ATI Medical-Surgical Respiratory Disorders Study Guide 2026
|Questions |Answers |Rationales
1. A nurse is reviewing the arterial blood gas (ABG) results of a client with COPD.
The results show pH 7.30, PaCO2 52 mm Hg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a
respiratory cause. Since the bicarbonate (HCO3) is within the normal range, it is
uncompensated respiratory acidosis.
2. A nurse is teaching a client who has a prescription for a fluticasone metered-
dose inhaler. Which of the following instructions should the nurse include?
A. Clean the inhaler with soap and water daily
B. Use the medication to treat an acute asthma attack
C. Rinse your mouth after each use
D. Take a deep breath and hold it for 2 seconds after inhalation
Answer: C
Rationale: Fluticasone is a corticosteroid; rinsing the mouth after use prevents
oropharyngeal candidiasis (thrush). It is a maintenance medication, not for acute attacks.
,3. A nurse is monitoring a client who is 1 hour postoperative following a
thoracentesis. Which of the following findings is the priority?
A. Heart rate of 105/min
B. Small amount of drainage on the dressing
C. Diminished breath sounds on the affected side
D. Pain at the insertion site
Answer: C
Rationale: Diminished breath sounds can indicate a pneumothorax, a serious complication
of thoracentesis. This requires immediate assessment and intervention over stable post-op
findings.
4. A nurse is caring for a client with a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal
chamber. Which action should the nurse take?
A. Lower the drainage system below the chest level
B. Check for a leak in the system
C. Document this as a normal finding
D. Increase the suction pressure
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or at the insertion site. Intermittent bubbling is normal during expiration or
coughing.
, 5. A nurse is providing discharge teaching to a client with COPD about nutrition.
Which instruction should the nurse include?
A. Drink plenty of fluids during meals
B. Eat three large meals a day
C. Eat high-calorie, high-protein foods
D. Increase intake of high-carbohydrate foods
Answer: C
Rationale: Clients with COPD have increased work of breathing and need high-calorie,
high-protein diets. Fluids should be taken between meals to avoid early satiety.
6. A nurse is teaching a client how to use an incentive spirometer. Which
instruction is correct?
A. Exhale forcefully into the device
B. Perform 20 breaths in rapid succession
C. Use the device once every 4 hours while awake
D. Inhale slowly and deeply through the mouthpiece
Answer: D
Rationale: The incentive spirometer is used to promote lung expansion by having the
client inhale slowly and deeply. It is typically used 10 times every hour while awake.
7. A nurse is preparing to suction a client who has a tracheostomy. Which action
should the nurse take first?
A. Apply suction while inserting the catheter
B. Preoxygenate the client with 100% oxygen
C. Suction for 20 seconds at a time
D. Insert the catheter until the client coughs
Answer: B
Rationale: Preoxygenation prevents hypoxia during the suctioning procedure. Suction
should never be applied during insertion, and should only last 10-15 seconds.
|Questions |Answers |Rationales
1. A nurse is reviewing the arterial blood gas (ABG) results of a client with COPD.
The results show pH 7.30, PaCO2 52 mm Hg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a
respiratory cause. Since the bicarbonate (HCO3) is within the normal range, it is
uncompensated respiratory acidosis.
2. A nurse is teaching a client who has a prescription for a fluticasone metered-
dose inhaler. Which of the following instructions should the nurse include?
A. Clean the inhaler with soap and water daily
B. Use the medication to treat an acute asthma attack
C. Rinse your mouth after each use
D. Take a deep breath and hold it for 2 seconds after inhalation
Answer: C
Rationale: Fluticasone is a corticosteroid; rinsing the mouth after use prevents
oropharyngeal candidiasis (thrush). It is a maintenance medication, not for acute attacks.
,3. A nurse is monitoring a client who is 1 hour postoperative following a
thoracentesis. Which of the following findings is the priority?
A. Heart rate of 105/min
B. Small amount of drainage on the dressing
C. Diminished breath sounds on the affected side
D. Pain at the insertion site
Answer: C
Rationale: Diminished breath sounds can indicate a pneumothorax, a serious complication
of thoracentesis. This requires immediate assessment and intervention over stable post-op
findings.
4. A nurse is caring for a client with a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal
chamber. Which action should the nurse take?
A. Lower the drainage system below the chest level
B. Check for a leak in the system
C. Document this as a normal finding
D. Increase the suction pressure
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or at the insertion site. Intermittent bubbling is normal during expiration or
coughing.
, 5. A nurse is providing discharge teaching to a client with COPD about nutrition.
Which instruction should the nurse include?
A. Drink plenty of fluids during meals
B. Eat three large meals a day
C. Eat high-calorie, high-protein foods
D. Increase intake of high-carbohydrate foods
Answer: C
Rationale: Clients with COPD have increased work of breathing and need high-calorie,
high-protein diets. Fluids should be taken between meals to avoid early satiety.
6. A nurse is teaching a client how to use an incentive spirometer. Which
instruction is correct?
A. Exhale forcefully into the device
B. Perform 20 breaths in rapid succession
C. Use the device once every 4 hours while awake
D. Inhale slowly and deeply through the mouthpiece
Answer: D
Rationale: The incentive spirometer is used to promote lung expansion by having the
client inhale slowly and deeply. It is typically used 10 times every hour while awake.
7. A nurse is preparing to suction a client who has a tracheostomy. Which action
should the nurse take first?
A. Apply suction while inserting the catheter
B. Preoxygenate the client with 100% oxygen
C. Suction for 20 seconds at a time
D. Insert the catheter until the client coughs
Answer: B
Rationale: Preoxygenation prevents hypoxia during the suctioning procedure. Suction
should never be applied during insertion, and should only last 10-15 seconds.
