ATI RN Targeted Medical-
Surgical Respiratory Practice
Exam 2026–2027| Complete
Test Prep Practice Questions
With Answers & Detailed
Rationales |clinical Judgment
&Safety |A+ Rated
1. A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which finding should the nurse expect?
A. Increased anteroposterior chest diameter
B. Bradycardia
C. Frothy pink sputum
D. Peripheral cyanosis only
Answer: A. Increased anteroposterior chest diameter
Rationale: Chronic hyperinflation associated with COPD can produce
a barrel-shaped chest with an increased anteroposterior diameter.
2. A nurse is caring for a client experiencing an acute asthma
exacerbation. Which medication should the nurse expect to
administer first?
,A. Montelukast
B. Albuterol
C. Fluticasone
D. Salmeterol
Answer: B. Albuterol
Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that
rapidly relaxes bronchial smooth muscle during acute bronchospasm.
3. A nurse is assessing a client with pneumonia. Which finding is
most concerning?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Respiratory rate of 32/min
D. Fatigue
Answer: C. Respiratory rate of 32/min
Rationale: Marked tachypnea can indicate significant respiratory
compromise and requires prompt evaluation.
4. A client with COPD is receiving oxygen at 2 L/min via nasal
cannula. Which finding requires immediate intervention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing somnolence and confusion
D. Mild dyspnea with activity
Answer: C. Increasing somnolence and confusion
Rationale: Increasing somnolence and confusion can indicate
worsening hypercapnia or respiratory failure and require immediate
assessment.
,5. A nurse is teaching a client who has COPD about pursed-lip
breathing. Which instruction should the nurse provide?
A. Inhale through pursed lips and exhale through the nose.
B. Inhale through the nose and exhale slowly through pursed lips.
C. Take rapid shallow breaths.
D. Hold the breath for 10 seconds before exhaling.
Answer: B. Inhale through the nose and exhale slowly through
pursed lips.
Rationale: Pursed-lip breathing prolongs exhalation and helps
prevent premature airway closure and air trapping.
6. A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which finding indicates an expected
response?
A. Continuous bubbling in the water-seal chamber
B. Tidaling in the water-seal chamber
C. Absence of drainage immediately after insertion
D. Clamping the tube routinely
Answer: B. Tidaling in the water-seal chamber
Rationale: Tidaling reflects pressure changes within the pleural space
and can be expected with a functioning chest tube.
7. A client has a chest tube and suddenly develops severe dyspnea,
tracheal deviation, and hypotension. Which complication should
the nurse suspect?
A. Atelectasis
B. Tension pneumothorax
, C. Pleural effusion
D. Pulmonary fibrosis
Answer: B. Tension pneumothorax
Rationale: Sudden respiratory distress, hypotension, and tracheal
deviation are classic manifestations of tension pneumothorax, a life-
threatening emergency.
8. A nurse is caring for a client after a thoracentesis. Which finding
should the nurse report immediately?
A. Mild soreness at the puncture site
B. Respiratory rate of 18/min
C. Sudden dyspnea and decreased breath sounds
D. Small dressing over the puncture site
Answer: C. Sudden dyspnea and decreased breath sounds
Rationale: These findings can indicate a pneumothorax, a potential
complication of thoracentesis.
9. Which position should a nurse place a client in to promote lung
expansion during an acute respiratory exacerbation?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone with the head flat
Answer: B. High-Fowler's
Rationale: Upright positioning improves diaphragmatic excursion and
maximizes lung expansion.
Surgical Respiratory Practice
Exam 2026–2027| Complete
Test Prep Practice Questions
With Answers & Detailed
Rationales |clinical Judgment
&Safety |A+ Rated
1. A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which finding should the nurse expect?
A. Increased anteroposterior chest diameter
B. Bradycardia
C. Frothy pink sputum
D. Peripheral cyanosis only
Answer: A. Increased anteroposterior chest diameter
Rationale: Chronic hyperinflation associated with COPD can produce
a barrel-shaped chest with an increased anteroposterior diameter.
2. A nurse is caring for a client experiencing an acute asthma
exacerbation. Which medication should the nurse expect to
administer first?
,A. Montelukast
B. Albuterol
C. Fluticasone
D. Salmeterol
Answer: B. Albuterol
Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that
rapidly relaxes bronchial smooth muscle during acute bronchospasm.
3. A nurse is assessing a client with pneumonia. Which finding is
most concerning?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Respiratory rate of 32/min
D. Fatigue
Answer: C. Respiratory rate of 32/min
Rationale: Marked tachypnea can indicate significant respiratory
compromise and requires prompt evaluation.
4. A client with COPD is receiving oxygen at 2 L/min via nasal
cannula. Which finding requires immediate intervention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing somnolence and confusion
D. Mild dyspnea with activity
Answer: C. Increasing somnolence and confusion
Rationale: Increasing somnolence and confusion can indicate
worsening hypercapnia or respiratory failure and require immediate
assessment.
,5. A nurse is teaching a client who has COPD about pursed-lip
breathing. Which instruction should the nurse provide?
A. Inhale through pursed lips and exhale through the nose.
B. Inhale through the nose and exhale slowly through pursed lips.
C. Take rapid shallow breaths.
D. Hold the breath for 10 seconds before exhaling.
Answer: B. Inhale through the nose and exhale slowly through
pursed lips.
Rationale: Pursed-lip breathing prolongs exhalation and helps
prevent premature airway closure and air trapping.
6. A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which finding indicates an expected
response?
A. Continuous bubbling in the water-seal chamber
B. Tidaling in the water-seal chamber
C. Absence of drainage immediately after insertion
D. Clamping the tube routinely
Answer: B. Tidaling in the water-seal chamber
Rationale: Tidaling reflects pressure changes within the pleural space
and can be expected with a functioning chest tube.
7. A client has a chest tube and suddenly develops severe dyspnea,
tracheal deviation, and hypotension. Which complication should
the nurse suspect?
A. Atelectasis
B. Tension pneumothorax
, C. Pleural effusion
D. Pulmonary fibrosis
Answer: B. Tension pneumothorax
Rationale: Sudden respiratory distress, hypotension, and tracheal
deviation are classic manifestations of tension pneumothorax, a life-
threatening emergency.
8. A nurse is caring for a client after a thoracentesis. Which finding
should the nurse report immediately?
A. Mild soreness at the puncture site
B. Respiratory rate of 18/min
C. Sudden dyspnea and decreased breath sounds
D. Small dressing over the puncture site
Answer: C. Sudden dyspnea and decreased breath sounds
Rationale: These findings can indicate a pneumothorax, a potential
complication of thoracentesis.
9. Which position should a nurse place a client in to promote lung
expansion during an acute respiratory exacerbation?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone with the head flat
Answer: B. High-Fowler's
Rationale: Upright positioning improves diaphragmatic excursion and
maximizes lung expansion.
