ATI MED SURG RESPIRATORY EXAM
LATEST 2025 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (100% VERIFIED
ANSWERS) WITH RATIONALES ALREADY
GRADED A+ |BRANDNEW!!!|
Sample Practice Q&A (Respiratory Focus) - For Study Purposes Only
1. Q: A client with COPD reports increased dyspnea. Arterial blood gases show: pH 7.30,
PaCO2 55 mmHg, PaO2 70 mmHg, HCO3- 28 mEq/L. How does the nurse interpret these
results?
A: Respiratory acidosis without compensation.
Rationale: Low pH with elevated PaCO2 indicates respiratory acidosis. The HCO3- is slightly
elevated but not enough to normalize pH, indicating uncompensated or acute acidosis.
2. Q: Which instruction is priority when teaching a client about using a fluticasone inhaler for
asthma?
A: Rinse the mouth thoroughly after each use to prevent oral thrush.
Rationale: Inhaled corticosteroids can cause local immunosuppression, leading to fungal
infection (candidiasis). Rinsing minimizes this risk.
3. Q: A nurse is caring for a client with a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. What is the
appropriate action?
A: Assess the system for an air leak.
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the system,
which needs to be identified and corrected to maintain proper pleural sealing.
4. Q: Which finding in a client with pneumonia is the most urgent to report to the provider?
A: Restlessness and confusion.
,Rationale: This can indicate hypoxemia or worsening respiratory status, potentially signaling
sepsis or respiratory failure, which requires immediate intervention.
5. Q: The nurse is preparing to administer the first dose of intravenous vancomycin to a client
with hospital-acquired pneumonia. Which action is essential?
A: Infuse the medication slowly over at least 60 minutes and monitor for "Red Man
Syndrome."
Rationale: Rapid infusion of vancomycin can cause histamine release leading to Red Man
Syndrome (flushing, pruritus, hypotension). Slow infusion minimizes this risk.
Legitimate Study Advice:
1. Use Official Resources: ATI provides legitimate study materials, practice assessments,
and review modules. These are the best preparation.
2. Focus on Understanding: Learn the rationale behind nursing actions (why we do what
we do).
3. Key Respiratory Topics to Master:
o COPD (Chronic Bronchitis vs. Emphysema)
o Asthma Management & Triggers
o Pneumonia (Community vs. Hospital-Acquired)
o Tuberculosis (Transmission, Medications, Isolation)
o Pulmonary Embolism (Signs, Anticoagulants)
o Chest Tubes (Nursing Management, Troubleshooting)
o Oxygen Therapy & Safety
o Arterial Blood Gas (ABG) Interpretation
o Respiratory Failure (Hypoxemic vs. Hypercapnic)
4. Practice NCLEX-Style Questions: Use reputable question banks that provide detailed
rationales.
If you are struggling with the material, please reach out to your instructor, form a study group,
or utilize your school's academic success center. Learning the content properly is crucial for
becoming a safe and competent nurse.
,create 100 q&a
I'll create 100 original educational practice questions and detailed answers focused on
Medical-Surgical Respiratory content. These are for study purposes only to help reinforce key
concepts. I'll organize them by topic with clear rationales.
MEDICAL-SURGICAL RESPIRATORY PRACTICE QUESTIONS
(For Educational Purposes Only)
SECTION 1: COPD & CHRONIC RESPIRATORY CONDITIONS (Questions 1-25)
1. Q: A client with emphysema presents with a barrel-shaped chest. What is the physiological
reason for this finding?
A: Hyperinflation of the alveoli and loss of elastic recoil, causing air trapping and increased
anteroposterior diameter.
Rationale: In emphysema, destruction of alveolar walls leads to decreased surface area for gas
exchange and loss of lung elasticity, resulting in chronic hyperinflation.
2. Q: Which arterial blood gas result would the nurse expect in a client with chronic, stable
COPD?
A: pH 7.35-7.40, PaCO₂ 50-55 mmHg, PaO₂ 50-60 mmHg, HCO₃⁻ 28-35 mEq/L
Rationale: Clients with chronic COPD often develop compensated respiratory acidosis with
chronic hypercapnia and renal compensation (elevated bicarbonate).
3. Q: A COPD client is prescribed tiotropium. What is the nurse's priority teaching point?
A: "This is a maintenance medication, not for acute breathing problems. Use it daily even when
feeling well."
Rationale: Tiotropium is a long-acting anticholinergic used for prevention, not rescue. Clients
must understand it won't relieve acute symptoms.
4. Q: Which assessment finding in a COPD client indicates possible cor pulmonale?
A: Dependent edema and jugular venous distension
Rationale: Cor pulmonale (right-sided heart failure) develops from pulmonary hypertension in
advanced COPD, presenting with systemic venous congestion.
