NU NUR 340 Module 8 (pdf) | 2026/2027 | Nursing Care of Adults and
Older Adults II Q&A | Nursing
1. A nurse is assessing a patient with a suspected alteration in oxygenation.
Which of the following assessment findings is an early indicator of hypoxia?
A) Cyanosis
B) Bradycardia
C) Restlessness and confusion
D) Hypotension
Correct Answer: Restlessness and confusion
Rationale: Restlessness and confusion are early signs of hypoxia as the brain
is highly sensitive to decreased oxygen levels. Cyanosis is a late sign, and
bradycardia and hypotension are not typical early indicators; tachycardia and
hypertension often occur initially.
2. An advanced practice nurse is evaluating a patient's arterial blood gas
(ABG) results. Which of the following values indicates a state of
uncompensated respiratory acidosis?
A) pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L
B) pH 7.46, PaCO2 30 mmHg, HCO3 22 mEq/L
C) pH 7.38, PaCO2 40 mmHg, HCO3 24 mEq/L
D) pH 7.25, PaCO2 55 mmHg, HCO3 30 mEq/L
Correct Answer: pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L
Rationale: Uncompensated respiratory acidosis is characterized by a low pH
(<7.35) and an elevated PaCO2 (>45 mmHg) with a normal bicarbonate (22-
26 mEq/L). Option A meets these criteria. Option D shows compensation with
elevated HCO3.
,3. A nurse is caring for a patient with acute respiratory distress syndrome
(ARDS). Which of the following is the hallmark pathophysiological finding in
this condition?
A) Decreased alveolar-capillary membrane permeability
B) Increased surfactant production
C) Increased alveolar-capillary membrane permeability
D) Bronchospasm and airway constriction
Correct Answer: Increased alveolar-capillary membrane permeability
Rationale: ARDS is characterized by diffuse alveolar damage and increased
permeability of the alveolar-capillary membrane, leading to pulmonary
edema and severe hypoxemia. Surfactant production is decreased, not
increased.
4. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula. The nurse should monitor the patient for which
complication related to oxygen therapy?
A) Oxygen toxicity
B) Carbon dioxide narcosis
C) Respiratory alkalosis
D) Pulmonary fibrosis
Correct Answer: Carbon dioxide narcosis
Rationale: Patients with COPD may have a hypoxic drive to breathe. High-
flow oxygen can eliminate this drive, leading to hypoventilation, carbon
dioxide retention, and carbon dioxide narcosis.
,5. A nurse is assessing a patient with a chest tube after a pneumothorax.
Which of the following findings indicates that the chest tube is functioning
correctly?
A) Continuous bubbling in the water-seal chamber
B) Tidaling (fluctuation) in the water-seal chamber with respiration
C) Absence of drainage in the collection chamber
D) Suction pressure set at -40 cm H2O
Correct Answer: Tidaling (fluctuation) in the water-seal chamber with
respiration
Rationale: Tidaling in the water-seal chamber indicates that the chest tube is
patent and functioning correctly. Continuous bubbling suggests an air leak,
and the absence of drainage is not necessarily an indicator of correct
function.
6. A patient is being mechanically ventilated. The nurse notes a sudden
increase in peak airway pressure. Which of the following is the most likely
cause?
A) Patient-ventilator asynchrony
B) A dislodged endotracheal tube
C) Mucus plugging or bronchospasm
D) A leak in the ventilator circuit
Correct Answer: Mucus plugging or bronchospasm
Rationale: A sudden increase in peak airway pressure is often caused by an
obstruction in the airway, such as a mucus plug or bronchospasm. A
dislodged tube or a circuit leak would typically cause a decrease in pressure.
, 7. A nurse is caring for a patient following a pulmonary embolism. Which of
the following is the priority nursing intervention?
A) Administering prescribed anticoagulants
B) Monitoring oxygen saturation and respiratory status
C) Encouraging early ambulation
D) Administering thrombolytic therapy
Correct Answer: Monitoring oxygen saturation and respiratory status
Rationale: The priority is to maintain adequate oxygenation and assess for
deterioration. While anticoagulants and thrombolytics are treatments, the
immediate priority is respiratory assessment and support.
8. A nurse is assessing a patient with a new tracheostomy. Which of the
following actions is most important to prevent tracheostomy tube occlusion?
A) Changing the inner cannula every shift
B) Suctioning the tracheostomy tube every 2 hours
C) Keeping the tracheostomy ties snug to prevent displacement
D) Providing humidified oxygen and adequate hydration
Correct Answer: Providing humidified oxygen and adequate hydration
Rationale: Humidified oxygen helps prevent the formation of thick, dry
secretions that can occlude the tracheostomy tube. Adequate hydration also
helps thin secretions. Suctioning is done as needed, not on a fixed schedule.
9. A patient is experiencing an acute asthma exacerbation. Which of the
following is the most appropriate initial treatment?
