Test bank for NR 603 Pulmonary Test Bank – Practice Questions & Answers
1. Question: A patient with COPD is experiencing increased shortness of breath. Which nursing
intervention should be prioritized?
Answer: Place the patient in high Fowler’s or tripod position and administer prescribed
bronchodilator.
Rationale: Upright positioning maximizes lung expansion; bronchodilators relieve airway
constriction.
2. Question: A patient presents with sudden-onset dyspnea and pleuritic chest pain. Which
condition should be suspected?
Answer: Pulmonary embolism (PE).
Rationale: PE causes acute obstruction of pulmonary arteries, leading to hypoxemia and pain
from tissue infarction.
3. Question: Which diagnostic test is the gold standard for confirming pulmonary embolism?
Answer: CT pulmonary angiography.
Rationale: Provides direct visualization of clots in the pulmonary arteries.
4. Question: A patient with asthma reports wheezing and low oxygen saturation. Which
medication is most appropriate for immediate relief?
Answer: Short-acting beta-agonist (e.g., albuterol) via nebulizer.
Rationale: Rapid bronchodilation improves airflow and oxygenation during acute
exacerbations.
5. Question: A patient has chronic productive cough for ≥3 months per year for 2 consecutive
years. What condition does this indicate?
Answer: Chronic bronchitis.
Rationale: This is the diagnostic criterion for chronic bronchitis, part of COPD.
6. Question: Which physical assessment finding is most characteristic of emphysema?
Answer: Barrel chest, decreased breath sounds, prolonged expiration.
Rationale: Alveolar destruction leads to hyperinflated lungs and impaired ventilation.
7. Question: Which lab value is commonly elevated in bacterial pneumonia?
Answer: White blood cell (WBC) count.
Rationale: Indicates systemic inflammatory response to infection.
8. Question: A patient with pulmonary edema has frothy pink sputum. What is the priority
intervention?
Answer: Place upright, administer oxygen, and notify the provider immediately.
Rationale: Improves oxygenation and reduces pulmonary congestion.
, 9. Question: Which ABG finding suggests hypoxemic respiratory failure?
Answer: PaO2 < 60 mmHg with normal or low PaCO2.
Rationale: Oxygenation is impaired while CO2 retention may not yet be present.
10. Question: A patient with sleep apnea reports daytime sleepiness. Which comorbidity is
most commonly associated?
Answer: Hypertension.
Rationale: Recurrent nocturnal hypoxia activates sympathetic pathways, raising blood
pressure.
11. Question: Which intervention prevents postoperative atelectasis?
Answer: Incentive spirometry, deep breathing, and early ambulation.
Rationale: Expands alveoli, improves ventilation, and prevents lung collapse.
12. Question: A patient with cystic fibrosis has thick airway secretions. What therapy is
essential?
Answer: Chest physiotherapy, mucolytics, and bronchodilators.
Rationale: Mobilizes mucus and maintains airway patency.
13. Question: A patient with ARDS has low oxygen saturation despite supplemental oxygen.
What pathophysiology explains this?
Answer: Non-cardiogenic pulmonary edema from alveolar-capillary membrane damage.
Rationale: Fluid in alveoli impairs oxygen diffusion.
14. Question: Which symptom is more specific to interstitial lung disease (ILD) than COPD?
Answer: Progressive dry cough and fine bibasilar crackles.
Rationale: Fibrosis reduces lung compliance and produces characteristic auscultatory findings.
15. Question: What is the first-line empiric treatment for community-acquired pneumonia (CAP)
in a healthy adult?
Answer: Oral macrolide (e.g., azithromycin) or doxycycline.
Rationale: Covers common CAP pathogens like Streptococcus pneumoniae.
16. Question: Which ABG pattern is expected in early COPD exacerbation?
Answer: Respiratory alkalosis (low PaCO2, high pH).
Rationale: Hyperventilation compensates for hypoxemia initially.
17. Question: Which patient is at highest risk for hospital-acquired pneumonia (HAP)?
Answer: Mechanically ventilated or immunocompromised patients.
Rationale: Impaired airway defenses and colonization increase infection risk.
18. Question: Which assessment finding suggests right-sided heart failure due to pulmonary
disease?
Answer: Peripheral edema, hepatomegaly, jugular venous distension.
Rationale: Pulmonary hypertension increases right heart workload, causing systemic venous
congestion.
