NCLEX NGN EAQ RESPIRATORY
REVIEW QUESTIONS WITH VERIFIED
ANSWERS
1. A client with an acute exacerbation of COPD is reported to have a pH of 7.30 and a PaCO2
of 60 mmHg. The nurse understands this represents which acid-base imbalance?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg indicates a respiratory cause. This is classic respiratory acidosis seen in COPD due
to alveolar hypoventilation.
2. Which clinical manifestation should the nurse prioritize as the most critical when assessing
a client with a suspected pulmonary embolism?
A. Sudden onset dyspnea
B. Hemoptysis
,C. Pleuritic chest pain
D. Low-grade fever
Answer: A
Conceptual Explanation: Sudden onset dyspnea is the most common and urgent symptom
of PE, indicating a significant compromise in gas exchange.
3. A client with a chest tube has continuous bubbling in the water seal chamber. What is the
nurse’s immediate interpretation?
A. The system is functioning normally.
B. There is an air leak in the system.
C. The lung has fully re-expanded.
D. The suction pressure is too high.
Answer: B
Conceptual Explanation: Intermittent bubbling is expected in a client with a
pneumothorax, but continuous bubbling indicates a leak in the drainage system or the
client’s pleural space.
4. The nurse is caring for a client with tuberculosis. Which personal protective equipment
(PPE) is mandatory when entering the room?
A. N95 respirator and gloves
B. Gown and face shield
, C. Surgical mask and gloves
D. Standard surgical mask only
Answer: A
Conceptual Explanation: TB requires airborne precautions, including a private negative-
pressure room and a fit-tested N95 respirator for healthcare workers.
5. A client is prescribed Rifampin for TB. What essential teaching point should the nurse
include?
A. Avoid foods high in tyramine.
B. The medication will cause permanent hearing loss.
C. Your urine and sweat may turn orange-red.
D. Do not take the medication with water.
Answer: C
Conceptual Explanation: Rifampin causes a harmless reddish-orange discoloration of
bodily fluids, which can be alarming to clients if not forewarned.
6. During an assessment of a client with asthma, the nurse hears a ‘silent chest’ upon
auscultation. What is the nurse’s priority action?
A. Administer a scheduled corticosteroid.
B. Place the client in a supine position.
C. Encourage the client to use a peak flow meter.
REVIEW QUESTIONS WITH VERIFIED
ANSWERS
1. A client with an acute exacerbation of COPD is reported to have a pH of 7.30 and a PaCO2
of 60 mmHg. The nurse understands this represents which acid-base imbalance?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg indicates a respiratory cause. This is classic respiratory acidosis seen in COPD due
to alveolar hypoventilation.
2. Which clinical manifestation should the nurse prioritize as the most critical when assessing
a client with a suspected pulmonary embolism?
A. Sudden onset dyspnea
B. Hemoptysis
,C. Pleuritic chest pain
D. Low-grade fever
Answer: A
Conceptual Explanation: Sudden onset dyspnea is the most common and urgent symptom
of PE, indicating a significant compromise in gas exchange.
3. A client with a chest tube has continuous bubbling in the water seal chamber. What is the
nurse’s immediate interpretation?
A. The system is functioning normally.
B. There is an air leak in the system.
C. The lung has fully re-expanded.
D. The suction pressure is too high.
Answer: B
Conceptual Explanation: Intermittent bubbling is expected in a client with a
pneumothorax, but continuous bubbling indicates a leak in the drainage system or the
client’s pleural space.
4. The nurse is caring for a client with tuberculosis. Which personal protective equipment
(PPE) is mandatory when entering the room?
A. N95 respirator and gloves
B. Gown and face shield
, C. Surgical mask and gloves
D. Standard surgical mask only
Answer: A
Conceptual Explanation: TB requires airborne precautions, including a private negative-
pressure room and a fit-tested N95 respirator for healthcare workers.
5. A client is prescribed Rifampin for TB. What essential teaching point should the nurse
include?
A. Avoid foods high in tyramine.
B. The medication will cause permanent hearing loss.
C. Your urine and sweat may turn orange-red.
D. Do not take the medication with water.
Answer: C
Conceptual Explanation: Rifampin causes a harmless reddish-orange discoloration of
bodily fluids, which can be alarming to clients if not forewarned.
6. During an assessment of a client with asthma, the nurse hears a ‘silent chest’ upon
auscultation. What is the nurse’s priority action?
A. Administer a scheduled corticosteroid.
B. Place the client in a supine position.
C. Encourage the client to use a peak flow meter.
