Med-Surg II Respiratory Exam – 100 Verified
Q&A
Topic Coverage: COPD, Asthma, Pneumonia, ARDS, Pulmonary Embolism, TB, Lung Cancer,
Mechanical Ventilation, Chest Tubes, Oxygen Therapy, Assessment, and Interventions.
1. Which arterial blood gas (ABG) result is most indicative of chronic compensated respiratory
acidosis?
A. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L
C. ✓ pH 7.36, PaCO₂ 55 mmHg, HCO₃⁻ 34 mEq/L
D. pH 7.48, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L
2. A patient with COPD is using pursed-lip breathing. The nurse understands this technique
primarily helps by:
A. Increasing oxygen saturation
B. Strengthening the diaphragm
C. ✓ Preventing airway collapse during exhalation
D. Reducing respiratory rate
3. Which assessment finding is a late sign of hypoxemia?
A. Tachycardia
B. Restlessness
C. Hypertension
D. ✓ Cyanosis
4. A patient with a suspected pulmonary embolism (PE) reports sudden dyspnea and pleuritic
chest pain. Which diagnostic test is most definitive?
A. Chest X-ray
B. ✓ CT pulmonary angiography
C. Electrocardiogram
D. Arterial blood gas
5. The nurse is preparing to administer albuterol via nebulizer to a patient with asthma.
Which adverse effect should be monitored most closely?
A. Sedation
B. Bradycardia
,C. ✓ Tachycardia
D. Constipation
6. Which position is best for a patient with dyspnea associated with pulmonary edema?
A. Prone
B. Trendelenburg
C. ✓ High-Fowler's
D. Supine
7. A patient with ARDS is on mechanical ventilation. Which ventilator setting is critical to
prevent further lung injury?
A. ✓ Low tidal volume (6-8 mL/kg ideal body weight)
B. High tidal volume (10-12 mL/kg)
C. High respiratory rate (>30/min)
D. Zero PEEP
8. Chest tube drainage system bubbling continuously in the water seal chamber indicates:
A. Normal evaporation
B. A leak in the system
C. ✓ An air leak from the patient (pneumothorax)
D. Proper suction control
9. Which vaccine is recommended annually for patients with COPD?
A. Pneumococcal
B. ✓ Influenza
C. Hepatitis B
D. MMR
10. Tuberculosis transmission is best prevented by placing the patient in:
A. Standard precautions
B. ✓ Airborne isolation (negative pressure room)
C. Droplet precautions
D. Contact precautions
11. A patient with emphysema typically has a barrel chest due to:
A. Kyphosis
B. ✓ Hyperinflation of alveoli
C. Pectus excavatum
D. Muscle wasting
,12. The most common cause of community-acquired pneumonia (CAP) in adults is:
A. Haemophilus influenzae
B. ✓ Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Mycoplasma pneumoniae
13. Which ABG finding is consistent with uncompensated respiratory alkalosis?
A. pH 7.30, PaCO₂ 50, HCO₃⁻ 24
B. pH 7.38, PaCO₂ 42, HCO₃⁻ 24
C. ✓ pH 7.50, PaCO₂ 30, HCO₃⁻ 24
D. pH 7.32, PaCO₂ 33, HCO₃⁻ 18
14. When suctioning a tracheostomy, the nurse should apply suction:
A. Continuously for 30 seconds
B. While inserting the catheter
C. ✓ While withdrawing the catheter (no more than 10-15 seconds)
D. After normal saline instillation
15. Which is a sign of tension pneumothorax?
A. Mild dyspnea
B. Tracheal deviation to the affected side
C. ✓ Tracheal deviation to the unaffected side, hypotension, distended neck veins
D. Increased breath sounds on affected side
16. The primary risk factor for lung cancer is:
A. High-fat diet
B. Family history
C. ✓ Cigarette smoking
D. Occupational dust exposure
17. For a patient with COPD, oxygen should be titrated to maintain SpO₂ between:
A. 85-89%
B. ✓ 88-92%
C. 93-98%
D. 99-100%
18. Which finding is a hallmark of ARDS?
A. High PaO₂/FiO₂ ratio
B. ✓ Refractory hypoxemia (low PaO₂/FiO₂ ratio ≤300)
, C. Hypercapnia responsive to oxygen
D. Clear chest X-ray
19. Heparin is initiated for a pulmonary embolism to:
A. Dissolve the clot
B. ✓ Prevent further clot formation
C. Reduce inflammation
D. Relieve bronchospasm
20. Peak expiratory flow rate (PEFR) monitoring in asthma helps to:
A. Diagnose asthma
B. Replace ABG testing
C. ✓ Assess severity and monitor treatment
D. Prevent infections
21. Postural drainage with percussion is contraindicated in which condition?
A. Cystic fibrosis
B. ✓ Hemoptysis
C. Chronic bronchitis
D. Atelectasis
22. Which symptom is most suggestive of lung cancer?
A. Productive cough for 3 days
B. Wheezing after exercise
C. ✓ Persistent cough changing in pattern, hemoptysis
D. Pleuritic chest pain with fever
23. A patient with asthma is prescribed montelukast (Singulair). The nurse teaches that this
medication is used for:
A. Acute bronchospasm
B. ✓ Long-term control and prevention
C. Expectoration of mucus
D. Reducing anxiety
24. The best method to confirm placement of a newly inserted endotracheal tube is:
A. Chest X-ray
B. Observation of chest rise
C. ✓ End-tidal CO₂ detection (capnography)
D. Auscultation of breath sounds
Q&A
Topic Coverage: COPD, Asthma, Pneumonia, ARDS, Pulmonary Embolism, TB, Lung Cancer,
Mechanical Ventilation, Chest Tubes, Oxygen Therapy, Assessment, and Interventions.
