NUR 185 Final Exam Study Guide 2026/2027 | Hondros
Nursing | 300+ Practice Questions, Answers & Detailed
Rationales
Questions 1–50: Gas Exchange, Oxygenation & Respiratory Care
1. A client with hypoxemia is most likely to demonstrate which early
finding?
A. Cyanosis
B. Restlessness
C. Bradycardia
D. Severe hypotension
Answer: B. Restlessness
Rationale: Restlessness and anxiety can be early manifestations of
inadequate oxygenation. Cyanosis is generally a later finding.
2. Which oxygen-delivery device provides the most precise
concentration of oxygen for a spontaneously breathing client?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
Answer: C. Venturi mask
Rationale: A Venturi mask delivers a controlled, precise FiO₂ and is
particularly useful when exact oxygen concentration is important.
3. A client has a chest tube connected to a drainage system. Which
finding indicates the system is functioning as expected?
,A. Continuous vigorous bubbling in the water-seal chamber
B. Tidaling in the water-seal chamber
C. No drainage under all circumstances
D. Clamping the tube routinely
Answer: B. Tidaling in the water-seal chamber
Rationale: Tidaling with respiration can indicate that the chest tube
system is patent and responding to changes in intrathoracic pressure.
4. Continuous bubbling in the water-seal chamber of a chest-tube
system most commonly suggests:
A. Normal lung expansion
B. An air leak
C. Fluid overload
D. Tube obstruction
Answer: B. An air leak
Rationale: Continuous bubbling in the water-seal chamber is commonly
associated with an air leak somewhere in the system.
5. A chest tube becomes accidentally disconnected from the drainage
system. What should the nurse do first?
A. Leave the tube open to air
B. Place the tube end in sterile water
C. Clamp the tube for 30 minutes
D. Remove the tube
Answer: B. Place the tube end in sterile water
Rationale: Placing the tube in sterile water temporarily recreates a
water seal and helps prevent air from entering the pleural space.
,6. Which intervention helps prevent ventilator-associated pneumonia?
A. Keeping the client completely supine
B. Providing regular oral care
C. Avoiding suctioning
D. Limiting repositioning
Answer: B. Providing regular oral care
Rationale: Oral hygiene reduces bacterial colonization and is an
important component of VAP prevention.
7. A high-pressure ventilator alarm sounds. Which problem should the
nurse assess first?
A. Disconnected tubing
B. Secretions obstructing the airway
C. Low oxygen supply
D. Empty humidifier
Answer: B. Secretions obstructing the airway
Rationale: Increased airway resistance from secretions, coughing,
bronchospasm, or tube obstruction can trigger a high-pressure alarm.
8. A low-pressure ventilator alarm most commonly indicates:
A. Airway obstruction
B. Increased secretions
C. Circuit disconnection or leak
D. Bronchospasm
Answer: C. Circuit disconnection or leak
Rationale: A low-pressure alarm commonly occurs when the ventilator
circuit is disconnected or there is a significant leak.
, 9. Which arterial blood gas indicates respiratory acidosis?
A. pH 7.50, PaCO₂ 30
B. pH 7.30, PaCO₂ 50
C. pH 7.48, HCO₃⁻ 30
D. pH 7.30, HCO₃⁻ 18
Answer: B. pH 7.30, PaCO₂ 50
Rationale: A low pH with elevated PaCO₂ indicates respiratory acidosis.
10. Which ABG pattern indicates respiratory alkalosis?
A. pH 7.28, PaCO₂ 52
B. pH 7.31, HCO₃⁻ 18
C. pH 7.49, PaCO₂ 30
D. pH 7.30, HCO₃⁻ 30
Answer: C. pH 7.49, PaCO₂ 30
Rationale: Respiratory alkalosis is characterized by an elevated pH and
decreased PaCO₂.
11. Before suctioning a client with an artificial airway, the nurse should
first:
A. Administer food
B. Assess the need for suctioning
C. Deflate the airway cuff
D. Remove the oxygen source
Answer: B. Assess the need for suctioning
Rationale: Suctioning should be performed when clinically indicated
because unnecessary suctioning can cause hypoxemia and airway
trauma.
