NURS 272 FINAL EXAM 2025/2026
QUESTIONS AND ANSWERS 100% PASS
RESPIRATORY SYSTEM B&S CH 20, 21, 22, 23, & 24
Explain the anatomical components of the respiratory system. - ANS > respiratory zone
muscles
- major muscle = diaphragm
*controlled by the phrenic nerve (C3-C5 of the neck), so any pt w an injury to the spine/phrenic
nerve will require ventilatory support!
- accessory muscles = intercostals, abdominals, trapezius, sternocleidomastoid
To move air into the lungs...respiratory muscles generate negative intrapleural pressure =
allows air inflowing via the pressure gradient btwn atmospheric pressure at the mouth (zero
pressure) & alveolar pressure (negative pressure)
> conduction zone muscles = trachea, bronchi & bronchioles
- influenced by SNS' B2-adrenergic receptors (relaxation) & acetylcholine receptors
(constriction)
> gas exchange surfaces = alveoli
- chronic smoking & chewing tobacco = decr alveoli surface area *important to ask abt smoking
history!
- atelectasis = alveoli collapse resulting from trapped air or fluid buildup (ex: pts who are
bedridden *important to encourage mobility & coughing)
What are some of the risk factors for pulmonary disease? - ANS > pollution & travel
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,> 2nd hand/3rd hand smoke
> chemical exposure
> freq respiratory infections
> pre-existing/congenital conditions (ex: CF, chest injury, living in confined environs)
What are some of the common diagnostics used to screen for respiratory disease? - ANS 1)
chest X-ray (CXR)
= 2 view X-ray of PA (posterior & anterior) & Lateral (side) to help produce an accurate image of
the pt's heart/lungs/BV/bones
> looking for inflation of the lungs (COPD), fluid build up (pneumonia & HF), atelectasis, broken
bones (ribs), heart size (cardiomyopathy = enlarged heart), foreign bodies
- most common! cheap & inexpensive
2) CT scan (contrast)
= uses contrast dye to produce more detailed images of soft tissue damage/injuries
> looking for lesions, blood clots, etc
- make sure to flush dye out to ppx kidney toxicity!
3) Pulse Oximeter
= measures SaO2
> SaO2 = amt of O2 attached to Hgb/how much O2 being perfused via the blood
- factors that influence readings = dark nail polish, long nails, acrylics, cold temp, bright lights, &
anything that decr circulation to the finger
- pts w darker skin, will have falsely high readings even when desaturating
4) Pulmonary function tests
> looking for lung functioning in cases of COPD & asthma
5) Sputum Culture
> looking for lung infection?
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,6) ABGs
> looking for acid-base imbalances? & desaturation?
7) Bronchoscopy/Thoracoscopy
= uses endoscopy to view respiratory structures
> collecting biopsies & cultures
- broncho (via mouth) & thoraco (via chest tube)
- performed in ICU or OR w minimal sedation
8) Thoracentesis
> pulling fluid build up in pleural lining off
- important to assess baseline coagulation (order sets) to ppx excessive post-op bleeding
9) V/Q Scan
= looks at ventilation (pt uses inhaler) vs. perfusion (radioactive substance is injected into
blood)
> detecting PE = indicated by altered V/Q
- no longer commonly used
10) Mantoux test
= ID injection
> testing for TB
What are the various components of a respiratory assessment? - ANS 1) lung sounds = use
systematic approach! (ex: R > L moving down)
- clear? bilateral?
2) breathing patterns = rate & quality
- tachypnea? dyspnea? SOB?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, - difficulty breathing? shallow?
3) O2 saturation = 95-99% expected
4) accessory muscle usage = indicates acute respiratory distress
5) hypoxia S/Sx
- early.= restlessness, anxiety, confusion, <95% SaO2
- compensation = tachypnea, tachycardia, SOB
- later = bradypnea, bradycardia, hypotension, decr LOC, cyanosis, & pallor
6) Crepitus (SQ emphysema) = air trapped in/under the skin
- caused by chest injury, blunt force trauma, etc...
- palpable as rice krispies under the skin
7) percussion = using 2 fingers tapping on 2 fingers
- good for assessing w limited resources
- dull sound (compromised lung) vs. resonate sound (healthy lung)
What are some examples of abnormal breath sounds commonly heard during lung
auscultation? - ANS > fine crackles/rales = air moving into deflated airways, "popping, velcro,
rolled hair"
- ex: atelectasis, pneumonia, COPD
> coarse crackles = "lower pitched rattling" *have pt cough to see if they can clear their airway
- ex: pneumonia, flu, COVID, COPD, tumors
> wheeze = narrowed airway w inflammation/secretions, "squeeky, musical"
- ex: asthma, COPD, bronchospasms
> rhonchi = obstruction, "low pitched wheeze, snore"
- ex: anatomical (enlarged tonsils or adenoids), nasal congestion, thick secretions, tumor
> stridor = something stuck in the trachea, "harsh grating"
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
QUESTIONS AND ANSWERS 100% PASS
RESPIRATORY SYSTEM B&S CH 20, 21, 22, 23, & 24
Explain the anatomical components of the respiratory system. - ANS > respiratory zone
muscles
- major muscle = diaphragm
*controlled by the phrenic nerve (C3-C5 of the neck), so any pt w an injury to the spine/phrenic
nerve will require ventilatory support!
