,ASU NUR 326 Exam 2 | Health & Illness Concepts II
(2026) Q&A
1. Which physiological change is the primary cause of hypoxemia in a client with
pneumonia?
A) Reduced alveolar surface area
B) Intrapulmonary shunting and ventilation-perfusion mismatch
C) Decreased respiratory drive
D) Airway obstruction from bronchospasm
Correct Answer: Intrapulmonary shunting and ventilation-perfusion mismatch
Rationale: Pneumonia causes alveolar consolidation with exudate, creating
areas that are perfused but not ventilated, leading to intrapulmonary shunting and
a low ventilation-perfusion ratio. Reduced surface area is more characteristic of
emphysema, decreased respiratory drive occurs in opioid overdose, and
bronchospasm is typical of asthma.
2. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which finding should the nurse expect?
A) Crackles in the lung bases
B) Clubbing of the fingers
C) Increased tactile fremitus
D) Dullness on percussion
,Correct Answer: Clubbing of the fingers
Rationale: Clubbing is a sign of chronic hypoxia, which is common in clients
with long-standing respiratory conditions like COPD. Crackles are typically
associated with fluid in the alveoli, increased tactile fremitus is seen with
consolidation, and dullness on percussion is a sign of fluid or a solid mass.
3. Which position is most appropriate for a client experiencing an acute asthma
exacerbation?
A) Supine
B) High Fowler’s
C) Trendelenburg
D) Prone
Correct Answer: High Fowler’s
Rationale: High Fowler’s position maximizes lung expansion by allowing gravity
to pull the diaphragm downward, which facilitates breathing during an acute
asthma exacerbation. Supine, Trendelenburg, and prone positions can worsen
respiratory distress.
4. What is the primary purpose of administering a short-acting beta-agonist
(SABA) such as albuterol during an acute asthma attack?
A) To reduce airway inflammation
B) To rapidly relieve bronchoconstriction
C) To thin respiratory secretions
, D) To prevent respiratory infections
Correct Answer: To rapidly relieve bronchoconstriction
Rationale: SABAs stimulate beta-2 receptors in the airways, causing rapid
bronchodilation and relief of acute bronchospasm. They do not primarily reduce
inflammation (that is the role of corticosteroids), thin secretions, or prevent
infections.
5. A client with a new tracheostomy has difficulty breathing and absent breath
sounds on the right side. What is the nurse’s priority action?
A) Suction the tracheostomy
B) Notify the provider and prepare for emergency intervention
C) Document the finding and reassess in one hour
D) Deflate the cuff and remove the tube
Correct Answer: Notify the provider and prepare for emergency intervention
Rationale: Unilateral absent breath sounds in a client with a tracheostomy
suggests tube obstruction, dislodgment, or a pneumothorax, requiring immediate
intervention. Suctioning may be attempted, but if unsuccessful, emergency
response is needed.
6. Which finding is most consistent with a tension pneumothorax?
A) Tracheal deviation toward the affected side
(2026) Q&A
1. Which physiological change is the primary cause of hypoxemia in a client with
pneumonia?
A) Reduced alveolar surface area
B) Intrapulmonary shunting and ventilation-perfusion mismatch
C) Decreased respiratory drive
D) Airway obstruction from bronchospasm
Correct Answer: Intrapulmonary shunting and ventilation-perfusion mismatch
Rationale: Pneumonia causes alveolar consolidation with exudate, creating
areas that are perfused but not ventilated, leading to intrapulmonary shunting and
a low ventilation-perfusion ratio. Reduced surface area is more characteristic of
emphysema, decreased respiratory drive occurs in opioid overdose, and
bronchospasm is typical of asthma.
2. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which finding should the nurse expect?
A) Crackles in the lung bases
B) Clubbing of the fingers
C) Increased tactile fremitus
D) Dullness on percussion
,Correct Answer: Clubbing of the fingers
Rationale: Clubbing is a sign of chronic hypoxia, which is common in clients
with long-standing respiratory conditions like COPD. Crackles are typically
associated with fluid in the alveoli, increased tactile fremitus is seen with
consolidation, and dullness on percussion is a sign of fluid or a solid mass.
3. Which position is most appropriate for a client experiencing an acute asthma
exacerbation?
A) Supine
B) High Fowler’s
C) Trendelenburg
D) Prone
Correct Answer: High Fowler’s
Rationale: High Fowler’s position maximizes lung expansion by allowing gravity
to pull the diaphragm downward, which facilitates breathing during an acute
asthma exacerbation. Supine, Trendelenburg, and prone positions can worsen
respiratory distress.
4. What is the primary purpose of administering a short-acting beta-agonist
(SABA) such as albuterol during an acute asthma attack?
A) To reduce airway inflammation
B) To rapidly relieve bronchoconstriction
C) To thin respiratory secretions
, D) To prevent respiratory infections
Correct Answer: To rapidly relieve bronchoconstriction
Rationale: SABAs stimulate beta-2 receptors in the airways, causing rapid
bronchodilation and relief of acute bronchospasm. They do not primarily reduce
inflammation (that is the role of corticosteroids), thin secretions, or prevent
infections.
5. A client with a new tracheostomy has difficulty breathing and absent breath
sounds on the right side. What is the nurse’s priority action?
A) Suction the tracheostomy
B) Notify the provider and prepare for emergency intervention
C) Document the finding and reassess in one hour
D) Deflate the cuff and remove the tube
Correct Answer: Notify the provider and prepare for emergency intervention
Rationale: Unilateral absent breath sounds in a client with a tracheostomy
suggests tube obstruction, dislodgment, or a pneumothorax, requiring immediate
intervention. Suctioning may be attempted, but if unsuccessful, emergency
response is needed.
6. Which finding is most consistent with a tension pneumothorax?
A) Tracheal deviation toward the affected side
