NCLEX NGN EAQ RESPIRATORY
MASTERY EXAM QUESTIONS AND
ANSWERS
1. A client with chronic obstructive pulmonary disease (COPD) presents with arterial blood
gas (ABG) results of pH 7.33, PaCO2 52 mmHg, and HCO3 28 mEq/L. Which interpretation is
correct?
A. Uncompensated metabolic acidosis
B. Fully compensated respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated respiratory acidosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high, indicating the kidneys are attempting to compensate but the pH is
not yet within normal range, making it partially compensated.
,2. The nurse is caring for a client who is 6 hours post-thoracentesis. Which assessment finding
requires immediate notification of the healthcare provider?
A. Pulse oximetry of 94% on room air
B. Slight discomfort at the needle insertion site
C. Diminished breath sounds on the affected side
D. Scattered crackles in the lung bases
Answer: C
Conceptual Explanation: Diminished breath sounds on the affected side after a
thoracentesis may indicate a pneumothorax, which is a significant complication requiring
immediate intervention.
3. A client with a suspected pulmonary embolism (PE) is being evaluated. Which diagnostic
test is considered the ‘gold standard’ for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
D. Computed Tomography Angiography (CTA)
Answer: D
, Conceptual Explanation: While D-dimer is a screening tool, Computed Tomography
Angiography (CTA) is the preferred and definitive diagnostic imaging for identifying a
pulmonary embolism.
4. When caring for a client with a chest tube, the nurse notes continuous bubbling in the
water-seal chamber. What is the priority action?
A. Document this as a normal finding
B. Increase the suction pressure on the wall regulator
C. Clamp the chest tube near the patient’s chest
D. Check the system for an air leak starting at the insertion site
Answer: D
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system; intermittent bubbling with respiration or coughing is normal. The nurse
must locate the leak.
5. A client is admitted with Acute Respiratory Distress Syndrome (ARDS). Which clinical
manifestation is the hallmark of this condition?
A. Improvement in oxygenation with high-flow oxygen
B. Increased lung compliance on ventilation
C. Hypoxemia that is refractory to oxygen therapy
D. Productive cough with pink frothy sputum
MASTERY EXAM QUESTIONS AND
ANSWERS
1. A client with chronic obstructive pulmonary disease (COPD) presents with arterial blood
gas (ABG) results of pH 7.33, PaCO2 52 mmHg, and HCO3 28 mEq/L. Which interpretation is
correct?
A. Uncompensated metabolic acidosis
B. Fully compensated respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated respiratory acidosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high, indicating the kidneys are attempting to compensate but the pH is
not yet within normal range, making it partially compensated.
,2. The nurse is caring for a client who is 6 hours post-thoracentesis. Which assessment finding
requires immediate notification of the healthcare provider?
A. Pulse oximetry of 94% on room air
B. Slight discomfort at the needle insertion site
C. Diminished breath sounds on the affected side
D. Scattered crackles in the lung bases
Answer: C
Conceptual Explanation: Diminished breath sounds on the affected side after a
thoracentesis may indicate a pneumothorax, which is a significant complication requiring
immediate intervention.
3. A client with a suspected pulmonary embolism (PE) is being evaluated. Which diagnostic
test is considered the ‘gold standard’ for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
D. Computed Tomography Angiography (CTA)
Answer: D
, Conceptual Explanation: While D-dimer is a screening tool, Computed Tomography
Angiography (CTA) is the preferred and definitive diagnostic imaging for identifying a
pulmonary embolism.
4. When caring for a client with a chest tube, the nurse notes continuous bubbling in the
water-seal chamber. What is the priority action?
A. Document this as a normal finding
B. Increase the suction pressure on the wall regulator
C. Clamp the chest tube near the patient’s chest
D. Check the system for an air leak starting at the insertion site
Answer: D
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system; intermittent bubbling with respiration or coughing is normal. The nurse
must locate the leak.
5. A client is admitted with Acute Respiratory Distress Syndrome (ARDS). Which clinical
manifestation is the hallmark of this condition?
A. Improvement in oxygenation with high-flow oxygen
B. Increased lung compliance on ventilation
C. Hypoxemia that is refractory to oxygen therapy
D. Productive cough with pink frothy sputum
