SAUNDERS NCLEX
RESPIRATORY EXIT EXAM
2024/2025 (QUESTIONS AND
CORRECT ANSWERS)
A client who experiences frequent upper respiratory infec5ons (uris) asks the
nurse why food does not seem to have any taste during illness. Which response
by the nurse is most appropriate?
1"you lack the energy to cook wholesome meals."
2"blocked nasal passages impair the sense of smell."
3"loss of appe5te is triggered by the infec5ous organism."
4"infec5on blocks sensa5on in the taste buds of the tongue."
A: "blocked nasal passages impair the sense of smell."
ra5onale: when nasal passages become blocked as a result of a uri, the client
has an impaired sense of taste and smell. This occurs because one of the
normal func5ons of the nose is to s5mulate appe5te through the sense of
smell. The other op5ons are incorrect and unrelated to this symptom.
A registered nurse who is orien5ng a new nursing graduate to the hospital
emergency department instructs the new graduate to monitor a client for one-
sided chest movement on the right side while the client is being intubated by
the primary health care provider (phcp). Which statement made by the new
nursing graduate indicates understanding of the importance of this
observa5on?
1"it will enter the leJ main bronchus if inserted too far."
,2"it will enter the right main bronchus if inserted too far."
3"it may enter the leJ main bronchus if not inserted far enough."
4"it may enter the right main bronchus if not inserted far enough."
A: "it will enter the right main bronchus if inserted too far."
ra5onale:if the endotracheal tube is inserted too far into the client's trachea,
the tube will enter the right main bronchus. This occurs because the right
bronchus is shorter and wider than the leJ and extends downward in a more
ver5cal plane. If the tube is not inserted far enough, no chest expansion at all
will occur. The other op5ons are incorrect.
The nurse is reinforcing instruc5ons to a client with pneumonia about the use
of an incen5ve spirometer. The nurse tells the client to sustain the inhaled
breath for 3 seconds. When the client asks the nurse about the ra5onale for
this ac5on, the nurse explains that which is the primary benefit?
1dilate the major bronchi.
2increase surfactant produc5on.
3maintain infla5on of the alveoli.
4enhance ciliary ac5on in the tracheobronchial tree.
A: maintain infla5on of the alveoli.
Sustained inhala5on when using an incen5ve spirometer helps maintain
infla5on of the terminal bronchioles and alveoli, thereby promo5ng beQer gas
exchange. Rou5ne use of devices such as an incen5ve spirometer can help
prevent atelectasis and pneumonia in clients at risk. The remaining op5ons are
not benefits for sustained inhala5on.
,The nurse and an assis5ve personnel (ap) are assis5ng the respiratory therapist
to posi5on a client for postural drainage. The ap asks the nurse how the
respiratory therapist selects the posi5on to be used for the procedure. The
nurse responds that a posi5on is chosen that will use gravity to help drain
secre5ons from which primary areas?
1lobes
2alveoli
3trachea
4main bronchi
A: lobes
ra5onale: postural drainage uses specific client posi5ons that vary depending
on the affected lobe or lobes. The posi5ons usually place the head lower than
the affected lung segments to facilitate drainage of secre5ons. Postural
drainage oJen is done in conjunc5on with chest percussion for maximum
effec5veness. The other op5ons are incorrect.
A client with chronic obstruc5ve pulmonary disease (copd) who is beginning
oxygen therapy asks the nurse how to manage the amount of oxygen given.
How would the nurse instruct the client?
1do not exceed 1 l/min.
2do not exceed 2 l/min.
3adjust the oxygen depending on spo2.
4adjust the oxygen depending on respiratory rate.
A: adjust the oxygen depending on spo2.
, Ra5onale: the client with copd is oJen dependent on oxygen. The oxygen
would be adjusted depending on the spo2, which needs to be 88% to 92%. All
other op5ons are incorrect.
A client who is experiencing respiratory difficulty asks the nurse, "why is it so
much easier to breathe out than in?" in providing a response, the nurse
explains that breathing is easier on exhala5on because of which respiratory
responses?
1air flows by gravity.
2the respiratory muscles relax.
3the respiratory muscles contract.
4air is flowing against a pressure gradient.
A: the respiratory muscles relax.
Ra5onale:
exhala5on is less taxing for the client because it is a passive process in which
the respiratory muscles relax. This allows air to flow upward out of the lungs.
Air flows according to a pressure gradient from higher pressure to lower
pressure. It does not flow by gravity or against a pressure gradient.
A client who has been diagnosed with pleurisy tells the nurse that it is painful
to inhale. The nurse responds that this is an expected finding because of which
physical response to this disorder?
1the stretch receptors in the lungs are irritated.
2the diaphragm is weak and is difficult to move.
3this condi5on causes nerve endings to be especially sensi5ve.
4the inflamed pleurae cannot glide against each other as they normally do.
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