1. Question: A patient with COPD is experiencing increased shortness of breath. Which nursing
intervention should be prioritized?
Answer: Place the patient in high Fowler’s or tripod position and administer prescribed
bronchodilator.
Rationale: Upright positioning maximizes lung expansion; bronchodilators relieve airway
constriction.
2. Question: A patient presents with sudden-onset dyspnea and pleuritic chest pain. Which
condition should be suspected?
Answer: Pulmonary embolism (PE).
Rationale: PE causes acute obstruction of pulmonary arteries, leading to hypoxemia and pain
from tissue infarction.
3. Question: Which diagnostic test is the gold standard for confirming pulmonary embolism?
Answer: CT pulmonary angiography.
Rationale: Provides direct visualization of clots in the pulmonary arteries.
4. Question: A patient with asthma reports wheezing and low oxygen saturation. Which
medication is most appropriate for immediate relief?
Answer: Short-acting beta-agonist (e.g., albuterol) via nebulizer.
Rationale: Rapid bronchodilation improves airflow and oxygenation during acute
exacerbations.
5. Question: A patient has chronic productive cough for ≥3 months per year for 2 consecutive
years. What condition does this indicate?
Answer: Chronic bronchitis.
Rationale: This is the diagnostic criterion for chronic bronchitis, part of COPD.
6. Question: Which physical assessment finding is most characteristic of emphysema?
Answer: Barrel chest, decreased breath sounds, prolonged expiration.
Rationale: Alveolar destruction leads to hyperinflated lungs and impaired ventilation.
7. Question: Which lab value is commonly elevated in bacterial pneumonia?
Answer: White blood cell (WBC) count.
Rationale: Indicates systemic inflammatory response to infection.
8. Question: A patient with pulmonary edema has frothy pink sputum. What is the priority
intervention?
Answer: Place upright, administer oxygen, and notify the provider immediately.
Rationale: Improves oxygenation and reduces pulmonary congestion.
, 9. Question: Which ABG finding suggests hypoxemic respiratory failure?
Answer: PaO2 < 60 mmHg with normal or low PaCO2.
Rationale: Oxygenation is impaired while CO2 retention may not yet be present.
10. Question: A patient with sleep apnea reports daytime sleepiness. Which comorbidity is
most commonly associated?
Answer: Hypertension.
Rationale: Recurrent nocturnal hypoxia activates sympathetic pathways, raising blood
pressure.
11. Question: Which intervention prevents postoperative atelectasis?
Answer: Incentive spirometry, deep breathing, and early ambulation.
Rationale: Expands alveoli, improves ventilation, and prevents lung collapse.
12. Question: A patient with cystic fibrosis has thick airway secretions. What therapy is
essential?
Answer: Chest physiotherapy, mucolytics, and bronchodilators.
Rationale: Mobilizes mucus and maintains airway patency.
13. Question: A patient with ARDS has low oxygen saturation despite supplemental oxygen.
What pathophysiology explains this?
Answer: Non-cardiogenic pulmonary edema from alveolar-capillary membrane damage.
Rationale: Fluid in alveoli impairs oxygen diffusion.
14. Question: Which symptom is more specific to interstitial lung disease (ILD) than COPD?
Answer: Progressive dry cough and fine bibasilar crackles.
Rationale: Fibrosis reduces lung compliance and produces characteristic auscultatory findings.
15. Question: What is the first-line empiric treatment for community-acquired pneumonia (CAP)
in a healthy adult?
Answer: Oral macrolide (e.g., azithromycin) or doxycycline.
Rationale: Covers common CAP pathogens like Streptococcus pneumoniae.
16. Question: Which ABG pattern is expected in early COPD exacerbation?
Answer: Respiratory alkalosis (low PaCO2, high pH).
Rationale: Hyperventilation compensates for hypoxemia initially.
17. Question: Which patient is at highest risk for hospital-acquired pneumonia (HAP)?
Answer: Mechanically ventilated or immunocompromised patients.
Rationale: Impaired airway defenses and colonization increase infection risk.
18. Question: Which assessment finding suggests right-sided heart failure due to pulmonary
disease?
Answer: Peripheral edema, hepatomegaly, jugular venous distension.
Rationale: Pulmonary hypertension increases right heart workload, causing systemic venous
congestion.
