NSG 3130 Final Exam Funds 2
Comprehensive Respiratory & Fundamental
Nursing Care Examination
Academic Year 2026
Question 1
A patient with diabetic ketoacidosis presents with deep, rapid, labored breathing. The nurse recognizes
this breathing pattern as:
A) Cheyne-Stokes respirations
B) Kussmaul's respirations
C) Biot's respirations
D) Apneustic breathing
ANSWER: B
Rationale:
A) Incorrect - Cheyne-Stokes respirations are characterized by a cyclical pattern of increasing and
decreasing depth with periods of apnea, commonly seen in heart failure or neurological conditions.
B) Correct - Kussmaul's respirations are deep, rapid, and labored breathing patterns that occur as a
compensatory mechanism in metabolic acidosis, particularly diabetic ketoacidosis (DKA). The body
attempts to blow off excess CO2 to correct the acidosis.
C) Incorrect - Biot's respirations are irregular breathing patterns with unpredictable periods of apnea,
typically associated with increased intracranial pressure or brain stem injury.
D) Incorrect - Apneustic breathing involves prolonged inspiration followed by inadequate expiration,
usually indicating damage to the upper pons in the brainstem.
Question 2
When providing staff education on prevention of pulmonary infections in hospitalized patients, which
intervention is the MOST important?
A) Administer prophylactic antibiotics to all patients
,B) Have patients turn, cough, and deep breathe every 2 hours PRN
C) Restrict fluid intake to prevent pulmonary edema
D) Keep patients on bed rest to conserve energy
ANSWER: B
Rationale:
A) Incorrect - Prophylactic antibiotics are not indicated for all patients and can lead to antibiotic
resistance and adverse effects. Antibiotics should be used only when there is a confirmed or suspected
infection.
B) Correct - Turning, coughing, and deep breathing every 2 hours helps prevent atelectasis, promotes
lung expansion, mobilizes secretions, and prevents stasis that can lead to pneumonia. This is a
cornerstone of pulmonary infection prevention.
C) Incorrect - Adequate hydration is actually essential to thin secretions and make them easier to
expectorate. Fluid restriction would thicken secretions and increase infection risk.
D) Incorrect - Early ambulation and position changes are critical for preventing pulmonary
complications. Bed rest increases the risk of atelectasis and pneumonia.
Question 3
The most effective way for a nurse to assess a patient for signs and symptoms of hypoxia is through:
A) Pulse oximetry alone
B) Clinical assessment of skin color
C) Arterial blood gas (ABG) analysis
D) Patient's subjective report of dyspnea
ANSWER: C
Rationale:
A) Incorrect - While pulse oximetry is useful for continuous monitoring, it only measures oxygen
saturation and does not provide information about CO2 levels, pH, or bicarbonate, which are crucial for
comprehensive oxygenation assessment.
B) Incorrect - Skin color changes (cyanosis) are a late sign of hypoxia and are not reliable, especially in
patients with darker skin tones or poor perfusion.
C) Correct - ABG analysis provides the most comprehensive and accurate assessment of oxygenation
status, including PaO2, PaCO2, pH, bicarbonate levels, and oxygen saturation. It is the gold standard for
assessing hypoxia and acid-base balance.
,D) Incorrect - While patient reports are important, dyspnea is subjective and may not correlate with
actual oxygenation status. Some patients with severe hypoxia may not report dyspnea, while others may
report it without actual hypoxia.
Question 4
A patient with COPD would typically present with which assessment findings? (Select all that apply)
A) Hyperinflation of the chest
B) Decreased elasticity of alveoli
C) Increased mucus in bronchioles
D) Increased breath sounds
E) Decreased anteroposterior chest diameter
ANSWER: A, B, C
Rationale:
A) Correct - COPD causes air trapping leading to hyperinflation of the chest, often resulting in a "barrel
chest" appearance with increased anteroposterior diameter.
B) Correct - In COPD, particularly emphysema, there is destruction of alveolar walls and loss of elastic
recoil, leading to decreased elasticity of alveoli.
C) Correct - Chronic bronchitis, a component of COPD, is characterized by inflammation and increased
mucus production in the airways, leading to mucus accumulation in bronchioles.
D) Incorrect - Breath sounds are typically decreased in COPD due to air trapping and poor air movement,
not increased.
E) Incorrect - COPD causes an INCREASED anteroposterior chest diameter (barrel chest), not decreased.
Question 5
Which sequence represents the correct order of steps for tracheal suctioning?
