NR 226 Adult Health I Exam 4 Study Guide 2026 |Chamberlain College
1. A nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min via nasal cannula. The nurse
understands that for this patient, a high concentration of oxygen may result in
which of the following?
A. Hypoventilation and carbon dioxide retention
B. Oxygen toxicity
C. Respiratory alkalosis
D. Increased respiratory rate
Answer: A
Rationale: In patients with chronic CO2 retention, the primary stimulus for breathing is a
low oxygen level (hypoxic drive). Providing too much oxygen can suppress this drive,
leading to hypoventilation and further CO2 retention.
2. When assessing a patient post-operatively, which clinical finding is the
earliest indicator of hypoxemia?
A. Cyanosis
B. Bradycardia
C. Restlessness and agitation
D. Bradypnea
Answer: C
Rationale: Restlessness, agitation, and confusion are early signs of hypoxemia as the brain
is highly sensitive to oxygen deprivation. Cyanosis is a late sign.
,3. The nurse is teaching a patient how to use an incentive spirometer. What
instruction should the nurse include?
A. Exhale forcefully into the device.
B. N/A
C. Hold your breath for 30 seconds after inhalation.
D. Use the device once every 4 hours while awake.
E. Inhale slowly and deeply through the mouthpiece.
Answer: E
Rationale: Incentive spirometry requires the patient to take a slow, deep breath in to
expand the alveoli and prevent atelectasis. It is usually performed 10 times every hour
while awake.
4. Which of the following lung sounds would the nurse expect to hear in a
patient with fluid overload and heart failure?
A. Fine crackles
B. Wheezes
C. Stridor
D. Pleural friction rub
Answer: A
Rationale: Fine crackles are caused by air moving through fluid in the small airways or
alveoli, common in pulmonary edema associated with heart failure.
5. A patient is diagnosed with right-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Pulmonary congestion
B. Peripheral edema
C. Dyspnea on exertion
D. Orthopnea
Answer: B
, Rationale: Right-sided heart failure leads to systemic venous congestion, manifesting as
peripheral edema, jugular venous distention, and hepatomegaly. The other options are
signs of left-sided heart failure.
6. A nurse is assessing a patient for deep vein thrombosis (DVT). Which finding is
most characteristic of this condition?
A. Bilateral leg swelling
B. Absence of pedal pulses
C. Cool, pale skin on the affected limb
D. Unilateral calf pain and redness
Answer: D
Rationale: DVT typically presents as unilateral swelling, warmth, redness, and pain in the
affected extremity. Bilateral swelling is more often related to heart failure or fluid
retention.
7. Which oxygen delivery device provides the most precise concentration of
oxygen?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C
Rationale: The Venturi mask uses different sized ports to deliver a highly specific and
precise FiO2, making it ideal for patients with COPD.
1. A nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who is receiving oxygen at 2 L/min via nasal cannula. The nurse
understands that for this patient, a high concentration of oxygen may result in
which of the following?
A. Hypoventilation and carbon dioxide retention
B. Oxygen toxicity
C. Respiratory alkalosis
D. Increased respiratory rate
Answer: A
Rationale: In patients with chronic CO2 retention, the primary stimulus for breathing is a
low oxygen level (hypoxic drive). Providing too much oxygen can suppress this drive,
leading to hypoventilation and further CO2 retention.
2. When assessing a patient post-operatively, which clinical finding is the
earliest indicator of hypoxemia?
A. Cyanosis
B. Bradycardia
C. Restlessness and agitation
D. Bradypnea
Answer: C
Rationale: Restlessness, agitation, and confusion are early signs of hypoxemia as the brain
is highly sensitive to oxygen deprivation. Cyanosis is a late sign.
,3. The nurse is teaching a patient how to use an incentive spirometer. What
instruction should the nurse include?
A. Exhale forcefully into the device.
B. N/A
C. Hold your breath for 30 seconds after inhalation.
D. Use the device once every 4 hours while awake.
E. Inhale slowly and deeply through the mouthpiece.
Answer: E
Rationale: Incentive spirometry requires the patient to take a slow, deep breath in to
expand the alveoli and prevent atelectasis. It is usually performed 10 times every hour
while awake.
4. Which of the following lung sounds would the nurse expect to hear in a
patient with fluid overload and heart failure?
A. Fine crackles
B. Wheezes
C. Stridor
D. Pleural friction rub
Answer: A
Rationale: Fine crackles are caused by air moving through fluid in the small airways or
alveoli, common in pulmonary edema associated with heart failure.
5. A patient is diagnosed with right-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Pulmonary congestion
B. Peripheral edema
C. Dyspnea on exertion
D. Orthopnea
Answer: B
, Rationale: Right-sided heart failure leads to systemic venous congestion, manifesting as
peripheral edema, jugular venous distention, and hepatomegaly. The other options are
signs of left-sided heart failure.
6. A nurse is assessing a patient for deep vein thrombosis (DVT). Which finding is
most characteristic of this condition?
A. Bilateral leg swelling
B. Absence of pedal pulses
C. Cool, pale skin on the affected limb
D. Unilateral calf pain and redness
Answer: D
Rationale: DVT typically presents as unilateral swelling, warmth, redness, and pain in the
affected extremity. Bilateral swelling is more often related to heart failure or fluid
retention.
7. Which oxygen delivery device provides the most precise concentration of
oxygen?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C
Rationale: The Venturi mask uses different sized ports to deliver a highly specific and
precise FiO2, making it ideal for patients with COPD.
