NURS231 PATHOPHYSIOLOGY MODULE 1
COMPREHENSIVE ASSESSMENT 2026 SOLVED
QUESTIONS WITH VERIFIED SOLUTION GUIDE
◉ The nurse is assessing a client who is receiving mechanical
ventilation with positive end-expiratory pressure. Which findings
would cause the nurse to suspect a left-sided tension
pneumothorax?
a) Chest asymmetry and jugular vein distention are present.
b) The client has bloody sputum and wheezes.
c) The left lung field is dull to percussion with crackles present on
auscultation.
d) The left chest caves in on inspiration and "puffs out" on
expiration.. Answer: a) Chest asymmetry and jugular vein distention
are present.
*Symptoms of tension pneumothorax include chest asymmetry,
tracheal deviation toward the unaffected side, dyspnea, absent
breath sounds, JVD, cyanosis. If not promptly detected and treated,
tension pneumothorax is quickly fatal.
◉ The charge nurse in the intensive care unit is overseeing care for a
group of clients. The nurse is especially vigilant in collaboration with
,the primary nurse and interprofessional team in assessing for ARDS
in which of these clients?
a) Client with acute kidney failure
b) Client with aspiration pneumonia
c) Client with atrial fibrillation
d) Client with DKA. Answer: b) Client with aspiration pneumonia
*Acute Respiratory Distress Syndrome is characterized by
widespread inflammation in the lungs. Aspiration of acidic gastric
contents promotes inflammation and is a risk for ARDS.
*Clients with DKA may develop metabolic acidosis, but do not
typically ARDS, which develops as a result of lung injury. Atrial
fibrillation does not cause lung injury unless embolization occurs.
Acute kidney failure results in metabolic acidosis, not in acute lung
injury.
◉ The nurse is providing education about the management of
respiratory failure to the family of a client who is receiving
mechanical ventilation. Which statement reflects the MOST
appropriate info that the nurse will communicate?
a) "Paralytics and sedatives help decrease the demand for oxygen."
b) "Sedation is needed so your loved one does not rip the breathing
tube out."
c) "Suctioning is important to remove organisms from the lower
airway."
,d) "We are encouraging oral and IV fluids to keep your loved one
hydrated.". Answer: a) "Paralytics and sedatives help decrease the
demand for oxygen."
*Sedation is needed more for its effects on oxygenation than to
prevent the client from ripping out the endotracheal tube.
Suctioning is performed to remove upper airway secretions and
maintain airway patency. Clients receiving mechanical ventilation
typically receive hydration by enteral tube or parenteral route and
not orally.
◉ The nurse is caring for a client with impending respiratory failure
who refuses intubation and mechanical ventilation. Which
respiratory modality does the nurse suggest to the interdisciplinary
team as an alternative to mechanical ventilation?
a) Bi-level positive airway pressure (BiPAP)
b) Non-rebreather mask with 100% oxygen
c) Positive end-expiratory pressure (PEEP)
d) Oropharyngeal airway. Answer: *a) Bi-level positive airway
pressure (BiPAP)
* this type of ventilation provides noninvasive pressure support
ventilation by nasal mask or facemask rather than by endotracheal
intubation. Generally, it used for clients with sleep apnea but can
also be used for clients with respiratory muscle fatigue or
, impending respiratory failure to avoid more invasive ventilation
methods; this may provide short-term relief of an acute problem.
*A non-rebreather mask will assist with oxygenation; however,
muscle fatigue and hypoventilation may occur as causes of
respiratory failure. The need for PEEP indicates a severe gas-
exchange problem. This modality is "dialed in" on the mechanical
ventilator.
◉ The nurse is assessing a client with possible pulmonary embolism
(PE). For which symptoms consistent with PE will the nurse assess?
(Select all that apply.)
a) Inspiratory chest pain
b) Pink, frothy sputum
c) Tachycardia
d) Shortness of breath (SOB) worsening over the last 2 weeks
e) Dizziness and syncope
f) Productive cough. Answer: a) Inspiratory chest pain
c) Tachycardia
e) Dizziness and syncope
*s/s of PE include SOB, dyspnea, dizziness, syncope, hypotension,
fainting, hemoptysis, tachycardia, dry cough, and sharp pleuritic,
inspiratory chest pain that develop abruptly rather than gradually
over two weeks.