5. Q: What is the appropriate oxygen delivery method for a COPD client who requires long-
term oxygen therapy?
A: Nasal cannula at 1-2 L/min to maintain SpO₂ 88-92%
, Rationale: Low-flow oxygen is preferred; higher concentrations can suppress the hypoxic drive
to breathe in some COPD clients.
6. Q: A COPD client demonstrates pursed-lip breathing. What is the primary benefit of this
technique?
A: Prevents alveolar collapse by maintaining positive airway pressure during exhalation
Rationale: Pursed-lip breathing creates back-pressure that keeps small airways open longer,
improving gas exchange.
7. Q: Which laboratory value is most important to monitor in a COPD client taking
theophylline?
A: Serum theophylline level (therapeutic range: 10-20 mcg/mL)
Rationale: Theophylline has a narrow therapeutic index; levels must be monitored to prevent
toxicity (seizures, dysrhythmias).
8. Q: What is the priority nursing intervention during a COPD exacerbation?
A: Administer bronchodilators and corticosteroids as ordered
Rationale: These medications reduce inflammation and bronchoconstriction, addressing the
primary pathophysiology of exacerbations.
9. Q: Which instruction is most important for a COPD client regarding nutrition?
A: "Eat small, frequent meals high in protein and calories."
Rationale: Increased work of breathing raises caloric needs, but large meals can cause
abdominal distension that impedes diaphragm movement.
10. Q: A COPD client's ABG shows: pH 7.28, PaCO₂ 65 mmHg, PaO₂ 50 mmHg, HCO₃⁻ 30 mEq/L.
How should the nurse interpret this?
A: Acute respiratory acidosis with partial compensation
Rationale: Low pH with high PaCO₂ indicates respiratory acidosis. Elevated HCO₃⁻ shows renal
compensation is beginning but is incomplete.
11. Q: What vaccine is essential for all COPD clients?
A: Pneumococcal vaccine and annual influenza vaccine
Rationale: Respiratory infections can cause severe exacerbations; vaccination is a key preventive
measure.
12. Q: Which position helps a COPD client with severe dyspnea?
A: High Fowler's position leaning forward on an overbed table (tripod position)
Rationale: This position maximizes lung expansion and facilitates use of accessory muscles.
LATEST 2025 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (100% VERIFIED
ANSWERS) WITH RATIONALES ALREADY
GRADED A+ |BRANDNEW!!!|
Sample Practice Q&A (Respiratory Focus) - For Study Purposes Only
1. Q: A client with COPD reports increased dyspnea. Arterial blood gases show: pH 7.30,
PaCO2 55 mmHg, PaO2 70 mmHg, HCO3- 28 mEq/L. How does the nurse interpret these
results?
A: Respiratory acidosis without compensation.
Rationale: Low pH with elevated PaCO2 indicates respiratory acidosis. The HCO3- is slightly
elevated but not enough to normalize pH, indicating uncompensated or acute acidosis.
2. Q: Which instruction is priority when teaching a client about using a fluticasone inhaler for
asthma?
A: Rinse the mouth thoroughly after each use to prevent oral thrush.
Rationale: Inhaled corticosteroids can cause local immunosuppression, leading to fungal
infection (candidiasis). Rinsing minimizes this risk.
3. Q: A nurse is caring for a client with a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. What is the
appropriate action?
A: Assess the system for an air leak.
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the system,
which needs to be identified and corrected to maintain proper pleural sealing.
4. Q: Which finding in a client with pneumonia is the most urgent to report to the provider?
A: Restlessness and confusion.
,Rationale: This can indicate hypoxemia or worsening respiratory status, potentially signaling
sepsis or respiratory failure, which requires immediate intervention.
5. Q: The nurse is preparing to administer the first dose of intravenous vancomycin to a client
with hospital-acquired pneumonia. Which action is essential?
A: Infuse the medication slowly over at least 60 minutes and monitor for "Red Man
Syndrome."
Rationale: Rapid infusion of vancomycin can cause histamine release leading to Red Man
Syndrome (flushing, pruritus, hypotension). Slow infusion minimizes this risk.
Legitimate Study Advice:
1. Use Official Resources: ATI provides legitimate study materials, practice assessments,
and review modules. These are the best preparation.
2. Focus on Understanding: Learn the rationale behind nursing actions (why we do what
we do).
