ATI Medical-Surgical Respiratory Proctored Exam
Prep with Actual Complete Questions and Correct
Answers with Detailed Rationales Already Graded
+ | 2026 Updated
Ace your ATI Medical-Surgical Respiratory Proctored Exam with this ultimate study resource!
This guide contains 350 authentic, high-yield practice questions paired with clear, detailed
rationales. Key topics include COPD, asthma, chest tubes, ventilator alarms, and ABG
interpretation. Crafted specifically to match the ABCs priority framework, these materials help
you think like a nurse and spot trap answers. Instant download. Perfect for NGN prep!
,ATI Respiratory Proctored Exam Practice Quiz
1. A nurse is teaching a client who has Chronic Obstructive Pulmonary Disease (COPD)
about pursed-lip breathing. Which of the following is the primary purpose of this
technique?
A) It helps increase the depth of respirations.
B) It prevents airway collapse by maintaining positive pressure.
C) It increases the amount of oxygen reaching the alveoli.
D) It loosens secretions in the lower airways.
Rationale: Pursed-lip breathing creates a gentle resistance that maintains positive
end-expiratory pressure (PEEP) in the airways. This keeps the small airways open
longer during exhalation, allowing the client to expel trapped carbon dioxide.
2. A nurse is instructing a client on how to use an albuterol metered-dose inhaler (MDI)
and a beclomethasone MDI. Which of the following statements by the client indicates an
understanding of the teaching?
A) "I should use the albuterol inhaler 5 minutes before using the beclomethasone
inhaler."
B) "I should use the beclomethasone inhaler first to reduce inflammation, then the
albuterol."
C) "I should hold my breath for 3 seconds after inhaling the medication."
D) "I do not need to rinse my mouth after using the albuterol inhaler."
Rationale: Albuterol is a fast-acting bronchodilator that opens the airways. Taking it
first allows the maintenance corticosteroid (beclomethasone) to penetrate deeper into
the lungs for better effect.
3. A nurse is assessing a client with status asthmaticus. Which of the following assessment
findings indicates the client's condition is worsening?
A) A respiratory rate of 24/min
B) Wheezing that is louder during expiration
C) An oxygen saturation of 94% on room air
D) Absence of wheezing with a decrease in breath sounds
Rationale: A sudden disappearance of wheezing and diminished breath sounds—often
called a "silent chest"—indicates severe airway obstruction and imminent respiratory
failure. This is a medical emergency.
4. A nurse is caring for a client who is receiving theophylline for chronic bronchitis. Which
of the following findings should alert the nurse to the possibility of theophylline toxicity?
A) Constipation and abdominal distension
B) Bradycardia and lethargy
, C) Tremors and tachycardia
D) Hypothermia and hypotension
Rationale: Theophylline is a central nervous system stimulant. Toxic levels cause signs
of overstimulation, including muscle tremors, restlessness, and a fast heart rate
(tachycardia).
5. A nurse is performing a physical assessment on a client with advanced emphysema.
Which of the following findings should the nurse expect?
A) An increased anteroposterior (AP) diameter of the chest
B) Clubbing of the fingers
C) Dependent edema and weight gain
D) Tracheal deviation to the unaffected side
Rationale: Chronic air trapping causes hyperinflation of the lungs. Over time, this
changes the shape of the ribcage, resulting in a "barrel chest" where the chest's front-
to-back width increases.
6. A nurse is caring for a client who has a prescription for ipratropium. Which of the
following conditions in the client's medical history should the nurse report to the
provider before administering this medication?
A) Peptic ulcer disease
B) Narrow-angle glaucoma
C) Hypertension
D) Diabetes mellitus
Rationale: Ipratropium is an inhaled anticholinergic drug. Anticholinergics can increase
fluid pressure inside the eyes, which can dangerously worsen narrow-angle glaucoma.
7. A nurse is providing discharge teaching to a client who has a new prescription for
montelukast. Which of the following statements by the client indicates an understanding
of the teaching?
A) "I will take this medication during an acute asthma attack."
B) "I should take this medication 30 minutes before exercising."
C) "I will take this medication once a day in the evening."
D) "I can crush this medication and put it in my applesauce."
Rationale: Montelukast is a leukotriene modifier used for long-term control of asthma.
