8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
EVOLVE Respiratory case study with complete
questions and verified answers HESI nursing
exam prep
ANS: B
Listen to the client's breath sounds.
During the evening after a
Because anxiety is frequently an early manifestation of
thoracentesis, the client
hypoxemia, the nurse's initial action will be to assess for
reports anxiety. Which
complications of thoracentesis such as pneumothorax
action would the nurse
by listening for lung sounds.
take first?
A. Administering an analgesic may be indicated if the
A. Administer the prescribed
analgesic. client states that pain is contributing to anxiety, but
B. Listen to the client's breath would be done after further assessment.
sounds.
C. Give the client the
C. Administration of lorazepam may be indicated after
prescribed as needed the nurse assesses for potential physiological or
lorazepam. psychological causes of anxiety.
D. Ask the client about
specific concerns or D. Asking about specific client concerns or worries is
indicated once the nurse is sure that physiological
worries. factors are not the cause of the anxiety.
1/35
,8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
ANS: C
Decreased right breath sounds
Which assessment finding After thoracentesis the breath sounds should be audible on the
affected side and
on a client who has just
decreased breath sounds may indicate pneumothorax.
had a thoracentesis for a
The nurse would immediately notify the health care
right
provider and expect actions such as a chest x-ray and
pleural effusion would
possible insertion of a chest tube.
require the most rapid
action by the nurse?
A. The oxygen saturation of 93% is slightly below
normal, but would not be surprising in a client who
A. Oxygen saturation of 93%
has a history of lung disease.
B. Blood pressure of 160/94
mm Hg
C. Decreased right side breath
B. Hypotension after thoracentesis may indicate bleeding or that
sounds too much pleural
D. Ecchymosis at the
fluid has been removed at once, but mild hypertension
site of the may occur due to anxiety or pain.
thoracentesis
D. Ecchymosis at the thoracentesis site would be
monitored, but would be expected after thoracentesis.
Immediately after a ANS: D
thoracentesis, a client's
right lung collapses. A The fluid rises in the tube of the water-seal chamber during
inspiration.
chest tube is
inserted and is attached to a
three- Increased negative intrapleural pressure on inspiration
chamber closed drainage causes the fluid to rise; a decrease in negative
system. The
intrapleural pressure on expiration causes the fluid to
nurse assesses the fluid in the
fall.
system and recognizes that
which finding indicates that
A. Remaining constant in the chest drainage chamber
the chest tube is
indicates that an obstruction is present in the drainage
functioning properly?
tubing or that the suction is too low; a slight increase in
fluid should be evident in this chamber
A. The fluid remains
postoperatively.
constant in the chest
drainage chamber.
B. Bubbling gently in the chest drainage chamber indicates an air
2/35
,8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
B. The fluid is bubbling leak.
gently in the chest
drainage chamber. C. If the water is bubbling vigorously in the suction
C. The fluid is bubbling control chamber, the suction is too hight; bubbling
vigorously in the suction should be gentle.
control chamber.
D. The fluid rises in the tube
of the water- seal
chamber during
inspiration.
ANS: C
After a thoracentesis for
pleural effusion, a client "I get a sharp, stabbing pain when I take a
returns to an outpatient
deep breath." Rationale:
clinic for a follow-up visit. Tension is placed on the pleura at the height of inspiration and
The nurse suspects a causes pain.
recurrence of pleural
effusion when the client A. The response "Lately I can only breathe well if I sit up" is
typical of heart failure."
makes which statement?
B. The response "During the night I sometimes get the
A. "Lately I can only breathe
well if I sit up." chills" may indicate a pulmonary infection.
B. "During the night I
D. The response "I'm coughing up large amounts of
sometimes get the chills." thicker mucus for the past several days" may indicate a
C. "I get a sharp, stabbing pulmonary infection.
pain when I take a deep
breath."
D. "I'm coughing up large
amounts of thicker
mucus for the past several
days."
3/35
, 8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
ANS: A, C, D
Which actions will the
nurse take when preparing
Rationale:
a client before
A- The client is usually positioned sitting up at the side
thoracentesis? Select all
of the bed or seated facing backward on a chair so
that apply. One, some, or
that the posterior thorax is exposed.
all responses may be
correct.
C- The client will rest the arms on the bedside table,
which increases the size of the intercostal spaces.
A. Assist the client to sit up
on the edge of the bed.
D- Informed consent is needed before thoracentesis.
B. Remind the client not to
eat before the procedure. B- Because no sedation or general anesthesia is needed
C. Instruct the client to rest for thoracentesis, the client does not need to refrain
the arms on the bedside from eating before the procedure.
table.
E- The client should be instructed to avoid coughing or
D. Verify that the client
moving during the procedure to decrease risk for
has signed the informed pneumothorax.
consent form.
E. Educate the client about
when to cough during the
procedure.
ANS: A, B, C, D
Which actions will the nurse
take when caring for a
Rationale:
client with possible lung
A- Breath sounds should be verified in all lung fields
cancer who has just had a
after thoracentesis to rule out lung collapse.
thoracentesis? Select all
that apply. One, some, or
B- The client is encouraged to perform deep breaths to help
all responses may be expand the lungs.
correct.
C- Pleural fluid will be sent to the laboratory to look for
A. Listen to breath sounds. malignant cells.
B. Encourage deep breaths.
C. Send pleural fluid to the
D- A chest x-ray should be obtained after the procedure to check
laboratory. for pneumothorax.
D. Ensure that a chest x-ray is
performed. E- There is no need for the client to remain on bed rest after the
E. Place the client on bed
procedure.