- accessory muscles = intercostals, abdominals, trapezius, sternocleidomastoid
To move air into the lungs...respiratory muscles generate negative intrapleural pressure =
allows air inflowing via the pressure gradient btwn atmospheric pressure at the mouth (zero
pressure) & alveolar pressure (negative pressure)
> conduction zone muscles = trachea, bronchi & bronchioles
- influenced by SNS' B2-adrenergic receptors (relaxation) & acetylcholine receptors
(constriction)
> gas exchange surfaces = alveoli
- chronic smoking & chewing tobacco = decr alveoli surface area *important to ask abt smoking
history!
- atelectasis = alveoli collapse resulting from trapped air or fluid buildup (ex: pts who are
bedridden *important to encourage mobility & coughing)
What are some of the risk factors for pulmonary disease? - ANS > pollution & travel
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,> 2nd hand/3rd hand smoke
> chemical exposure
> freq respiratory infections
> pre-existing/congenital conditions (ex: CF, chest injury, living in confined environs)
What are some of the common diagnostics used to screen for respiratory disease? - ANS 1)
chest X-ray (CXR)
= 2 view X-ray of PA (posterior & anterior) & Lateral (side) to help produce an accurate image of
the pt's heart/lungs/BV/bones
> looking for inflation of the lungs (COPD), fluid build up (pneumonia & HF), atelectasis, broken
bones (ribs), heart size (cardiomyopathy = enlarged heart), foreign bodies
- most common! cheap & inexpensive
2) CT scan (contrast)
= uses contrast dye to produce more detailed images of soft tissue damage/injuries
> looking for lesions, blood clots, etc
- make sure to flush dye out to ppx kidney toxicity!
3) Pulse Oximeter
= measures SaO2
> SaO2 = amt of O2 attached to Hgb/how much O2 being perfused via the blood
- factors that influence readings = dark nail polish, long nails, acrylics, cold temp, bright lights, &
anything that decr circulation to the finger
- pts w darker skin, will have falsely high readings even when desaturating
4) Pulmonary function tests
> looking for lung functioning in cases of COPD & asthma
5) Sputum Culture
> looking for lung infection?
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,6) ABGs
> looking for acid-base imbalances? & desaturation?
7) Bronchoscopy/Thoracoscopy
= uses endoscopy to view respiratory structures
> collecting biopsies & cultures
- broncho (via mouth) & thoraco (via chest tube)
- performed in ICU or OR w minimal sedation
8) Thoracentesis
> pulling fluid build up in pleural lining off
- important to assess baseline coagulation (order sets) to ppx excessive post-op bleeding
9) V/Q Scan
= looks at ventilation (pt uses inhaler) vs. perfusion (radioactive substance is injected into
blood)
> detecting PE = indicated by altered V/Q
- no longer commonly used
10) Mantoux test
= ID injection
> testing for TB
What are the various components of a respiratory assessment? - ANS 1) lung sounds = use
systematic approach! (ex: R > L moving down)
- clear? bilateral?
2) breathing patterns = rate & quality
- tachypnea? dyspnea? SOB?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, - difficulty breathing? shallow?
3) O2 saturation = 95-99% expected
4) accessory muscle usage = indicates acute respiratory distress
5) hypoxia S/Sx
- early.= restlessness, anxiety, confusion, <95% SaO2
- compensation = tachypnea, tachycardia, SOB
- later = bradypnea, bradycardia, hypotension, decr LOC, cyanosis, & pallor
6) Crepitus (SQ emphysema) = air trapped in/under the skin
- caused by chest injury, blunt force trauma, etc...
- palpable as rice krispies under the skin
7) percussion = using 2 fingers tapping on 2 fingers
- good for assessing w limited resources
- dull sound (compromised lung) vs. resonate sound (healthy lung)
What are some examples of abnormal breath sounds commonly heard during lung
auscultation? - ANS > fine crackles/rales = air moving into deflated airways, "popping, velcro,
rolled hair"
- ex: atelectasis, pneumonia, COPD
> coarse crackles = "lower pitched rattling" *have pt cough to see if they can clear their airway
- ex: pneumonia, flu, COVID, COPD, tumors
> wheeze = narrowed airway w inflammation/secretions, "squeeky, musical"
- ex: asthma, COPD, bronchospasms
> rhonchi = obstruction, "low pitched wheeze, snore"
- ex: anatomical (enlarged tonsils or adenoids), nasal congestion, thick secretions, tumor
> stridor = something stuck in the trachea, "harsh grating"
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