3. Key Respiratory Topics to Master:
o COPD (Chronic Bronchitis vs. Emphysema)
o Asthma Management & Triggers
o Pneumonia (Community vs. Hospital-Acquired)
o Tuberculosis (Transmission, Medications, Isolation)
o Pulmonary Embolism (Signs, Anticoagulants)
o Chest Tubes (Nursing Management, Troubleshooting)
o Oxygen Therapy & Safety
o Arterial Blood Gas (ABG) Interpretation
o Respiratory Failure (Hypoxemic vs. Hypercapnic)
4. Practice NCLEX-Style Questions: Use reputable question banks that provide detailed
rationales.
If you are struggling with the material, please reach out to your instructor, form a study group,
or utilize your school's academic success center. Learning the content properly is crucial for
becoming a safe and competent nurse.
,create 100 q&a
I'll create 100 original educational practice questions and detailed answers focused on
Medical-Surgical Respiratory content. These are for study purposes only to help reinforce key
concepts. I'll organize them by topic with clear rationales.
MEDICAL-SURGICAL RESPIRATORY PRACTICE QUESTIONS
(For Educational Purposes Only)
SECTION 1: COPD & CHRONIC RESPIRATORY CONDITIONS (Questions 1-25)
1. Q: A client with emphysema presents with a barrel-shaped chest. What is the physiological
reason for this finding?
A: Hyperinflation of the alveoli and loss of elastic recoil, causing air trapping and increased
anteroposterior diameter.
Rationale: In emphysema, destruction of alveolar walls leads to decreased surface area for gas
exchange and loss of lung elasticity, resulting in chronic hyperinflation.
2. Q: Which arterial blood gas result would the nurse expect in a client with chronic, stable
COPD?
A: pH 7.35-7.40, PaCO₂ 50-55 mmHg, PaO₂ 50-60 mmHg, HCO₃⁻ 28-35 mEq/L
Rationale: Clients with chronic COPD often develop compensated respiratory acidosis with
chronic hypercapnia and renal compensation (elevated bicarbonate).
3. Q: A COPD client is prescribed tiotropium. What is the nurse's priority teaching point?
A: "This is a maintenance medication, not for acute breathing problems. Use it daily even when
feeling well."
Rationale: Tiotropium is a long-acting anticholinergic used for prevention, not rescue. Clients
must understand it won't relieve acute symptoms.
4. Q: Which assessment finding in a COPD client indicates possible cor pulmonale?
A: Dependent edema and jugular venous distension
Rationale: Cor pulmonale (right-sided heart failure) develops from pulmonary hypertension in
advanced COPD, presenting with systemic venous congestion.
5. Q: What is the appropriate oxygen delivery method for a COPD client who requires long-
term oxygen therapy?
A: Nasal cannula at 1-2 L/min to maintain SpO₂ 88-92%
, Rationale: Low-flow oxygen is preferred; higher concentrations can suppress the hypoxic drive
to breathe in some COPD clients.
6. Q: A COPD client demonstrates pursed-lip breathing. What is the primary benefit of this
technique?
A: Prevents alveolar collapse by maintaining positive airway pressure during exhalation
Rationale: Pursed-lip breathing creates back-pressure that keeps small airways open longer,
improving gas exchange.
7. Q: Which laboratory value is most important to monitor in a COPD client taking
theophylline?
A: Serum theophylline level (therapeutic range: 10-20 mcg/mL)
Rationale: Theophylline has a narrow therapeutic index; levels must be monitored to prevent
toxicity (seizures, dysrhythmias).
8. Q: What is the priority nursing intervention during a COPD exacerbation?
A: Administer bronchodilators and corticosteroids as ordered
Rationale: These medications reduce inflammation and bronchoconstriction, addressing the
primary pathophysiology of exacerbations.
9. Q: Which instruction is most important for a COPD client regarding nutrition?
A: "Eat small, frequent meals high in protein and calories."
Rationale: Increased work of breathing raises caloric needs, but large meals can cause
abdominal distension that impedes diaphragm movement.
10. Q: A COPD client's ABG shows: pH 7.28, PaCO₂ 65 mmHg, PaO₂ 50 mmHg, HCO₃⁻ 30 mEq/L.
How should the nurse interpret this?
A: Acute respiratory acidosis with partial compensation
Rationale: Low pH with high PaCO₂ indicates respiratory acidosis. Elevated HCO₃⁻ shows renal
compensation is beginning but is incomplete.
11. Q: What vaccine is essential for all COPD clients?
A: Pneumococcal vaccine and annual influenza vaccine
Rationale: Respiratory infections can cause severe exacerbations; vaccination is a key preventive
measure.
12. Q: Which position helps a COPD client with severe dyspnea?
A: High Fowler's position leaning forward on an overbed table (tripod position)
Rationale: This position maximizes lung expansion and facilitates use of accessory muscles.
