NCLEX Respiratory System
Disorders Practice Exam 2025
(60 Questions)
,Question 1
CORRECT
Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When teaching
the patient about this drug, the nurse should explain that it may cause:
A Nasal congestion
Nervousness
C Lethargy
D Hyperkalemia
Question 1 Explanation: Albuterol may cause nervousness. The inhaled form of the drug may cause
dryness and irritation of the nose and throat, not nasal congestion; insomnia, not lethargy; and hypokalemia
(with high doses), not hyperkalemia. Otther adverse effects of albuterol include tremor, dizziness, headache,
tachycardia, palpitations, hypertension, heartburn, nausea, vomiting and muscle cramps.
Question 2
CORRECT
Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal drainage. The
nurse asks the patient about the color of the drainage. In acute rhinitis, nasal drainage normally is:
A Green
Yellow
B
D Gray
Clear
Question 2 Explanation: Normally, nasal drainage in acute rhinitis is clear. Yellow or green drainage
indicates spread of the infection to the sinuses. Gray drainage may indicate a secondary infection.
Question 3
WRONG
A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis.
Which clinical findings commonly accompany respiratory alkalosis?
Nausea or vomiting
B Abdominal pain or diarrhea
C Hallucinations or tinnitus
Lightheadedness or paresthesia
,Question 3 Explanation: The patient with respiratory alkalosis may complain of lightheadedness or
paresthesia (numbness and tingling in the arms and legs). Nausea, vomiting, abdominal pain, and diarrhea
may accompany respiratory acidosis. Hallucinations and tinnitus rare are associated with respiratory
alkalosis or any other acid-base imbalance.
Question 4
CORRECT
Before administering ephedrine, Nurse Tony assesses the patient’s history. Because of ephedrine’s central
nervous system (CNS) effects, it is not recommended for:
A Patients with an acute asthma attack
B Patients with narcolepsy
C Patients under age 6
Elderly patients
Question 4 Explanation: Ephedrine is not recommended for elderly patients, who are particularly
susceptible to CNS reactions (such as confusion and anxiety) and to cardiovascular reactions (such as
increased systolic blood pressure, coldness in the extremities, and anginal pain). Ephedrine is used for its
bronchodilator effects with acute and chronic asthma and occasionally for its CNS stimulant actions for
narcolepsy. It can be administered to children age 2 and older.
Question 5
CORRECT
A female patient suffers adult respiratory distress syndrome as a consequence of shock. The patient’s
condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When
the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause.
Which condition triggers the high-pressure alarm?
Kinking of the ventilator tubing
B A disconnected ventilator tube
C An endotracheal cuff leak
A change in the oxygen concentration without resetting the
D oxygen level alarm
Question 5 Explanation: Conditions that trigger the high-pressure alarm include kinking of the ventilator
tubing, bronchospasm or pulmonary embolus, mucus plugging, water in the tube, coughing or biting on
endotracheal tube, and the patient’s being out of breathing rhythm with the ventilator. A disconnected
ventilator tube or an endotracheal cuff leak would trigger the low-pressure alarm. Changing the oxygen
concentration without resetting the oxygen level alarm would trigger the oxygen alarm.
Question 6
CORRECT
A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V.
as needed. Which assessment finding indicates that the patient needs another pancuronium dose?
, A Leg movement
B Finger movement
C Lip movement
Fighting the ventilator
Question 6 Explanation: Pancuronium, a nondepolarizing blocking agent, is used for muscle relaxation and
paralysis. It assists mechanical ventilation by promoting encdotracheal intubation and paralyzing the patient
so that the mechanical ventilator can do its work. Fighting the ventilator is a sign that the patient needs
another pancuronium dose. The nurse should administer 0.01 to 0.02 mg/kg I.V. every 20 to 60 minutes.
Movement of the legs, or lips has no effect on the ventilator and therefore is not used to determine the need
for another dose.
Question 7
CORRECT
On auscultation, which finding suggests a right pneumothorax?
A Bilateral inspiratory and expiratory crackles
Absence of breaths sound in the right thorax
C Inspiratory wheezes in the right thorax
D Bilateral pleural friction rub
Question 7 Explanation: In pneumothorax, the alveoli are deflated and no air exchange occurs in the lungs.
Therefore, breath sounds in the affected lung field are absent. None of the other options are associated with
pneumothorax. Bilateral crackles may result from pulmonary congestion, inspiratory wheezes may signal
asthma, and a pleural friction rub may indicate pleural inflammation.
Question 8
CORRECT
Rhea, confused and short breath, is brought to the emergency department by a family member. The medical
history reveals chronic bronchitis and hypertension. To learn more about the current respiratory problem, the
doctor orders a chest x-ray and arterial blood gas (ABG) analysis. When reviewing the ABG report, the
nurses sees many abbreviations. What does a lowercase “a” in ABG value present?
A Acid-base balance
Arterial Blood
C Arterial oxygen saturation
D Alveoli
Question 8 Explanation: A lowercase “a” in an ABG value represents arterial blood. For instance, the
abbreviation PaO2 refers to the partial pressure of oxygen in arterial blood. The pH value reflects the
acid-base balance in arterial blood. Sa02 indicates arterial oxygen saturation. An uppercase “A” represents
alveolar conditions: for example, PA02 indicates the partial pressure of oxygen in the alveoli.
