🫁 Human Respiratory System Mock Test
100 Questions | MCQ Quiz with Live Score
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Human Respiratory System MCQ Quiz – 100 Questions and Answers Mock Test
Question 1
Which anatomical structure acts as a lid to prevent food from entering the trachea during swallowing?
A. Thyroid cartilage
B. Cricoid ring
C. Epiglottis
D. Glottis
Explanation:
The epiglottis is a leaf-shaped flap of cartilage located above the larynx. During swallowing, it folds down over the tracheal opening to prevent aspiration. This mechanism directs food and liquids into the esophagus instead of the airway. Damage or dysfunction of the epiglottis increases the risk of choking and aspiration pneumonia. It plays a vital role in airway protection.
The epiglottis is a leaf-shaped flap of cartilage located above the larynx. During swallowing, it folds down over the tracheal opening to prevent aspiration. This mechanism directs food and liquids into the esophagus instead of the airway. Damage or dysfunction of the epiglottis increases the risk of choking and aspiration pneumonia. It plays a vital role in airway protection.
Question 2
What is the medical term for the volume of air moved during a normal quiet breath?
A. Tidal Volume
B. Residual Volume
C. Vital Capacity
D. Inspiratory Reserve
Explanation:
Tidal volume is the amount of air inhaled or exhaled during a normal quiet breath. In a healthy adult, it is approximately 500 mL per breath. It represents the basic volume exchanged during resting respiration. Tidal volume is an important parameter used in respiratory assessment and ventilator settings. Changes may indicate respiratory dysfunction.
Tidal volume is the amount of air inhaled or exhaled during a normal quiet breath. In a healthy adult, it is approximately 500 mL per breath. It represents the basic volume exchanged during resting respiration. Tidal volume is an important parameter used in respiratory assessment and ventilator settings. Changes may indicate respiratory dysfunction.
Question 3
Which lung cells are primarily responsible for surfactant production to prevent the alveoli from collapsing?
A. Type I Alveolar Cells
B. Alveolar Macrophages
C. Type II Alveolar Cells
D. Goblet Cells
Explanation:
Type II alveolar cells produce pulmonary surfactant, a substance that reduces surface tension. Surfactant prevents the alveoli from collapsing during exhalation. Adequate surfactant improves lung compliance and facilitates gas exchange. Premature infants often lack sufficient surfactant, leading to respiratory distress syndrome. These cells also help repair damaged alveolar tissue.
Type II alveolar cells produce pulmonary surfactant, a substance that reduces surface tension. Surfactant prevents the alveoli from collapsing during exhalation. Adequate surfactant improves lung compliance and facilitates gas exchange. Premature infants often lack sufficient surfactant, leading to respiratory distress syndrome. These cells also help repair damaged alveolar tissue.
Question 4
What is the normal resting respiratory rate range for a healthy adult in breaths per minute?
A. 8 to 12
B. 12 to 20
C. 20 to 30
D. 30 to 40
Explanation:
The normal respiratory rate for a healthy resting adult is 12 to 20 breaths per minute. Respiratory rate is one of the four primary vital signs. A rate above 20 breaths per minute is called tachypnea. A rate below 12 breaths per minute is called bradypnea. Accurate assessment helps identify respiratory and metabolic disorders.
The normal respiratory rate for a healthy resting adult is 12 to 20 breaths per minute. Respiratory rate is one of the four primary vital signs. A rate above 20 breaths per minute is called tachypnea. A rate below 12 breaths per minute is called bradypnea. Accurate assessment helps identify respiratory and metabolic disorders.
Question 5
Which part of the brain contains the centers that set the basic rhythm of normal breathing?
A. Cerebral cortex
B. Cerebellum
C. Medulla oblongata
D. Thalamus
Explanation:
The medulla oblongata contains the primary respiratory centers responsible for automatic breathing. These centers regulate the rate and depth of respiration. They respond to changes in carbon dioxide, oxygen, and blood pH levels. Damage to the medulla can result in serious breathing abnormalities. It is an essential part of the brainstem for life-sustaining functions.
The medulla oblongata contains the primary respiratory centers responsible for automatic breathing. These centers regulate the rate and depth of respiration. They respond to changes in carbon dioxide, oxygen, and blood pH levels. Damage to the medulla can result in serious breathing abnormalities. It is an essential part of the brainstem for life-sustaining functions.
Question 6
What term describes the bluish discoloration of skin indicating a severe lack of systemic oxygenation?
A. Pallor
B. Jaundice
C. Erythema
D. Cyanosis
Explanation:
Cyanosis is a bluish discoloration of the skin, lips, or nail beds caused by inadequate oxygen in the blood. It is often seen in severe respiratory or cardiac conditions. Central cyanosis is considered a medical emergency and requires prompt assessment. The finding indicates significant hypoxemia and impaired tissue oxygenation.
Cyanosis is a bluish discoloration of the skin, lips, or nail beds caused by inadequate oxygen in the blood. It is often seen in severe respiratory or cardiac conditions. Central cyanosis is considered a medical emergency and requires prompt assessment. The finding indicates significant hypoxemia and impaired tissue oxygenation.
Question 7
Which structure is colloquially known as the “voice box” and contains the vocal cords for speech?
A. Pharynx
B. Larynx
C. Trachea
D. Bronchus
Explanation:
The larynx is commonly called the voice box because it houses the vocal cords. Air passing through the vocal cords produces sound for speech. It also protects the lower airway during swallowing. The larynx connects the pharynx to the trachea.
The larynx is commonly called the voice box because it houses the vocal cords. Air passing through the vocal cords produces sound for speech. It also protects the lower airway during swallowing. The larynx connects the pharynx to the trachea.
Question 8
What clinical term describes the difficult or labored breathing often reported by patients in respiratory distress?
A. Dyspnea
B. Eupnea
C. Bradypnea
D. Apnea
Explanation:
Dyspnea refers to the subjective sensation of difficult or uncomfortable breathing. Patients often describe it as shortness of breath or air hunger. It is commonly associated with asthma, COPD, heart failure, and pneumonia. Assessment of dyspnea is important in determining respiratory status.
Dyspnea refers to the subjective sensation of difficult or uncomfortable breathing. Patients often describe it as shortness of breath or air hunger. It is commonly associated with asthma, COPD, heart failure, and pneumonia. Assessment of dyspnea is important in determining respiratory status.
Question 9
Which anatomical structure is wider, shorter, and straighter, making it the common site for aspirated objects?
A. Left main bronchus
B. Trachea
C. Right main bronchus
D. Larynx
Explanation:
The right main bronchus is wider, shorter, and more vertical than the left bronchus. Because of this anatomy, foreign bodies are more likely to enter the right lung. This is a common nursing and medical exam question. Bronchoscopy is often required to remove aspirated objects.
The right main bronchus is wider, shorter, and more vertical than the left bronchus. Because of this anatomy, foreign bodies are more likely to enter the right lung. This is a common nursing and medical exam question. Bronchoscopy is often required to remove aspirated objects.
Question 10
What is the standard pH range for arterial blood in a healthy human body for homeostasis?
A. 7.00 to 7.10
B. 7.25 to 7.35
C. 7.35 to 7.45
D. 7.45 to 7.55
Explanation:
The normal arterial blood pH range is 7.35 to 7.45. A pH below 7.35 indicates acidosis, while a pH above 7.45 indicates alkalosis. The body maintains this narrow range through respiratory and renal regulation. Even small deviations can significantly affect cellular function and metabolism.