4/35
EVOLVE Respiratory case study with complete
questions and verified answers HESI nursing
exam prep
ANS: B
Listen to the client's breath sounds.
During the evening after a
Because anxiety is frequently an early manifestation of
thoracentesis, the client
hypoxemia, the nurse's initial action will be to assess for
reports anxiety. Which
complications of thoracentesis such as pneumothorax
action would the nurse
by listening for lung sounds.
take first?
A. Administering an analgesic may be indicated if the
A. Administer the prescribed
analgesic. client states that pain is contributing to anxiety, but
B. Listen to the client's breath would be done after further assessment.
sounds.
C. Give the client the
C. Administration of lorazepam may be indicated after
prescribed as needed the nurse assesses for potential physiological or
lorazepam. psychological causes of anxiety.
D. Ask the client about
specific concerns or D. Asking about specific client concerns or worries is
indicated once the nurse is sure that physiological
worries. factors are not the cause of the anxiety.
1/35
,8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
ANS: C
Decreased right breath sounds
Which assessment finding After thoracentesis the breath sounds should be audible on the
affected side and
on a client who has just
decreased breath sounds may indicate pneumothorax.
had a thoracentesis for a
The nurse would immediately notify the health care
right
provider and expect actions such as a chest x-ray and
pleural effusion would
possible insertion of a chest tube.
require the most rapid
action by the nurse?
A. The oxygen saturation of 93% is slightly below
normal, but would not be surprising in a client who
A. Oxygen saturation of 93%
has a history of lung disease.
B. Blood pressure of 160/94
mm Hg
C. Decreased right side breath
B. Hypotension after thoracentesis may indicate bleeding or that
sounds too much pleural
D. Ecchymosis at the
fluid has been removed at once, but mild hypertension
site of the may occur due to anxiety or pain.
thoracentesis
D. Ecchymosis at the thoracentesis site would be
monitored, but would be expected after thoracentesis.
Immediately after a ANS: D
thoracentesis, a client's
right lung collapses. A The fluid rises in the tube of the water-seal chamber during
inspiration.
chest tube is
inserted and is attached to a
three- Increased negative intrapleural pressure on inspiration
chamber closed drainage causes the fluid to rise; a decrease in negative
system. The
intrapleural pressure on expiration causes the fluid to
nurse assesses the fluid in the
fall.
system and recognizes that
which finding indicates that
A. Remaining constant in the chest drainage chamber
the chest tube is
indicates that an obstruction is present in the drainage
functioning properly?
tubing or that the suction is too low; a slight increase in
fluid should be evident in this chamber
A. The fluid remains
postoperatively.
constant in the chest
drainage chamber.
B. Bubbling gently in the chest drainage chamber indicates an air
2/35
,8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
B. The fluid is bubbling leak.
gently in the chest
drainage chamber. C. If the water is bubbling vigorously in the suction
C. The fluid is bubbling control chamber, the suction is too hight; bubbling
vigorously in the suction should be gentle.
control chamber.
D. The fluid rises in the tube
of the water- seal
chamber during
inspiration.
ANS: C
After a thoracentesis for
pleural effusion, a client "I get a sharp, stabbing pain when I take a
returns to an outpatient
deep breath." Rationale:
clinic for a follow-up visit. Tension is placed on the pleura at the height of inspiration and
The nurse suspects a causes pain.
recurrence of pleural
effusion when the client A. The response "Lately I can only breathe well if I sit up" is
typical of heart failure."
makes which statement?
B. The response "During the night I sometimes get the
A. "Lately I can only breathe
well if I sit up." chills" may indicate a pulmonary infection.
B. "During the night I
D. The response "I'm coughing up large amounts of
sometimes get the chills." thicker mucus for the past several days" may indicate a
C. "I get a sharp, stabbing pulmonary infection.
pain when I take a deep
breath."
D. "I'm coughing up large
amounts of thicker
mucus for the past several
days."
3/35
, 8/22/25, 5:49 PM Respiratory Quiz- EVOLVE
ANS: A, C, D
Which actions will the
nurse take when preparing
Rationale:
a client before
A- The client is usually positioned sitting up at the side
thoracentesis? Select all
of the bed or seated facing backward on a chair so
that apply. One, some, or
that the posterior thorax is exposed.
all responses may be
correct.
C- The client will rest the arms on the bedside table,
which increases the size of the intercostal spaces.
A. Assist the client to sit up
on the edge of the bed.
D- Informed consent is needed before thoracentesis.
B. Remind the client not to
eat before the procedure. B- Because no sedation or general anesthesia is needed
C. Instruct the client to rest for thoracentesis, the client does not need to refrain
the arms on the bedside from eating before the procedure.
table.
E- The client should be instructed to avoid coughing or
D. Verify that the client
moving during the procedure to decrease risk for
has signed the informed pneumothorax.
consent form.
E. Educate the client about
when to cough during the
procedure.
ANS: A, B, C, D
Which actions will the nurse
take when caring for a
Rationale:
client with possible lung
A- Breath sounds should be verified in all lung fields
cancer who has just had a
after thoracentesis to rule out lung collapse.
thoracentesis? Select all
that apply. One, some, or
B- The client is encouraged to perform deep breaths to help
all responses may be expand the lungs.
correct.
C- Pleural fluid will be sent to the laboratory to look for
A. Listen to breath sounds. malignant cells.
B. Encourage deep breaths.
C. Send pleural fluid to the
D- A chest x-ray should be obtained after the procedure to check
laboratory. for pneumothorax.
D. Ensure that a chest x-ray is
performed. E- There is no need for the client to remain on bed rest after the
E. Place the client on bed
procedure.
4/35
