Respiratory Nursing NCLEX-Style
Practice Exam Review
Comprehensive Respiratory Nursing
Practice Examination
1. A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88% on
room air. Which intervention should the nurse implement first?
A) Administer oxygen at 2 L/min via nasal cannula
B) Position the patient in high Fowler's position
C) Encourage deep breathing and coughing
D) Notify the healthcare provider
Answer: A) Administer oxygen at 2 L/min via nasal cannula
Rationale: The patient's oxygen saturation of 88% is below the target of 90-92% for COPD patients. The
priority intervention is to administer oxygen to improve oxygenation. While positioning, breathing
exercises, and notification are important, oxygen administration is the immediate priority to prevent
hypoxia and respiratory failure.
2. A patient with asthma is experiencing an acute exacerbation. Which assessment finding indicates
the patient is in severe respiratory distress?
A) Respiratory rate of 22 breaths/min
B) Oxygen saturation of 92%
C) Use of accessory muscles
D) Peak flow of 80% of personal best
Answer: C) Use of accessory muscles
Rationale: Use of accessory muscles indicates severe respiratory distress and impending respiratory
failure. A respiratory rate of 22 is mildly elevated, oxygen saturation of 92% is acceptable, and peak flow
of 80% indicates mild to moderate exacerbation.
3. A patient is prescribed an albuterol inhaler for asthma. Which instruction should the nurse include?
,A) "Use the inhaler once daily in the morning"
B) "Rinse your mouth after using the inhaler"
C) "Wait 1 minute between puffs"
D) "Use the inhaler only when you are short of breath"
Answer: C) "Wait 1 minute between puffs"
Rationale: Albuterol is a rescue inhaler used for acute symptoms. The patient should wait 1 minute
between puffs to allow for optimal medication delivery. Rinsing the mouth is important for corticosteroid
inhalers, not bronchodilators.
4. A patient with pneumonia has a fever, productive cough, and pleuritic chest pain. Which finding
indicates the patient's condition is worsening?
A) Increased sputum production
B) Decreased oxygen saturation
C) Elevated temperature
D) Crackles in the lung bases
Answer: B) Decreased oxygen saturation
Rationale: Decreasing oxygen saturation indicates worsening gas exchange and is a sign of deterioration.
Increased sputum production, fever, and crackles are expected findings in pneumonia.
5. A patient is receiving oxygen via a non-rebreather mask. Which nursing intervention is most
important?
A) Keep the reservoir bag inflated
B) Set the flow rate to 4 L/min
C) Change the mask every 24 hours
D) Apply petroleum jelly to the nares
Answer: A) Keep the reservoir bag inflated
Rationale: The reservoir bag should remain inflated to ensure the patient receives the prescribed oxygen
concentration (up to 90%). A non-rebreather mask requires a flow rate of 10-15 L/min. Petroleum jelly is
flammable and should not be used with oxygen.
6. A patient is diagnosed with a pulmonary embolism. Which finding is most concerning?
A) Tachypnea
B) Tachycardia
C) Hemoptysis
D) Pleuritic chest pain
, Answer: C) Hemoptysis
Rationale: Hemoptysis (coughing up blood) indicates pulmonary infarction and is a serious complication
of PE. Tachypnea, tachycardia, and pleuritic chest pain are common findings but hemoptysis is a more
severe sign.
7. A patient is receiving mechanical ventilation. The ventilator alarm sounds indicating high-pressure
limit. Which action should the nurse take first?
A) Suction the patient's endotracheal tube
B) Manually ventilate the patient with a bag-valve-mask
C) Check the ventilator settings
D) Sedate the patient
Answer: B) Manually ventilate the patient with a bag-valve-mask
Rationale: The priority when a high-pressure alarm sounds is to ensure the patient is ventilated. The
nurse should disconnect the ventilator and manually ventilate while assessing for the cause. This ensures
oxygenation and ventilation are maintained.
8. A patient with asthma is prescribed an inhaled corticosteroid. Which instruction should the nurse
include?
A) "Rinse your mouth after using the inhaler"
B) "Use the inhaler during an acute asthma attack"
C) "Stop using the inhaler if you feel better"
D) "Take the inhaler before the bronchodilator"
Answer: A) "Rinse your mouth after using the inhaler"
Rationale: Inhaled corticosteroids can cause oral candidiasis (thrush). Rinsing the mouth after each use
reduces this risk. These medications are controller medications used daily, not for acute attacks.
9. A patient is diagnosed with a pneumothorax. Which assessment finding is most consistent with this
condition?
