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Nursing 354 Respiratory Failure Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
___________________________________________________________________
1. A patient with acute respiratory failure has a PaO₂ of 52 mm Hg while
breathing room air. How should the nurse interpret this finding?
A. Normal oxygenation
B. Mild hyperventilation
C. Severe hypoxemia
D. Metabolic alkalosis
Answer: C. Severe hypoxemia
Rationale: A PaO₂ below approximately 60 mm Hg indicates significant
hypoxemia and is consistent with hypoxemic respiratory failure when other
clinical findings support the diagnosis.
2. Which arterial blood gas pattern is most consistent with acute respiratory
failure caused by hypoventilation?
A. PaO₂ 95 mm Hg, PaCO₂ 35 mm Hg
B. PaO₂ 55 mm Hg, PaCO₂ 58 mm Hg
C. PaO₂ 100 mm Hg, PaCO₂ 40 mm Hg
D. PaO₂ 85 mm Hg, PaCO₂ 30 mm Hg
,Answer: B. PaO₂ 55 mm Hg, PaCO₂ 58 mm Hg
Rationale: Hypoventilation causes carbon dioxide retention and reduced
oxygenation. A low PaO₂ combined with an elevated PaCO₂ is characteristic of
hypercapnic respiratory failure.
3. Which assessment finding should concern the nurse most in a patient
developing respiratory failure?
A. Respiratory rate of 18/min
B. Oxygen saturation of 98%
C. Warm skin
D. Increasing confusion and agitation
Answer: D. Increasing confusion and agitation
Rationale: Changes in mental status can indicate inadequate cerebral
oxygenation or significant carbon dioxide retention and may be an early sign of
worsening respiratory failure.
4. Which condition is a common cause of acute hypoxemic respiratory failure?
A. Pneumonia
B. Simple headache
C. Mild anemia
D. Controlled hypertension
Answer: A. Pneumonia
Rationale: Pneumonia can cause alveolar inflammation and fluid accumulation,
impairing gas exchange and producing significant hypoxemia.
5. A patient with respiratory failure is receiving supplemental oxygen. Which
assessment is the priority?
A. Appetite
B. Bowel sounds
C. Oxygen saturation and respiratory effort
D. Skin temperature
,Answer: C. Oxygen saturation and respiratory effort
Rationale: Oxygenation and work of breathing provide immediate information
about the effectiveness of respiratory support and the patient's clinical status.
6. Which ABG result indicates respiratory acidosis?
A. pH 7.48, PaCO₂ 30 mm Hg
B. pH 7.50, HCO₃⁻ 24 mEq/L
C. pH 7.28, PaCO₂ 58 mm Hg
D. pH 7.45, PaCO₂ 40 mm Hg
Answer: C. pH 7.28, PaCO₂ 58 mm Hg
Rationale: Respiratory acidosis occurs when carbon dioxide accumulates,
causing the pH to decrease.
7. A patient with COPD develops increasing somnolence and a PaCO₂ of 70
mm Hg. What complication should the nurse suspect?
A. Hypoglycemia
B. Carbon dioxide retention
C. Metabolic alkalosis
D. Hypercalcemia
Answer: B. Carbon dioxide retention
Rationale: A markedly elevated PaCO₂ can produce respiratory acidosis and
neurologic changes such as drowsiness, confusion, and eventually decreased
consciousness.
8. Which finding is most characteristic of increased work of breathing?
A. Bradycardia
B. Use of accessory muscles
C. Decreased respiratory effort
D. Warm, dry skin
Answer: B. Use of accessory muscles
, Rationale: Accessory muscle use indicates that the patient is working harder to
maintain ventilation and may be progressing toward respiratory fatigue.
9. Which patient is at greatest risk for developing acute respiratory failure?
A. Patient with controlled seasonal allergies
B. Patient with a healed fracture
C. Patient with severe pneumonia and increasing oxygen requirements
D. Patient with mild constipation
Answer: C. Patient with severe pneumonia and increasing oxygen requirements
Rationale: Severe pulmonary infection can substantially impair oxygen exchange
and increase the risk of acute respiratory failure.
10.Which finding suggests impending respiratory muscle fatigue?
A. Decreased respiratory rate with improved oxygenation
B. Shallow respirations with increasing fatigue
C. Increased appetite
D. Normal mental status with effortless breathing
Answer: B. Shallow respirations with increasing fatigue
Rationale: As respiratory muscles become exhausted, respirations may become
shallow and less effective despite continued respiratory distress.
11.Which oxygen-delivery device provides a relatively precise oxygen
concentration?
A. Nasal cannula
B. Simple face mask
C. Nonrebreather mask
D. Venturi mask
Answer: D. Venturi mask
Rationale: A Venturi mask delivers a controlled and relatively precise fraction of
inspired oxygen, making it useful when precise oxygen administration is
important.