A) Hyper-oxygenate, don sterile gloves, insert catheter, apply suction, assess clearance
B) Don sterile gloves, check function of catheter, hyper-oxygenate, insert catheter with suction, assess
C) Adjust suction, don sterile gloves, check function of suction catheter, hyper-oxygenate client, insert
catheters with suction, apply suction while rotating catheters, assess for clearance of secretions
D) Insert catheter, apply suction, hyper-oxygenate, assess, document
ANSWER: C
Rationale:
A) Incorrect - This sequence is incomplete and out of order. The catheter function should be checked
before insertion, and suction should not be applied during insertion.
, B) Incorrect - Hyper-oxygenation should occur BEFORE inserting the catheter, not after donning gloves.
Also, suction should never be applied during insertion, only during withdrawal.
C) Correct - This is the proper sequence: adjust suction pressure first, maintain sterile technique with
gloves, verify catheter function, pre-oxygenate the patient to prevent hypoxia, insert catheter WITHOUT
suction, apply suction only while withdrawing and rotating the catheter, then assess effectiveness.
D) Incorrect - This sequence is dangerous. Hyper-oxygenation must occur BEFORE suctioning, not after.
Suction should never be applied during insertion, and assessment should occur throughout the
procedure.
Question 6
A patient is ordered to receive oxygen at 12 L/min. Which oxygen delivery device should the nurse use?
A) Nasal cannula
B) Simple face mask
C) Non-rebreather mask
D) Venturi mask
ANSWER: C
Rationale:
A) Incorrect - Nasal cannula can deliver 1-6 L/min, providing 24-44% FiO2. It cannot safely deliver 12
L/min as flows above 6 L/min cause nasal mucosa drying and patient discomfort without increasing
oxygen delivery.
B) Incorrect - Simple face mask delivers 5-8 L/min, providing 35-55% FiO2. It requires a minimum of 5
L/min to flush CO2 from the mask but cannot deliver 12 L/min effectively.
C) Correct - A non-rebreather mask can deliver 10-15 L/min, providing 60-95% FiO2. It is the appropriate
device for high-flow oxygen delivery at 12 L/min and is used for patients requiring high concentrations
of oxygen.
D) Incorrect - Venturi mask delivers precise oxygen concentrations (24-50%) at specific flow rates but is
not designed for 12 L/min delivery. It is used when precise FiO2 is needed, particularly in COPD patients.
Question 7
When reviewing chest assessment data, lab values, vital signs, physical assessment, and medication
reconciliation, which finding would be MOST concerning for the nurse?
A) Respiratory rate of 22 breaths/min
B) O2 saturation of 85%
C) Blood pressure of 150/90 mmHg
D) Heart rate of 88 bpm
Comprehensive Respiratory & Fundamental
Nursing Care Examination
Academic Year 2026
Question 1
A patient with diabetic ketoacidosis presents with deep, rapid, labored breathing. The nurse recognizes
this breathing pattern as:
A) Cheyne-Stokes respirations
B) Kussmaul's respirations
C) Biot's respirations
D) Apneustic breathing
ANSWER: B
Rationale:
A) Incorrect - Cheyne-Stokes respirations are characterized by a cyclical pattern of increasing and
decreasing depth with periods of apnea, commonly seen in heart failure or neurological conditions.
B) Correct - Kussmaul's respirations are deep, rapid, and labored breathing patterns that occur as a
compensatory mechanism in metabolic acidosis, particularly diabetic ketoacidosis (DKA). The body
attempts to blow off excess CO2 to correct the acidosis.
C) Incorrect - Biot's respirations are irregular breathing patterns with unpredictable periods of apnea,
typically associated with increased intracranial pressure or brain stem injury.
D) Incorrect - Apneustic breathing involves prolonged inspiration followed by inadequate expiration,
usually indicating damage to the upper pons in the brainstem.
Question 2
When providing staff education on prevention of pulmonary infections in hospitalized patients, which
intervention is the MOST important?
A) Administer prophylactic antibiotics to all patients
,B) Have patients turn, cough, and deep breathe every 2 hours PRN
C) Restrict fluid intake to prevent pulmonary edema
D) Keep patients on bed rest to conserve energy
ANSWER: B
Rationale:
A) Incorrect - Prophylactic antibiotics are not indicated for all patients and can lead to antibiotic
resistance and adverse effects. Antibiotics should be used only when there is a confirmed or suspected
infection.
B) Correct - Turning, coughing, and deep breathing every 2 hours helps prevent atelectasis, promotes
lung expansion, mobilizes secretions, and prevents stasis that can lead to pneumonia. This is a
cornerstone of pulmonary infection prevention.
C) Incorrect - Adequate hydration is actually essential to thin secretions and make them easier to
expectorate. Fluid restriction would thicken secretions and increase infection risk.
D) Incorrect - Early ambulation and position changes are critical for preventing pulmonary
complications. Bed rest increases the risk of atelectasis and pneumonia.
