NSG 3800 final Exam| Nursing Practice Adult Health II |
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
Questions 1–50: Respiratory, Oxygenation & Perfusion
1.
A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen therapy. Which finding requires the nurse's greatest attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing somnolence and difficulty arousing
D. Mild dyspnea after ambulation
Correct Answer: C. Increasing somnolence and difficulty arousing
Rationale: Increasing somnolence may indicate worsening carbon
dioxide retention and hypoventilation. The nurse should immediately
assess respiratory status and notify the provider as appropriate.
2.
Which assessment finding is most characteristic of emphysema?
A. Copious purulent sputum
B. Hyperinflated chest and prolonged expiration
C. Sudden pleuritic chest pain
D. Inspiratory stridor
Correct Answer: B. Hyperinflated chest and prolonged expiration
,Rationale: Emphysema involves destruction of alveolar walls and loss of
elastic recoil, producing air trapping, hyperinflation, prolonged
expiration, and often a barrel-shaped chest.
3.
A client with chronic bronchitis is experiencing increased sputum
production. Which intervention is most appropriate?
A. Restrict oral fluids
B. Encourage adequate hydration if not contraindicated
C. Keep the client supine
D. Discourage coughing
Correct Answer: B. Encourage adequate hydration if not
contraindicated
Rationale: Adequate hydration helps thin respiratory secretions, making
them easier to mobilize and expectorate.
4.
A client suddenly develops severe dyspnea, hypotension, tachycardia,
and tracheal deviation away from the affected side. Which condition
should the nurse suspect?
A. Pleural effusion
B. Tension pneumothorax
C. Atelectasis
D. Chronic bronchitis
,Correct Answer: B. Tension pneumothorax
Rationale: Tension pneumothorax causes increasing intrathoracic
pressure, lung collapse, impaired venous return, hypotension, and
possible tracheal deviation. It is an emergency requiring immediate
intervention.
5.
Which finding is most concerning in a client with a chest tube?
A. Tidaling in the water-seal chamber
B. Mild discomfort at the insertion site
C. Sudden absence of previously present drainage accompanied by
respiratory distress
D. Small amount of serous drainage
Correct Answer: C. Sudden absence of previously present drainage
accompanied by respiratory distress
Rationale: Sudden cessation of drainage combined with respiratory
deterioration may indicate obstruction or another complication
requiring immediate assessment.
6.
A client with a chest tube accidentally disconnects the tubing from the
drainage system. What should the nurse do first?
A. Clamp the chest tube
B. Place the disconnected end in sterile water
, C. Remove the chest tube
D. Apply an occlusive dressing over the insertion site
Correct Answer: B. Place the disconnected end in sterile water
Rationale: Placing the end in sterile water temporarily restores a water
seal and helps prevent air from entering the pleural space while the
system is replaced.
7.
Which client has the greatest risk for pulmonary embolism?
A. Client with controlled hypertension
B. Client who ambulates every two hours
C. Client recovering from major surgery with prolonged immobility
D. Client with seasonal allergies
Correct Answer: C. Client recovering from major surgery with
prolonged immobility
Rationale: Immobility and surgery increase venous stasis and
thrombosis risk, which can lead to pulmonary embolism.
8.
Which finding is most suggestive of pulmonary embolism?
A. Gradual bilateral ankle edema
B. Sudden dyspnea and pleuritic chest pain
C. Chronic productive cough
D. Slow respiratory rate without distress
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
Questions 1–50: Respiratory, Oxygenation & Perfusion
1.
A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen therapy. Which finding requires the nurse's greatest attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing somnolence and difficulty arousing
D. Mild dyspnea after ambulation
Correct Answer: C. Increasing somnolence and difficulty arousing
Rationale: Increasing somnolence may indicate worsening carbon
dioxide retention and hypoventilation. The nurse should immediately
assess respiratory status and notify the provider as appropriate.
2.
Which assessment finding is most characteristic of emphysema?
A. Copious purulent sputum
B. Hyperinflated chest and prolonged expiration
C. Sudden pleuritic chest pain
D. Inspiratory stridor
Correct Answer: B. Hyperinflated chest and prolonged expiration
,Rationale: Emphysema involves destruction of alveolar walls and loss of
elastic recoil, producing air trapping, hyperinflation, prolonged
expiration, and often a barrel-shaped chest.
3.
A client with chronic bronchitis is experiencing increased sputum
production. Which intervention is most appropriate?
A. Restrict oral fluids
B. Encourage adequate hydration if not contraindicated
C. Keep the client supine
D. Discourage coughing
Correct Answer: B. Encourage adequate hydration if not
contraindicated
Rationale: Adequate hydration helps thin respiratory secretions, making
them easier to mobilize and expectorate.
4.
A client suddenly develops severe dyspnea, hypotension, tachycardia,
and tracheal deviation away from the affected side. Which condition
should the nurse suspect?
A. Pleural effusion
B. Tension pneumothorax
C. Atelectasis
D. Chronic bronchitis
,Correct Answer: B. Tension pneumothorax
Rationale: Tension pneumothorax causes increasing intrathoracic
pressure, lung collapse, impaired venous return, hypotension, and
possible tracheal deviation. It is an emergency requiring immediate
intervention.
5.
Which finding is most concerning in a client with a chest tube?
A. Tidaling in the water-seal chamber
B. Mild discomfort at the insertion site
C. Sudden absence of previously present drainage accompanied by
respiratory distress
D. Small amount of serous drainage
Correct Answer: C. Sudden absence of previously present drainage
accompanied by respiratory distress
Rationale: Sudden cessation of drainage combined with respiratory
deterioration may indicate obstruction or another complication
requiring immediate assessment.
6.
A client with a chest tube accidentally disconnects the tubing from the
drainage system. What should the nurse do first?
A. Clamp the chest tube
B. Place the disconnected end in sterile water
, C. Remove the chest tube
D. Apply an occlusive dressing over the insertion site
Correct Answer: B. Place the disconnected end in sterile water
Rationale: Placing the end in sterile water temporarily restores a water
seal and helps prevent air from entering the pleural space while the
system is replaced.
7.
Which client has the greatest risk for pulmonary embolism?
A. Client with controlled hypertension
B. Client who ambulates every two hours
C. Client recovering from major surgery with prolonged immobility
D. Client with seasonal allergies
Correct Answer: C. Client recovering from major surgery with
prolonged immobility
Rationale: Immobility and surgery increase venous stasis and
thrombosis risk, which can lead to pulmonary embolism.
8.
Which finding is most suggestive of pulmonary embolism?
A. Gradual bilateral ankle edema
B. Sudden dyspnea and pleuritic chest pain
C. Chronic productive cough
D. Slow respiratory rate without distress
