ATI RESPIRATORY DISORDERS EXAM GUIDE 2026 EDITION Q&A
,A nurse is auscultating the lungs of a client with chronic obstructive
pulmonary disease (COPD). Which finding is most characteristic of
COPD?
A. High-pitched wheezes on inspiration only
B. Diminished breath sounds with prolonged expiration
C. Coarse crackles that clear after coughing
D. Stridor heard over the trachea
Correct Answer: B
Explanation: COPD causes air trapping and hyperinflation, leading to
diminished breath sounds and prolonged expiration due to airway
obstruction. Wheezes may be present but are typically expiratory, not
inspiratory-only. Crackles suggest pneumonia or heart failure. Stridor
indicates upper airway obstruction.
A client with asthma presents to the emergency department with
severe respiratory distress. Which nursing intervention should be
performed FIRST?
A. Administer inhaled corticosteroids
B. Provide oxygen via nasal cannula
C. Administer a short-acting beta-agonist (SABA)
D. Obtain arterial blood gas (ABG) values
Correct Answer: C
Explanation: SABAs (like albuterol) are the first-line treatment for acute
asthma exacerbations as they rapidly reverse bronchoconstriction.
Oxygen is important but bronchodilation is the priority. Corticosteroids
take hours to work. ABGs are diagnostic but not the immediate
intervention.
,Which arterial blood gas (ABG) result is most consistent with acute
respiratory acidosis in a client with COPD exacerbation?
A. pH 7.50, PaCO₂ 32 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L
C. pH 7.48, PaCO₂ 35 mmHg, HCO₃⁻ 30 mEq/L
D. pH 7.35, PaCO₂ 45 mmHg, HCO₃⁻ 28 mEq/L
Correct Answer: B
Explanation: Acute respiratory acidosis shows low pH (<7.35), elevated
PaCO₂ (>45 mmHg), and normal HCO₃⁻ (no renal compensation yet).
Option B shows pH 7.30, PaCO₂ 55 mmHg. Option A shows respiratory
alkalosis. Option C shows metabolic alkalosis. Option D is compensated.
A client with pneumonia has a temperature of 102.5°F, productive
cough with green sputum, and oxygen saturation of 88% on room air.
Which assessment finding is MOST concerning?
A. Temperature 102.5°F
B. Green sputum production
C. Oxygen saturation 88%
D. Respiratory rate 32/min
Correct Answer: D
Explanation: Tachypnea >30/min indicates respiratory distress and
impending respiratory failure, which is the most critical finding. While
hypoxemia (88%) is concerning, the respiratory rate indicates the client
is working harder to compensate. Fever and sputum color are expected
with pneumonia.
, The nurse is teaching a client with COPD about pursed-lip breathing.
Which statement by the client indicates understanding?
A. "I will inhale quickly through my mouth."
B. "I will exhale slowly through pursed lips like I'm whistling."
C. "I will hold my breath for 10 seconds after inhaling."
D. "I will breathe rapidly to get more oxygen."
Correct Answer: B
Explanation: Pursed-lip breathing involves inhaling slowly through the
nose and exhaling slowly through pursed lips, which creates
backpressure to keep airways open and prevent air trapping. Rapid
breathing worsens air trapping. Breath-holding is not part of this
technique.
A client with a pulmonary embolism (PE) is most likely to exhibit which
combination of symptoms?
A. Productive cough, fever, and chest consolidation
B. Sudden dyspnea, pleuritic chest pain, and tachycardia
C. Barrel chest, pursed-lip breathing, and wheezing
D. Gradual onset of dyspnea, weight gain, and edema
Correct Answer: B
Explanation: PE typically presents with sudden onset dyspnea, sharp
pleuritic chest pain (worsens with breathing), and tachycardia. Option A
suggests pneumonia. Option C suggests COPD. Option D suggests heart
failure.
