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1. A nurse is caring for a patient with chronic obstructive
pulmonary disease (COPD). Which assessment finding is most
characteristic of COPD?
A. Bradycardia B. Barrel-shaped chest C. Decreased respiratory
rate D. Absent cough reflex
Answer: B. Barrel-shaped chest
Rationale: COPD commonly causes hyperinflation of the lungs,
leading to a barrel-shaped chest. Patients may also experience
dyspnea, chronic cough, and wheezing. Bradycardia is not typical, and
respiratory rate is often increased rather than decreased.
2. Which nursing intervention is most important for a patient
experiencing an acute asthma attack?
A. Encourage fluid restriction B. Place the patient in a supine
position C. Administer prescribed bronchodilators D. Limit oxygen
administration
,Answer: C. Administer prescribed bronchodilators
Rationale: Bronchodilators help open the airways quickly during an
asthma attack and are a priority intervention. Positioning the patient
upright also assists breathing. Fluid restriction and limiting oxygen
are inappropriate interventions during respiratory distress.
3. A patient with pneumonia is prescribed antibiotics. Which
assessment finding best indicates that treatment is effective?
A. Increased fatigue B. Oxygen saturation of 88% C. Reduced fever
and improved breath sounds D. Presence of productive cough with
blood
Answer: C. Reduced fever and improved breath sounds
Rationale: Improvement in fever, breath sounds, and respiratory status
indicates that infection is resolving. Low oxygen saturation and
hemoptysis may indicate worsening respiratory compromise.
4. Which assessment finding is most concerning in a patient with
pulmonary embolism?
A. Mild fatigue B. Sudden chest pain and shortness of breath C.
Productive cough with mucus D. Bradycardia during sleep
Answer: B. Sudden chest pain and shortness of breath
Rationale: Pulmonary embolism often presents with sudden chest
pain, dyspnea, tachycardia, and hypoxia. This is a medical emergency
requiring immediate intervention.
5. A nurse is teaching a patient how to use an incentive
spirometer. What is the primary purpose of this device?
A. Increase blood pressure B. Prevent atelectasis C. Reduce heart
rate D. Strengthen arm muscles
, Answer: B. Prevent atelectasis
Rationale: Incentive spirometry promotes lung expansion and prevents
atelectasis, especially after surgery. It improves oxygenation and helps
maintain airway patency.
6. Which arterial blood gas (ABG) finding is consistent with
respiratory acidosis?
A. pH 7.50, PaCO2 30 mmHg B. pH 7.40, PaCO2 40 mmHg C. pH
7.30, PaCO2 55 mmHg D. pH 7.48, HCO3 24 mEq/L
Answer: C. pH 7.30, PaCO2 55 mmHg
Rationale: Respiratory acidosis occurs when carbon dioxide
accumulates due to hypoventilation, resulting in decreased pH and
elevated PaCO2 levels.
7. Which symptom is most commonly associated with
tuberculosis?
A. Sudden weight gain B. Night sweats and chronic cough C.
Frequent urination D. Bradycardia
Answer: B. Night sweats and chronic cough
Rationale: Tuberculosis commonly presents with chronic cough,
weight loss, night sweats, fever, and fatigue. Early recognition is
essential to prevent transmission.
8. A patient with pleural effusion may exhibit which assessment
finding?
A. Hyperactive bowel sounds B. Diminished breath sounds C.
Increased appetite D. Elevated blood glucose
Answer: B. Diminished breath sounds