Cindys CPNRE ACTUAL FINAL EXAM 2026/2027
ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
(CORRECT VERIFIED SOLUTIONS) CURRENTLY
UPDATED VERSION 2026 EDITION
The nurse is teaching a male client with chronic bronchitis about
breathing exercises. Which of the following should the nurse
include in the teaching?
A) Make inhalation longer than exhalation.
B) Exhale through an open mouth.
C) Use diaphragmatic breathing.
D) Use chest breathing.
C) Use diaphragmatic breathing.
Response Feedback:
In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic
breathing helps to strengthen the diaphragm and maximizes
ventilation. Exhalation should be longer than inhalation to
prevent collapse of the bronchioles. The client with chronic
bronchitis should exhale through
pursed lips to prolong exhalation, keep the bronchioles from
collapsing, and prevent air trapping. Diaphragmatic breathing —
not chest breathing
— increases lung expansion.
,A female client must take streptomycin for tuberculosis. Before
therapy begins, the nurse should instruct the client to notify the
physician if which health concern occurs?
A) Impaired color discrimination
B) Increased urinary frequency
C) Decreased hearing acuity
D) Increased appetite
C) Decreased hearing
acuity Response
Feedback:
Decreased hearing acuity indicates ototoxicity, a serious
adverse effect of streptomycin therapy. The client should
notify the physician
immediately if it occurs so that streptomycin can be discontinued
and an alternative drug can be prescribed. The other options
aren't associated with streptomycin. Impaired color
discrimination indicates color
blindness; increased urinary frequency and increased appetite
accompany diabetes mellitus.
The nurse assesses a male client's respiratory status. Which observation
indicates that the client is experiencing difficulty breathing?
A) Diaphragmatic breathing
B) Use of accessory muscles
C) Pursed-lip breathing
D) Controlled breathing
B) Use of accessory muscles
Response Feedback:
The use of accessory muscles for respiration indicates the client is having difficulty
breathing. Diaphragmatic and pursed-lip breathing are two
controlled breathing techniques that help the client conserve energy.
,A male client who weighs 175 lb (79.4 kg) is receiving aminophylline
(Aminophyllin) (400 mg in 500 ml) at 50 ml/hour. The theophylline
level is reported as 6 mcg/ml. The nurse calls the physician who
instructs the
nurse to change the dosage to 0.45 mg/kg/hour. The nurse should:
A) Question the order because it's too low.
B) Question the order because it's too high.
C) Set the pump at 45 ml/hour.
D) Stop the infusion and have the laboratory repeat the
theophylline measurement.
A) Question the order because it's too low.
Response Feedback:
A therapeutic theophylline level is 10 to 20 mcg/ml. The client is
currently receiving 0.5 mg/kg/hour of aminophylline. Because
the client's
theophylline level is sub-therapeutic, reducing the dose (which
is what the physician's order would do) would be inappropriate.
Therefore, the nurse should question the order.
, A male client admitted to an acute care facility with pneumonia is
receiving supplemental oxygen, 2 L/minute via nasal cannula. The
client's history includes chronic obstructive pulmonary disease
(COPD) and
coronary artery disease. Because of these history findings, the
nurse closely monitors the oxygen flow and the client's
respiratory status.
Which complication may arise if the client receives a high oxygen
concentration?
A) Apnea
B) Anginal pain
C) Respiratory alkalosis
D) Metabolic acidosis
A) Apnea
Response Feedback:
Hypoxia is the main breathing stimulus for a client with COPD.
Excessive oxygen administration may lead to apnea by removing
that stimulus.
Anginal pain results from a reduced myocardial oxygen supply.
A client with COPD may have anginal pain from generalized
vasoconstriction
secondary to hypoxia; however, administering oxygen at any
concentration dilates blood vessels, easing anginal pain.
Respiratory alkalosis results from alveolar hyperventilation,
not excessive oxygen administration. In a client with COPD,
high oxygen concentrations
decrease the ventilatory drive, leading to respiratory acidosis, not
alkalosis. High oxygen concentrations don't cause metabolic
acidosis.
ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
(CORRECT VERIFIED SOLUTIONS) CURRENTLY
UPDATED VERSION 2026 EDITION
The nurse is teaching a male client with chronic bronchitis about
breathing exercises. Which of the following should the nurse
include in the teaching?
A) Make inhalation longer than exhalation.
B) Exhale through an open mouth.
C) Use diaphragmatic breathing.
D) Use chest breathing.
C) Use diaphragmatic breathing.
Response Feedback:
In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic
breathing helps to strengthen the diaphragm and maximizes
ventilation. Exhalation should be longer than inhalation to
prevent collapse of the bronchioles. The client with chronic
bronchitis should exhale through
pursed lips to prolong exhalation, keep the bronchioles from
collapsing, and prevent air trapping. Diaphragmatic breathing —
not chest breathing
— increases lung expansion.
,A female client must take streptomycin for tuberculosis. Before
therapy begins, the nurse should instruct the client to notify the
physician if which health concern occurs?
A) Impaired color discrimination
B) Increased urinary frequency
C) Decreased hearing acuity
D) Increased appetite
C) Decreased hearing
acuity Response
Feedback:
Decreased hearing acuity indicates ototoxicity, a serious
adverse effect of streptomycin therapy. The client should
notify the physician
immediately if it occurs so that streptomycin can be discontinued
and an alternative drug can be prescribed. The other options
aren't associated with streptomycin. Impaired color
discrimination indicates color
blindness; increased urinary frequency and increased appetite
accompany diabetes mellitus.
The nurse assesses a male client's respiratory status. Which observation
indicates that the client is experiencing difficulty breathing?
A) Diaphragmatic breathing
B) Use of accessory muscles
C) Pursed-lip breathing
D) Controlled breathing
B) Use of accessory muscles
Response Feedback:
The use of accessory muscles for respiration indicates the client is having difficulty
breathing. Diaphragmatic and pursed-lip breathing are two
controlled breathing techniques that help the client conserve energy.
,A male client who weighs 175 lb (79.4 kg) is receiving aminophylline
(Aminophyllin) (400 mg in 500 ml) at 50 ml/hour. The theophylline
level is reported as 6 mcg/ml. The nurse calls the physician who
instructs the
nurse to change the dosage to 0.45 mg/kg/hour. The nurse should:
A) Question the order because it's too low.
B) Question the order because it's too high.
C) Set the pump at 45 ml/hour.
D) Stop the infusion and have the laboratory repeat the
theophylline measurement.
A) Question the order because it's too low.
Response Feedback:
A therapeutic theophylline level is 10 to 20 mcg/ml. The client is
currently receiving 0.5 mg/kg/hour of aminophylline. Because
the client's
theophylline level is sub-therapeutic, reducing the dose (which
is what the physician's order would do) would be inappropriate.
Therefore, the nurse should question the order.
, A male client admitted to an acute care facility with pneumonia is
receiving supplemental oxygen, 2 L/minute via nasal cannula. The
client's history includes chronic obstructive pulmonary disease
(COPD) and
coronary artery disease. Because of these history findings, the
nurse closely monitors the oxygen flow and the client's
respiratory status.
Which complication may arise if the client receives a high oxygen
concentration?
A) Apnea
B) Anginal pain
C) Respiratory alkalosis
D) Metabolic acidosis
A) Apnea
Response Feedback:
Hypoxia is the main breathing stimulus for a client with COPD.
Excessive oxygen administration may lead to apnea by removing
that stimulus.
Anginal pain results from a reduced myocardial oxygen supply.
A client with COPD may have anginal pain from generalized
vasoconstriction
secondary to hypoxia; however, administering oxygen at any
concentration dilates blood vessels, easing anginal pain.
Respiratory alkalosis results from alveolar hyperventilation,
not excessive oxygen administration. In a client with COPD,
high oxygen concentrations
decrease the ventilatory drive, leading to respiratory acidosis, not
alkalosis. High oxygen concentrations don't cause metabolic
acidosis.
