N172 Exam 3: Comprehensive Practice Questions and Correct Answers with Detailed Rationales |
Latest Update 2026/2027 | Complete Exam Review and Study Guide
Section 1: Respiratory System
Question 1
Which assessment finding is an early sign of hypoxia?
A) Bradycardia
B) Restlessness and confusion
C) Hypertension
D) Constipation
Answer
Answer: B
Rationale
** Restlessness and confusion are early neurologic signs of hypoxia as the brain senses a drop in
oxygen. Bradycardia and severe hypotension are later, more ominous signs.
Question 2
A patient with COPD has an oxygen saturation of 88%. Which action is appropriate?
A) Administer oxygen at 10 L/min
B) Withhold oxygen
C) Administer oxygen at 1–2 L/min as ordered
D) Place the patient supine
Answer
Answer: C
Rationale
** In COPD, the hypoxic drive may be the primary stimulus to breathe. Low-flow oxygen (1–2 L/min) is
titrated to a target saturation (often 88–92%) to avoid suppressing respiratory drive.
,Question 3
Which finding indicates a tension pneumothorax?
A) Bradycardia
B) Tracheal deviation away from the affected side
C) Hypertension
D) Warm, dry skin
Answer
Answer: B
Rationale
** Tension pneumothorax causes mediastinal shift, tracheal deviation away from the affected side,
severe respiratory distress, and hypotension. It is a life-threatening emergency requiring immediate
intervention.
Question 4
A patient with a chest tube has the tube become disconnected. What is the priority action?
A) Clamp the tube
B) Milk the tube
C) Place the tube end in sterile water
D) Ambulate the patient
Answer
Answer: C
Rationale
** Placing the tube end in sterile water creates a water seal and prevents air from entering the pleural
space until the system can be reconnected. Clamping can worsen a pneumothorax.
Question 5
Which clinical manifestation is a hallmark sign of left-sided heart failure?
A) Jugular venous distention
B) Crackles in the lungs
C) Peripheral edema
2
,D) Hepatomegaly
Answer
Answer: B
Rationale
** Left-sided heart failure causes blood to back up into the pulmonary circulation, leading to pulmonary
congestion and crackles (rales). Right-sided failure causes systemic congestion (JVD, edema,
hepatomegaly).
Question 6
A patient with pneumonia becomes increasingly confused and tachypneic. What should the
nurse do first?
A) Obtain a dietary history
B) Assess oxygen saturation and respiratory effort
C) Encourage ambulation
D) Offer oral fluids and reassess in one hour
Answer
Answer: B
Rationale
** New confusion and tachypnea in a patient with pneumonia may indicate worsening hypoxemia or
sepsis. Immediate assessment of oxygenation and work of breathing guides urgent intervention.
Question 7
Which action is appropriate when a patient with a new tracheostomy has audible secretions
and oxygen desaturation?
A) Deflate the cuff
B) Suction the tracheostomy
C) Change the tracheostomy tube
D) Increase the oxygen flow only
Answer
3
, Answer: B
Rationale
** Audible secretions and desaturation indicate the need for suctioning to clear the airway. Suctioning
should be performed according to protocol, with pre-oxygenation as indicated.
Question 8
A patient with asthma is using accessory muscles and can speak only one or two words. What
is the priority?
A) Offer a glass of water
B) Call for urgent assistance and assess ABCs
C) Complete the admission history
D) Encourage the patient to lie flat
Answer
Answer: B
Rationale
** Severe work of breathing and inability to speak in full sentences signal impending respiratory failure.
Immediate ABC assessment and emergency escalation are required.
Question 9
Which finding in a client with a new tracheostomy requires immediate intervention?
A) Pink-tinged secretions
B) Cuff pressure of 25 cm H₂O
C) Pale, dusky stoma
D) Occasional cough
Answer
Answer: C
Rationale
** A pale, dusky, or black stoma indicates compromised blood flow and possible necrosis. It requires
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Latest Update 2026/2027 | Complete Exam Review and Study Guide
Section 1: Respiratory System
Question 1
Which assessment finding is an early sign of hypoxia?