A) Inhaled corticosteroids
Older Adults II Q&A | Nursing
1. A nurse is assessing a patient with a suspected alteration in oxygenation.
Which of the following assessment findings is an early indicator of hypoxia?
A) Cyanosis
B) Bradycardia
C) Restlessness and confusion
D) Hypotension
Correct Answer: Restlessness and confusion
Rationale: Restlessness and confusion are early signs of hypoxia as the brain
is highly sensitive to decreased oxygen levels. Cyanosis is a late sign, and
bradycardia and hypotension are not typical early indicators; tachycardia and
hypertension often occur initially.
2. An advanced practice nurse is evaluating a patient's arterial blood gas
(ABG) results. Which of the following values indicates a state of
uncompensated respiratory acidosis?
A) pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L
B) pH 7.46, PaCO2 30 mmHg, HCO3 22 mEq/L
C) pH 7.38, PaCO2 40 mmHg, HCO3 24 mEq/L
D) pH 7.25, PaCO2 55 mmHg, HCO3 30 mEq/L
Correct Answer: pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L
Rationale: Uncompensated respiratory acidosis is characterized by a low pH
(<7.35) and an elevated PaCO2 (>45 mmHg) with a normal bicarbonate (22-
26 mEq/L). Option A meets these criteria. Option D shows compensation with
elevated HCO3.
,3. A nurse is caring for a patient with acute respiratory distress syndrome
(ARDS). Which of the following is the hallmark pathophysiological finding in
this condition?
A) Decreased alveolar-capillary membrane permeability
B) Increased surfactant production
C) Increased alveolar-capillary membrane permeability
D) Bronchospasm and airway constriction
Correct Answer: Increased alveolar-capillary membrane permeability
Rationale: ARDS is characterized by diffuse alveolar damage and increased
permeability of the alveolar-capillary membrane, leading to pulmonary
edema and severe hypoxemia. Surfactant production is decreased, not
increased.
4. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula. The nurse should monitor the patient for which
complication related to oxygen therapy?
A) Oxygen toxicity
B) Carbon dioxide narcosis
C) Respiratory alkalosis
D) Pulmonary fibrosis
Correct Answer: Carbon dioxide narcosis
Rationale: Patients with COPD may have a hypoxic drive to breathe. High-
flow oxygen can eliminate this drive, leading to hypoventilation, carbon
dioxide retention, and carbon dioxide narcosis.
,5. A nurse is assessing a patient with a chest tube after a pneumothorax.
Which of the following findings indicates that the chest tube is functioning
correctly?
A) Continuous bubbling in the water-seal chamber
B) Tidaling (fluctuation) in the water-seal chamber with respiration
C) Absence of drainage in the collection chamber
D) Suction pressure set at -40 cm H2O
Correct Answer: Tidaling (fluctuation) in the water-seal chamber with
respiration
Rationale: Tidaling in the water-seal chamber indicates that the chest tube is
patent and functioning correctly. Continuous bubbling suggests an air leak,
and the absence of drainage is not necessarily an indicator of correct
function.
6. A patient is being mechanically ventilated. The nurse notes a sudden
increase in peak airway pressure. Which of the following is the most likely
cause?
A) Patient-ventilator asynchrony
B) A dislodged endotracheal tube
C) Mucus plugging or bronchospasm
D) A leak in the ventilator circuit
Correct Answer: Mucus plugging or bronchospasm
Rationale: A sudden increase in peak airway pressure is often caused by an
obstruction in the airway, such as a mucus plug or bronchospasm. A
dislodged tube or a circuit leak would typically cause a decrease in pressure.
, 7. A nurse is caring for a patient following a pulmonary embolism. Which of
the following is the priority nursing intervention?
A) Administering prescribed anticoagulants
B) Monitoring oxygen saturation and respiratory status
C) Encouraging early ambulation
D) Administering thrombolytic therapy
Correct Answer: Monitoring oxygen saturation and respiratory status
Rationale: The priority is to maintain adequate oxygenation and assess for
deterioration. While anticoagulants and thrombolytics are treatments, the
immediate priority is respiratory assessment and support.
8. A nurse is assessing a patient with a new tracheostomy. Which of the
following actions is most important to prevent tracheostomy tube occlusion?
A) Changing the inner cannula every shift
B) Suctioning the tracheostomy tube every 2 hours
C) Keeping the tracheostomy ties snug to prevent displacement
D) Providing humidified oxygen and adequate hydration
Correct Answer: Providing humidified oxygen and adequate hydration
Rationale: Humidified oxygen helps prevent the formation of thick, dry
secretions that can occlude the tracheostomy tube. Adequate hydration also
helps thin secretions. Suctioning is done as needed, not on a fixed schedule.
9. A patient is experiencing an acute asthma exacerbation. Which of the
following is the most appropriate initial treatment?
A) Inhaled corticosteroids
