KAPLAN RESPIRATORY NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Respiratory Anatomy and Physiology
Airway Management and Oxygenation
Obstructive Pulmonary Diseases (COPD, Asthma)
Infective Respiratory Conditions (Pneumonia, TB)
Respiratory Failure and ARDS
Ventilation and ABG Interpretation
Preoperative and Postoperative Respiratory Care
Pharmacology for Respiratory Disorders
Emergency Respiratory Interventions
Ethics and Legal Compliance in Respiratory Nursing
Introduction
This exam assessment is designed to evaluate nursing competency in respiratory care, covering essential knowledge required for safe and effective
patient management. The test assesses skills in airway management, oxygenation therapy, recognition of respiratory distress, interpretation of
arterial blood gases, and implementation of evidence-based interventions for common respiratory conditions. The multiple-choice and scenario-
based structure emphasizes critical thinking and clinical decision-making in real-world healthcare settings. Candidates will demonstrate
proficiency in applied professional knowledge, regulatory compliance, ethical standards, and critical thinking necessary for respiratory nursing
practice. This assessment prepares nurses for certification and clinical excellence in respiratory care.
Section One: Questions 1–100
Question 1
A patient with moderate COPD is receiving 4 L/min of oxygen via nasal cannula. The nurse notes the patient's respiratory rate has decreased from 24
to 10 breaths/min and the patient appears lethargic. What is the nurse's priority action?
,A. Increase the oxygen flow to 6 L/min
B. Administer a bronchodilator immediately
C. Decrease the oxygen flow and notify the provider
D. Prepare for immediate intubation
🟢 Correct answer: C
🔴 RATIONALE: Patients with COPD have a hypoxic drive to breathe due to chronic CO2 retention. Oxygen administration greater than 2-3 L/min
can suppress this drive, causing respiratory depression and lethargy. The priority is to decrease oxygen to 1-3 L/min and notify the provider for
further evaluation.
Question 2
Which assessment finding in a patient with pneumonia indicates the need for immediate intervention?
A. Productive cough with yellow sputum
B. Oxygen saturation of 88% on room air
C. Temperature of 38.9°C (102.°F)
D. Pleuritic chest pain
🟢 Correct answer: B
🔴 RATIONALE: Oxygen saturation below 90% indicates hypoxemia and requires immediate intervention to prevent respiratory failure. While fever,
productive cough, and chest pain are expected in pneumonia, hypoxemia is the most critical finding requiring immediate action.
Question 3
A patient is scheduled for a thoracentesis. Which preoperative instruction is most important for the nurse to provide?
A. "You will be given a sedative before the procedure"
B. "You must remain in a sitting position during the procedure"
C. "You will need to miss breakfast before the procedure"
D. "You should not urinate before the procedure"
🟢 Correct answer: B
,🔴 RATIONALE: Patients must sit upright during thoracentesis to allow optimal access to the pleural space and facilitate fluid removal. This
position expands the intercostal spaces and allows the fluid to collect at the lung base.
Question 4
Which arterial blood gas (ABG) result indicates uncompensated respiratory alkalosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.43, PaCO2 32 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 52 mmHg, HCO3 28 mEq/L
D. pH 7.50, PaCO2 42 mmHg, HCO3 30 mEq/L
🟢 Correct answer: A
🔴 RATIONALE: Respiratory alkalosis is characterized by pH >7.45 and PaCO2 <35 mmHg. Uncompensated means HCO3 is within normal range
(22-26 mEq/L). Option A shows pH 7.48 (alkalotic), PaCO2 30 (low), and HCO3 24 (normal), indicating uncompensated respiratory alkalosis.
Question 5
A patient with asthma is using a peak flow meter. What peak flow percentage indicates a yellow zone requiring caution?
A. 80-100% of personal best
B. 50-79% of personal best
C. 40-49% of personal best
D. Below 40% of personal best
🟢 Correct answer: B
🔴 RATIONALE: The yellow zone (50-79% of personal best) indicates caution and requires use of quick-relief medication. The green zone is 80-
100%, and the red zone is below 50%, indicating immediate medical attention is needed.
Question 6
Which medication is the priority for a patient experiencing acute bronchospasm?
, A. Ipratropium (anticholinergic)
B. Albuterol (short-acting beta-agonist)
C. Fluticasone (inhaled corticosteroid)
D. Prednisone (oral corticosteroid)
🟢 Correct answer: B
🔴 RATIONALE: Short-acting beta-agonists (SABAs) like albuterol are the first-line treatment for acute bronchospasm due to their rapid onset (5
minutes) and bronchodilating effects. Anticholinergics are adjunctive, and corticosteroids take hours to work.
Question 7
A patient with pulmonary embolism is most likely to present with which symptom?
A. Slow, shallow breathing
B. Sudden onset of sharp chest pain and dyspnea
C. Productive cough with frothy sputum
D. Gradual weight gain and edema
🟢 Correct answer: B
🔴 RATIONALE: Pulmonary embolism typically presents with sudden onset of sharp chest pain (often pleuritic) and dyspnea. Other symptoms
include tachycardia, tachypnea, and hypoxemia. Gradual symptoms suggest other conditions like heart failure.
Question 8
Which nursing intervention is most appropriate for preventing ventilator-associated pneumonia (VAP)?
A. Keep the patient supine at all times
B. Perform oral care with chlorhexidine every 4 hours
C. Change the ventilator circuit daily
D. Administer prophylactic antibiotics
🟢 Correct answer: B
🔴 RATIONALE: Oral care with chlorhexidine every 4 hours reduces bacterial colonization and is a key VAP prevention strategy. The head of bed
should be elevated 30-45 degrees, circuits are changed weekly, and prophylactic antibiotics are not recommended due to resistance concerns.