The normal arterial blood pH range is 7.35 to 7.45. A pH below 7.35 indicates acidosis, while a pH above 7.45 indicates alkalosis. The body maintains this narrow range through respiratory and renal regulation. Even small deviations can significantly affect cellular function and metabolism.
Question 11
A nurse is counting the respiratory rate of a resting one-month-old infant. What is the expected normal range for this age group?
A. 12 to 20
B. 20 to 30
C. 30 to 60
D. 60 to 80
Explanation:
Infants normally breathe faster than adults due to their higher metabolic demands. The normal respiratory rate for a newborn or young infant is 30–60 breaths per minute. Rates outside this range may indicate respiratory distress or illness. Respiratory assessment is an essential part of pediatric nursing care.
Infants normally breathe faster than adults due to their higher metabolic demands. The normal respiratory rate for a newborn or young infant is 30–60 breaths per minute. Rates outside this range may indicate respiratory distress or illness. Respiratory assessment is an essential part of pediatric nursing care.
Question 12
While assessing a patient with chronic hypoxia, the nurse notes bulbous enlargement of the fingertips. How should this clinical finding be documented?
A. Peripheral cyanosis
B. Raynaud’s phenomenon
C. Digital clubbing
D. Pitting edema
Explanation:
Digital clubbing is characterized by enlargement of the fingertips and loss of the normal nail-bed angle. It is commonly associated with chronic hypoxia and long-standing lung diseases. Conditions such as COPD, cystic fibrosis, and lung cancer may cause clubbing. This finding suggests prolonged oxygen deprivation at the tissue level.
Digital clubbing is characterized by enlargement of the fingertips and loss of the normal nail-bed angle. It is commonly associated with chronic hypoxia and long-standing lung diseases. Conditions such as COPD, cystic fibrosis, and lung cancer may cause clubbing. This finding suggests prolonged oxygen deprivation at the tissue level.
Question 13
During a lung assessment, the nurse hears high-pitched whistling sounds primarily on expiration. What is the correct medical term for these sounds?
A. Wheezes
B. Crackles
C. Rhonchi
D. Stridor
Explanation:
Wheezes are high-pitched musical sounds caused by narrowing of the airways. They are commonly heard during expiration in asthma and COPD. Air moving through constricted bronchi produces this characteristic sound. Wheezing often indicates airflow obstruction.
Wheezes are high-pitched musical sounds caused by narrowing of the airways. They are commonly heard during expiration in asthma and COPD. Air moving through constricted bronchi produces this characteristic sound. Wheezing often indicates airflow obstruction.
Question 14
A patient is leaning forward with arms resting on a table to facilitate easier breathing. Which term describes this specific compensatory posture?
A. Supine position
B. Prone position
C. Tripod position
D. Trendelenburg position
Explanation:
The tripod position helps patients maximize chest expansion and improve ventilation. It allows accessory respiratory muscles to assist breathing more effectively. This posture is commonly observed in severe asthma, COPD, and respiratory distress. Its presence often indicates increased work of breathing.
The tripod position helps patients maximize chest expansion and improve ventilation. It allows accessory respiratory muscles to assist breathing more effectively. This posture is commonly observed in severe asthma, COPD, and respiratory distress. Its presence often indicates increased work of breathing.
Question 15
Which physiological buffer system is the fastest acting in the human body, responding within seconds to stabilize changes in the blood pH?
A. Carbonic acid-bicarbonate
B. Renal system
C. Phosphate system
D. Protein buffering
Explanation:
The carbonic acid-bicarbonate buffer system is the body’s primary and fastest buffer. It reacts within seconds to minimize sudden changes in blood pH. This system works closely with the lungs and kidneys to maintain acid-base balance. Proper function is essential for cellular metabolism and homeostasis.
The carbonic acid-bicarbonate buffer system is the body’s primary and fastest buffer. It reacts within seconds to minimize sudden changes in blood pH. This system works closely with the lungs and kidneys to maintain acid-base balance. Proper function is essential for cellular metabolism and homeostasis.
Question 16
What is the volume of air that remains in the conducting airways and does not participate in pulmonary gas exchange in adults?
A. Tidal Volume
B. Residual Volume
C. Anatomical dead space
D. Vital capacity
Explanation:
Anatomical dead space refers to air in the conducting airways that does not reach the alveoli. This air remains in structures such as the trachea and bronchi. In adults, anatomical dead space is approximately 150 mL. It does not participate in oxygen and carbon dioxide exchange.
Anatomical dead space refers to air in the conducting airways that does not reach the alveoli. This air remains in structures such as the trachea and bronchi. In adults, anatomical dead space is approximately 150 mL. It does not participate in oxygen and carbon dioxide exchange.
Question 17
A nurse interprets an arterial blood gas result with a pH of 7.50 and a PaCO₂ of 30 mmHg. What is the diagnosis?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Explanation:
A pH above 7.45 indicates alkalosis. The low PaCO₂ value shows that the respiratory system is causing the imbalance. This pattern is consistent with respiratory alkalosis, often due to hyperventilation. Anxiety, pain, and hypoxemia are common causes.
A pH above 7.45 indicates alkalosis. The low PaCO₂ value shows that the respiratory system is causing the imbalance. This pattern is consistent with respiratory alkalosis, often due to hyperventilation. Anxiety, pain, and hypoxemia are common causes.
Question 18
Which diagnostic test is considered the “gold standard” for definitively confirming a diagnosis of cystic fibrosis in a symptomatic pediatric patient?
A. Chest X-ray
B. Sputum culture
C. Sweat chloride test
D. Bronchoscopy
Explanation:
The sweat chloride test measures the concentration of chloride in sweat. Children with cystic fibrosis have abnormally elevated chloride levels. It is considered the gold standard diagnostic test for cystic fibrosis. The test is simple, reliable, and widely used in pediatric practice.
The sweat chloride test measures the concentration of chloride in sweat. Children with cystic fibrosis have abnormally elevated chloride levels. It is considered the gold standard diagnostic test for cystic fibrosis. The test is simple, reliable, and widely used in pediatric practice.
Question 19
A patient is prescribed Isoniazid for tuberculosis. Which vitamin supplement should be administered to prevent the development of drug-induced peripheral neuropathy?
A. Vitamin C
B. Vitamin B6
C. Vitamin B12
D. Vitamin D
Explanation:
Isoniazid can interfere with vitamin B6 metabolism and lead to peripheral neuropathy. Pyridoxine (Vitamin B6) supplementation helps prevent this adverse effect. Patients taking long-term INH therapy commonly receive Vitamin B6 routinely. This improves medication safety and treatment adherence.
Isoniazid can interfere with vitamin B6 metabolism and lead to peripheral neuropathy. Pyridoxine (Vitamin B6) supplementation helps prevent this adverse effect. Patients taking long-term INH therapy commonly receive Vitamin B6 routinely. This improves medication safety and treatment adherence.
Question 20
While monitoring a chest tube, the nurse observes the water level rising with inspiration and falling with expiration. How is this documented?
