ATI MED SURG I RESPIRATORY
ALTERATIONS STUDY GUIDE
PRACTICE QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
1. Respiratory Assessment & Diagnostic Findings
2. Obstructive Pulmonary Disorders (COPD, Asthma)
3. Infectious & Inflammatory Respiratory Disorders (Pneumonia, TB)
4. Vascular & Pleural Disorders (PE, Pneumothorax, Chest Tubes)
5. Acid-Base Balance & Arterial Blood Gases
6. Oxygenation & Mechanical Ventilation
7. Respiratory Pharmacology & Inhaler Technique
8. Airway Management & Suctioning
9. Patient Education & Health Promotion
10. Clinical Judgment & Prioritization
Introduction
The ATI Medical-Surgical Respiratory Alterations Study Guide Examination
assesses a nursing student's mastery of respiratory system disorders and
evidence-based nursing interventions. The exam evaluates competence in
assessing oxygenation and ventilation, interpreting arterial blood gases,
managing COPD, asthma, pneumonia, and pulmonary embolism, and safely
administering respiratory medications and oxygen therapy. Questions
,emphasize clinical judgment, prioritization, patient education, and real-world
decision-making. The examination combines multiple-choice questions with
detailed rationales, ensuring candidates can apply respiratory assessment
findings, analyze ABG results, and implement safe, competent nursing care for
clients with acute and chronic respiratory conditions.
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a client with COPD. Which finding should the
nurse expect?
A. Decreased anterior-posterior chest diameter
B. Increased residual volume
C. Increased PaO2
D. Normal breath sounds
B. Increased residual volume
RATIONALE: COPD causes air trapping due to loss of lung elasticity and
airway collapse, leading to an increase in residual volume. Clients also
develop a barrel chest (increased AP diameter), decreased PaO2, and
diminished breath sounds.
2. A nurse is caring for a client with chronic obstructive pulmonary
disease who is experiencing increased dyspnea. Which assessment
finding should the nurse recognize as the priority to report to the
provider?
A. Oxygen saturation of 91% on room air
B. Productive cough with yellow-green sputum
C. Use of accessory muscles during inspiration
,D. Respiratory rate of 24 breaths per minute
B. Productive cough with yellow-green sputum
RATIONALE: A productive cough with yellow-green sputum indicates a
possible respiratory infection, which can exacerbate COPD and lead to
respiratory failure. This requires prompt provider notification for potential
antibiotic therapy.
3. A nurse is preparing to administer albuterol via metered-dose
inhaler to a client with asthma. Which instruction should the nurse
include to ensure optimal medication delivery?
A. Inhale rapidly and deeply while activating the inhaler
B. Hold breath for 10 seconds after inhaling the medication
C. Rinse mouth with water immediately before using the inhaler
D. Use the inhaler only when experiencing severe shortness of breath
B. Hold breath for 10 seconds after inhaling the medication
RATIONALE: Holding the breath for 5-10 seconds after inhaling a
bronchodilator allows the medication to deposit in the airways and improves
absorption. Rapid inhalation causes the medication to impact the oropharynx
rather than reaching the lungs.
4. A nurse is assessing a client who is 2 hours postoperative following a
thoracentesis. Which finding should the nurse identify as indicative of
a pneumothorax?
A. Decreased breath sounds on the affected side
B. Mild pain at the insertion site rated 3/10
C. Small amount of serosanguineous drainage on dressing
, D. Temperature of 37.8°C (100°F)
A. Decreased breath sounds on the affected side
RATIONALE: Decreased or absent breath sounds on the affected side
following thoracentesis is a classic sign of pneumothorax, a potential
complication of the procedure. Pneumothorax requires immediate
intervention, such as chest tube insertion.
5. A nurse is developing a teaching plan for a client newly diagnosed
with tuberculosis. Which statement by the client indicates
understanding of infection control measures?
A. "I will wear a surgical mask when visitors come to my room."
B. "I can return to work after 1 week of treatment."
C. "I need to stay in my room until three sputum cultures are negative."
D. "I should cover my mouth with my hand when I cough."
C. "I need to stay in my room until three sputum cultures are negative."
RATIONALE: Clients with active TB remain infectious until three
consecutive sputum cultures are negative. Airborne precautions (N95 mask,
negative-pressure room) are required. A surgical mask is not adequate
protection for visitors.