Nursing | 300+ Practice Questions, Answers & Detailed
Rationales
Questions 1–50: Gas Exchange, Oxygenation & Respiratory Care
1. A client with hypoxemia is most likely to demonstrate which early
finding?
A. Cyanosis
B. Restlessness
C. Bradycardia
D. Severe hypotension
Answer: B. Restlessness
Rationale: Restlessness and anxiety can be early manifestations of
inadequate oxygenation. Cyanosis is generally a later finding.
2. Which oxygen-delivery device provides the most precise
concentration of oxygen for a spontaneously breathing client?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
Answer: C. Venturi mask
Rationale: A Venturi mask delivers a controlled, precise FiO₂ and is
particularly useful when exact oxygen concentration is important.
3. A client has a chest tube connected to a drainage system. Which
finding indicates the system is functioning as expected?
,A. Continuous vigorous bubbling in the water-seal chamber
B. Tidaling in the water-seal chamber
C. No drainage under all circumstances
D. Clamping the tube routinely
Answer: B. Tidaling in the water-seal chamber
Rationale: Tidaling with respiration can indicate that the chest tube
system is patent and responding to changes in intrathoracic pressure.
4. Continuous bubbling in the water-seal chamber of a chest-tube
system most commonly suggests:
A. Normal lung expansion
B. An air leak
C. Fluid overload
D. Tube obstruction
Answer: B. An air leak
Rationale: Continuous bubbling in the water-seal chamber is commonly
associated with an air leak somewhere in the system.
5. A chest tube becomes accidentally disconnected from the drainage
system. What should the nurse do first?
A. Leave the tube open to air
B. Place the tube end in sterile water
C. Clamp the tube for 30 minutes
D. Remove the tube
Answer: B. Place the tube end in sterile water
Rationale: Placing the tube in sterile water temporarily recreates a
water seal and helps prevent air from entering the pleural space.
,6. Which intervention helps prevent ventilator-associated pneumonia?
A. Keeping the client completely supine
B. Providing regular oral care
C. Avoiding suctioning
D. Limiting repositioning
Answer: B. Providing regular oral care
Rationale: Oral hygiene reduces bacterial colonization and is an
important component of VAP prevention.
7. A high-pressure ventilator alarm sounds. Which problem should the
nurse assess first?
A. Disconnected tubing
B. Secretions obstructing the airway
C. Low oxygen supply
D. Empty humidifier
Answer: B. Secretions obstructing the airway
Rationale: Increased airway resistance from secretions, coughing,
bronchospasm, or tube obstruction can trigger a high-pressure alarm.
8. A low-pressure ventilator alarm most commonly indicates:
A. Airway obstruction
B. Increased secretions
C. Circuit disconnection or leak
D. Bronchospasm
Answer: C. Circuit disconnection or leak
Rationale: A low-pressure alarm commonly occurs when the ventilator
circuit is disconnected or there is a significant leak.
, 9. Which arterial blood gas indicates respiratory acidosis?
A. pH 7.50, PaCO₂ 30
B. pH 7.30, PaCO₂ 50
C. pH 7.48, HCO₃⁻ 30
D. pH 7.30, HCO₃⁻ 18
Answer: B. pH 7.30, PaCO₂ 50
Rationale: A low pH with elevated PaCO₂ indicates respiratory acidosis.
10. Which ABG pattern indicates respiratory alkalosis?
A. pH 7.28, PaCO₂ 52
B. pH 7.31, HCO₃⁻ 18
C. pH 7.49, PaCO₂ 30
D. pH 7.30, HCO₃⁻ 30
Answer: C. pH 7.49, PaCO₂ 30
Rationale: Respiratory alkalosis is characterized by an elevated pH and
decreased PaCO₂.
11. Before suctioning a client with an artificial airway, the nurse should
first:
A. Administer food
B. Assess the need for suctioning
C. Deflate the airway cuff
D. Remove the oxygen source
Answer: B. Assess the need for suctioning
Rationale: Suctioning should be performed when clinically indicated
because unnecessary suctioning can cause hypoxemia and airway
trauma.