A. Tidaling
B. Air leak
C. Crepitus
D. Bubbling
Explanation:
Tidaling refers to normal fluctuation of water in the water-seal chamber. The water level rises and falls with changes in intrathoracic pressure during breathing. This finding generally indicates that the chest tube is patent and functioning. Absence of tidaling may indicate lung re-expansion or tube obstruction.
Tidaling refers to normal fluctuation of water in the water-seal chamber. The water level rises and falls with changes in intrathoracic pressure during breathing. This finding generally indicates that the chest tube is patent and functioning. Absence of tidaling may indicate lung re-expansion or tube obstruction.
Question 21
A patient with COPD has a 1:1 anteroposterior-to-transverse chest ratio. What clinical term is used to describe this specific chest configuration?
A. Pectus excavatum
B. Kyphosis
C. Barrel chest
D. Funnel chest
Explanation:
Barrel chest is commonly seen in clients with chronic COPD and emphysema. The chest becomes rounded, causing the anteroposterior diameter to equal the transverse diameter. It develops due to chronic air trapping and lung hyperinflation. This finding is a classic sign of long-standing obstructive lung disease.
Barrel chest is commonly seen in clients with chronic COPD and emphysema. The chest becomes rounded, causing the anteroposterior diameter to equal the transverse diameter. It develops due to chronic air trapping and lung hyperinflation. This finding is a classic sign of long-standing obstructive lung disease.
Question 22
Which ventilator setting is specifically designed to keep the alveoli open at the end of expiration to improve pulmonary gas exchange?
A. Tidal Volume
B. Fraction of Inspired Oxygen
C. PEEP
D. Pressure Support
Explanation:
PEEP stands for Positive End-Expiratory Pressure. It prevents alveolar collapse at the end of expiration and improves oxygenation. PEEP increases functional residual capacity and enhances gas exchange. Excessive PEEP, however, may increase the risk of barotrauma and hypotension.
PEEP stands for Positive End-Expiratory Pressure. It prevents alveolar collapse at the end of expiration and improves oxygenation. PEEP increases functional residual capacity and enhances gas exchange. Excessive PEEP, however, may increase the risk of barotrauma and hypotension.
Question 23
A nurse finds a child with a “seal-like” barking cough and inspiratory stridor. Which acute pediatric condition is most likely being described?
A. Epiglottitis
B. Laryngotracheobronchitis
C. Bronchiolitis
D. Asthma
Explanation:
Laryngotracheobronchitis, commonly called croup, is characterized by a barking cough and inspiratory stridor. It usually results from viral inflammation of the upper airway. Symptoms often worsen at night and may cause respiratory distress. Humidified air and corticosteroids are commonly used treatments.
Laryngotracheobronchitis, commonly called croup, is characterized by a barking cough and inspiratory stridor. It usually results from viral inflammation of the upper airway. Symptoms often worsen at night and may cause respiratory distress. Humidified air and corticosteroids are commonly used treatments.
Question 24
What is the correct sequence of administration for a patient prescribed both a bronchodilator inhaler and an inhaled corticosteroid for asthma management?
A. Bronchodilator then corticosteroid
B. Corticosteroid then bronchodilator
C. Simultaneously together
D. Sequence does not matter
Explanation:
The bronchodilator should be administered first to open the airways. Once the bronchi are dilated, the corticosteroid can penetrate deeper into the lungs. This sequence improves medication effectiveness. Patients should also rinse their mouth after using inhaled corticosteroids.
The bronchodilator should be administered first to open the airways. Once the bronchi are dilated, the corticosteroid can penetrate deeper into the lungs. This sequence improves medication effectiveness. Patients should also rinse their mouth after using inhaled corticosteroids.
Question 25
In cases of an opioid overdose causing severe respiratory depression, which medication is administered as the specific reversal agent or antagonist?
A. Atropine
B. Naloxone
C. Vitamin K
D. Flumazenil
Explanation:
Naloxone is an opioid antagonist used to reverse opioid overdose. It rapidly restores respiratory drive by displacing opioids from receptor sites. The medication may need repeated doses because its duration of action is shorter than some opioids. Continuous monitoring is essential after administration.
Naloxone is an opioid antagonist used to reverse opioid overdose. It rapidly restores respiratory drive by displacing opioids from receptor sites. The medication may need repeated doses because its duration of action is shorter than some opioids. Continuous monitoring is essential after administration.
Question 26
A patient with a head injury is on a ventilator. The provider increases the respiratory rate to “blow off” CO₂ for:
A. Improving oxygenation
B. Cerebral vasoconstriction
C. Metabolic compensation
D. Increasing tidal volume
Explanation:
Reducing PaCO₂ causes cerebral blood vessels to constrict. This decreases cerebral blood flow and helps lower intracranial pressure. The technique may be used temporarily in severe head injuries. Careful monitoring is required to avoid excessive cerebral ischemia.
Reducing PaCO₂ causes cerebral blood vessels to constrict. This decreases cerebral blood flow and helps lower intracranial pressure. The technique may be used temporarily in severe head injuries. Careful monitoring is required to avoid excessive cerebral ischemia.
Question 27
Which type of embolus is specifically associated with long bone fractures and requires vigilant monitoring for sudden respiratory distress in patients?
A. Fat embolus
B. Air embolus
C. Septic embolus
D. Amniotic embolus
Explanation:
Fat embolism syndrome can occur after fractures of long bones such as the femur. Fat droplets enter the bloodstream and obstruct pulmonary vessels. Common signs include respiratory distress, neurological changes, and petechial rash. Early recognition and supportive care are essential.
Fat embolism syndrome can occur after fractures of long bones such as the femur. Fat droplets enter the bloodstream and obstruct pulmonary vessels. Common signs include respiratory distress, neurological changes, and petechial rash. Early recognition and supportive care are essential.
Question 28
During the removal of a chest tube, the patient is instructed to perform which maneuver to prevent air from entering the space?
A. Deep coughing
B. Rapid panting
C. Valsalva maneuver
D. Forced expiration
Explanation:
The Valsalva maneuver increases intrathoracic pressure during chest tube removal. This helps prevent atmospheric air from entering the pleural space. It reduces the risk of developing a pneumothorax after tube removal. Patients are usually instructed to bear down or hold their breath.
The Valsalva maneuver increases intrathoracic pressure during chest tube removal. This helps prevent atmospheric air from entering the pleural space. It reduces the risk of developing a pneumothorax after tube removal. Patients are usually instructed to bear down or hold their breath.
Question 29
What is the maximum recommended suction pressure in mmHg when performing tracheal suctioning on an adult patient to avoid tissue damage?
A. 120 mmHg
B. 150 mmHg
C. 180 mmHg
D. 200 mmHg
Explanation:
The recommended suction pressure for adults should not exceed 120 mmHg. Higher pressures can damage airway mucosa and increase hypoxemia risk. Suctioning should be performed only when necessary and for the shortest duration possible. Pre-oxygenation is recommended before the procedure.
The recommended suction pressure for adults should not exceed 120 mmHg. Higher pressures can damage airway mucosa and increase hypoxemia risk. Suctioning should be performed only when necessary and for the shortest duration possible. Pre-oxygenation is recommended before the procedure.
Question 30
A nurse notes “Rice Krispies” crackling sensations while palpating the skin around a chest tube site. How should this be documented?
