NSG 2610 Exam 1 2026-2027 BANK QUESTIONS WITH
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Question 1
A patient with a history of chronic obstructive pulmonary disease
(COPD) presents with increasing dyspnea and a productive cough of
purulent sputum. Arterial blood gas (ABG) analysis reveals a pH of 7.31,
PaCO2 of 58 mm Hg, and HCO3- of 26 mEq/L. Which of the following
best interprets this ABG result?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with metabolic compensation
C) Acute respiratory acidosis with metabolic compensation
D) Partially compensated respiratory acidosis
Answer: D) Partially compensated respiratory acidosis
Explanation: The pH is low (acidemia), PaCO2 is elevated (respiratory
acidosis), and HCO3- is slightly elevated but not enough to normalize
the pH, indicating that metabolic compensation is underway but
incomplete. In chronic respiratory acidosis, the pH would be closer to
normal with a significantly higher HCO3-. Acute respiratory acidosis
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would show a normal HCO3-. Thus, partially compensated respiratory
acidosis is correct.
Question 2
A nurse is caring for a patient with status asthmaticus who is receiving
continuous nebulizer treatments with albuterol. The patient's heart
rate is 140 bpm and they report feeling shaky. Which intervention is
most appropriate?
A) Discontinue the albuterol immediately
B) Administer a beta-blocker to reduce heart rate
C) Continue the albuterol and monitor for adverse effects
D) Switch to a long-acting muscarinic antagonist
Answer: C) Continue the albuterol and monitor for adverse effects
Explanation: Albuterol, a beta-2 agonist, can cause tachycardia and
tremors as side effects. In status asthmaticus, the bronchodilator effect
is critical, and the benefits outweigh the risks of these side effects.
Stopping the medication could compromise the patient's airway; beta-
blockers are contraindicated in asthma; and a muscarinic antagonist
such as ipratropium is an adjunct but not a primary substitute in acute
severe bronchospasm.
Question 3
A patient with community-acquired pneumonia is prescribed
levofloxacin. Which of the following adverse effects should the nurse
prioritize when teaching the patient?
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A) Tendon rupture
B) Hepatotoxicity
C) Nephrotoxicity
D) Bone marrow suppression
Answer: A) Tendon rupture
Explanation: Fluoroquinolones such as levofloxacin are associated with
an increased risk of tendonitis and tendon rupture, particularly in older
adults, those on corticosteroids, and patients with renal impairment.
While hepatotoxicity and nephrotoxicity are possible, they are not the
most distinctive or prioritized adverse effect. Bone marrow suppression
is more common with other antibiotics like chloramphenicol.
Question 4
In a patient with acute exacerbation of COPD, which of the following
findings would indicate the need for mechanical ventilation?
A) Respiratory rate of 26 breaths/min
B) PaO2 of 58 mm Hg on 4 L nasal cannula
C) pH of 7.28 and PaCO2 of 65 mm Hg with altered mental status
D) Use of accessory muscles
Answer: C) pH of 7.28 and PaCO2 of 65 mm Hg with altered mental
status
Explanation: Indications for mechanical ventilation in COPD
exacerbation include severe hypoxemia, hypercapnia with acidosis (pH <
7.30), and altered mental status. A respiratory rate of 26, mild
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hypoxemia, or accessory muscle use can often be managed with
noninvasive ventilation or medical therapy alone.
Question 5
The nurse is assessing a patient with a chest tube connected to a water-
seal drainage system. Which observation indicates an air leak?
A) Continuous bubbling in the water-seal chamber
B) Intermittent bubbling in the water-seal chamber during exhalation
C) Absence of tidaling in the water-seal chamber
D) Drainage of 100 mL in the first hour
Answer: A) Continuous bubbling in the water-seal chamber
Explanation: Continuous bubbling in the water-seal chamber indicates a
large air leak, typically from the patient's pleural space or the system
itself. Intermittent bubbling during exhalation is normal and expected.
Absence of tidaling may indicate obstruction or full lung expansion.
Drainage of 100 mL in the first hour is within normal limits.
Question 6
Which laboratory value is most consistent with a diagnosis of bacterial
pneumonia?
A) White blood cell count of 18,000/µL with a left shift
B) Lymphocyte count of 4,500/µL
C) Platelet count of 50,000/µL
D) Hemoglobin of 10.5 g/dL