It is taken once daily in the evening to target nighttime allergy and asthma symptoms.
8. A nurse is assessing a client's peak expiratory flow rate (PEFR). The client's reading falls
into the red zone of their peak flow meter. Which of the following actions should the
nurse take first?
A) Instruct the client to use their prescribed short-acting beta2-agonist immediately.
, B) Notify the client's provider.
C) Administer the client's maintenance corticosteroid.
D) Re-evaluate the client's peak flow rate in 1 hour.
Rationale: The red zone means severe airway narrowing (less than 50% of the patient's
personal best). Following ABC priorities, the nurse must immediately give the rescue
bronchodilator to reopen the airways before doing anything else.
9. A nurse is caring for a client with severe COPD on 2 L/min of oxygen via a nasal cannula.
The client becomes increasingly lethargic and confused. Which of the following
complications should the nurse suspect?
A) Hypoxia
B) Carbon dioxide narcosis
C) Pulmonary embolism
D) Dehydration
Rationale: Patients with chronic hypercapnia (high CO2) rely on low oxygen levels to
stimulate breathing. Too much oxygen can suppress this drive, causing them to retain
even more carbon dioxide, which acts like a sedative (narcosis).
10. A nurse is assessing an older adult client who has COPD. Which of the following is an
expected physiological change in the respiratory system due to aging?
A) Increased chest wall compliance
B) Increased vital capacity
C) Increased residual volume
D) Decreased airway resistance
Rationale: As people age, lung tissues lose elastic recoil and chest walls become stiffer.
This causes more air to remain trapped in the lungs after a full exhalation, raising the
residual volume.
11. A nurse is planning care for a client newly admitted with active tuberculosis (TB). Which
of the following isolation precautions should the nurse implement?
A) Droplet precautions
B) Contact precautions
C) Airborne precautions
D) Standard precautions only
Rationale: Tuberculosis is spread through tiny respiratory particles that remain
suspended in the air. Airborne precautions are mandatory, requiring a negative-
pressure private room and N95 respirators for staff.
12. A nurse is reading a Mantoux tuberculin skin test (TST) for a client who has HIV. Which of
the following findings indicates a positive result?
Prep with Actual Complete Questions and Correct
Answers with Detailed Rationales Already Graded
+ | 2026 Updated
Ace your ATI Medical-Surgical Respiratory Proctored Exam with this ultimate study resource!
This guide contains 350 authentic, high-yield practice questions paired with clear, detailed
rationales. Key topics include COPD, asthma, chest tubes, ventilator alarms, and ABG
interpretation. Crafted specifically to match the ABCs priority framework, these materials help
you think like a nurse and spot trap answers. Instant download. Perfect for NGN prep!
,ATI Respiratory Proctored Exam Practice Quiz
1. A nurse is teaching a client who has Chronic Obstructive Pulmonary Disease (COPD)
about pursed-lip breathing. Which of the following is the primary purpose of this
technique?
A) It helps increase the depth of respirations.
B) It prevents airway collapse by maintaining positive pressure.
C) It increases the amount of oxygen reaching the alveoli.
D) It loosens secretions in the lower airways.
Rationale: Pursed-lip breathing creates a gentle resistance that maintains positive
end-expiratory pressure (PEEP) in the airways. This keeps the small airways open
longer during exhalation, allowing the client to expel trapped carbon dioxide.
2. A nurse is instructing a client on how to use an albuterol metered-dose inhaler (MDI)
and a beclomethasone MDI. Which of the following statements by the client indicates an
understanding of the teaching?
A) "I should use the albuterol inhaler 5 minutes before using the beclomethasone
inhaler."
B) "I should use the beclomethasone inhaler first to reduce inflammation, then the
albuterol."
C) "I should hold my breath for 3 seconds after inhaling the medication."
D) "I do not need to rinse my mouth after using the albuterol inhaler."
Rationale: Albuterol is a fast-acting bronchodilator that opens the airways. Taking it
first allows the maintenance corticosteroid (beclomethasone) to penetrate deeper into
the lungs for better effect.
3. A nurse is assessing a client with status asthmaticus. Which of the following assessment
findings indicates the client's condition is worsening?