A. Tactile fremitus
B. Pleural rub
C. Crepitus
D. Thrill
Explanation:
Crepitus is a crackling sensation felt under the skin due to trapped air in subcutaneous tissues. It is commonly associated with subcutaneous emphysema around chest tube sites. The sensation is often compared to touching Rice Krispies. The finding should be monitored because it may indicate an air leak.
Crepitus is a crackling sensation felt under the skin due to trapped air in subcutaneous tissues. It is commonly associated with subcutaneous emphysema around chest tube sites. The sensation is often compared to touching Rice Krispies. The finding should be monitored because it may indicate an air leak.
Question 31
A patient’s arterial blood gas results are: pH 7.26, PaCO₂ 32 mmHg, and HCO₃ 18 mEq/L. Which state of compensation is represented?
A. Uncompensated metabolic acidosis
B. Partially compensated metabolic acidosis
C. Fully compensated respiratory alkalosis
D. Partially compensated respiratory acidosis
Explanation:
The pH is acidic and HCO₃ is low, indicating metabolic acidosis. The low PaCO₂ shows respiratory compensation has started. Since the pH is still abnormal, the condition is only partially compensated.
The pH is acidic and HCO₃ is low, indicating metabolic acidosis. The low PaCO₂ shows respiratory compensation has started. Since the pH is still abnormal, the condition is only partially compensated.
Question 32
The nurse is responding to a high-pressure alarm on a patient’s mechanical ventilator. Which of the following is a common cause?
A. Disconnection of the tubing
B. A leak in the tube cuff
C. The patient is biting the tube
D. Total accidental extubation
Explanation:
High-pressure alarms occur when airflow meets resistance. Common causes include biting the tube, secretions, or kinks in tubing. The patient should be assessed immediately.
High-pressure alarms occur when airflow meets resistance. Common causes include biting the tube, secretions, or kinks in tubing. The patient should be assessed immediately.
Question 33
A chest tube is accidentally dislodged from a patient’s chest. What is the nurse’s immediate priority action to prevent a tension pneumothorax?
A. Submerge the distal end in water
B. Apply occlusive dressing taped on three sides
C. Call the rapid response team
D. Instruct the patient to pant
Explanation:
A sterile occlusive dressing taped on three sides prevents air from entering the pleural space. This creates a flutter-valve effect and reduces the risk of tension pneumothorax. Emergency assistance should then be obtained.
A sterile occlusive dressing taped on three sides prevents air from entering the pleural space. This creates a flutter-valve effect and reduces the risk of tension pneumothorax. Emergency assistance should then be obtained.
Question 34
For a patient with an acute COPD exacerbation who is a chronic carbon dioxide retainer, what is the target SpO₂ range?
A. 88% to 92%
B. 94% to 100%
C. 90% to 95%
D. 85% to 88%
Explanation:
The recommended oxygen saturation target is 88%–92%. Higher oxygen levels may suppress the hypoxic drive in some COPD patients. Careful oxygen administration is essential.
The recommended oxygen saturation target is 88%–92%. Higher oxygen levels may suppress the hypoxic drive in some COPD patients. Careful oxygen administration is essential.
Question 35
A child with cystic fibrosis requires pancreatic enzyme supplements. When should the nurse instruct the parents to administer these medications?
A. Once daily in the morning
B. Before all meals and snacks
C. Two hours after eating
D. Only if diarrhea occurs
Explanation:
Pancreatic enzymes should be taken before meals and snacks. They aid digestion and improve nutrient absorption. This helps prevent malnutrition in children with cystic fibrosis.
Pancreatic enzymes should be taken before meals and snacks. They aid digestion and improve nutrient absorption. This helps prevent malnutrition in children with cystic fibrosis.
Question 36
Ten minutes after extubation, the nurse hears a high-pitched inspiratory “squeak” (stridor). What is the priority nursing action?
A. Encourage incentive spirometer use
B. Notify the healthcare provider immediately
C. Perform oral care with chlorhexidine
D. Place the patient in prone position
Explanation:
Stridor after extubation suggests upper airway obstruction. This is a medical emergency that can rapidly compromise breathing. Immediate provider notification is required.
Stridor after extubation suggests upper airway obstruction. This is a medical emergency that can rapidly compromise breathing. Immediate provider notification is required.
Question 37
To prevent Ventilator-Associated Pneumonia (VAP), the nurse should maintain the head of the bed (HOB) at which angle?
A. Flat (0 degrees)
B. 15 to 20 degrees
C. 30 to 45 degrees
D. 90 degrees
Explanation:
Keeping the head of the bed elevated 30–45 degrees reduces aspiration risk. This is a key component of VAP prevention bundles. It helps decrease ventilator-associated infections.
Keeping the head of the bed elevated 30–45 degrees reduces aspiration risk. This is a key component of VAP prevention bundles. It helps decrease ventilator-associated infections.
Question 38
Which diagnostic finding on a chest X-ray is most characteristic of a tension pneumothorax requiring emergency intervention?
A. Lobar consolidation
B. Tracheal deviation to the unaffected side
C. Blunting of the costophrenic angle
D. Fluid level in the pleural space
Explanation:
Tension pneumothorax causes pressure buildup in the chest. This shifts the mediastinum and trachea away from the affected side. It is a life-threatening emergency requiring immediate treatment.
Tension pneumothorax causes pressure buildup in the chest. This shifts the mediastinum and trachea away from the affected side. It is a life-threatening emergency requiring immediate treatment.
Question 39
Before suctioning an intubated patient, which action is essential to prevent hypoxemia during the procedure?
A. Hyperoxygenate with 100% O₂ for 30–60 seconds
B. Administer a dose of Albuterol
C. Instill 5 mL of saline into the tube
D. Decrease the ventilator respiratory rate
Explanation:
Suctioning temporarily removes oxygen from the airway. Pre-oxygenating with 100% oxygen helps prevent hypoxemia. This is a standard safety measure before suctioning.
Suctioning temporarily removes oxygen from the airway. Pre-oxygenating with 100% oxygen helps prevent hypoxemia. This is a standard safety measure before suctioning.
Question 40
A nurse notes that “tidaling” in the water seal chamber of a chest tube system has stopped. What is the most likely cause?
A. An air leak in the system
B. Full lung re-expansion or a kink
C. The suction is set too low
D. The collection chamber is full
Explanation:
Stopped tidaling may indicate that the lung has fully re-expanded. It can also occur if the tubing is kinked or obstructed. The patient should be assessed before taking action.
Stopped tidaling may indicate that the lung has fully re-expanded. It can also occur if the tubing is kinked or obstructed. The patient should be assessed before taking action.
Question 41
A patient with severe anemia (Hb=6 g/dL) has an SpO₂ of 99%. The nurse understands that this patient:
A. May still have tissue hypoxia
B. Is perfectly oxygenated
C. Has high arterial oxygen content
D. Requires a decrease in O₂ flow
Explanation:
SpO₂ measures oxygen saturation, not total oxygen-carrying capacity. Severe anemia means fewer red blood cells are available to transport oxygen. Tissue hypoxia may still occur despite a normal saturation reading.
SpO₂ measures oxygen saturation, not total oxygen-carrying capacity. Severe anemia means fewer red blood cells are available to transport oxygen. Tissue hypoxia may still occur despite a normal saturation reading.
Question 42
Which medication is a “clot buster” (thrombolytic) that may be administered in cases of a massive, hemodynamically unstable pulmonary embolism?
