ATI Med Surg Respiratory Proctored Exam Prep 2026-200 Practice
Questions & Detailed Answers | Test Bank 1 with Detailed Rationales
| Verified Solutions
1. A nurse is providing discharge instructions to a client who has a new laryngectomy. The nurse should
tell the client to be careful while bathing to prevent which of the following complications?
A) Aspiration of water
B) Infection of the stoma
C) Bleeding around the stoma
D) Skin breakdown around the stoma
Answer: A) Aspiration of water
Explanation: The client should be careful during bathing and showering and should avoid swimming due
to the risk of aspiration of water. The client should use a shower shield over the stoma when bathing or
showering to keep water out of the airway.
2. A client with COPD reports dyspnea and uses accessory muscles to breathe. What is the priority
nursing action?
A) Administer highflow oxygen at 10 L/min
B) Encourage pursedlip breathing
C) Encourage lying flat
D) Administer a betablocker
Answer: B) Encourage pursedlip breathing
Explanation: Pursedlip breathing reduces air trapping and improves oxygenation. Highflow oxygen may
depress the hypoxic drive in COPD. The client should not lie flat as this can worsen dyspnea.
,3. A client with pneumonia has an SpO₂ of 88%. What is the nurse's first action?
A) Administer antibiotics
B) Apply oxygen
C) Encourage coughing
D) Give antipyretics
Answer: B) Apply oxygen
Explanation: Oxygen addresses immediate hypoxia (ABCs first). Medications follow stabilization.
4. A nurse is providing preoperative teaching to a client who is to undergo a pneumonectomy. The client
states, "I am afraid it will hurt to cough after the surgery." Which response by the nurse is appropriate?
A) "After the surgeon removes the lung, you will not need to cough."
B) "I'll make sure you get a cough suppressant to keep you from straining the incision."
C) "Don't worry. You will have a pump that delivers pain medication as you need it, so you will have very
little pain."
D) "I will show you how to splint your incision while coughing."
Answer: D) "I will show you how to splint your incision while coughing."
Explanation: The client who had a pneumonectomy should cough to clear secretions from the remaining
lung. The nurse should show the client how to splint the incision to reduce pain when coughing.
,5. A nurse is providing instructions about pursedlip breathing for a client who has COPD with
emphysema. The nurse should explain that this breathing technique accomplishes which of the
following?
A) Increases oxygen intake
B) Promotes carbon dioxide elimination
C) Uses the intercostal muscles
D) Strengthens the diaphragm
Answer: B) Promotes carbon dioxide elimination
Explanation: Pursedlip breathing slows the client's pace of breathing, making each breath more
effective. It releases trapped air in the lungs and prolongs exhalation to slow the breathing rate. This
improved breathing pattern moves carbon dioxide out of the lungs more efficiently.
6. A client's ABG results show: pH 7.32, PaCO₂ 58 mmHg, HCO₃ 25 mEq/L. Which interpretation is
correct?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: C) Respiratory acidosis
Explanation: Low pH (7.32 < 7.35) indicates acidosis. High PaCO₂ (58 > 45 mmHg) indicates a respiratory
cause. HCO₃ is normal (2226 mEq/L), confirming no metabolic compensation.
7. A client on 2 L/min nasal cannula has an SpO₂ of 89%. The nurse should first:
, A) Increase O₂ to 4 L/min
B) Apply a nonrebreather mask
C) Assess respiratory rate and lung sounds
D) Notify the provider immediately
Answer: C) Assess respiratory rate and lung sounds
Explanation: Before changing O₂ settings, assess the client's clinical status. The SpO₂ of 89% is low
(target >90% for most, 8892% for COPD). Increase O₂ if needed after assessment.
8. A nurse is caring for a client with COPD and an SpO₂ of 88% on 2 L/min. The client is alert and
breathing comfortably. What should the nurse do?
A) Increase to 4 L/min to achieve SpO₂ >95%
B) Leave O₂ at 2 L/min because 8892% is target for COPD
C) Switch to a nonrebreather mask
D) Prepare for intubation
Answer: B) Leave O₂ at 2 L/min because 8892% is target for COPD
Explanation: In COPD, the hypoxic drive may be present. Target SpO₂ is 8892%. Higher O₂ can lead to
CO₂ retention and respiratory failure.
