ATI Medical-Surgical Respiratory Retake
Exam: 1000+ NGN Questions with Verified
Rationalized Answers (Updated Edition)
CHAPTER 1: RESPIRATORY ASSESSMENT &
DIAGNOSTIC PROCEDURES (Questions 1–120)
Q1. A nurse is performing a respiratory assessment on a client. Which of the
following findings should the nurse document as normal breath sounds heard
over the trachea?
A. Vesicular
B. Bronchial
C. Bronchovesicular
D. Crackles
Answer: B
Rationale: Bronchial breath sounds are loud, high-pitched, and heard over
the trachea. Vesicular sounds are heard over peripheral lung fields.
Bronchovesicular sounds are heard over the mainstem bronchi. Crackles are
abnormal adventitious sounds.
Q2. A nurse is assessing a client who reports shortness of breath. Which of
the following findings should the nurse recognize as an early sign of
hypoxemia?
A. Cyanosis
B. Restlessness
,C. Bradycardia
D. Clubbing of fingers
Answer: B
Rationale: Restlessness and confusion are early signs of hypoxemia due to
decreased oxygen to the brain. Cyanosis is a late sign. Tachycardia, not
bradycardia, occurs early. Clubbing is a chronic sign.
Q3. A nurse is preparing a client for a thoracentesis. In which position should
the nurse place the client?
A. Supine with arms raised overhead
B. Sitting upright, leaning over a bedside table
C. Left lateral decubitus with head elevated
D. Prone with arms extended
Answer: B
Rationale: For thoracentesis, the client sits upright and leans over a
bedside table to widen the intercostal spaces and allow fluid to pool at the
base of the lung for easier aspiration.
Q4. A nurse is caring for a client following a bronchoscopy. Which of the
following assessments is the priority?
A. Monitor for gag reflex return
B. Assess for hemoptysis
C. Check oxygen saturation
D. Monitor for fever
Answer: A
Rationale: The priority after bronchoscopy is assessing for the return of the
gag reflex before allowing the client to eat or drink, to prevent aspiration.
Airway is always the priority.
,Q5. A nurse is interpreting arterial blood gas (ABG) results. The results show
pH 7.30, PaCO₂ 50 mm Hg, and HCO₃⁻ 24 mEq/L. Which of the following acid-
base imbalances should the nurse identify?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: B
Rationale: pH is low (acidosis), PaCO₂ is elevated (respiratory cause), and
HCO₃⁻ is normal (no metabolic compensation yet). This indicates
uncompensated respiratory acidosis.
Q6. A nurse is performing a respiratory assessment. Which of the following
findings should the nurse recognize as increased tactile fremitus?
A. Pneumothorax
B. Pleural effusion
C. Pneumonia
D. Emphysema
Answer: C
Rationale: Increased tactile fremitus occurs with consolidation (pneumonia)
because solid tissue transmits sound vibrations better than air-filled tissue.
Fremitus is decreased in pneumothorax, pleural effusion, and emphysema.
Q7. A nurse is assessing a client who has a chest tube in place. Which of the
following findings indicates a need for immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber
C. Serosanguineous drainage in the collection chamber
D. Clots in the tubing
, Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air
leak in the system, which requires immediate intervention. Tidaling is
expected. Clots in tubing should be monitored but are not immediately life-
threatening.
Q8. A nurse is teaching a client about pulse oximetry. Which of the following
factors should the nurse identify as a potential cause of an inaccurate
reading?
A. Client is wearing nail polish
B. Client is lying supine
C. Client has a fever
D. Client has dark skin
Answer: A
Rationale: Nail polish (especially dark colors) can interfere with light
transmission and cause inaccurate pulse oximetry readings. Other factors
include motion, poor perfusion, and bright ambient light.
Q9. A nurse is performing a respiratory assessment. Which of the following
findings should the nurse document as a normal finding?
A. Resonance on percussion
B. Dullness on percussion
C. Hyperresonance on percussion
D. Flatness on percussion
Answer: A
Rationale: Resonance is the normal percussion tone over healthy lung
tissue. Dullness indicates consolidation or fluid. Hyperresonance indicates
hyperinflation (COPD, pneumothorax). Flatness indicates large amounts of
fluid or solid tissue.