Which oxygen delivery device is most appropriate for a client with COPD
who requires precise oxygen concentration?
,A nurse is auscultating the lungs of a client with chronic obstructive
pulmonary disease (COPD). Which finding is most characteristic of
COPD?
A. High-pitched wheezes on inspiration only
B. Diminished breath sounds with prolonged expiration
C. Coarse crackles that clear after coughing
D. Stridor heard over the trachea
Correct Answer: B
Explanation: COPD causes air trapping and hyperinflation, leading to
diminished breath sounds and prolonged expiration due to airway
obstruction. Wheezes may be present but are typically expiratory, not
inspiratory-only. Crackles suggest pneumonia or heart failure. Stridor
indicates upper airway obstruction.
A client with asthma presents to the emergency department with
severe respiratory distress. Which nursing intervention should be
performed FIRST?
A. Administer inhaled corticosteroids
B. Provide oxygen via nasal cannula
C. Administer a short-acting beta-agonist (SABA)
D. Obtain arterial blood gas (ABG) values
Correct Answer: C
Explanation: SABAs (like albuterol) are the first-line treatment for acute
asthma exacerbations as they rapidly reverse bronchoconstriction.
Oxygen is important but bronchodilation is the priority. Corticosteroids
take hours to work. ABGs are diagnostic but not the immediate
intervention.
,Which arterial blood gas (ABG) result is most consistent with acute
respiratory acidosis in a client with COPD exacerbation?
A. pH 7.50, PaCO₂ 32 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L
C. pH 7.48, PaCO₂ 35 mmHg, HCO₃⁻ 30 mEq/L
D. pH 7.35, PaCO₂ 45 mmHg, HCO₃⁻ 28 mEq/L
Correct Answer: B
Explanation: Acute respiratory acidosis shows low pH (<7.35), elevated
PaCO₂ (>45 mmHg), and normal HCO₃⁻ (no renal compensation yet).
Option B shows pH 7.30, PaCO₂ 55 mmHg. Option A shows respiratory
alkalosis. Option C shows metabolic alkalosis. Option D is compensated.
A client with pneumonia has a temperature of 102.5°F, productive
cough with green sputum, and oxygen saturation of 88% on room air.
Which assessment finding is MOST concerning?
A. Temperature 102.5°F
B. Green sputum production
C. Oxygen saturation 88%
D. Respiratory rate 32/min
Correct Answer: D
Explanation: Tachypnea >30/min indicates respiratory distress and
impending respiratory failure, which is the most critical finding. While
hypoxemia (88%) is concerning, the respiratory rate indicates the client
is working harder to compensate. Fever and sputum color are expected
with pneumonia.
, The nurse is teaching a client with COPD about pursed-lip breathing.
Which statement by the client indicates understanding?
A. "I will inhale quickly through my mouth."
B. "I will exhale slowly through pursed lips like I'm whistling."
C. "I will hold my breath for 10 seconds after inhaling."
D. "I will breathe rapidly to get more oxygen."
Correct Answer: B
Explanation: Pursed-lip breathing involves inhaling slowly through the
nose and exhaling slowly through pursed lips, which creates
backpressure to keep airways open and prevent air trapping. Rapid
breathing worsens air trapping. Breath-holding is not part of this
technique.
A client with a pulmonary embolism (PE) is most likely to exhibit which
combination of symptoms?
A. Productive cough, fever, and chest consolidation
B. Sudden dyspnea, pleuritic chest pain, and tachycardia
C. Barrel chest, pursed-lip breathing, and wheezing
D. Gradual onset of dyspnea, weight gain, and edema
Correct Answer: B
Explanation: PE typically presents with sudden onset dyspnea, sharp
pleuritic chest pain (worsens with breathing), and tachycardia. Option A
suggests pneumonia. Option C suggests COPD. Option D suggests heart
failure.
Which oxygen delivery device is most appropriate for a client with COPD
who requires precise oxygen concentration?
