ATI Medical-Surgical Respiratory Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which finding should the nurse
expect?
A. Respiratory rate of 10/min with shallow respirations
B. Bradycardia with intermittent apnea
C. Increased anterior-posterior chest diameter
D. Inspiratory stridor
Rationale: COPD, particularly emphysema, causes chronic air
trapping and hyperinflation of the lungs. Over time, this can
produce an increased anterior-posterior chest diameter,
commonly described as a barrel chest. Clients can also have
prolonged expiration, dyspnea, wheezing, decreased breath
sounds, and use of accessory muscles. Inspiratory stridor is more
suggestive of upper-airway obstruction rather than COPD.
,Question 2
A nurse is caring for a client who has COPD and is receiving
oxygen therapy. Which intervention is most appropriate?
A. Administer oxygen at the highest available flow rate
B. Titrate oxygen according to the prescribed target saturation
and clinical response
C. Withhold oxygen because oxygen therapy is contraindicated
in COPD
D. Maintain oxygen saturation at 100% for all clients with COPD
Rationale: Supplemental oxygen is an important treatment for
hypoxemia in COPD, but it should be carefully titrated and
monitored. Some clients with advanced COPD have chronic
carbon dioxide retention, so excessive oxygen administration
can contribute to worsening hypercapnia in susceptible
individuals. The nurse should follow the prescribed target range,
monitor respiratory status and oxygen saturation, and obtain
arterial blood gases when indicated. Oxygen is not
contraindicated in COPD; untreated hypoxemia is dangerous.
(OpenStax)
Question 3
,A client with COPD is experiencing dyspnea. Which position
should the nurse encourage?
A. Supine with the legs elevated
B. Trendelenburg
C. High-Fowler's position with the arms supported
D. Prone with the head turned to the side
Rationale: High-Fowler's positioning promotes maximum lung
expansion and decreases pressure from abdominal organs on
the diaphragm. Supporting the arms can improve use of
accessory respiratory muscles and make breathing more
efficient. Supine and Trendelenburg positions can interfere with
diaphragmatic movement and may worsen dyspnea.
Question 4
A nurse is teaching a client who has COPD about pursed-lip
breathing. Which instruction should the nurse provide?
A. Inhale through pursed lips and exhale through the nose
B. Hold the breath for 10 seconds after each inhalation
C. Inhale through the nose and exhale slowly through pursed
lips
D. Take rapid, shallow breaths through the mouth
Rationale: Pursed-lip breathing involves inhaling slowly through
the nose and exhaling slowly through partially closed lips. The
, prolonged exhalation creates positive pressure within the
airways and helps prevent premature airway collapse. It can
reduce air trapping, improve ventilation, and decrease the
sensation of dyspnea. Rapid shallow breathing increases the
likelihood of ineffective ventilation.
Question 5
A nurse is evaluating a client with COPD. Which arterial blood
gas result is most consistent with chronic respiratory acidosis
with compensation?
A. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 30 mm Hg, HCO₃⁻ 15 mEq/L
C. pH 7.36, PaCO₂ 55 mm Hg, HCO₃⁻ 30 mEq/L
D. pH 7.48, PaCO₂ 50 mm Hg, HCO₃⁻ 35 mEq/L
Rationale: A chronic increase in PaCO₂ indicates respiratory
acidosis. The kidneys compensate by retaining bicarbonate,
causing an increased HCO₃⁻ concentration. In a compensated
state, the pH can return toward the normal range. Therefore, a
pH of 7.36, PaCO₂ of 55 mm Hg, and HCO₃⁻ of 30 mEq/L are
consistent with compensated respiratory acidosis. COPD is a
common cause of chronic carbon dioxide retention.
Question 6
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which finding should the nurse
expect?
A. Respiratory rate of 10/min with shallow respirations
B. Bradycardia with intermittent apnea
C. Increased anterior-posterior chest diameter
D. Inspiratory stridor
Rationale: COPD, particularly emphysema, causes chronic air
trapping and hyperinflation of the lungs. Over time, this can
produce an increased anterior-posterior chest diameter,
commonly described as a barrel chest. Clients can also have
prolonged expiration, dyspnea, wheezing, decreased breath
sounds, and use of accessory muscles. Inspiratory stridor is more
suggestive of upper-airway obstruction rather than COPD.
,Question 2
A nurse is caring for a client who has COPD and is receiving
oxygen therapy. Which intervention is most appropriate?
A. Administer oxygen at the highest available flow rate
B. Titrate oxygen according to the prescribed target saturation
and clinical response
C. Withhold oxygen because oxygen therapy is contraindicated
in COPD
D. Maintain oxygen saturation at 100% for all clients with COPD
Rationale: Supplemental oxygen is an important treatment for
hypoxemia in COPD, but it should be carefully titrated and
monitored. Some clients with advanced COPD have chronic
carbon dioxide retention, so excessive oxygen administration
can contribute to worsening hypercapnia in susceptible
individuals. The nurse should follow the prescribed target range,
monitor respiratory status and oxygen saturation, and obtain
arterial blood gases when indicated. Oxygen is not
contraindicated in COPD; untreated hypoxemia is dangerous.
(OpenStax)
Question 3
,A client with COPD is experiencing dyspnea. Which position
should the nurse encourage?
A. Supine with the legs elevated
B. Trendelenburg
C. High-Fowler's position with the arms supported
D. Prone with the head turned to the side
Rationale: High-Fowler's positioning promotes maximum lung
expansion and decreases pressure from abdominal organs on
the diaphragm. Supporting the arms can improve use of
accessory respiratory muscles and make breathing more
efficient. Supine and Trendelenburg positions can interfere with
diaphragmatic movement and may worsen dyspnea.
Question 4
A nurse is teaching a client who has COPD about pursed-lip
breathing. Which instruction should the nurse provide?
A. Inhale through pursed lips and exhale through the nose
B. Hold the breath for 10 seconds after each inhalation
C. Inhale through the nose and exhale slowly through pursed
lips
D. Take rapid, shallow breaths through the mouth
Rationale: Pursed-lip breathing involves inhaling slowly through
the nose and exhaling slowly through partially closed lips. The
, prolonged exhalation creates positive pressure within the
airways and helps prevent premature airway collapse. It can
reduce air trapping, improve ventilation, and decrease the
sensation of dyspnea. Rapid shallow breathing increases the
likelihood of ineffective ventilation.
Question 5
A nurse is evaluating a client with COPD. Which arterial blood
gas result is most consistent with chronic respiratory acidosis
with compensation?
A. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.30, PaCO₂ 30 mm Hg, HCO₃⁻ 15 mEq/L
C. pH 7.36, PaCO₂ 55 mm Hg, HCO₃⁻ 30 mEq/L
D. pH 7.48, PaCO₂ 50 mm Hg, HCO₃⁻ 35 mEq/L
Rationale: A chronic increase in PaCO₂ indicates respiratory
acidosis. The kidneys compensate by retaining bicarbonate,
causing an increased HCO₃⁻ concentration. In a compensated
state, the pH can return toward the normal range. Therefore, a
pH of 7.36, PaCO₂ of 55 mm Hg, and HCO₃⁻ of 30 mEq/L are
consistent with compensated respiratory acidosis. COPD is a
common cause of chronic carbon dioxide retention.
Question 6