Disorders Practice Exam 2025
(60 Questions)
,Question 1
CORRECT
Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When teaching
the patient about this drug, the nurse should explain that it may cause:
A Nasal congestion
Nervousness
C Lethargy
D Hyperkalemia
Question 1 Explanation: Albuterol may cause nervousness. The inhaled form of the drug may cause
dryness and irritation of the nose and throat, not nasal congestion; insomnia, not lethargy; and hypokalemia
(with high doses), not hyperkalemia. Otther adverse effects of albuterol include tremor, dizziness, headache,
tachycardia, palpitations, hypertension, heartburn, nausea, vomiting and muscle cramps.
Question 2
CORRECT
Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal drainage. The
nurse asks the patient about the color of the drainage. In acute rhinitis, nasal drainage normally is:
A Green
Yellow
B
D Gray
Clear
Question 2 Explanation: Normally, nasal drainage in acute rhinitis is clear. Yellow or green drainage
indicates spread of the infection to the sinuses. Gray drainage may indicate a secondary infection.
Question 3
WRONG
A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis.
Which clinical findings commonly accompany respiratory alkalosis?
Nausea or vomiting
B Abdominal pain or diarrhea
C Hallucinations or tinnitus
Lightheadedness or paresthesia
,Question 3 Explanation: The patient with respiratory alkalosis may complain of lightheadedness or
paresthesia (numbness and tingling in the arms and legs). Nausea, vomiting, abdominal pain, and diarrhea
may accompany respiratory acidosis. Hallucinations and tinnitus rare are associated with respiratory
alkalosis or any other acid-base imbalance.
Question 4
CORRECT
Before administering ephedrine, Nurse Tony assesses the patient’s history. Because of ephedrine’s central
nervous system (CNS) effects, it is not recommended for:
A Patients with an acute asthma attack
B Patients with narcolepsy
C Patients under age 6
Elderly patients
Question 4 Explanation: Ephedrine is not recommended for elderly patients, who are particularly
susceptible to CNS reactions (such as confusion and anxiety) and to cardiovascular reactions (such as
increased systolic blood pressure, coldness in the extremities, and anginal pain). Ephedrine is used for its
bronchodilator effects with acute and chronic asthma and occasionally for its CNS stimulant actions for
narcolepsy. It can be administered to children age 2 and older.
Question 5
CORRECT
A female patient suffers adult respiratory distress syndrome as a consequence of shock. The patient’s
condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When
the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause.
Which condition triggers the high-pressure alarm?
Kinking of the ventilator tubing
B A disconnected ventilator tube
C An endotracheal cuff leak
A change in the oxygen concentration without resetting the
D oxygen level alarm
Question 5 Explanation: Conditions that trigger the high-pressure alarm include kinking of the ventilator
tubing, bronchospasm or pulmonary embolus, mucus plugging, water in the tube, coughing or biting on
endotracheal tube, and the patient’s being out of breathing rhythm with the ventilator. A disconnected
ventilator tube or an endotracheal cuff leak would trigger the low-pressure alarm. Changing the oxygen
concentration without resetting the oxygen level alarm would trigger the oxygen alarm.
Question 6
CORRECT
A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V.
as needed. Which assessment finding indicates that the patient needs another pancuronium dose?
, A Leg movement
B Finger movement
C Lip movement
Fighting the ventilator
Question 6 Explanation: Pancuronium, a nondepolarizing blocking agent, is used for muscle relaxation and
paralysis. It assists mechanical ventilation by promoting encdotracheal intubation and paralyzing the patient
so that the mechanical ventilator can do its work. Fighting the ventilator is a sign that the patient needs
another pancuronium dose. The nurse should administer 0.01 to 0.02 mg/kg I.V. every 20 to 60 minutes.
Movement of the legs, or lips has no effect on the ventilator and therefore is not used to determine the need
for another dose.
Question 7
CORRECT
On auscultation, which finding suggests a right pneumothorax?
A Bilateral inspiratory and expiratory crackles
Absence of breaths sound in the right thorax
C Inspiratory wheezes in the right thorax
D Bilateral pleural friction rub
Question 7 Explanation: In pneumothorax, the alveoli are deflated and no air exchange occurs in the lungs.
Therefore, breath sounds in the affected lung field are absent. None of the other options are associated with
pneumothorax. Bilateral crackles may result from pulmonary congestion, inspiratory wheezes may signal
asthma, and a pleural friction rub may indicate pleural inflammation.
Question 8
CORRECT
Rhea, confused and short breath, is brought to the emergency department by a family member. The medical
history reveals chronic bronchitis and hypertension. To learn more about the current respiratory problem, the
doctor orders a chest x-ray and arterial blood gas (ABG) analysis. When reviewing the ABG report, the
nurses sees many abbreviations. What does a lowercase “a” in ABG value present?
A Acid-base balance
Arterial Blood
C Arterial oxygen saturation
D Alveoli
Question 8 Explanation: A lowercase “a” in an ABG value represents arterial blood. For instance, the
abbreviation PaO2 refers to the partial pressure of oxygen in arterial blood. The pH value reflects the
acid-base balance in arterial blood. Sa02 indicates arterial oxygen saturation. An uppercase “A” represents
alveolar conditions: for example, PA02 indicates the partial pressure of oxygen in the alveoli.
