ATI Med Surg Respiratory Proctored Exam
Test Bank 20262027 300 Verified
Questions with Detailed ANS
Exam
## SECTION 1: ASSESSMENT & DIAGNOSTIC TESTS (Questions 1-15)
**1. A nurse is preparing a client for a bronchoscopy. Which action
should the nurse take?**
- A. Administer atropine to dry secretions.
- B. Ensure the client has been NPO for 12 hours.
- C. Remove the client's dentures before the procedure.
- D. Place the client in a prone position post-procedure.
**Answer: C. Remove the client's dentures before the procedure.**
**Rationale:** Dentures, partials, or loose teeth pose an aspiration
risk and can obstruct the bronchoscope. NPO is typically required for
4-8 hours, not 12. Atropine is rarely used pre-procedurally for
bronchoscopy anymore; moderate sedation is standard. Post-
procedure, the client is placed in semi-Fowler's position to facilitate
breathing and prevent aspiration .
,---
**2. A nurse is preparing a client for discharge following a
bronchoscopy with moderate sedation. Which assessment is the
priority?**
- A. Presence of gag reflex
- B. Pain level rating using a 0-10 scale
- C. Hydration status
- D. Appearance of the IV insertion site
**Answer: A. Presence of gag reflex**
**Rationale:** The greatest risk is aspiration due to a depressed gag
reflex from the topical anesthetic used during the procedure.
Therefore, the priority assessment by the nurse is to determine the
return of the gag reflex before allowing the client to eat or drink .
---
**3. A nurse is caring for a client following a thoracentesis. Which
finding requires immediate intervention?**
- A. Serous drainage on the dressing.
- B. Client reports a dry, hacking cough.
- C. Pulse oximetry of 91% on room air.
- D. Respiratory rate of 24/min.
,**Answer: C. Pulse oximetry of 91% on room air.**
**Rationale:** A post-thoracentesis SpO2 of 91% is below the
expected reference range (>95%) and could indicate a complication
such as pneumothorax (re-expansion pulmonary edema or air entry
into pleural space). A dry cough is common post-procedure. Serous
drainage is expected. A respiratory rate of 24 is elevated but
expected with underlying lung disease .
---
**4. A nurse is reviewing arterial blood gas (ABG) results: pH 7.30,
PaCO2 60 mm Hg, HCO3 24 mEq/L. Which condition do these values
indicate?**
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
**Answer: C. Respiratory acidosis**
**Rationale:** The pH is acidic (<7.35). PaCO2 is elevated (>45),
indicating a respiratory cause. HCO3 is normal (22-26), showing no
renal compensation yet. This is acute respiratory acidosis, typical in
COPD exacerbation, opioid overdose, or pneumonia .
, ---
**5. A nurse is assessing a client with a chest tube connected to a
water-seal drainage system. Which finding indicates proper
functioning?**
- A. Continuous bubbling in the water-seal chamber.
- B. Fluctuation (tidaling) in the water-seal chamber with
respirations.
- C. Absence of drainage in the collection chamber for 2 hours.
- D. Suction chamber pressure set at -5 cm H2O.
**Answer: B. Fluctuation (tidaling) in the water-seal chamber with
respirations.**
**Rationale:** Tidaling indicates that the chest tube is patent and
the pleural space is intact. Continuous bubbling indicates an air leak.
Absence of drainage is fine if output was previously documented; it
does not indicate function alone. Suction pressure is typically -20 cm
H2O for adults .
---
**6. A nurse is providing teaching to a client about pulmonary
function tests. Which test measures the volume of air the lungs can
hold at the end of maximum inhalation?**
- A. Total lung capacity
- B. Vital lung capacity
Test Bank 20262027 300 Verified
Questions with Detailed ANS
Exam
## SECTION 1: ASSESSMENT & DIAGNOSTIC TESTS (Questions 1-15)
**1. A nurse is preparing a client for a bronchoscopy. Which action
should the nurse take?**
- A. Administer atropine to dry secretions.
- B. Ensure the client has been NPO for 12 hours.
- C. Remove the client's dentures before the procedure.
- D. Place the client in a prone position post-procedure.
**Answer: C. Remove the client's dentures before the procedure.**
**Rationale:** Dentures, partials, or loose teeth pose an aspiration
risk and can obstruct the bronchoscope. NPO is typically required for
4-8 hours, not 12. Atropine is rarely used pre-procedurally for
bronchoscopy anymore; moderate sedation is standard. Post-
procedure, the client is placed in semi-Fowler's position to facilitate
breathing and prevent aspiration .
,---
**2. A nurse is preparing a client for discharge following a
bronchoscopy with moderate sedation. Which assessment is the
priority?**
- A. Presence of gag reflex
- B. Pain level rating using a 0-10 scale
- C. Hydration status
- D. Appearance of the IV insertion site
**Answer: A. Presence of gag reflex**
**Rationale:** The greatest risk is aspiration due to a depressed gag
reflex from the topical anesthetic used during the procedure.
Therefore, the priority assessment by the nurse is to determine the
return of the gag reflex before allowing the client to eat or drink .
---
**3. A nurse is caring for a client following a thoracentesis. Which
finding requires immediate intervention?**
- A. Serous drainage on the dressing.
- B. Client reports a dry, hacking cough.
- C. Pulse oximetry of 91% on room air.
- D. Respiratory rate of 24/min.
,**Answer: C. Pulse oximetry of 91% on room air.**
**Rationale:** A post-thoracentesis SpO2 of 91% is below the
expected reference range (>95%) and could indicate a complication
such as pneumothorax (re-expansion pulmonary edema or air entry
into pleural space). A dry cough is common post-procedure. Serous
drainage is expected. A respiratory rate of 24 is elevated but
expected with underlying lung disease .
---
**4. A nurse is reviewing arterial blood gas (ABG) results: pH 7.30,
PaCO2 60 mm Hg, HCO3 24 mEq/L. Which condition do these values
indicate?**
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
**Answer: C. Respiratory acidosis**
**Rationale:** The pH is acidic (<7.35). PaCO2 is elevated (>45),
indicating a respiratory cause. HCO3 is normal (22-26), showing no
renal compensation yet. This is acute respiratory acidosis, typical in
COPD exacerbation, opioid overdose, or pneumonia .
, ---
**5. A nurse is assessing a client with a chest tube connected to a
water-seal drainage system. Which finding indicates proper
functioning?**
- A. Continuous bubbling in the water-seal chamber.
- B. Fluctuation (tidaling) in the water-seal chamber with
respirations.
- C. Absence of drainage in the collection chamber for 2 hours.
- D. Suction chamber pressure set at -5 cm H2O.
**Answer: B. Fluctuation (tidaling) in the water-seal chamber with
respirations.**
**Rationale:** Tidaling indicates that the chest tube is patent and
the pleural space is intact. Continuous bubbling indicates an air leak.
Absence of drainage is fine if output was previously documented; it
does not indicate function alone. Suction pressure is typically -20 cm
H2O for adults .
---
**6. A nurse is providing teaching to a client about pulmonary
function tests. Which test measures the volume of air the lungs can
hold at the end of maximum inhalation?**
- A. Total lung capacity
- B. Vital lung capacity
