FINAL EXAM
(RESPIRATORY/CARDIAC)
QUESTIONS AND ANSWERS
UPDATED (2025/2026)
(VERIFIED ANSWERS)
Asthma PFT diagnosis - ANS ✓Greater than 20% difference in morning and
afternoon tests indicate a diagnosis of asthma.
Cor Pulmonale - ANS ✓Right sided heart failure in relation to COPD
complication.
Hypoxia
Fatigue
Enlarged liver
Distended neck veins
Dependent edema
COPD ABGs - ANS ✓pH ↓
PaO2 ↓
PaCO2⬆
HCO3 ⬆
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,COPD O2 Saturation Goal - ANS ✓COPD patients should maintain an O2 of at
least 88%
Normal patients should be 95%-100%
O2 Therapy for COPD - ANS ✓Keep on the lowest setting possible.
Do not have clients with COPD at 100% saturation, this will knock out their
respiratory drive!
Should RARELY exceed 4L on NC.
COPD (Patient Education) - ANS ✓Teach deep breathing techniques and
diaphragmatic breathing.
Educate patient on O2 safety in the home.
- Watch for frayed wires
- Do not smoke near oxygen tank
- Keep oxygen tank away from extreme heat. (Ovens, heaters, etc.)
Receive flu vaccinations to avoid respiratory infection complications.
A client admitted to the hospital has these arterial blood gas (ABG) results:
pH 7.50; PaCO 2 PaCO2 40; HCO − 3 HCO3− 29. Which question should the
nurse ask the client to help determine an etiology for these results?
a. "Have you had diarrhea lately?"
b. "Do you have a history of COPD?"
c. "How long have you had nausea and vomiting?"
d. "Do you smoke?" - ANS ✓Answer: C; ABG results reflect elevated pH,
indicating alkalosis, and normal PaCO 2 PaCO2 and an increased HCO − 3 ,
HCO3−, indicating metabolic alkalosis. Vomiting is a common cause of this
condition. The presence of diarrhea is associated with metabolic acidosis. COPD
is associated with respiratory acidosis. Smoking can be associated with
respiratory acidosis if it leads to respiratory disease.
A client's arterial blood gas (ABG) results are pH 7.36; PaCO 2 PaCO2 50;
HCO − 3 HCO3− 28. What should these results indicate to the nurse?
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,a. Compensated respiratory acidosis
b. Compensated metabolic acidosis
c. Uncompensated metabolic acidosis
d. Uncompensated respiratory acidosis - ANS ✓Answer: A; The pH is just
within normal range, so the blood gas results are either normal or compensated.
However, the PaCO 2 PaCO2 is high, indicating a respiratory problem, and thus
the ABGs cannot be normal. The HCO − 3 HCO3− is also high, which along with a
normal pH indicates complete compensation. The metabolic acidosis options
(compensated or uncompensated) are incorrect because the primary disturbance
is respiratory, as reflected by the correlation between an elevated PaCO 2 PaCO2
and a pH toward the low end of normal. Uncompensated respiratory acidosis is
incorrect because the HCO − 3 HCO3− level would be normal if no compensation
is taking place.
A client asks the nurse why beclomethasone was prescribed for his chronic
obstructive pulmonary disease (COPD). Which statement by the nurse is
most appropriate?
a. "Beclomethasone prevents airway dilation."
b. "Beclomethasone decreases inflammation, and makes it easier to
breathe."
c. "Beclomethasone suppresses the immune response."
d. "Beclomethasone decreases responsiveness to medications that dilate
the airway." - ANS ✓Answer: B; Beclomethasone is an inhaled corticosteroid
that is thought to decrease inflammation and dilate the airway. Preventing
airway dilation is undesirable for this client, and the exact opposite action of
beclomethasone. The exact mechanism of action is unknown. Beclomethasone,
like any other corticosteroid, does suppress the immune response, but this is not
the rationale for administration of the medication. Inhaled corticosteroids are
thought to increase responsiveness of bronchial smooth muscle to beta-agonist
drugs.
What should the nurse include when teaching health maintenance
strategies to the client with COPD? Select all that apply.
a. Yearly influenza immunizations
b. Immunization against pneumonia
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, c. Limitation of physical activity
d. Oral fluid restriction
e. Adequate caloric intake - ANS ✓Answer: A, B, E; Clients with COPD are highly
susceptible to respiratory infections such as influenza, so they should be
immunized yearly. Clients with COPD are highly susceptible to respiratory
infections such as pneumonia so they should be immunized as prescribed by
their healthcare provider. Clients with COPD use a large amount of calories
because of labored respiratory function; increased caloric intake is necessary to
maintain a healthy weight. Clients with COPD should undergo a progressive
rehabilitation program to increase their activity tolerance. Fluid restriction is not
needed with COPD unless there is fluid retention from another etiology.
Pnuemonia - ANS ✓Infection of lungs that results in fluid build up in alveoli.
Result of virus, bacteria, fungi, parasites, or chemical agents.
- Culture before treating so we know how to treat.
Pneumonia (S/S) - ANS ✓Chest pain*
Tachypnea
Hemoptysis
Sputum production
Crackles
Fever
Chills
Cough
CAP, HAP, and VAP?
- What are they?
Hint: Related to pneumonia acquisition. - ANS ✓Community Acquired
Pneumonia
Hospital Acquired Pneumonia
Ventilator Acquired Pneumonia
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