9. A client with respiratory alkalosis is likely to exhibit which finding?
A) Slow, shallow breathing
B) Tingling in the fingers and around the mouth
C) Lethargy and confusion
Questions & Detailed Answers | Test Bank 1 with Detailed Rationales
| Verified Solutions
1. A nurse is providing discharge instructions to a client who has a new laryngectomy. The nurse should
tell the client to be careful while bathing to prevent which of the following complications?
A) Aspiration of water
B) Infection of the stoma
C) Bleeding around the stoma
D) Skin breakdown around the stoma
Answer: A) Aspiration of water
Explanation: The client should be careful during bathing and showering and should avoid swimming due
to the risk of aspiration of water. The client should use a shower shield over the stoma when bathing or
showering to keep water out of the airway.
2. A client with COPD reports dyspnea and uses accessory muscles to breathe. What is the priority
nursing action?
A) Administer highflow oxygen at 10 L/min
B) Encourage pursedlip breathing
C) Encourage lying flat
D) Administer a betablocker
Answer: B) Encourage pursedlip breathing
Explanation: Pursedlip breathing reduces air trapping and improves oxygenation. Highflow oxygen may
depress the hypoxic drive in COPD. The client should not lie flat as this can worsen dyspnea.
,3. A client with pneumonia has an SpO₂ of 88%. What is the nurse's first action?
A) Administer antibiotics
B) Apply oxygen
C) Encourage coughing
D) Give antipyretics
Answer: B) Apply oxygen
Explanation: Oxygen addresses immediate hypoxia (ABCs first). Medications follow stabilization.
4. A nurse is providing preoperative teaching to a client who is to undergo a pneumonectomy. The client
states, "I am afraid it will hurt to cough after the surgery." Which response by the nurse is appropriate?
A) "After the surgeon removes the lung, you will not need to cough."
B) "I'll make sure you get a cough suppressant to keep you from straining the incision."
C) "Don't worry. You will have a pump that delivers pain medication as you need it, so you will have very
little pain."
D) "I will show you how to splint your incision while coughing."
Answer: D) "I will show you how to splint your incision while coughing."
Explanation: The client who had a pneumonectomy should cough to clear secretions from the remaining
lung. The nurse should show the client how to splint the incision to reduce pain when coughing.
,5. A nurse is providing instructions about pursedlip breathing for a client who has COPD with
emphysema. The nurse should explain that this breathing technique accomplishes which of the
following?
A) Increases oxygen intake
B) Promotes carbon dioxide elimination
C) Uses the intercostal muscles
D) Strengthens the diaphragm
Answer: B) Promotes carbon dioxide elimination
Explanation: Pursedlip breathing slows the client's pace of breathing, making each breath more
effective. It releases trapped air in the lungs and prolongs exhalation to slow the breathing rate. This
improved breathing pattern moves carbon dioxide out of the lungs more efficiently.
6. A client's ABG results show: pH 7.32, PaCO₂ 58 mmHg, HCO₃ 25 mEq/L. Which interpretation is
correct?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: C) Respiratory acidosis
Explanation: Low pH (7.32 < 7.35) indicates acidosis. High PaCO₂ (58 > 45 mmHg) indicates a respiratory
cause. HCO₃ is normal (2226 mEq/L), confirming no metabolic compensation.
7. A client on 2 L/min nasal cannula has an SpO₂ of 89%. The nurse should first:
, A) Increase O₂ to 4 L/min
B) Apply a nonrebreather mask
C) Assess respiratory rate and lung sounds
D) Notify the provider immediately
Answer: C) Assess respiratory rate and lung sounds
Explanation: Before changing O₂ settings, assess the client's clinical status. The SpO₂ of 89% is low
(target >90% for most, 8892% for COPD). Increase O₂ if needed after assessment.
8. A nurse is caring for a client with COPD and an SpO₂ of 88% on 2 L/min. The client is alert and
breathing comfortably. What should the nurse do?
A) Increase to 4 L/min to achieve SpO₂ >95%
B) Leave O₂ at 2 L/min because 8892% is target for COPD
C) Switch to a nonrebreather mask
D) Prepare for intubation
Answer: B) Leave O₂ at 2 L/min because 8892% is target for COPD
Explanation: In COPD, the hypoxic drive may be present. Target SpO₂ is 8892%. Higher O₂ can lead to
CO₂ retention and respiratory failure.
9. A client with respiratory alkalosis is likely to exhibit which finding?
A) Slow, shallow breathing
B) Tingling in the fingers and around the mouth
C) Lethargy and confusion