A. Heparin
B. Warfarin
C. Alteplase (tPA)
D. Aspirin
Explanation:
Alteplase (tPA) is a thrombolytic medication that dissolves blood clots. It is used in life-threatening pulmonary embolism with hemodynamic instability. Close monitoring for bleeding is essential.
Alteplase (tPA) is a thrombolytic medication that dissolves blood clots. It is used in life-threatening pulmonary embolism with hemodynamic instability. Close monitoring for bleeding is essential.
Question 43
A child presents with high fever, drooling, and a “tripod” position. Which action is strictly contraindicated by the nurse?
A. Using a tongue depressor to inspect the throat
B. Administering humidified oxygen
C. Allowing the child to sit with parents
D. Monitoring oxygen saturation
Explanation:
These findings suggest acute epiglottitis. Using a tongue depressor may trigger complete airway obstruction. The airway should be secured by experienced personnel.
These findings suggest acute epiglottitis. Using a tongue depressor may trigger complete airway obstruction. The airway should be secured by experienced personnel.
Question 44
What is the therapeutic serum level range for the medication Theophylline used in chronic lung disease management?
A. 5–10 mcg/mL
B. 10–20 mcg/mL
C. 25–40 mcg/mL
D. 1–5 mcg/mL
Explanation:
The therapeutic serum level of Theophylline is 10–20 mcg/mL. Levels above this range increase the risk of toxicity. Monitoring blood levels is important during treatment.
The therapeutic serum level of Theophylline is 10–20 mcg/mL. Levels above this range increase the risk of toxicity. Monitoring blood levels is important during treatment.
Question 45
A patient taking Rifampin for tuberculosis notes that their urine has turned orange-red. What is the nurse’s best response?
A. Explain it is a harmless side effect
B. Notify the physician of liver failure
C. Stop the medication immediately
D. Prepare for an emergency biopsy
Explanation:
Rifampin commonly causes orange-red discoloration of body fluids. This effect is harmless and expected. Patients should be informed before starting therapy.
Rifampin commonly causes orange-red discoloration of body fluids. This effect is harmless and expected. Patients should be informed before starting therapy.
Question 46
Which ventilator mode provides full machine control over the respiratory rate and is often used after cardiac arrest?
A. Assist Control (AC)
B. SIMV
C. Pressure Support
D. CPAP
Explanation:
Assist Control mode delivers a preset number of breaths and volume. It provides maximum ventilatory support. This mode is commonly used in critically ill patients.
Assist Control mode delivers a preset number of breaths and volume. It provides maximum ventilatory support. This mode is commonly used in critically ill patients.
Question 47
A “sedation vacation” is implemented daily for a ventilated patient primarily to assess:
A. Nutritional intake
B. Readiness for weaning and extubation
C. Gastric stress ulcers
D. Pain management levels
Explanation:
Sedation is temporarily stopped to evaluate neurologic status and breathing ability. This helps determine readiness for ventilator weaning. It may shorten ventilation time and ICU stay.
Sedation is temporarily stopped to evaluate neurologic status and breathing ability. This helps determine readiness for ventilator weaning. It may shorten ventilation time and ICU stay.
Question 48
In the Tic-Tac-Toe method, if the pH and HCO₃ are both in the “Acidosis” column, the primary problem is:
A. Respiratory
B. Metabolic
C. Compensated
D. Alkalotic
Explanation:
When pH and bicarbonate move in the same direction, the disorder is metabolic. Both values falling in the acidosis column indicate metabolic acidosis. This method simplifies ABG interpretation.
When pH and bicarbonate move in the same direction, the disorder is metabolic. Both values falling in the acidosis column indicate metabolic acidosis. This method simplifies ABG interpretation.
Question 49
Excessive PEEP on a ventilator can lead to which serious cardiovascular complication?
A. Decreased cardiac output
B. Fluid volume overload
C. Respiratory alkalosis
D. Hypertension
Explanation:
High PEEP increases intrathoracic pressure. This reduces venous return to the heart and decreases cardiac output. Blood pressure should be monitored closely.
High PEEP increases intrathoracic pressure. This reduces venous return to the heart and decreases cardiac output. Blood pressure should be monitored closely.
Question 50
During chest physiotherapy, which technique involves rhythmic “clapping” on the chest wall with cupped hands?
A. Vibration
B. Percussion
C. Postural drainage
D. Incentive spirometry
Explanation:
Percussion involves rhythmic clapping over the chest wall using cupped hands. It helps loosen secretions from the airways. The technique is commonly used during chest physiotherapy.
Percussion involves rhythmic clapping over the chest wall using cupped hands. It helps loosen secretions from the airways. The technique is commonly used during chest physiotherapy.
Question 51
A patient with a T6 spinal cord injury has a BP of 210/106 and facial flushing. What is the priority assessment?
A. Check temperature
B. Assess for distended bladder/bowel
C. Check pedal pulses
D. Administer pain meds
Explanation:
These findings suggest autonomic dysreflexia. A full bladder or bowel is the most common trigger. Identifying and removing the cause is the priority.
These findings suggest autonomic dysreflexia. A full bladder or bowel is the most common trigger. Identifying and removing the cause is the priority.
Question 52
Continuous bubbling is suddenly noted in the water seal chamber. To troubleshoot the source, where should the nurse clamp first?
A. Near the drainage unit
B. Close to the patient’s chest wall
C. In the middle of the tubing
D. At the suction regulator
Explanation:
Clamping near the chest wall helps identify whether the leak originates from the patient or the drainage system. This is the first step in troubleshooting a suspected air leak.
Clamping near the chest wall helps identify whether the leak originates from the patient or the drainage system. This is the first step in troubleshooting a suspected air leak.
Question 53
A patient on a ventilator has a sudden drop in SpO₂. What is the very first action the nurse should take?
A. Auscultate lung sounds
B. Increase FiO₂ to 100%
C. Call the doctor
D. Manually ventilate
Explanation:
Always assess the patient first. Auscultation may reveal secretions, pneumothorax, or tube displacement. Assessment guides the next intervention.
Always assess the patient first. Auscultation may reveal secretions, pneumothorax, or tube displacement. Assessment guides the next intervention.
Question 54
Which diagnostic test allows for direct visualization of arterial obstruction under fluoroscopy in a patient with suspected pulmonary embolism?
A. Chest X-ray
B. V/Q scan
C. Pulmonary angiogram
D. Echocardiogram
Explanation:
Pulmonary angiography directly visualizes pulmonary blood vessels. It is considered a definitive diagnostic test for pulmonary embolism. Contrast dye is used during fluoroscopy.
Pulmonary angiography directly visualizes pulmonary blood vessels. It is considered a definitive diagnostic test for pulmonary embolism. Contrast dye is used during fluoroscopy.
Question 55
A nurse observes 250 mL of bright red drainage in a chest tube collection chamber over one hour. The priority is:
A. Notify the healthcare provider immediately
B. Document and monitor
C. Increase suction
D. Clamp the chest tube
Explanation:
Large amounts of fresh bloody drainage may indicate active hemorrhage. The healthcare provider should be notified immediately. Rapid assessment is essential.
Large amounts of fresh bloody drainage may indicate active hemorrhage. The healthcare provider should be notified immediately. Rapid assessment is essential.
