NSG 3800 Actual Exam 2 | Nursing Practice Adult Health II |
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
SECTION I — ALTERATIONS IN OXYGENATION
Questions 1–84
1. A patient with COPD is receiving oxygen at 2 L/min by nasal cannula.
Which assessment finding requires the nurse's immediate attention?
A. Respiratory rate of 20/min
B. Oxygen saturation of 91%
C. Increasing somnolence and difficulty arousing
D. Barrel-shaped chest
Correct Answer: C. Increasing somnolence and difficulty arousing
Rationale: Increasing somnolence can indicate worsening hypercapnia
and respiratory failure in a patient with COPD.
2. Which position is most appropriate for a patient experiencing acute
dyspnea?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Flat lateral
Correct Answer: B. High-Fowler's
Rationale: High-Fowler's maximizes lung expansion and decreases
diaphragmatic pressure.
,3. Which finding is most characteristic of hypoxemia?
A. Bradycardia
B. Restlessness and confusion
C. Warm flushed skin
D. Increased urine output
Correct Answer: B. Restlessness and confusion
Rationale: Early neurologic manifestations of hypoxemia include
restlessness, anxiety, confusion, and impaired concentration.
4. A patient with pneumonia has an oxygen saturation of 84%. What is
the nurse's priority?
A. Encourage oral fluids
B. Apply prescribed supplemental oxygen
C. Obtain a dietary history
D. Place the patient supine
Correct Answer: B. Apply prescribed supplemental oxygen
Rationale: Severe hypoxemia requires immediate support of
oxygenation.
5. Which assessment finding is most consistent with pneumonia?
A. Productive cough and crackles
B. Bradycardia and dry skin
C. Hyperactive bowel sounds
D. Peripheral edema only
Correct Answer: A. Productive cough and crackles
Rationale: Pneumonia commonly produces alveolar inflammation,
secretions, productive cough, crackles, fever, and hypoxemia.
,6. Which intervention best promotes secretion clearance in a patient
with pneumonia?
A. Restrict fluids
B. Encourage adequate hydration when not contraindicated
C. Maintain strict bed rest
D. Avoid coughing
Correct Answer: B. Encourage adequate hydration when not
contraindicated
Rationale: Adequate hydration helps thin respiratory secretions and
facilitates expectoration.
7. Which finding in a patient with pneumonia suggests deterioration?
A. Temperature decreasing
B. Improved appetite
C. Increasing respiratory distress
D. Decreased sputum production
Correct Answer: C. Increasing respiratory distress
Rationale: Increasing work of breathing indicates worsening
oxygenation or respiratory failure.
8. A patient with COPD demonstrates pursed-lip breathing. The nurse
understands this technique primarily:
A. Increases respiratory rate
B. Promotes airway collapse
C. Helps maintain airway pressure during exhalation
D. Prevents oxygen absorption
, Correct Answer: C. Helps maintain airway pressure during exhalation
Rationale: Pursed-lip breathing prolongs exhalation and helps prevent
premature airway closure.
9. Which instruction should the nurse provide to a patient with COPD?
A. Avoid all physical activity
B. Exhale slowly through pursed lips
C. Breathe rapidly during exertion
D. Limit rest periods
Correct Answer: B. Exhale slowly through pursed lips
Rationale: Controlled exhalation decreases air trapping and improves
ventilation.
10. Which finding is commonly associated with emphysema?
A. Increased sputum production as the only symptom
B. Barrel chest and prolonged expiration
C. Sudden unilateral leg swelling
D. Hematemesis
Correct Answer: B. Barrel chest and prolonged expiration
Rationale: Emphysema causes hyperinflation, air trapping, prolonged
expiration, and increased anterior-posterior chest diameter.
11. Which finding is more characteristic of chronic bronchitis than
emphysema?
A. Chronic productive cough
B. Severe weight loss only
C. Minimal mucus production
D. Hyperinflation without secretions
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
SECTION I — ALTERATIONS IN OXYGENATION
Questions 1–84
1. A patient with COPD is receiving oxygen at 2 L/min by nasal cannula.
Which assessment finding requires the nurse's immediate attention?
A. Respiratory rate of 20/min
B. Oxygen saturation of 91%
C. Increasing somnolence and difficulty arousing
D. Barrel-shaped chest
Correct Answer: C. Increasing somnolence and difficulty arousing
Rationale: Increasing somnolence can indicate worsening hypercapnia
and respiratory failure in a patient with COPD.
2. Which position is most appropriate for a patient experiencing acute
dyspnea?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Flat lateral
Correct Answer: B. High-Fowler's
Rationale: High-Fowler's maximizes lung expansion and decreases
diaphragmatic pressure.
,3. Which finding is most characteristic of hypoxemia?
A. Bradycardia
B. Restlessness and confusion
C. Warm flushed skin
D. Increased urine output
Correct Answer: B. Restlessness and confusion
Rationale: Early neurologic manifestations of hypoxemia include
restlessness, anxiety, confusion, and impaired concentration.
4. A patient with pneumonia has an oxygen saturation of 84%. What is
the nurse's priority?
A. Encourage oral fluids
B. Apply prescribed supplemental oxygen
C. Obtain a dietary history
D. Place the patient supine
Correct Answer: B. Apply prescribed supplemental oxygen
Rationale: Severe hypoxemia requires immediate support of
oxygenation.
5. Which assessment finding is most consistent with pneumonia?
A. Productive cough and crackles
B. Bradycardia and dry skin
C. Hyperactive bowel sounds
D. Peripheral edema only
Correct Answer: A. Productive cough and crackles
Rationale: Pneumonia commonly produces alveolar inflammation,
secretions, productive cough, crackles, fever, and hypoxemia.
,6. Which intervention best promotes secretion clearance in a patient
with pneumonia?
A. Restrict fluids
B. Encourage adequate hydration when not contraindicated
C. Maintain strict bed rest
D. Avoid coughing
Correct Answer: B. Encourage adequate hydration when not
contraindicated
Rationale: Adequate hydration helps thin respiratory secretions and
facilitates expectoration.
7. Which finding in a patient with pneumonia suggests deterioration?
A. Temperature decreasing
B. Improved appetite
C. Increasing respiratory distress
D. Decreased sputum production
Correct Answer: C. Increasing respiratory distress
Rationale: Increasing work of breathing indicates worsening
oxygenation or respiratory failure.
8. A patient with COPD demonstrates pursed-lip breathing. The nurse
understands this technique primarily:
A. Increases respiratory rate
B. Promotes airway collapse
C. Helps maintain airway pressure during exhalation
D. Prevents oxygen absorption
, Correct Answer: C. Helps maintain airway pressure during exhalation
Rationale: Pursed-lip breathing prolongs exhalation and helps prevent
premature airway closure.
9. Which instruction should the nurse provide to a patient with COPD?
A. Avoid all physical activity
B. Exhale slowly through pursed lips
C. Breathe rapidly during exertion
D. Limit rest periods
Correct Answer: B. Exhale slowly through pursed lips
Rationale: Controlled exhalation decreases air trapping and improves
ventilation.
10. Which finding is commonly associated with emphysema?
A. Increased sputum production as the only symptom
B. Barrel chest and prolonged expiration
C. Sudden unilateral leg swelling
D. Hematemesis
Correct Answer: B. Barrel chest and prolonged expiration
Rationale: Emphysema causes hyperinflation, air trapping, prolonged
expiration, and increased anterior-posterior chest diameter.
11. Which finding is more characteristic of chronic bronchitis than
emphysema?
A. Chronic productive cough
B. Severe weight loss only
C. Minimal mucus production
D. Hyperinflation without secretions