6. A nurse reviews ABG results: pH 7.30, PaCO2 55 mm Hg, HCO3- 24
mEq/L. Which condition does this represent?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
ALTERATIONS STUDY GUIDE
PRACTICE QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
1. Respiratory Assessment & Diagnostic Findings
2. Obstructive Pulmonary Disorders (COPD, Asthma)
3. Infectious & Inflammatory Respiratory Disorders (Pneumonia, TB)
4. Vascular & Pleural Disorders (PE, Pneumothorax, Chest Tubes)
5. Acid-Base Balance & Arterial Blood Gases
6. Oxygenation & Mechanical Ventilation
7. Respiratory Pharmacology & Inhaler Technique
8. Airway Management & Suctioning
9. Patient Education & Health Promotion
10. Clinical Judgment & Prioritization
Introduction
The ATI Medical-Surgical Respiratory Alterations Study Guide Examination
assesses a nursing student's mastery of respiratory system disorders and
evidence-based nursing interventions. The exam evaluates competence in
assessing oxygenation and ventilation, interpreting arterial blood gases,
managing COPD, asthma, pneumonia, and pulmonary embolism, and safely
administering respiratory medications and oxygen therapy. Questions
,emphasize clinical judgment, prioritization, patient education, and real-world
decision-making. The examination combines multiple-choice questions with
detailed rationales, ensuring candidates can apply respiratory assessment
findings, analyze ABG results, and implement safe, competent nursing care for
clients with acute and chronic respiratory conditions.
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a client with COPD. Which finding should the
nurse expect?
A. Decreased anterior-posterior chest diameter
B. Increased residual volume
C. Increased PaO2
D. Normal breath sounds
B. Increased residual volume
RATIONALE: COPD causes air trapping due to loss of lung elasticity and
airway collapse, leading to an increase in residual volume. Clients also
develop a barrel chest (increased AP diameter), decreased PaO2, and
diminished breath sounds.
2. A nurse is caring for a client with chronic obstructive pulmonary
disease who is experiencing increased dyspnea. Which assessment
finding should the nurse recognize as the priority to report to the
provider?
A. Oxygen saturation of 91% on room air
B. Productive cough with yellow-green sputum
C. Use of accessory muscles during inspiration
,D. Respiratory rate of 24 breaths per minute
B. Productive cough with yellow-green sputum
RATIONALE: A productive cough with yellow-green sputum indicates a
possible respiratory infection, which can exacerbate COPD and lead to
respiratory failure. This requires prompt provider notification for potential
antibiotic therapy.
3. A nurse is preparing to administer albuterol via metered-dose
inhaler to a client with asthma. Which instruction should the nurse
include to ensure optimal medication delivery?
A. Inhale rapidly and deeply while activating the inhaler
B. Hold breath for 10 seconds after inhaling the medication
C. Rinse mouth with water immediately before using the inhaler
D. Use the inhaler only when experiencing severe shortness of breath
B. Hold breath for 10 seconds after inhaling the medication
RATIONALE: Holding the breath for 5-10 seconds after inhaling a
bronchodilator allows the medication to deposit in the airways and improves
absorption. Rapid inhalation causes the medication to impact the oropharynx
rather than reaching the lungs.
4. A nurse is assessing a client who is 2 hours postoperative following a
thoracentesis. Which finding should the nurse identify as indicative of
a pneumothorax?
A. Decreased breath sounds on the affected side
B. Mild pain at the insertion site rated 3/10
C. Small amount of serosanguineous drainage on dressing
, D. Temperature of 37.8°C (100°F)
A. Decreased breath sounds on the affected side
RATIONALE: Decreased or absent breath sounds on the affected side
following thoracentesis is a classic sign of pneumothorax, a potential
complication of the procedure. Pneumothorax requires immediate
intervention, such as chest tube insertion.
5. A nurse is developing a teaching plan for a client newly diagnosed
with tuberculosis. Which statement by the client indicates
understanding of infection control measures?
A. "I will wear a surgical mask when visitors come to my room."
B. "I can return to work after 1 week of treatment."
C. "I need to stay in my room until three sputum cultures are negative."
D. "I should cover my mouth with my hand when I cough."
C. "I need to stay in my room until three sputum cultures are negative."
RATIONALE: Clients with active TB remain infectious until three
consecutive sputum cultures are negative. Airborne precautions (N95 mask,
negative-pressure room) are required. A surgical mask is not adequate
protection for visitors.
6. A nurse reviews ABG results: pH 7.30, PaCO2 55 mm Hg, HCO3- 24
mEq/L. Which condition does this represent?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