Question 56
Infants and children are considered primarily diaphragmatic breathers until approximately what age?
A. 1 year
B. 3 years
C. 7 years
D. 12 years
Explanation:
Young children mainly use the diaphragm for breathing. This pattern continues until around 7 years of age. Abdominal movement is therefore more noticeable in children.
Young children mainly use the diaphragm for breathing. This pattern continues until around 7 years of age. Abdominal movement is therefore more noticeable in children.
Question 57
If a chest tube becomes disconnected from the drainage unit and contaminated, the nurse should immediately:
A. Clamp the tube with two clamps
B. Submerge the end in sterile water
C. Cover the end with dry gauze
D. Reconnect it immediately
Explanation:
Placing the tube end in sterile water creates a temporary water seal. This prevents air from entering the pleural cavity. A new drainage system should then be obtained.
Placing the tube end in sterile water creates a temporary water seal. This prevents air from entering the pleural cavity. A new drainage system should then be obtained.
Question 58
Which law of physics states that at a constant temperature, the pressure and volume of a gas are inversely related?
A. Dalton’s Law
B. Boyle’s Law
C. Henry’s Law
D. Starling’s Law
Explanation:
Boyle’s Law states that pressure and volume are inversely proportional. As volume increases, pressure decreases, and vice versa. This principle helps explain lung expansion during breathing.
Boyle’s Law states that pressure and volume are inversely proportional. As volume increases, pressure decreases, and vice versa. This principle helps explain lung expansion during breathing.
Question 59
For a patient with a “sucking chest wound,” how should the emergency dressing be secured?
A. Taped on all four sides
B. Taped on three sides only
C. Not taped at all
D. Taped with a loose bandage
Explanation:
A dressing taped on three sides acts as a flutter valve. It allows air to escape while preventing air from entering the chest. This helps reduce the risk of tension pneumothorax.
A dressing taped on three sides acts as a flutter valve. It allows air to escape while preventing air from entering the chest. This helps reduce the risk of tension pneumothorax.
Question 60
A patient on a ventilator has an ABG showing a PaCO₂ of 30 mmHg and a pH of 7.48. This indicates:
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Normal values
Explanation:
The pH is elevated and PaCO₂ is low. This pattern indicates respiratory alkalosis. Hyperventilation is a common cause.
The pH is elevated and PaCO₂ is low. This pattern indicates respiratory alkalosis. Hyperventilation is a common cause.
Question 61
Before drawing an ABG, how long should a nurse wait after a patient has been suctioned to ensure accuracy?
A. 5 minutes
B. 20 minutes
C. 1 hour
D. No wait is necessary
Explanation:
Suctioning can temporarily alter oxygen and carbon dioxide levels. Waiting about 20 minutes helps obtain more accurate ABG results.
Suctioning can temporarily alter oxygen and carbon dioxide levels. Waiting about 20 minutes helps obtain more accurate ABG results.
Question 62
Which of the following is a classic clinical manifestation of an acute Pulmonary Embolism?
A. Sudden onset of tachypnea
B. Profuse frothy pink sputum
C. Barking cough and stridor
D. Barrel chest and clubbing
Explanation:
Pulmonary embolism often presents with sudden tachypnea and dyspnea. Chest pain and hypoxemia may also occur. Prompt treatment is critical.
Pulmonary embolism often presents with sudden tachypnea and dyspnea. Chest pain and hypoxemia may also occur. Prompt treatment is critical.
Question 63
A nurse is caring for a child with bronchiolitis. What is the primary nursing intervention for clearing the airway?
A. Administering broad antibiotics
B. Frequent suctioning of nasal secretions
C. Maintaining a prone position
D. Restricting oral fluids
Explanation:
Bronchiolitis produces excessive mucus and nasal congestion. Frequent suctioning helps maintain a clear airway and improve breathing. Supportive care is the main treatment.
Bronchiolitis produces excessive mucus and nasal congestion. Frequent suctioning helps maintain a clear airway and improve breathing. Supportive care is the main treatment.
Question 64
A “low-pressure” (low tidal volume) alarm on a ventilator typically signals which of the following?
A. Loss of connection or air leak
B. Patient biting the tube
C. Secretions in the airway
D. Kink in the ventilator tubing
Explanation:
Low-pressure alarms usually indicate a leak or disconnection. The ventilator is unable to deliver the expected volume or pressure. All connections should be checked immediately.
Low-pressure alarms usually indicate a leak or disconnection. The ventilator is unable to deliver the expected volume or pressure. All connections should be checked immediately.
Question 65
What is the standard ratio of base (Bicarbonate) to acid (Carbonic acid) the body maintains for pH balance?
A. 1:1
B. 10:1
C. 20:1
D. 1:20
Explanation:
The normal bicarbonate to carbonic acid ratio is 20:1. This balance helps maintain a blood pH of about 7.4. Disturbances lead to acid-base disorders.
The normal bicarbonate to carbonic acid ratio is 20:1. This balance helps maintain a blood pH of about 7.4. Disturbances lead to acid-base disorders.
Question 66
A nurse is reviewing a patient’s Flow-Volume loop. A “scooped-out” appearance on the expiratory curve is characteristic of:
A. Obstructive lung disease
B. Restrictive lung disease
C. Normal lung function
D. Pulmonary embolism
Explanation:
A scooped expiratory curve suggests airflow obstruction. It is commonly seen in asthma and COPD. Flow-volume loops aid pulmonary function interpretation.
A scooped expiratory curve suggests airflow obstruction. It is commonly seen in asthma and COPD. Flow-volume loops aid pulmonary function interpretation.
Question 67
Which anatomical structure is referred to as the “Adam’s apple” in both males and females?
A. Cricoid cartilage
B. Thyroid cartilage
C. Epiglottic cartilage
D. Arytenoid cartilage
Explanation:
The Adam’s apple is the visible prominence of the thyroid cartilage. It is usually more prominent in males after puberty. It protects the vocal cords within the larynx.
The Adam’s apple is the visible prominence of the thyroid cartilage. It is usually more prominent in males after puberty. It protects the vocal cords within the larynx.
Question 68
Upon percussing over an area of lobar pneumonia (consolidation), the nurse expects to hear which sound?
A. Resonance
B. Hyperresonance
C. Dullness
D. Tympany
Explanation:
Consolidated lung tissue produces a dull percussion note. Air-filled lungs normally sound resonant. Dullness often indicates fluid or solid tissue.
Consolidated lung tissue produces a dull percussion note. Air-filled lungs normally sound resonant. Dullness often indicates fluid or solid tissue.
Question 69
In a patient with “flail chest,” the nurse expects to see which specific type of breathing pattern?
A. Paradoxical respirations
B. Kussmaul respirations
C. Cheyne-Stokes respirations
D. Eupnea
Explanation:
The unstable chest segment moves opposite to the rest of the chest. This abnormal movement is called paradoxical respiration. It is a hallmark of flail chest.
The unstable chest segment moves opposite to the rest of the chest. This abnormal movement is called paradoxical respiration. It is a hallmark of flail chest.
Question 70
A patient with a mature tracheostomy (7 days old) accidentally dislodges the tube. The nurse should use what for reinsertion?
A. Padded clamps
B. An obturator and spare tube
C. A chest tube kit
D. A tongue depressor
Explanation:
A mature tracheostomy can usually be reinserted using a spare tube and obturator. Emergency tracheostomy equipment should always be available at the bedside. Airway patency is the priority.
