NR324/NR 324 Exam 1 V2 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who has
developed a barrel chest. Which pathophysiological change is responsible for this finding?
A. Chronic inflammation of the bronchial mucosa
B. Alveolar wall destruction and air trapping
C. Increased production of pulmonary surfactant
D. Hypertrophy of the accessory respiratory muscles
Correct Answer: B
Rationale: A barrel chest is a classic sign of emphysema, which is a component of COPD. It
results from the destruction of alveolar walls and loss of elastic recoil, leading to
hyperinflation of the lungs and permanent air trapping. This structural change increases
the anteroposterior diameter of the chest wall compared to the lateral diameter.
2. Which clinical manifestation should the nurse prioritize when assessing a patient suspected
of having a pulmonary embolism?
A. Sudden onset of shortness of breath
B. Productive cough with green sputum
C. Gradual increase in peripheral edema
,D. Slow, deep respiratory rate
Correct Answer: A
Rationale: Sudden onset dyspnea is the most common and critical symptom of a
pulmonary embolism due to the abrupt blockage of pulmonary blood flow. This leads to an
immediate ventilation-perfusion mismatch and potential respiratory failure. The nurse
must recognize this as an emergency requiring immediate oxygen therapy and provider
notification.
3. A patient is scheduled for a bronchoscopy. Which nursing action is essential during the
immediate post-procedure period?
A. Encourage the patient to drink fluids to clear the throat
B. Position the patient in a prone position for drainage
C. Assist the patient with vigorous incentive spirometry
D. Keep the patient NPO until the gag reflex returns
Correct Answer: D
Rationale: Post-bronchoscopy care requires that the patient remains NPO until the nurse
confirms the return of the gag reflex to prevent aspiration. The local anesthetic used during
the procedure numbs the airway, making it unsafe to consume liquids or solids
immediately. Monitoring for complications like bleeding or pneumothorax is also a vital
nursing responsibility in this phase.
, 4. A nurse is caring for a patient with a suspected Tuberculosis (TB) infection. Which type of
isolation precautions must be implemented?
A. Contact precautions
B. Droplet precautions
C. Standard precautions only
D. Airborne precautions
Correct Answer: D
Rationale: Mycobacterium tuberculosis is transmitted via small droplets that remain
suspended in the air, requiring airborne precautions. This includes placing the patient in a
negative-pressure room and healthcare workers wearing N95 respirators. These measures
are strictly enforced to prevent the spread of the bacteria to other patients and staff.
5. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with acute
respiratory failure and severe hypoventilation?
A. pH 7.50, PaCO2 30 mmHg
B. pH 7.35, PaCO2 40 mmHg
C. pH 7.48, PaCO2 48 mmHg
D. pH 7.25, PaCO2 55 mmHg
Correct Answer: D
Q&A with Rationale | Chamberlain
University
1. A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who has
developed a barrel chest. Which pathophysiological change is responsible for this finding?
A. Chronic inflammation of the bronchial mucosa
B. Alveolar wall destruction and air trapping
C. Increased production of pulmonary surfactant
D. Hypertrophy of the accessory respiratory muscles
Correct Answer: B
Rationale: A barrel chest is a classic sign of emphysema, which is a component of COPD. It
results from the destruction of alveolar walls and loss of elastic recoil, leading to
hyperinflation of the lungs and permanent air trapping. This structural change increases
the anteroposterior diameter of the chest wall compared to the lateral diameter.
2. Which clinical manifestation should the nurse prioritize when assessing a patient suspected
of having a pulmonary embolism?
A. Sudden onset of shortness of breath
B. Productive cough with green sputum
C. Gradual increase in peripheral edema
,D. Slow, deep respiratory rate
Correct Answer: A
Rationale: Sudden onset dyspnea is the most common and critical symptom of a
pulmonary embolism due to the abrupt blockage of pulmonary blood flow. This leads to an
immediate ventilation-perfusion mismatch and potential respiratory failure. The nurse
must recognize this as an emergency requiring immediate oxygen therapy and provider
notification.
3. A patient is scheduled for a bronchoscopy. Which nursing action is essential during the
immediate post-procedure period?
A. Encourage the patient to drink fluids to clear the throat
B. Position the patient in a prone position for drainage
C. Assist the patient with vigorous incentive spirometry
D. Keep the patient NPO until the gag reflex returns
Correct Answer: D
Rationale: Post-bronchoscopy care requires that the patient remains NPO until the nurse
confirms the return of the gag reflex to prevent aspiration. The local anesthetic used during
the procedure numbs the airway, making it unsafe to consume liquids or solids
immediately. Monitoring for complications like bleeding or pneumothorax is also a vital
nursing responsibility in this phase.
, 4. A nurse is caring for a patient with a suspected Tuberculosis (TB) infection. Which type of
isolation precautions must be implemented?
A. Contact precautions
B. Droplet precautions
C. Standard precautions only
D. Airborne precautions
Correct Answer: D
Rationale: Mycobacterium tuberculosis is transmitted via small droplets that remain
suspended in the air, requiring airborne precautions. This includes placing the patient in a
negative-pressure room and healthcare workers wearing N95 respirators. These measures
are strictly enforced to prevent the spread of the bacteria to other patients and staff.
5. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with acute
respiratory failure and severe hypoventilation?
A. pH 7.50, PaCO2 30 mmHg
B. pH 7.35, PaCO2 40 mmHg
C. pH 7.48, PaCO2 48 mmHg
D. pH 7.25, PaCO2 55 mmHg
Correct Answer: D