COMPREHENSIVE ASSESSMENT 2026 SOLVED
QUESTIONS WITH VERIFIED SOLUTION GUIDE
◉ The nurse is assessing a client who is receiving mechanical
ventilation with positive end-expiratory pressure. Which findings
would cause the nurse to suspect a left-sided tension
pneumothorax?
a) Chest asymmetry and jugular vein distention are present.
b) The client has bloody sputum and wheezes.
c) The left lung field is dull to percussion with crackles present on
auscultation.
d) The left chest caves in on inspiration and "puffs out" on
expiration.. Answer: a) Chest asymmetry and jugular vein distention
are present.
*Symptoms of tension pneumothorax include chest asymmetry,
tracheal deviation toward the unaffected side, dyspnea, absent
breath sounds, JVD, cyanosis. If not promptly detected and treated,
tension pneumothorax is quickly fatal.
◉ The charge nurse in the intensive care unit is overseeing care for a
group of clients. The nurse is especially vigilant in collaboration with
,the primary nurse and interprofessional team in assessing for ARDS
in which of these clients?
a) Client with acute kidney failure
b) Client with aspiration pneumonia
c) Client with atrial fibrillation
d) Client with DKA. Answer: b) Client with aspiration pneumonia
*Acute Respiratory Distress Syndrome is characterized by
widespread inflammation in the lungs. Aspiration of acidic gastric
contents promotes inflammation and is a risk for ARDS.
*Clients with DKA may develop metabolic acidosis, but do not
typically ARDS, which develops as a result of lung injury. Atrial
fibrillation does not cause lung injury unless embolization occurs.
Acute kidney failure results in metabolic acidosis, not in acute lung
injury.
◉ The nurse is providing education about the management of
respiratory failure to the family of a client who is receiving
mechanical ventilation. Which statement reflects the MOST
appropriate info that the nurse will communicate?
a) "Paralytics and sedatives help decrease the demand for oxygen."
b) "Sedation is needed so your loved one does not rip the breathing
tube out."
c) "Suctioning is important to remove organisms from the lower
airway."
,d) "We are encouraging oral and IV fluids to keep your loved one
hydrated.". Answer: a) "Paralytics and sedatives help decrease the
demand for oxygen."
*Sedation is needed more for its effects on oxygenation than to
prevent the client from ripping out the endotracheal tube.
Suctioning is performed to remove upper airway secretions and
maintain airway patency. Clients receiving mechanical ventilation
typically receive hydration by enteral tube or parenteral route and
not orally.
◉ The nurse is caring for a client with impending respiratory failure
who refuses intubation and mechanical ventilation. Which
respiratory modality does the nurse suggest to the interdisciplinary
team as an alternative to mechanical ventilation?
a) Bi-level positive airway pressure (BiPAP)
b) Non-rebreather mask with 100% oxygen
c) Positive end-expiratory pressure (PEEP)
d) Oropharyngeal airway. Answer: *a) Bi-level positive airway
pressure (BiPAP)
* this type of ventilation provides noninvasive pressure support
ventilation by nasal mask or facemask rather than by endotracheal
intubation. Generally, it used for clients with sleep apnea but can
also be used for clients with respiratory muscle fatigue or
, impending respiratory failure to avoid more invasive ventilation
methods; this may provide short-term relief of an acute problem.
*A non-rebreather mask will assist with oxygenation; however,
muscle fatigue and hypoventilation may occur as causes of
respiratory failure. The need for PEEP indicates a severe gas-
exchange problem. This modality is "dialed in" on the mechanical
ventilator.
◉ The nurse is assessing a client with possible pulmonary embolism
(PE). For which symptoms consistent with PE will the nurse assess?
(Select all that apply.)
a) Inspiratory chest pain
b) Pink, frothy sputum
c) Tachycardia
d) Shortness of breath (SOB) worsening over the last 2 weeks
e) Dizziness and syncope
f) Productive cough. Answer: a) Inspiratory chest pain
c) Tachycardia
e) Dizziness and syncope
*s/s of PE include SOB, dyspnea, dizziness, syncope, hypotension,
fainting, hemoptysis, tachycardia, dry cough, and sharp pleuritic,
inspiratory chest pain that develop abruptly rather than gradually
over two weeks.