A mature tracheostomy can usually be reinserted using a spare tube and obturator. Emergency tracheostomy equipment should always be available at the bedside. Airway patency is the priority.
Question 71
Which medication is the standard antidote for a heparin overdose in a patient being treated for a pulmonary embolism?
A. Vitamin K
B. Naloxone
C. Protamine Sulfate
D. Flumazenil
Explanation:
Protamine sulfate is the antidote for heparin overdose. It neutralizes the anticoagulant effect of heparin. Patients should be monitored closely for bleeding.
Protamine sulfate is the antidote for heparin overdose. It neutralizes the anticoagulant effect of heparin. Patients should be monitored closely for bleeding.
Question 72
What is the peak age for the occurrence of Sudden Infant Death Syndrome (SIDS)?
A. 0 to 1 month
B. 2 to 4 months
C. 6 to 9 months
D. 12 to 18 months
Explanation:
SIDS most commonly occurs between 2 and 4 months of age. Safe sleep practices significantly reduce the risk. Infants should always be placed on their backs to sleep.
SIDS most commonly occurs between 2 and 4 months of age. Safe sleep practices significantly reduce the risk. Infants should always be placed on their backs to sleep.
Question 73
A child recovering from a tonsillectomy is frequently swallowing. The nurse recognizes this as an early sign of:
A. Normal recovery
B. Postoperative hemorrhage
C. Excessive pain
D. Dehydration
Explanation:
Frequent swallowing may indicate bleeding at the surgical site. Blood trickling down the throat triggers swallowing. This finding should be reported immediately.
Frequent swallowing may indicate bleeding at the surgical site. Blood trickling down the throat triggers swallowing. This finding should be reported immediately.
Question 74
Which diagnostic test is the only definitive way to confirm active Mycobacterium tuberculosis infection?
A. Chest X-ray
B. Sputum culture
C. Tuberculin skin test
D. QuantiFERON Gold
Explanation:
Sputum culture is the gold standard for confirming active tuberculosis. It identifies the presence of Mycobacterium tuberculosis. Results may take several weeks.
Sputum culture is the gold standard for confirming active tuberculosis. It identifies the presence of Mycobacterium tuberculosis. Results may take several weeks.
Question 75
According to GOLD guidelines, what mandatory spirometry finding is required to definitively diagnose COPD?
A. FEV1/FVC ratio < 0.70
B. FVC < 80% predicted
C. FEV1 > 80% predicted
D. FEV1/FVC ratio > 0.85
Explanation:
A post-bronchodilator FEV1/FVC ratio below 0.70 confirms persistent airflow limitation. This is the key spirometry criterion for COPD diagnosis.
A post-bronchodilator FEV1/FVC ratio below 0.70 confirms persistent airflow limitation. This is the key spirometry criterion for COPD diagnosis.
Question 76
A patient with an NG tube on low intermittent suction is most at risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Explanation:
Gastric suction removes hydrochloric acid from the stomach. Loss of acid causes the blood to become more alkaline. This leads to metabolic alkalosis.
Gastric suction removes hydrochloric acid from the stomach. Loss of acid causes the blood to become more alkaline. This leads to metabolic alkalosis.
Question 77
The “AIR RAID” mnemonic is used for assessing which life-threatening pediatric respiratory emergency?
A. Asthma
B. Epiglottitis
C. Bronchiolitis
D. Pneumonia
Explanation:
AIR RAID is a mnemonic used to recognize signs of epiglottitis. This condition can rapidly obstruct the airway. Immediate medical attention is required.
AIR RAID is a mnemonic used to recognize signs of epiglottitis. This condition can rapidly obstruct the airway. Immediate medical attention is required.
Question 78
Which clinical finding is a “late” sign of hypoxia and is considered a medical emergency?
A. Restlessness
B. Tachycardia
C. Central cyanosis
D. Anxiety
Explanation:
Central cyanosis indicates severe oxygen deprivation. It is a late and serious sign of hypoxia. Immediate intervention is necessary.
Central cyanosis indicates severe oxygen deprivation. It is a late and serious sign of hypoxia. Immediate intervention is necessary.
Question 79
A nurse is counting respirations for a patient who is “fighting” the ventilator. This behavior often triggers which alarm?
A. High-pressure alarm
B. Low-pressure alarm
C. Power failure alarm
D. Low oxygen alarm
Explanation:
Patient-ventilator asynchrony increases airway resistance. This commonly activates the high-pressure alarm. The patient should be assessed promptly.
Patient-ventilator asynchrony increases airway resistance. This commonly activates the high-pressure alarm. The patient should be assessed promptly.
Question 80
What is the total volume of exchangeable air in the lungs (VT + IRV + ERV) called?
A. Total Lung Capacity
B. Vital Capacity
C. Residual Volume
D. Functional Residual Capacity
Explanation:
Vital Capacity is the maximum amount of air a person can exhale after a maximum inhalation. It equals tidal volume plus inspiratory and expiratory reserve volumes.
Vital Capacity is the maximum amount of air a person can exhale after a maximum inhalation. It equals tidal volume plus inspiratory and expiratory reserve volumes.
Question 81
A patient with severe diarrhea is at risk for which specific acid-base imbalance?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Explanation:
Diarrhea causes excessive loss of bicarbonate from the body. This results in metabolic acidosis. ABG analysis helps confirm the diagnosis.
Diarrhea causes excessive loss of bicarbonate from the body. This results in metabolic acidosis. ABG analysis helps confirm the diagnosis.
Question 82
Which ventilator mode is known as the “weaning mode” because it allows for spontaneous patient breaths?
A. Assist Control (AC)
B. SIMV
C. CPAP
D. Pressure Support
Explanation:
SIMV allows spontaneous breathing between mandatory breaths. It is commonly used when weaning patients from mechanical ventilation.
SIMV allows spontaneous breathing between mandatory breaths. It is commonly used when weaning patients from mechanical ventilation.
Question 83
A patient is hyperventilating due to a severe panic attack. Which ABG finding does the nurse expect?
A. Decreased PaCO₂
B. Increased HCO₃
C. Increased PaCO₂
D. Normal pH
Explanation:
Hyperventilation causes excessive carbon dioxide loss. This lowers PaCO₂ and may result in respiratory alkalosis.
Hyperventilation causes excessive carbon dioxide loss. This lowers PaCO₂ and may result in respiratory alkalosis.
Question 84
Which formula is used to calculate the expected PaCO₂ for respiratory compensation in metabolic acidosis?
A. Alveolar Equation
B. Winter’s Formula
C. Boyle’s Law
D. Dalton’s Law
Explanation:
Winter’s Formula estimates the expected PaCO₂ in metabolic acidosis. It helps determine whether respiratory compensation is appropriate.
Winter’s Formula estimates the expected PaCO₂ in metabolic acidosis. It helps determine whether respiratory compensation is appropriate.
Question 85
What does a “Base Excess” value of −5 mEq/L indicate to the nurse?
A. Metabolic Alkalosis
B. Metabolic Acidosis
C. Normal finding
D. Respiratory Acidosis
Explanation:
A negative base excess indicates a deficit of base in the blood. This finding is consistent with metabolic acidosis.
