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NUR 245 Exam 3
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Complex Health Problems — COPD, ARDS, Shock, & Critical Care
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Complex Health Problems 2
NUR 245 · Galen College of Nursing Page 1
,NUR 245 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Complex Health Problems — COPD, ARDS, Shock & Critical Care
1 The nurse is providing education to a client about modifiable risk factors for COPD.
Which risk factors should the nurse include? (Select all that apply.)
A Smoking
B Passive (secondhand) smoke
C Air pollution
D Workplace toxins
E Alpha-1 antitrypsin deficiency
Correct Answer: A, B, C, D Modifiable risk factors for COPD include smoking, passive
smoke, recurrent childhood infections, air pollution, and workplace toxins. Alpha-1
antitrypsin deficiency is a non-modifiable genetic risk factor.
E — Alpha-1 antitrypsin deficiency is a non-modifiable genetic risk factor, not modifiable.
Tested Concept: COPD modifiable risk factors
Source Concept: COPD modifiable risk factors — Smoking — Passive (secondhand) smoke —
Recurrent childhood infections — Air pollution — Work toxins
,2 The nurse is assessing a client with COPD. Which finding is a non-modifiable risk
factor for COPD?
A Smoking history
B Occupational exposure to dust
C Alpha-1 antitrypsin deficiency
D Air pollution exposure
Correct Answer: C Alpha-1 antitrypsin deficiency is a genetic (non-modifiable) risk factor
for COPD. Smoking, occupational exposures, and air pollution are modifiable risk factors.
A — Smoking is a modifiable risk factor.
B — Occupational exposure is a modifiable risk factor.
D — Air pollution is a modifiable risk factor.
Tested Concept: COPD non-modifiable risk factors
Source Concept: COPD non-modifiable risk factor — Alpha 1 antitrypsin deficiency (genetic) — Aging
— Asthma
, 3 The nurse is caring for a client with COPD. Which pathophysiological changes occur
in COPD? (Select all that apply.)
A Chronic inflammatory response to smoke
B Increased mucus production
C Mucus reduces the diameter of airways
D Decreased mucus production
E Airway dilation
Correct Answer: A, B, C COPD is a progressive disease characterized by a chronic
inflammatory response to smoke, increased mucus production, and airway narrowing due to
mucus accumulation.
D — Mucus production is increased, not decreased.
E — Airways are narrowed, not dilated.
Tested Concept: COPD pathophysiology
Source Concept: COPD — Progressive disease — Chronic inflammatory response to smoke —
Increased mucus production — Mucus reduces diameter of airways
4 The nurse is assessing a client with COPD. Which early sign of COPD should the
nurse expect?
A Shortness of breath with activity
B Barrel chest
C Use of accessory muscles
D Chest breathing instead of abdominal breathing
Correct Answer: A Early signs of COPD include dyspnea and shortness of breath with
activity. Barrel chest, use of accessory muscles, and chest breathing are late signs.
B — Barrel chest is a late sign of COPD.
C — Use of accessory muscles is a late sign.
D — Chest breathing instead of abdominal breathing is a late sign.
Tested Concept: Early signs of COPD
Source Concept: S/S of COPD — Dyspnea — SOB w/ activity (early) — SOB at rest (late)
NUR 245 Exam 3
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Complex Health Problems — COPD, ARDS, Shock, & Critical Care
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Complex Health Problems 2
NUR 245 · Galen College of Nursing Page 1
,NUR 245 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Complex Health Problems — COPD, ARDS, Shock & Critical Care
1 The nurse is providing education to a client about modifiable risk factors for COPD.
Which risk factors should the nurse include? (Select all that apply.)
A Smoking
B Passive (secondhand) smoke
C Air pollution
D Workplace toxins
E Alpha-1 antitrypsin deficiency
Correct Answer: A, B, C, D Modifiable risk factors for COPD include smoking, passive
smoke, recurrent childhood infections, air pollution, and workplace toxins. Alpha-1
antitrypsin deficiency is a non-modifiable genetic risk factor.
E — Alpha-1 antitrypsin deficiency is a non-modifiable genetic risk factor, not modifiable.
Tested Concept: COPD modifiable risk factors
Source Concept: COPD modifiable risk factors — Smoking — Passive (secondhand) smoke —
Recurrent childhood infections — Air pollution — Work toxins
,2 The nurse is assessing a client with COPD. Which finding is a non-modifiable risk
factor for COPD?
A Smoking history
B Occupational exposure to dust
C Alpha-1 antitrypsin deficiency
D Air pollution exposure
Correct Answer: C Alpha-1 antitrypsin deficiency is a genetic (non-modifiable) risk factor
for COPD. Smoking, occupational exposures, and air pollution are modifiable risk factors.
A — Smoking is a modifiable risk factor.
B — Occupational exposure is a modifiable risk factor.
D — Air pollution is a modifiable risk factor.
Tested Concept: COPD non-modifiable risk factors
Source Concept: COPD non-modifiable risk factor — Alpha 1 antitrypsin deficiency (genetic) — Aging
— Asthma
, 3 The nurse is caring for a client with COPD. Which pathophysiological changes occur
in COPD? (Select all that apply.)
A Chronic inflammatory response to smoke
B Increased mucus production
C Mucus reduces the diameter of airways
D Decreased mucus production
E Airway dilation
Correct Answer: A, B, C COPD is a progressive disease characterized by a chronic
inflammatory response to smoke, increased mucus production, and airway narrowing due to
mucus accumulation.
D — Mucus production is increased, not decreased.
E — Airways are narrowed, not dilated.
Tested Concept: COPD pathophysiology
Source Concept: COPD — Progressive disease — Chronic inflammatory response to smoke —
Increased mucus production — Mucus reduces diameter of airways
4 The nurse is assessing a client with COPD. Which early sign of COPD should the
nurse expect?
A Shortness of breath with activity
B Barrel chest
C Use of accessory muscles
D Chest breathing instead of abdominal breathing
Correct Answer: A Early signs of COPD include dyspnea and shortness of breath with
activity. Barrel chest, use of accessory muscles, and chest breathing are late signs.
B — Barrel chest is a late sign of COPD.
C — Use of accessory muscles is a late sign.
D — Chest breathing instead of abdominal breathing is a late sign.
Tested Concept: Early signs of COPD
Source Concept: S/S of COPD — Dyspnea — SOB w/ activity (early) — SOB at rest (late)
