,NURS 3661 Exam 2 | Nursing of Adults (2026) Q&A
| University of Texas at Arlington
1. Which postoperative respiratory complication is most directly caused by shallow
breathing and retained secretions?
A) Pulmonary embolism
B) Atelectasis
C) Pleurisy
D) Pneumothorax
Correct Answer: Atelectasis
Rationale: Atelectasis is the closure or collapse of alveoli, commonly occurring after
surgery due to shallow breathing, retained secretions, and reluctance to mobilize. It is the
most common postoperative respiratory complication and can progress to pneumonia if
untreated. Pulmonary embolism is a vascular complication related to venous stasis,
pleurisy is pleural inflammation, and pneumothorax involves air in the pleural space.
2. What is the primary purpose of incentive spirometry in a postoperative patient?
A) To measure peak expiratory flow
B) To promote alveolar expansion and prevent atelectasis
C) To deliver bronchodilator medication
D) To assess for pulmonary embolism
Correct Answer: To promote alveolar expansion and prevent atelectasis
Rationale: Incentive spirometry encourages slow, deep inhalation to expand alveoli and
prevent collapse, reducing the risk of atelectasis after surgery. It does not measure peak
,expiratory flow, deliver medication, or assess for pulmonary embolism, which require
different tools and assessments.
3. A patient with pneumonia has copious tracheobronchial secretions and increased work
of breathing. Which nursing intervention is most appropriate?
A) Encourage increased oral fluids unless contraindicated
B) Restrict fluids to reduce secretion production
C) Maintain strict bed rest to conserve energy
D) Administer a cough suppressant to reduce discomfort
Correct Answer: Encourage increased oral fluids unless contraindicated
Rationale: Increased oral hydration helps thin tracheobronchial secretions, making them
easier to expectorate and improving airway clearance in pneumonia. Fluid restriction
would thicken secretions, bed rest does not promote clearance, and cough suppressants can
impair the protective cough reflex needed to remove secretions.
4. Which assessment finding best supports a diagnosis of pleurisy?
A) Pain that is relieved by deep breathing
B) Pain that intensifies with coughing or deep inspiration
C) Bilateral crackles on auscultation
D) Dull, constant chest pain
Correct Answer: Pain that intensifies with coughing or deep inspiration
Rationale: Pleurisy is inflammation of the pleura, causing sharp, localized chest pain that
worsens with inspiration, coughing, and movement. Pain relief with deep breathing is the
opposite of pleuritic pain, bilateral crackles suggest pneumonia or heart failure, and dull
constant pain is more characteristic of cardiac or musculoskeletal causes.
, 5. What is the most appropriate initial intervention for a patient with suspected acute
respiratory distress syndrome?
A) Administering high-flow oxygen and preparing for intubation
B) Encouraging aggressive oral fluid intake
C) Placing the patient in a supine position
D) Administering a cough suppressant
Correct Answer: Administering high-flow oxygen and preparing for intubation
Rationale: ARDS causes severe refractory hypoxemia, so initial management includes
high-flow oxygen and preparation for mechanical ventilation and intubation. Oral fluids do
not address the primary oxygenation failure, supine positioning can worsen ventilation-
perfusion mismatch, and cough suppressants do not treat ARDS.
6. Which assessment finding is most consistent with a pneumothorax?
A) Bilateral crackles throughout the lung fields
B) Diminished or absent breath sounds on the affected side
C) Tracheal deviation toward the affected side
D) Increased tactile fremitus on the affected side
Correct Answer: Diminished or absent breath sounds on the affected side
Rationale: Pneumothorax occurs when air enters the pleural space, causing lung collapse
and diminished or absent breath sounds over the affected area. Tracheal deviation shifts
away from the affected side in tension pneumothorax, tactile fremitus is decreased, and
bilateral crackles suggest pulmonary edema rather than pneumothorax.
| University of Texas at Arlington
1. Which postoperative respiratory complication is most directly caused by shallow
breathing and retained secretions?
A) Pulmonary embolism
B) Atelectasis
C) Pleurisy
D) Pneumothorax
Correct Answer: Atelectasis
Rationale: Atelectasis is the closure or collapse of alveoli, commonly occurring after
surgery due to shallow breathing, retained secretions, and reluctance to mobilize. It is the
most common postoperative respiratory complication and can progress to pneumonia if
untreated. Pulmonary embolism is a vascular complication related to venous stasis,
pleurisy is pleural inflammation, and pneumothorax involves air in the pleural space.
2. What is the primary purpose of incentive spirometry in a postoperative patient?
A) To measure peak expiratory flow
B) To promote alveolar expansion and prevent atelectasis
C) To deliver bronchodilator medication
D) To assess for pulmonary embolism
Correct Answer: To promote alveolar expansion and prevent atelectasis
Rationale: Incentive spirometry encourages slow, deep inhalation to expand alveoli and
prevent collapse, reducing the risk of atelectasis after surgery. It does not measure peak
,expiratory flow, deliver medication, or assess for pulmonary embolism, which require
different tools and assessments.
3. A patient with pneumonia has copious tracheobronchial secretions and increased work
of breathing. Which nursing intervention is most appropriate?
A) Encourage increased oral fluids unless contraindicated
B) Restrict fluids to reduce secretion production
C) Maintain strict bed rest to conserve energy
D) Administer a cough suppressant to reduce discomfort
Correct Answer: Encourage increased oral fluids unless contraindicated
Rationale: Increased oral hydration helps thin tracheobronchial secretions, making them
easier to expectorate and improving airway clearance in pneumonia. Fluid restriction
would thicken secretions, bed rest does not promote clearance, and cough suppressants can
impair the protective cough reflex needed to remove secretions.
4. Which assessment finding best supports a diagnosis of pleurisy?
A) Pain that is relieved by deep breathing
B) Pain that intensifies with coughing or deep inspiration
C) Bilateral crackles on auscultation
D) Dull, constant chest pain
Correct Answer: Pain that intensifies with coughing or deep inspiration
Rationale: Pleurisy is inflammation of the pleura, causing sharp, localized chest pain that
worsens with inspiration, coughing, and movement. Pain relief with deep breathing is the
opposite of pleuritic pain, bilateral crackles suggest pneumonia or heart failure, and dull
constant pain is more characteristic of cardiac or musculoskeletal causes.
, 5. What is the most appropriate initial intervention for a patient with suspected acute
respiratory distress syndrome?
A) Administering high-flow oxygen and preparing for intubation
B) Encouraging aggressive oral fluid intake
C) Placing the patient in a supine position
D) Administering a cough suppressant
Correct Answer: Administering high-flow oxygen and preparing for intubation
Rationale: ARDS causes severe refractory hypoxemia, so initial management includes
high-flow oxygen and preparation for mechanical ventilation and intubation. Oral fluids do
not address the primary oxygenation failure, supine positioning can worsen ventilation-
perfusion mismatch, and cough suppressants do not treat ARDS.
6. Which assessment finding is most consistent with a pneumothorax?
A) Bilateral crackles throughout the lung fields
B) Diminished or absent breath sounds on the affected side
C) Tracheal deviation toward the affected side
D) Increased tactile fremitus on the affected side
Correct Answer: Diminished or absent breath sounds on the affected side
Rationale: Pneumothorax occurs when air enters the pleural space, causing lung collapse
and diminished or absent breath sounds over the affected area. Tracheal deviation shifts
away from the affected side in tension pneumothorax, tactile fremitus is decreased, and
bilateral crackles suggest pulmonary edema rather than pneumothorax.
