NCLEX PRACTICE QUESTIONS
SAUNDERS RESPIRATORY SYSTEM
WITH VERIFIED QUESTIONS AND
ANSWERS
The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall.
Which finding would indicate the presence of a pneumothorax in this client?
1. A low respiratory rate
2. Diminished breath sounds
3. The presence of a barrel chest
4. A sucking sound at the site of injury - answer✔✔✨-2. Diminished breath sounds
Rationale: This client has sustained a blunt or closed-chest injury. Basic symptoms of a closed
pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause tachypnea,
cyanosis, diminished breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on
the affected side. A sucking sound at the site of injury would be noted with an open chest injury.
The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary
disease. Which finding would the nurse expect to note on assessment of this client? Select all that apply.
1. Hypocapnia
2. A hyperinflated chest noted on the chest x-ray
3. Decreased oxygen saturation with mild exercise
4. A widened diaphragm noted on the chest x-ray
5. Pulmonary function tests that demonstrate increased vital capacity - answer✔✔✨-2. A
hyperinflated chest noted on the chest x-ray
3. Decreased oxygen saturation with mild exercise
, Rationale: Clinical manifestations of chronic obstructive pulmonary disease (COPD) include hypoxemia,
hypercapnia, dyspnea on exertion and at rest, oxygen desaturation with exercise, and the use of
accessory muscles of respiration. Chest x-rays reveal a hyperinflated chest and a flattened diaphragm if
the disease is advanced. Pulmonary function tests will demonstrate decreased vital capacity.
The nurse instructs a client to use the pursed-lip method of breathing and the client asks the nurse
about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of
pursed-lip breathing is to promote which outcome?
1. Promote oxygen intake
2. Strengthen the diaphragm
3. Strengthen the intercostal muscles
4. Promote carbon dioxide elimination - answer✔✔✨-4. Promote carbon dioxide elimination
Rationale: Pursed-lip breathing facilitates maximal expiration for clients with obstructive lung disease.
This type of breathing allows better expiration by increasing airway pressure that keeps air passages
open during exhalation. Options 1, 2, and 3 are not the purposes of this type of breathing.
The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated
for tuberculosis. Which instructions should the nurse include on the list? Select all that apply.
1. Activities should be resumed gradually.
2. Avoid contact with other individuals, except family members, for at least 6 months.
3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated.
4. Respiratory isolation is not necessary because family members already have been exposed.
5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.
6. When one sputum culture is negative, the client is no longer considered infectious and usually can
return to former employment. - answer✔✔✨-1. Activities should be resumed gradually.
3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated.
4. Respiratory isolation is not necessary because family members already have been exposed.
5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.
SAUNDERS RESPIRATORY SYSTEM
WITH VERIFIED QUESTIONS AND
ANSWERS
The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall.
Which finding would indicate the presence of a pneumothorax in this client?
1. A low respiratory rate
2. Diminished breath sounds
3. The presence of a barrel chest
4. A sucking sound at the site of injury - answer✔✔✨-2. Diminished breath sounds
Rationale: This client has sustained a blunt or closed-chest injury. Basic symptoms of a closed
pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause tachypnea,
cyanosis, diminished breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on
the affected side. A sucking sound at the site of injury would be noted with an open chest injury.
The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary
disease. Which finding would the nurse expect to note on assessment of this client? Select all that apply.
1. Hypocapnia
2. A hyperinflated chest noted on the chest x-ray
3. Decreased oxygen saturation with mild exercise
4. A widened diaphragm noted on the chest x-ray
5. Pulmonary function tests that demonstrate increased vital capacity - answer✔✔✨-2. A
hyperinflated chest noted on the chest x-ray
3. Decreased oxygen saturation with mild exercise
, Rationale: Clinical manifestations of chronic obstructive pulmonary disease (COPD) include hypoxemia,
hypercapnia, dyspnea on exertion and at rest, oxygen desaturation with exercise, and the use of
accessory muscles of respiration. Chest x-rays reveal a hyperinflated chest and a flattened diaphragm if
the disease is advanced. Pulmonary function tests will demonstrate decreased vital capacity.
The nurse instructs a client to use the pursed-lip method of breathing and the client asks the nurse
about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of
pursed-lip breathing is to promote which outcome?
1. Promote oxygen intake
2. Strengthen the diaphragm
3. Strengthen the intercostal muscles
4. Promote carbon dioxide elimination - answer✔✔✨-4. Promote carbon dioxide elimination
Rationale: Pursed-lip breathing facilitates maximal expiration for clients with obstructive lung disease.
This type of breathing allows better expiration by increasing airway pressure that keeps air passages
open during exhalation. Options 1, 2, and 3 are not the purposes of this type of breathing.
The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated
for tuberculosis. Which instructions should the nurse include on the list? Select all that apply.
1. Activities should be resumed gradually.
2. Avoid contact with other individuals, except family members, for at least 6 months.
3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated.
4. Respiratory isolation is not necessary because family members already have been exposed.
5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.
6. When one sputum culture is negative, the client is no longer considered infectious and usually can
return to former employment. - answer✔✔✨-1. Activities should be resumed gradually.
3. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated.
4. Respiratory isolation is not necessary because family members already have been exposed.
5. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags.