A) A respiratory rate of 24/min
B) Wheezing that is louder during expiration
C) An oxygen saturation of 94% on room air
D) Absence of wheezing with a decrease in breath sounds
Rationale: A sudden disappearance of wheezing and diminished breath sounds—often
called a "silent chest"—indicates severe airway obstruction and imminent respiratory
failure. This is a medical emergency.
4. A nurse is caring for a client who is receiving theophylline for chronic bronchitis. Which
of the following findings should alert the nurse to the possibility of theophylline toxicity?
A) Constipation and abdominal distension
B) Bradycardia and lethargy
, C) Tremors and tachycardia
D) Hypothermia and hypotension
Rationale: Theophylline is a central nervous system stimulant. Toxic levels cause signs
of overstimulation, including muscle tremors, restlessness, and a fast heart rate
(tachycardia).
5. A nurse is performing a physical assessment on a client with advanced emphysema.
Which of the following findings should the nurse expect?
A) An increased anteroposterior (AP) diameter of the chest
B) Clubbing of the fingers
C) Dependent edema and weight gain
D) Tracheal deviation to the unaffected side
Rationale: Chronic air trapping causes hyperinflation of the lungs. Over time, this
changes the shape of the ribcage, resulting in a "barrel chest" where the chest's front-
to-back width increases.
6. A nurse is caring for a client who has a prescription for ipratropium. Which of the
following conditions in the client's medical history should the nurse report to the
provider before administering this medication?
A) Peptic ulcer disease
B) Narrow-angle glaucoma
C) Hypertension
D) Diabetes mellitus
Rationale: Ipratropium is an inhaled anticholinergic drug. Anticholinergics can increase
fluid pressure inside the eyes, which can dangerously worsen narrow-angle glaucoma.
7. A nurse is providing discharge teaching to a client who has a new prescription for
montelukast. Which of the following statements by the client indicates an understanding
of the teaching?
A) "I will take this medication during an acute asthma attack."
B) "I should take this medication 30 minutes before exercising."
C) "I will take this medication once a day in the evening."
D) "I can crush this medication and put it in my applesauce."
Rationale: Montelukast is a leukotriene modifier used for long-term control of asthma.
It is taken once daily in the evening to target nighttime allergy and asthma symptoms.
8. A nurse is assessing a client's peak expiratory flow rate (PEFR). The client's reading falls
into the red zone of their peak flow meter. Which of the following actions should the
nurse take first?
A) Instruct the client to use their prescribed short-acting beta2-agonist immediately.
, B) Notify the client's provider.
C) Administer the client's maintenance corticosteroid.
D) Re-evaluate the client's peak flow rate in 1 hour.
Rationale: The red zone means severe airway narrowing (less than 50% of the patient's
personal best). Following ABC priorities, the nurse must immediately give the rescue
bronchodilator to reopen the airways before doing anything else.
9. A nurse is caring for a client with severe COPD on 2 L/min of oxygen via a nasal cannula.
The client becomes increasingly lethargic and confused. Which of the following
complications should the nurse suspect?
A) Hypoxia
B) Carbon dioxide narcosis
C) Pulmonary embolism
D) Dehydration
Rationale: Patients with chronic hypercapnia (high CO2) rely on low oxygen levels to
stimulate breathing. Too much oxygen can suppress this drive, causing them to retain
even more carbon dioxide, which acts like a sedative (narcosis).
10. A nurse is assessing an older adult client who has COPD. Which of the following is an
expected physiological change in the respiratory system due to aging?
A) Increased chest wall compliance
B) Increased vital capacity
C) Increased residual volume
D) Decreased airway resistance
Rationale: As people age, lung tissues lose elastic recoil and chest walls become stiffer.
This causes more air to remain trapped in the lungs after a full exhalation, raising the
residual volume.
11. A nurse is planning care for a client newly admitted with active tuberculosis (TB). Which
of the following isolation precautions should the nurse implement?
A) Droplet precautions
B) Contact precautions
C) Airborne precautions
D) Standard precautions only
Rationale: Tuberculosis is spread through tiny respiratory particles that remain
suspended in the air. Airborne precautions are mandatory, requiring a negative-
pressure private room and N95 respirators for staff.
12. A nurse is reading a Mantoux tuberculin skin test (TST) for a client who has HIV. Which of
the following findings indicates a positive result?
