,NURS 480 final exam Advanced Medical Surgical Nursing Questions
And Answers 2026/2027 West Coast University
Q1. A client with acute respiratory failure has a PaO2 of 48 mm Hg despite
supplemental oxygen. Which interpretation is most appropriate?
A. Adequate oxygenation
B. Severe hypoxemia
C. Metabolic alkalosis
D. Hypervolemia
Correct Answer: B
Rationale: A PaO2 of 48 mm Hg indicates severe hypoxemia and requires
prompt assessment and intervention.
Q2. Which finding is most concerning in a client with acute respiratory
failure?
A. Oxygen saturation 82% despite oxygen therapy
B. Respiratory rate 18/min
C. Mild cough
D. Clear speech
Correct Answer: A
Rationale: Persistent severe hypoxemia despite oxygen therapy indicates
significant respiratory compromise.
Q3. Which arterial blood gas pattern indicates respiratory acidosis?
A. pH 7.29, PaCO2 54 mm Hg, HCO3 24 mEq/L
B. pH 7.50, PaCO2 30 mm Hg, HCO3 24 mEq/L
C. pH 7.28, PaCO2 30 mm Hg, HCO3 15 mEq/L
D. pH 7.48, PaCO2 48 mm Hg, HCO3 34 mEq/L
Correct Answer: A
Rationale: The pH is low and PaCO2 is elevated, indicating a primary
respiratory acidosis.
Q4. Which condition commonly causes respiratory acidosis?
A. Hypoventilation
B. Severe vomiting
C. Excessive bicarbonate intake
D. Hyperventilation
, Correct Answer: A
Rationale: Hypoventilation causes carbon dioxide retention, which lowers
blood pH.
Q5. Which condition commonly causes respiratory alkalosis?
A. Hyperventilation
B. Severe hypoventilation
C. Opioid overdose
D. Respiratory muscle paralysis
Correct Answer: A
Rationale: Excessive ventilation removes carbon dioxide faster than it is
produced, increasing blood pH.
Q6. Which intervention is appropriate for a client with severe acute
respiratory distress?
A. Assess airway and breathing and provide appropriate oxygen/ventilatory
support
B. Encourage oral fluids first
C. Delay intervention until laboratory results return
D. Place the client flat
Correct Answer: A
Rationale: Airway and breathing are immediate priorities in respiratory
distress.
Q7. Which ventilator setting helps prevent alveolar collapse at the end of
expiration?
A. PEEP
B. FiO2 alone
C. Respiratory rate alone
D. Tidal volume alone
Correct Answer: A
Rationale: Positive end-expiratory pressure keeps alveoli open during
expiration and can improve oxygenation.
Q8. Which complication should the nurse monitor for in a client receiving
mechanical ventilation?
And Answers 2026/2027 West Coast University
Q1. A client with acute respiratory failure has a PaO2 of 48 mm Hg despite
supplemental oxygen. Which interpretation is most appropriate?
A. Adequate oxygenation
B. Severe hypoxemia
C. Metabolic alkalosis
D. Hypervolemia
Correct Answer: B
Rationale: A PaO2 of 48 mm Hg indicates severe hypoxemia and requires
prompt assessment and intervention.
Q2. Which finding is most concerning in a client with acute respiratory
failure?
A. Oxygen saturation 82% despite oxygen therapy
B. Respiratory rate 18/min
C. Mild cough
D. Clear speech
Correct Answer: A
Rationale: Persistent severe hypoxemia despite oxygen therapy indicates
significant respiratory compromise.
Q3. Which arterial blood gas pattern indicates respiratory acidosis?
A. pH 7.29, PaCO2 54 mm Hg, HCO3 24 mEq/L
B. pH 7.50, PaCO2 30 mm Hg, HCO3 24 mEq/L
C. pH 7.28, PaCO2 30 mm Hg, HCO3 15 mEq/L
D. pH 7.48, PaCO2 48 mm Hg, HCO3 34 mEq/L
Correct Answer: A
Rationale: The pH is low and PaCO2 is elevated, indicating a primary
respiratory acidosis.
Q4. Which condition commonly causes respiratory acidosis?
A. Hypoventilation
B. Severe vomiting
C. Excessive bicarbonate intake
D. Hyperventilation
, Correct Answer: A
Rationale: Hypoventilation causes carbon dioxide retention, which lowers
blood pH.
Q5. Which condition commonly causes respiratory alkalosis?
A. Hyperventilation
B. Severe hypoventilation
C. Opioid overdose
D. Respiratory muscle paralysis
Correct Answer: A
Rationale: Excessive ventilation removes carbon dioxide faster than it is
produced, increasing blood pH.
Q6. Which intervention is appropriate for a client with severe acute
respiratory distress?
A. Assess airway and breathing and provide appropriate oxygen/ventilatory
support
B. Encourage oral fluids first
C. Delay intervention until laboratory results return
D. Place the client flat
Correct Answer: A
Rationale: Airway and breathing are immediate priorities in respiratory
distress.
Q7. Which ventilator setting helps prevent alveolar collapse at the end of
expiration?
A. PEEP
B. FiO2 alone
C. Respiratory rate alone
D. Tidal volume alone
Correct Answer: A
Rationale: Positive end-expiratory pressure keeps alveoli open during
expiration and can improve oxygenation.
Q8. Which complication should the nurse monitor for in a client receiving
mechanical ventilation?