Nursing 354 Respiratory Failure Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
___________________________________________________________________
1. A patient with acute respiratory failure has a PaO₂ of 52 mm Hg while
breathing room air. How should the nurse interpret this finding?
A. Normal oxygenation
B. Mild hyperventilation
C. Severe hypoxemia
D. Metabolic alkalosis
Answer: C. Severe hypoxemia
Rationale: A PaO₂ below approximately 60 mm Hg indicates significant
hypoxemia and is consistent with hypoxemic respiratory failure when other
clinical findings support the diagnosis.
2. Which arterial blood gas pattern is most consistent with acute respiratory
failure caused by hypoventilation?
A. PaO₂ 95 mm Hg, PaCO₂ 35 mm Hg
B. PaO₂ 55 mm Hg, PaCO₂ 58 mm Hg
C. PaO₂ 100 mm Hg, PaCO₂ 40 mm Hg
D. PaO₂ 85 mm Hg, PaCO₂ 30 mm Hg
,Answer: B. PaO₂ 55 mm Hg, PaCO₂ 58 mm Hg
Rationale: Hypoventilation causes carbon dioxide retention and reduced
oxygenation. A low PaO₂ combined with an elevated PaCO₂ is characteristic of
hypercapnic respiratory failure.
3. Which assessment finding should concern the nurse most in a patient
developing respiratory failure?
A. Respiratory rate of 18/min
B. Oxygen saturation of 98%
C. Warm skin
D. Increasing confusion and agitation
Answer: D. Increasing confusion and agitation
Rationale: Changes in mental status can indicate inadequate cerebral
oxygenation or significant carbon dioxide retention and may be an early sign of
worsening respiratory failure.
4. Which condition is a common cause of acute hypoxemic respiratory failure?
A. Pneumonia
B. Simple headache
C. Mild anemia
D. Controlled hypertension
Answer: A. Pneumonia
Rationale: Pneumonia can cause alveolar inflammation and fluid accumulation,
impairing gas exchange and producing significant hypoxemia.
5. A patient with respiratory failure is receiving supplemental oxygen. Which
assessment is the priority?
A. Appetite
B. Bowel sounds
C. Oxygen saturation and respiratory effort
D. Skin temperature
,Answer: C. Oxygen saturation and respiratory effort
Rationale: Oxygenation and work of breathing provide immediate information
about the effectiveness of respiratory support and the patient's clinical status.
6. Which ABG result indicates respiratory acidosis?
A. pH 7.48, PaCO₂ 30 mm Hg
B. pH 7.50, HCO₃⁻ 24 mEq/L
C. pH 7.28, PaCO₂ 58 mm Hg
D. pH 7.45, PaCO₂ 40 mm Hg
Answer: C. pH 7.28, PaCO₂ 58 mm Hg
Rationale: Respiratory acidosis occurs when carbon dioxide accumulates,
causing the pH to decrease.
7. A patient with COPD develops increasing somnolence and a PaCO₂ of 70
mm Hg. What complication should the nurse suspect?
A. Hypoglycemia
B. Carbon dioxide retention
C. Metabolic alkalosis
D. Hypercalcemia
Answer: B. Carbon dioxide retention
Rationale: A markedly elevated PaCO₂ can produce respiratory acidosis and
neurologic changes such as drowsiness, confusion, and eventually decreased
consciousness.
8. Which finding is most characteristic of increased work of breathing?
A. Bradycardia
B. Use of accessory muscles
C. Decreased respiratory effort
D. Warm, dry skin
Answer: B. Use of accessory muscles
, Rationale: Accessory muscle use indicates that the patient is working harder to
maintain ventilation and may be progressing toward respiratory fatigue.
9. Which patient is at greatest risk for developing acute respiratory failure?
A. Patient with controlled seasonal allergies
B. Patient with a healed fracture
C. Patient with severe pneumonia and increasing oxygen requirements
D. Patient with mild constipation
Answer: C. Patient with severe pneumonia and increasing oxygen requirements
Rationale: Severe pulmonary infection can substantially impair oxygen exchange
and increase the risk of acute respiratory failure.
10.Which finding suggests impending respiratory muscle fatigue?
A. Decreased respiratory rate with improved oxygenation
B. Shallow respirations with increasing fatigue
C. Increased appetite
D. Normal mental status with effortless breathing
Answer: B. Shallow respirations with increasing fatigue
Rationale: As respiratory muscles become exhausted, respirations may become
shallow and less effective despite continued respiratory distress.
11.Which oxygen-delivery device provides a relatively precise oxygen
concentration?
A. Nasal cannula
B. Simple face mask
C. Nonrebreather mask
D. Venturi mask
Answer: D. Venturi mask
Rationale: A Venturi mask delivers a controlled and relatively precise fraction of
inspired oxygen, making it useful when precise oxygen administration is
important.