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Respiratory Anatomy and Physiology
Airway Management and Oxygenation
Obstructive Pulmonary Diseases (COPD, Asthma)
Infective Respiratory Conditions (Pneumonia, TB)
Respiratory Failure and ARDS
Ventilation and ABG Interpretation
Preoperative and Postoperative Respiratory Care
Pharmacology for Respiratory Disorders
Emergency Respiratory Interventions
Ethics and Legal Compliance in Respiratory Nursing
Introduction
This exam assessment is designed to evaluate nursing competency in respiratory care, covering essential knowledge required for safe and effective
patient management. The test assesses skills in airway management, oxygenation therapy, recognition of respiratory distress, interpretation of
arterial blood gases, and implementation of evidence-based interventions for common respiratory conditions. The multiple-choice and scenario-
based structure emphasizes critical thinking and clinical decision-making in real-world healthcare settings. Candidates will demonstrate
proficiency in applied professional knowledge, regulatory compliance, ethical standards, and critical thinking necessary for respiratory nursing
practice. This assessment prepares nurses for certification and clinical excellence in respiratory care.
Section One: Questions 1–100
Question 1
A patient with moderate COPD is receiving 4 L/min of oxygen via nasal cannula. The nurse notes the patient's respiratory rate has decreased from 24
to 10 breaths/min and the patient appears lethargic. What is the nurse's priority action?
,A. Increase the oxygen flow to 6 L/min
B. Administer a bronchodilator immediately
C. Decrease the oxygen flow and notify the provider
D. Prepare for immediate intubation
🟢 Correct answer: C
🔴 RATIONALE: Patients with COPD have a hypoxic drive to breathe due to chronic CO2 retention. Oxygen administration greater than 2-3 L/min
can suppress this drive, causing respiratory depression and lethargy. The priority is to decrease oxygen to 1-3 L/min and notify the provider for
further evaluation.
Question 2
Which assessment finding in a patient with pneumonia indicates the need for immediate intervention?
A. Productive cough with yellow sputum
B. Oxygen saturation of 88% on room air
C. Temperature of 38.9°C (102.°F)
D. Pleuritic chest pain
🟢 Correct answer: B
🔴 RATIONALE: Oxygen saturation below 90% indicates hypoxemia and requires immediate intervention to prevent respiratory failure. While fever,
productive cough, and chest pain are expected in pneumonia, hypoxemia is the most critical finding requiring immediate action.
Question 3
A patient is scheduled for a thoracentesis. Which preoperative instruction is most important for the nurse to provide?
A. "You will be given a sedative before the procedure"
B. "You must remain in a sitting position during the procedure"
C. "You will need to miss breakfast before the procedure"
D. "You should not urinate before the procedure"
🟢 Correct answer: B
,🔴 RATIONALE: Patients must sit upright during thoracentesis to allow optimal access to the pleural space and facilitate fluid removal. This
position expands the intercostal spaces and allows the fluid to collect at the lung base.
Question 4
Which arterial blood gas (ABG) result indicates uncompensated respiratory alkalosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.43, PaCO2 32 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 52 mmHg, HCO3 28 mEq/L
D. pH 7.50, PaCO2 42 mmHg, HCO3 30 mEq/L
🟢 Correct answer: A
🔴 RATIONALE: Respiratory alkalosis is characterized by pH >7.45 and PaCO2 <35 mmHg. Uncompensated means HCO3 is within normal range
(22-26 mEq/L). Option A shows pH 7.48 (alkalotic), PaCO2 30 (low), and HCO3 24 (normal), indicating uncompensated respiratory alkalosis.
Question 5
A patient with asthma is using a peak flow meter. What peak flow percentage indicates a yellow zone requiring caution?
A. 80-100% of personal best
B. 50-79% of personal best
C. 40-49% of personal best
D. Below 40% of personal best
🟢 Correct answer: B
🔴 RATIONALE: The yellow zone (50-79% of personal best) indicates caution and requires use of quick-relief medication. The green zone is 80-
100%, and the red zone is below 50%, indicating immediate medical attention is needed.
Question 6
Which medication is the priority for a patient experiencing acute bronchospasm?
, A. Ipratropium (anticholinergic)
B. Albuterol (short-acting beta-agonist)
C. Fluticasone (inhaled corticosteroid)
D. Prednisone (oral corticosteroid)
🟢 Correct answer: B
🔴 RATIONALE: Short-acting beta-agonists (SABAs) like albuterol are the first-line treatment for acute bronchospasm due to their rapid onset (5
minutes) and bronchodilating effects. Anticholinergics are adjunctive, and corticosteroids take hours to work.
Question 7
A patient with pulmonary embolism is most likely to present with which symptom?
A. Slow, shallow breathing
B. Sudden onset of sharp chest pain and dyspnea
C. Productive cough with frothy sputum
D. Gradual weight gain and edema
🟢 Correct answer: B
🔴 RATIONALE: Pulmonary embolism typically presents with sudden onset of sharp chest pain (often pleuritic) and dyspnea. Other symptoms
include tachycardia, tachypnea, and hypoxemia. Gradual symptoms suggest other conditions like heart failure.
Question 8
Which nursing intervention is most appropriate for preventing ventilator-associated pneumonia (VAP)?
A. Keep the patient supine at all times
B. Perform oral care with chlorhexidine every 4 hours
C. Change the ventilator circuit daily
D. Administer prophylactic antibiotics
🟢 Correct answer: B
🔴 RATIONALE: Oral care with chlorhexidine every 4 hours reduces bacterial colonization and is a key VAP prevention strategy. The head of bed
should be elevated 30-45 degrees, circuits are changed weekly, and prophylactic antibiotics are not recommended due to resistance concerns.