A) Bradycardia
B) Restlessness and confusion
C) Hypertension
D) Constipation
Answer
Answer: B
Rationale
** Restlessness and confusion are early neurologic signs of hypoxia as the brain senses a drop in
oxygen. Bradycardia and severe hypotension are later, more ominous signs.
Question 2
A patient with COPD has an oxygen saturation of 88%. Which action is appropriate?
A) Administer oxygen at 10 L/min
B) Withhold oxygen
C) Administer oxygen at 1–2 L/min as ordered
D) Place the patient supine
Answer
Answer: C
Rationale
** In COPD, the hypoxic drive may be the primary stimulus to breathe. Low-flow oxygen (1–2 L/min) is
titrated to a target saturation (often 88–92%) to avoid suppressing respiratory drive.
,Question 3
Which finding indicates a tension pneumothorax?
A) Bradycardia
B) Tracheal deviation away from the affected side
C) Hypertension
D) Warm, dry skin
Answer
Answer: B
Rationale
** Tension pneumothorax causes mediastinal shift, tracheal deviation away from the affected side,
severe respiratory distress, and hypotension. It is a life-threatening emergency requiring immediate
intervention.
Question 4
A patient with a chest tube has the tube become disconnected. What is the priority action?
A) Clamp the tube
B) Milk the tube
C) Place the tube end in sterile water
D) Ambulate the patient
Answer
Answer: C
Rationale
** Placing the tube end in sterile water creates a water seal and prevents air from entering the pleural
space until the system can be reconnected. Clamping can worsen a pneumothorax.
Question 5
Which clinical manifestation is a hallmark sign of left-sided heart failure?
A) Jugular venous distention
B) Crackles in the lungs
C) Peripheral edema
2
,D) Hepatomegaly
Answer
Answer: B
Rationale
** Left-sided heart failure causes blood to back up into the pulmonary circulation, leading to pulmonary
congestion and crackles (rales). Right-sided failure causes systemic congestion (JVD, edema,
hepatomegaly).
Question 6
A patient with pneumonia becomes increasingly confused and tachypneic. What should the
nurse do first?
A) Obtain a dietary history
B) Assess oxygen saturation and respiratory effort
C) Encourage ambulation
D) Offer oral fluids and reassess in one hour
Answer
Answer: B
Rationale
** New confusion and tachypnea in a patient with pneumonia may indicate worsening hypoxemia or
sepsis. Immediate assessment of oxygenation and work of breathing guides urgent intervention.
Question 7
Which action is appropriate when a patient with a new tracheostomy has audible secretions
and oxygen desaturation?
A) Deflate the cuff
B) Suction the tracheostomy
C) Change the tracheostomy tube
D) Increase the oxygen flow only
Answer
3
, Answer: B
Rationale
** Audible secretions and desaturation indicate the need for suctioning to clear the airway. Suctioning
should be performed according to protocol, with pre-oxygenation as indicated.
Question 8
A patient with asthma is using accessory muscles and can speak only one or two words. What
is the priority?
A) Offer a glass of water
B) Call for urgent assistance and assess ABCs
C) Complete the admission history
D) Encourage the patient to lie flat
Answer
Answer: B
Rationale
** Severe work of breathing and inability to speak in full sentences signal impending respiratory failure.
Immediate ABC assessment and emergency escalation are required.
Question 9
Which finding in a client with a new tracheostomy requires immediate intervention?
A) Pink-tinged secretions
B) Cuff pressure of 25 cm H₂O
C) Pale, dusky stoma
D) Occasional cough
Answer
Answer: C
Rationale
** A pale, dusky, or black stoma indicates compromised blood flow and possible necrosis. It requires
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