A negative base excess indicates a deficit of base in the blood. This finding is consistent with metabolic acidosis.
Question 86
A patient is referred to as a “blue bloater.” This term is specifically associated with which condition?
A. Emphysema
B. Chronic Bronchitis
C. Asthma
D. Pneumonia
Explanation:
“Blue bloater” is a classic description of chronic bronchitis. Patients often have cyanosis, edema, and chronic productive cough.
“Blue bloater” is a classic description of chronic bronchitis. Patients often have cyanosis, edema, and chronic productive cough.
Question 87
In emphysema, the primary underlying pathology involves which of the following permanent changes?
A. Destruction of alveolar walls
B. Mucous gland hyperplasia
C. Reversible airway spasms
D. Viral lung infection
Explanation:
Emphysema causes permanent destruction of alveolar walls. This reduces gas-exchange surface area and causes air trapping.
Emphysema causes permanent destruction of alveolar walls. This reduces gas-exchange surface area and causes air trapping.
Question 88
While assessing a patient with a three-chamber drainage system, the nurse notes constant, gentle bubbling in the suction chamber. Action?
A. Document as normal
B. Notify provider of leak
C. Decrease wall suction
D. Clamp the chest tube
Explanation:
Gentle continuous bubbling in the suction chamber is expected. It indicates that suction is functioning properly.
Gentle continuous bubbling in the suction chamber is expected. It indicates that suction is functioning properly.
Question 89
To determine the cause of metabolic acidosis, which calculation is routinely used by clinical staff?
A. P/F Ratio
B. Anion Gap
C. Tidal Volume
D. Base Excess
Explanation:
The anion gap helps identify the underlying cause of metabolic acidosis. It distinguishes high-anion-gap from normal-anion-gap acidosis.
The anion gap helps identify the underlying cause of metabolic acidosis. It distinguishes high-anion-gap from normal-anion-gap acidosis.
Question 90
Which clinical manifestation is a hallmark sign of a massive, life-threatening tension pneumothorax?
A. Subcutaneous emphysema
B. Tracheal deviation
C. Intermittent bubbling
D. Pleuritic chest pain
Explanation:
Tracheal deviation away from the affected side is a classic sign of tension pneumothorax. It indicates severe pressure buildup and requires emergency treatment.
Tracheal deviation away from the affected side is a classic sign of tension pneumothorax. It indicates severe pressure buildup and requires emergency treatment.
Question 91
A patient on a ventilator has a sudden drop in BP after PEEP was increased. The nurse understands:
A. PEEP reduces venous return
B. PEEP causes vasodilation
C. It is an allergic reaction
D. Too much oxygen was given
Explanation:
High PEEP increases intrathoracic pressure. This decreases venous return to the heart and may lower blood pressure. Hemodynamic monitoring is important after PEEP adjustments.
High PEEP increases intrathoracic pressure. This decreases venous return to the heart and may lower blood pressure. Hemodynamic monitoring is important after PEEP adjustments.
Question 92
Infants are considered “obligate” breathers of which organ until approximately three months of age?
A. Mouth
B. Lungs
C. Nose
D. Diaphragm
Explanation:
Young infants primarily breathe through their nose. Nasal obstruction can quickly cause respiratory difficulty. This is why keeping the nasal passages clear is important.
Young infants primarily breathe through their nose. Nasal obstruction can quickly cause respiratory difficulty. This is why keeping the nasal passages clear is important.
Question 93
Frequent oral care with Chlorhexidine for ventilated patients is performed every 2 hours to prevent:
A. Oral thrush
B. Ventilator-Associated Pneumonia
C. Dry mouth
D. Tooth decay
Explanation:
Regular oral care reduces bacterial colonization in the mouth. This lowers the risk of Ventilator-Associated Pneumonia (VAP). It is a key component of ventilator care bundles.
Regular oral care reduces bacterial colonization in the mouth. This lowers the risk of Ventilator-Associated Pneumonia (VAP). It is a key component of ventilator care bundles.
Question 94
Which medication should an asthmatic patient take FIRST during an acute attack to open the airways?
A. Albuterol
B. Fluticasone
C. Montelukast
D. Salmeterol
Explanation:
Albuterol is a short-acting bronchodilator. It provides rapid relief by relaxing bronchial smooth muscle. It is the rescue medication used during acute asthma attacks.
Albuterol is a short-acting bronchodilator. It provides rapid relief by relaxing bronchial smooth muscle. It is the rescue medication used during acute asthma attacks.
Question 95
A nurse observes “intercostal retractions” in a child with a respiratory infection. This finding indicates:
A. Deep sleep
B. Respiratory distress
C. Effective gas exchange
D. Normal infant breathing
Explanation:
Intercostal retractions occur when extra effort is needed to breathe. They are a sign of increased work of breathing and respiratory distress. Prompt assessment is required.
Intercostal retractions occur when extra effort is needed to breathe. They are a sign of increased work of breathing and respiratory distress. Prompt assessment is required.
Question 96
Which law explains that the total pressure of a gas mixture is the sum of its partial pressures?
A. Dalton’s Law
B. Henry’s Law
C. Boyle’s Law
D. Starling’s Law
Explanation:
Dalton’s Law states that total gas pressure equals the sum of individual gas pressures. This principle is important in respiratory physiology and gas exchange.
Dalton’s Law states that total gas pressure equals the sum of individual gas pressures. This principle is important in respiratory physiology and gas exchange.
Question 97
A patient with pneumonia has “increased tactile vocal fremitus.” This is expected because:
A. Vibrations travel faster in fluid
B. Air in pleural space blocks it
C. The patient is hyperventilating
D. The bronchi are narrowed
Explanation:
Consolidated lung tissue transmits sound vibrations more effectively than air-filled lungs. Therefore, tactile fremitus increases in pneumonia.
Consolidated lung tissue transmits sound vibrations more effectively than air-filled lungs. Therefore, tactile fremitus increases in pneumonia.
Question 98
The normal ratio of the human inhalation phase to the exhalation phase is typically:
A. 1:2
B. 1:1
C. 2:1
D. 1:3
Explanation:
Normal expiration takes about twice as long as inspiration. Therefore, the normal inspiratory-to-expiratory ratio is 1:2.
Normal expiration takes about twice as long as inspiration. Therefore, the normal inspiratory-to-expiratory ratio is 1:2.
Question 99
A patient is using “pursed-lip breathing.” The primary goal of this technique is to:
A. Increase respiratory rate
B. Reduce air trapping
C. Shorten exhalation
D. Increase O₂ consumption
Explanation:
Pursed-lip breathing prolongs exhalation and prevents airway collapse. It helps reduce air trapping and improves ventilation in COPD patients.
Pursed-lip breathing prolongs exhalation and prevents airway collapse. It helps reduce air trapping and improves ventilation in COPD patients.
Question 100
Which anatomical structure is referred to as the “guardian of the airway” by sealing the glottis during swallowing?
A. Thyroid cartilage
B. Cricoid ring
C. Epiglottis
D. Uvula
Explanation:
The epiglottis acts like a protective flap during swallowing. It covers the airway and prevents food or liquids from entering the trachea. This is why it is often called the “guardian of the airway.”
The epiglottis acts like a protective flap during swallowing. It covers the airway and prevents food or liquids from entering the trachea. This is why it is often called the “guardian of the airway.”
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