ATI Medical-Surgical Nursing Respiratory 200 NCLEX-Style Questions with Rationales Based on Lewis's Med-Surg Nursing 11th Edition

1. The primary function of the respiratory system is to: A) Remove carbon dioxide from the blood B) Transport oxygen to body tissues C) Maintain acid-base balance through kidney function D) Regulate cardiac output Answer: A Rationale: The respiratory system’s main function is gas exchange—removing carbon dioxide from the blood and supplying oxygen to the body. ________________________________________ 2. During a respiratory assessment, the nurse notes a patient’s respiratory rate is 10 breaths per minute. This is considered: A) Normal B) Bradypnea C) Tachypnea D) Apnea Answer: B Rationale: Bradypnea is a slower than normal respiratory rate (<12 breaths/min). Normal adult respiratory rate is 12–20 breaths/min. ________________________________________ 3. The diaphragm’s movement during inspiration causes: A) Increased thoracic pressure B) Decreased thoracic volume C) Increased thoracic volume D) Passive expiration Answer: C Rationale: The diaphragm contracts and moves downward during inspiration, increasing thoracic cavity volume and decreasing pressure, allowing air to enter the lungs. ________________________________________ 4. Which structure prevents food from entering the trachea during swallowing? A) Epiglottis B) Larynx C) Pharynx D) Bronchi Answer: A Rationale: The epiglottis acts as a flap that covers the trachea during swallowing to prevent aspiration. ________________________________________ 5. Which of the following is the best method for assessing a patient’s oxygenation status? A) Pulse oximetry B) Arterial blood gases (ABGs) C) Capillary refill D) Respiratory rate Answer: B Rationale: ABGs provide the most accurate measurement of oxygenation, ventilation, and acid-base balance. ________________________________________ 6. What does the P wave represent on an electrocardiogram (ECG)? A) Ventricular depolarization B) Atrial depolarization C) Ventricular repolarization D) Atrial repolarization Answer: B Rationale: The P wave represents atrial depolarization. (Note: This is cardiac, but related to ECG, sometimes part of diagnostics.) ________________________________________ 7. Which diagnostic test involves the insertion of a flexible tube into the bronchi to visualize airways and collect specimens? A) Thoracentesis B) Bronchoscopy C) Pulmonary function test D) Chest X-ray Answer: B Rationale: Bronchoscopy allows direct visualization of the tracheobronchial tree and collection of biopsy or sputum samples. ________________________________________ 8. Which lung sound is described as high-pitched, musical, and heard primarily during expiration? A) Crackles B) Rhonchi C) Wheezes D) Pleural friction rub Answer: C Rationale: Wheezes are high-pitched, musical sounds often caused by narrowed airways and heard during expiration. ________________________________________ 9. The nurse is preparing a patient for a pulmonary function test. Which instruction is most appropriate? A) “Avoid eating 8 hours before the test.” B) “Do not use your bronchodilator inhaler before the test.” C) “You will be asked to breathe into a machine through a mouthpiece.” D) “You will need to lie flat during the test.” Answer: C Rationale: Pulmonary function tests require breathing into a machine to measure lung volumes and airflow. ________________________________________ 10. A sputum culture is ordered to diagnose: A) Viral pneumonia B) Bacterial infection C) Pulmonary embolism D) Bronchospasm Answer: B Rationale: Sputum cultures identify bacterial pathogens causing respiratory infections. ________________________________________ 11. The nurse assesses for tactile fremitus by: A) Placing a stethoscope on the chest B) Placing hands on the patient’s chest and asking them to say “99” C) Percussing the chest D) Observing chest expansion Answer: B Rationale: Tactile fremitus is assessed by placing hands on the chest while the patient repeats “99,” detecting vibrations. ________________________________________ 12. Which of the following ABG values indicates respiratory acidosis? A) pH 7.50, PaCO2 30 mmHg B) pH 7.30, PaCO2 50 mmHg C) pH 7.40, PaCO2 40 mmHg D) pH 7.48, PaCO2 35 mmHg Answer: B Rationale: Respiratory acidosis is indicated by low pH (<7.35) and elevated PaCO2 (>45 mmHg). ________________________________________ 13. What is the normal range for oxygen saturation (SpO2) in a healthy adult? A) 75–85% B) 85–90% C) 95–100% D) 100–105% Answer: C Rationale: Normal oxygen saturation in healthy individuals is 95%–100%. ________________________________________ 14. Which of the following is a contraindication for performing a thoracentesis? A) Pleural effusion B) Coagulopathy or bleeding disorder C) Pneumonia D) Lung cancer Answer: B Rationale: Coagulopathy increases the risk of bleeding and is a contraindication for thoracentesis. ________________________________________ 15. The nurse auscultates crackles in the lower lobes. This finding suggests: A) Airway obstruction B) Fluid in alveoli C) Pleural friction D) Bronchospasm Answer: B Rationale: Crackles are caused by fluid in the alveoli and are commonly heard in pneumonia or heart failure. ________________________________________ 16. The function of surfactant in the lungs is to: A) Protect against infection B) Reduce surface tension in alveoli C) Facilitate oxygen transport D) Stimulate cilia movement Answer: B Rationale: Surfactant reduces surface tension in alveoli, preventing collapse during exhalation. ________________________________________