Exam: 1000+ NGN Questions with Verified
Rationalized Answers (Updated Edition)
CHAPTER 1: RESPIRATORY ASSESSMENT &
DIAGNOSTIC PROCEDURES (Questions 1–120)
Q1. A nurse is performing a respiratory assessment on a client. Which of the
following findings should the nurse document as normal breath sounds heard
over the trachea?
A. Vesicular
B. Bronchial
C. Bronchovesicular
D. Crackles
Answer: B
Rationale: Bronchial breath sounds are loud, high-pitched, and heard over
the trachea. Vesicular sounds are heard over peripheral lung fields.
Bronchovesicular sounds are heard over the mainstem bronchi. Crackles are
abnormal adventitious sounds.
Q2. A nurse is assessing a client who reports shortness of breath. Which of
the following findings should the nurse recognize as an early sign of
hypoxemia?
A. Cyanosis
B. Restlessness
,C. Bradycardia
D. Clubbing of fingers
Answer: B
Rationale: Restlessness and confusion are early signs of hypoxemia due to
decreased oxygen to the brain. Cyanosis is a late sign. Tachycardia, not
bradycardia, occurs early. Clubbing is a chronic sign.
Q3. A nurse is preparing a client for a thoracentesis. In which position should
the nurse place the client?
A. Supine with arms raised overhead
B. Sitting upright, leaning over a bedside table
C. Left lateral decubitus with head elevated
D. Prone with arms extended
Answer: B
Rationale: For thoracentesis, the client sits upright and leans over a
bedside table to widen the intercostal spaces and allow fluid to pool at the
base of the lung for easier aspiration.
Q4. A nurse is caring for a client following a bronchoscopy. Which of the
following assessments is the priority?
A. Monitor for gag reflex return
B. Assess for hemoptysis
C. Check oxygen saturation
D. Monitor for fever
Answer: A
Rationale: The priority after bronchoscopy is assessing for the return of the
gag reflex before allowing the client to eat or drink, to prevent aspiration.
Airway is always the priority.
,Q5. A nurse is interpreting arterial blood gas (ABG) results. The results show
pH 7.30, PaCO₂ 50 mm Hg, and HCO₃⁻ 24 mEq/L. Which of the following acid-
base imbalances should the nurse identify?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: B
Rationale: pH is low (acidosis), PaCO₂ is elevated (respiratory cause), and
HCO₃⁻ is normal (no metabolic compensation yet). This indicates
uncompensated respiratory acidosis.
Q6. A nurse is performing a respiratory assessment. Which of the following
findings should the nurse recognize as increased tactile fremitus?
A. Pneumothorax
B. Pleural effusion
C. Pneumonia
D. Emphysema
Answer: C
Rationale: Increased tactile fremitus occurs with consolidation (pneumonia)
because solid tissue transmits sound vibrations better than air-filled tissue.
Fremitus is decreased in pneumothorax, pleural effusion, and emphysema.
Q7. A nurse is assessing a client who has a chest tube in place. Which of the
following findings indicates a need for immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Tidaling in the water seal chamber
C. Serosanguineous drainage in the collection chamber
D. Clots in the tubing
, Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air
leak in the system, which requires immediate intervention. Tidaling is
expected. Clots in tubing should be monitored but are not immediately life-
threatening.
Q8. A nurse is teaching a client about pulse oximetry. Which of the following
factors should the nurse identify as a potential cause of an inaccurate
reading?
A. Client is wearing nail polish
B. Client is lying supine
C. Client has a fever
D. Client has dark skin
Answer: A
Rationale: Nail polish (especially dark colors) can interfere with light
transmission and cause inaccurate pulse oximetry readings. Other factors
include motion, poor perfusion, and bright ambient light.
Q9. A nurse is performing a respiratory assessment. Which of the following
findings should the nurse document as a normal finding?
A. Resonance on percussion
B. Dullness on percussion
C. Hyperresonance on percussion
D. Flatness on percussion
Answer: A
Rationale: Resonance is the normal percussion tone over healthy lung
tissue. Dullness indicates consolidation or fluid. Hyperresonance indicates
hyperinflation (COPD, pneumothorax). Flatness indicates large amounts of
fluid or solid tissue.