A) Absent breath sounds on the affected side
B) Crackles in the lung bases
C) Wheezing on expiration
D) Bronchial breath sounds
Answer: A) Absent breath sounds on the affected side
Practice Exam Review
Comprehensive Respiratory Nursing
Practice Examination
1. A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88% on
room air. Which intervention should the nurse implement first?
A) Administer oxygen at 2 L/min via nasal cannula
B) Position the patient in high Fowler's position
C) Encourage deep breathing and coughing
D) Notify the healthcare provider
Answer: A) Administer oxygen at 2 L/min via nasal cannula
Rationale: The patient's oxygen saturation of 88% is below the target of 90-92% for COPD patients. The
priority intervention is to administer oxygen to improve oxygenation. While positioning, breathing
exercises, and notification are important, oxygen administration is the immediate priority to prevent
hypoxia and respiratory failure.
2. A patient with asthma is experiencing an acute exacerbation. Which assessment finding indicates
the patient is in severe respiratory distress?
A) Respiratory rate of 22 breaths/min
B) Oxygen saturation of 92%
C) Use of accessory muscles
D) Peak flow of 80% of personal best
Answer: C) Use of accessory muscles
Rationale: Use of accessory muscles indicates severe respiratory distress and impending respiratory
failure. A respiratory rate of 22 is mildly elevated, oxygen saturation of 92% is acceptable, and peak flow
of 80% indicates mild to moderate exacerbation.
3. A patient is prescribed an albuterol inhaler for asthma. Which instruction should the nurse include?
,A) "Use the inhaler once daily in the morning"
B) "Rinse your mouth after using the inhaler"
C) "Wait 1 minute between puffs"
D) "Use the inhaler only when you are short of breath"
Answer: C) "Wait 1 minute between puffs"
Rationale: Albuterol is a rescue inhaler used for acute symptoms. The patient should wait 1 minute
between puffs to allow for optimal medication delivery. Rinsing the mouth is important for corticosteroid
inhalers, not bronchodilators.
4. A patient with pneumonia has a fever, productive cough, and pleuritic chest pain. Which finding
indicates the patient's condition is worsening?
A) Increased sputum production
B) Decreased oxygen saturation
C) Elevated temperature
D) Crackles in the lung bases
Answer: B) Decreased oxygen saturation
Rationale: Decreasing oxygen saturation indicates worsening gas exchange and is a sign of deterioration.
Increased sputum production, fever, and crackles are expected findings in pneumonia.
5. A patient is receiving oxygen via a non-rebreather mask. Which nursing intervention is most
important?
A) Keep the reservoir bag inflated
B) Set the flow rate to 4 L/min
C) Change the mask every 24 hours
D) Apply petroleum jelly to the nares
Answer: A) Keep the reservoir bag inflated
Rationale: The reservoir bag should remain inflated to ensure the patient receives the prescribed oxygen
concentration (up to 90%). A non-rebreather mask requires a flow rate of 10-15 L/min. Petroleum jelly is
flammable and should not be used with oxygen.
6. A patient is diagnosed with a pulmonary embolism. Which finding is most concerning?
A) Tachypnea
B) Tachycardia
C) Hemoptysis
D) Pleuritic chest pain
, Answer: C) Hemoptysis
Rationale: Hemoptysis (coughing up blood) indicates pulmonary infarction and is a serious complication
of PE. Tachypnea, tachycardia, and pleuritic chest pain are common findings but hemoptysis is a more
severe sign.
7. A patient is receiving mechanical ventilation. The ventilator alarm sounds indicating high-pressure
limit. Which action should the nurse take first?
A) Suction the patient's endotracheal tube
B) Manually ventilate the patient with a bag-valve-mask
C) Check the ventilator settings
D) Sedate the patient
Answer: B) Manually ventilate the patient with a bag-valve-mask
Rationale: The priority when a high-pressure alarm sounds is to ensure the patient is ventilated. The
nurse should disconnect the ventilator and manually ventilate while assessing for the cause. This ensures
oxygenation and ventilation are maintained.
8. A patient with asthma is prescribed an inhaled corticosteroid. Which instruction should the nurse
include?
A) "Rinse your mouth after using the inhaler"
B) "Use the inhaler during an acute asthma attack"
C) "Stop using the inhaler if you feel better"
D) "Take the inhaler before the bronchodilator"
Answer: A) "Rinse your mouth after using the inhaler"
Rationale: Inhaled corticosteroids can cause oral candidiasis (thrush). Rinsing the mouth after each use
reduces this risk. These medications are controller medications used daily, not for acute attacks.
9. A patient is diagnosed with a pneumothorax. Which assessment finding is most consistent with this
condition?
A) Absent breath sounds on the affected side
B) Crackles in the lung bases
C) Wheezing on expiration
D) Bronchial breath sounds
Answer: A) Absent breath sounds on the affected side