1. Which arterial blood gas (ABG) result is most indicative of chronic compensated respiratory
acidosis?
A. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L
C. ✓ pH 7.36, PaCO₂ 55 mmHg, HCO₃⁻ 34 mEq/L
D. pH 7.48, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L
2. A patient with COPD is using pursed-lip breathing. The nurse understands this technique
primarily helps by:
A. Increasing oxygen saturation
B. Strengthening the diaphragm
C. ✓ Preventing airway collapse during exhalation
D. Reducing respiratory rate
3. Which assessment finding is a late sign of hypoxemia?
A. Tachycardia
B. Restlessness
C. Hypertension
D. ✓ Cyanosis
4. A patient with a suspected pulmonary embolism (PE) reports sudden dyspnea and pleuritic
chest pain. Which diagnostic test is most definitive?
A. Chest X-ray
B. ✓ CT pulmonary angiography
C. Electrocardiogram
D. Arterial blood gas
5. The nurse is preparing to administer albuterol via nebulizer to a patient with asthma.
Which adverse effect should be monitored most closely?
A. Sedation
B. Bradycardia
,C. ✓ Tachycardia
D. Constipation
6. Which position is best for a patient with dyspnea associated with pulmonary edema?
A. Prone
B. Trendelenburg
C. ✓ High-Fowler's
D. Supine
7. A patient with ARDS is on mechanical ventilation. Which ventilator setting is critical to
prevent further lung injury?
A. ✓ Low tidal volume (6-8 mL/kg ideal body weight)
B. High tidal volume (10-12 mL/kg)
C. High respiratory rate (>30/min)
D. Zero PEEP
8. Chest tube drainage system bubbling continuously in the water seal chamber indicates:
A. Normal evaporation
B. A leak in the system
C. ✓ An air leak from the patient (pneumothorax)
D. Proper suction control
9. Which vaccine is recommended annually for patients with COPD?
A. Pneumococcal
B. ✓ Influenza
C. Hepatitis B
D. MMR
10. Tuberculosis transmission is best prevented by placing the patient in:
A. Standard precautions
B. ✓ Airborne isolation (negative pressure room)
C. Droplet precautions
D. Contact precautions
11. A patient with emphysema typically has a barrel chest due to:
A. Kyphosis
B. ✓ Hyperinflation of alveoli
C. Pectus excavatum
D. Muscle wasting
,12. The most common cause of community-acquired pneumonia (CAP) in adults is:
A. Haemophilus influenzae
B. ✓ Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Mycoplasma pneumoniae
13. Which ABG finding is consistent with uncompensated respiratory alkalosis?
A. pH 7.30, PaCO₂ 50, HCO₃⁻ 24
B. pH 7.38, PaCO₂ 42, HCO₃⁻ 24
C. ✓ pH 7.50, PaCO₂ 30, HCO₃⁻ 24
D. pH 7.32, PaCO₂ 33, HCO₃⁻ 18
14. When suctioning a tracheostomy, the nurse should apply suction:
A. Continuously for 30 seconds
B. While inserting the catheter
C. ✓ While withdrawing the catheter (no more than 10-15 seconds)
D. After normal saline instillation
15. Which is a sign of tension pneumothorax?
A. Mild dyspnea
B. Tracheal deviation to the affected side
C. ✓ Tracheal deviation to the unaffected side, hypotension, distended neck veins
D. Increased breath sounds on affected side
16. The primary risk factor for lung cancer is:
A. High-fat diet
B. Family history
C. ✓ Cigarette smoking
D. Occupational dust exposure
17. For a patient with COPD, oxygen should be titrated to maintain SpO₂ between:
A. 85-89%
B. ✓ 88-92%
C. 93-98%
D. 99-100%
18. Which finding is a hallmark of ARDS?
A. High PaO₂/FiO₂ ratio
B. ✓ Refractory hypoxemia (low PaO₂/FiO₂ ratio ≤300)
, C. Hypercapnia responsive to oxygen
D. Clear chest X-ray
19. Heparin is initiated for a pulmonary embolism to:
A. Dissolve the clot
B. ✓ Prevent further clot formation
C. Reduce inflammation
D. Relieve bronchospasm
20. Peak expiratory flow rate (PEFR) monitoring in asthma helps to:
A. Diagnose asthma
B. Replace ABG testing
C. ✓ Assess severity and monitor treatment
D. Prevent infections
21. Postural drainage with percussion is contraindicated in which condition?
A. Cystic fibrosis
B. ✓ Hemoptysis
C. Chronic bronchitis
D. Atelectasis
22. Which symptom is most suggestive of lung cancer?
A. Productive cough for 3 days
B. Wheezing after exercise
C. ✓ Persistent cough changing in pattern, hemoptysis
D. Pleuritic chest pain with fever
23. A patient with asthma is prescribed montelukast (Singulair). The nurse teaches that this
medication is used for:
A. Acute bronchospasm
B. ✓ Long-term control and prevention
C. Expectoration of mucus
D. Reducing anxiety
24. The best method to confirm placement of a newly inserted endotracheal tube is:
A. Chest X-ray
B. Observation of chest rise
C. ✓ End-tidal CO₂ detection (capnography)
D. Auscultation of breath sounds
