: Stridor is a high-pitched sound indicating upper airway obstruction and is a
medical emergency.
3. A nurse notes a client’s respiratory rate is 8 breaths/min after receiving morphine. What
is the priority action?
, 3
A. Reassess in 15 minutes
B. Notify the provider and prepare to administer naloxone
C. Encourage deep breathing
D. Increase IV fluid rate
Correct Answer: B
Rationale: Respiratory depression is a known opioid complication. Naloxone reverses
opioid effects.
4. Which sign indicates early hypoxia in a patient?
A. Cyanosis
B. Bradycardia
C. Restlessness and irritability
D. Decreased urine output
Correct Answer: C
Rationale: Restlessness and irritability are early neurologic signs of hypoxia due to reduced
oxygenation of brain tissue.
5. During respiratory assessment, what finding would suggest atelectasis?
A. Resonance on percussion
B. Diminished breath sounds and dullness on percussion
C. Inspiratory wheezing
D. Loud rhonchi
Correct Answer: B
, 4
Rationale: Diminished breath sounds and dullness suggest lung tissue collapse or
consolidation.
6. Which lab value is most relevant for evaluating respiratory function?
A. Hemoglobin A1C
B. Arterial blood gases (ABG)
C. Prothrombin time
D. Serum creatinine
Correct Answer: B
Rationale: ABG analysis provides detailed information on oxygenation, ventilation, and
acid-base balance.
7. What is the normal range for PaCO₂ in arterial blood gas (ABG)?
A. 20–30 mmHg
B. 35–45 mmHg
C. 50–60 mmHg
D. 60–70 mmHg
Correct Answer: B
Rationale: Normal PaCO₂ is 35–45 mmHg. Deviations may indicate respiratory acidosis or
alkalosis.
8. A client is experiencing dyspnea. Which nursing action is the priority?
A. Call respiratory therapy
B. Raise the head of the bed to high Fowler’s position
C. Check blood pressure