Question 3
The most effective way for a nurse to assess a patient for signs and symptoms of hypoxia is through:
A) Pulse oximetry alone
B) Clinical assessment of skin color
C) Arterial blood gas (ABG) analysis
D) Patient's subjective report of dyspnea
ANSWER: C
Rationale:
A) Incorrect - While pulse oximetry is useful for continuous monitoring, it only measures oxygen
saturation and does not provide information about CO2 levels, pH, or bicarbonate, which are crucial for
comprehensive oxygenation assessment.
B) Incorrect - Skin color changes (cyanosis) are a late sign of hypoxia and are not reliable, especially in
patients with darker skin tones or poor perfusion.
C) Correct - ABG analysis provides the most comprehensive and accurate assessment of oxygenation
status, including PaO2, PaCO2, pH, bicarbonate levels, and oxygen saturation. It is the gold standard for
assessing hypoxia and acid-base balance.
,D) Incorrect - While patient reports are important, dyspnea is subjective and may not correlate with
actual oxygenation status. Some patients with severe hypoxia may not report dyspnea, while others may
report it without actual hypoxia.
Question 4
A patient with COPD would typically present with which assessment findings? (Select all that apply)
A) Hyperinflation of the chest
B) Decreased elasticity of alveoli
C) Increased mucus in bronchioles
D) Increased breath sounds
E) Decreased anteroposterior chest diameter
ANSWER: A, B, C
Rationale:
A) Correct - COPD causes air trapping leading to hyperinflation of the chest, often resulting in a "barrel
chest" appearance with increased anteroposterior diameter.
B) Correct - In COPD, particularly emphysema, there is destruction of alveolar walls and loss of elastic
recoil, leading to decreased elasticity of alveoli.
C) Correct - Chronic bronchitis, a component of COPD, is characterized by inflammation and increased
mucus production in the airways, leading to mucus accumulation in bronchioles.
D) Incorrect - Breath sounds are typically decreased in COPD due to air trapping and poor air movement,
not increased.
E) Incorrect - COPD causes an INCREASED anteroposterior chest diameter (barrel chest), not decreased.
Question 5
Which sequence represents the correct order of steps for tracheal suctioning?
A) Hyper-oxygenate, don sterile gloves, insert catheter, apply suction, assess clearance
B) Don sterile gloves, check function of catheter, hyper-oxygenate, insert catheter with suction, assess
C) Adjust suction, don sterile gloves, check function of suction catheter, hyper-oxygenate client, insert
catheters with suction, apply suction while rotating catheters, assess for clearance of secretions
D) Insert catheter, apply suction, hyper-oxygenate, assess, document
ANSWER: C
Rationale:
A) Incorrect - This sequence is incomplete and out of order. The catheter function should be checked
before insertion, and suction should not be applied during insertion.
, B) Incorrect - Hyper-oxygenation should occur BEFORE inserting the catheter, not after donning gloves.
Also, suction should never be applied during insertion, only during withdrawal.
C) Correct - This is the proper sequence: adjust suction pressure first, maintain sterile technique with
gloves, verify catheter function, pre-oxygenate the patient to prevent hypoxia, insert catheter WITHOUT
suction, apply suction only while withdrawing and rotating the catheter, then assess effectiveness.
D) Incorrect - This sequence is dangerous. Hyper-oxygenation must occur BEFORE suctioning, not after.
Suction should never be applied during insertion, and assessment should occur throughout the
procedure.
Question 6
A patient is ordered to receive oxygen at 12 L/min. Which oxygen delivery device should the nurse use?
A) Nasal cannula
B) Simple face mask
C) Non-rebreather mask
D) Venturi mask
ANSWER: C
Rationale:
A) Incorrect - Nasal cannula can deliver 1-6 L/min, providing 24-44% FiO2. It cannot safely deliver 12
L/min as flows above 6 L/min cause nasal mucosa drying and patient discomfort without increasing
oxygen delivery.
B) Incorrect - Simple face mask delivers 5-8 L/min, providing 35-55% FiO2. It requires a minimum of 5
L/min to flush CO2 from the mask but cannot deliver 12 L/min effectively.
C) Correct - A non-rebreather mask can deliver 10-15 L/min, providing 60-95% FiO2. It is the appropriate
device for high-flow oxygen delivery at 12 L/min and is used for patients requiring high concentrations
of oxygen.
D) Incorrect - Venturi mask delivers precise oxygen concentrations (24-50%) at specific flow rates but is
not designed for 12 L/min delivery. It is used when precise FiO2 is needed, particularly in COPD patients.
Question 7
When reviewing chest assessment data, lab values, vital signs, physical assessment, and medication
reconciliation, which finding would be MOST concerning for the nurse?
A) Respiratory rate of 22 breaths/min
B) O2 saturation of 85%
C) Blood pressure of 150/90 mmHg
D) Heart rate of 88 bpm
