NUR 325 EXAM 2 QUESTIONS AND ANSWERS
1. A patient has been facing consecutive gas exchange impairment due to unmanaged
asthma. Pronounced issues with ventilation can cause a buildup of acid that will most
likely present itself through what condition?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Respiratory acidosis - Answers :d. Respiratory acidosis
2. A 30 year-old patient is suffering from 2 fractured ribs following a motor vehicle
accident. In addition to the pain experienced from injury, the patient is also experiencing
an impairment of gas exchange most likely to do what?
a. Inadequate perfusion
b. Ineffective ventilation
c. Inability to transport O2 .
d. Reduced capacity for gas transportation - Answers :b. Ineffective ventilation
3. A young adult patient is being assessed for gas exchange impairment. The patient
states that she was diagnosed with mild asthma in her adolescence, however has been
facing a recent increased difficulty breathing during exercise and stress. The nurse
decides to educate the patient on individual risk factors that could be playing a role on
her gas exchange ability. What statement made by the patient indicates a need for
further education?
a. "I am going to quit smoking cigarettes and using other tobacco products."
b. "As I get older, it is understandable that my breathing may get worse."
c. "The more active I am, the more complications I am going to have breathing."
d. "When I am sick, my immune system is impaired and might play a role in my regular
gas exchange ability." - Answers :c. "The more active I am, the more complications I am
going to have breathing."
4. The nurse is responsible for monitoring during the first 24 hours after the birth of a
neonate at 38 weeks' gestation. What is the most important parameter for the nurse to
monitor?
a. Duration of cry
b. Decreased body temperature
c. Sleep patterns
d. Respiratory distress - Answers :d. Respiratory distress
(ABC's always come first)
5. What is considered the earliest sign of decreased tissue oxygenation?
a. Unexplained restlessness
b. Blue-ish nail beds
,c. Cold skin
d. Cyanosis - Answers :a. Unexplained restlessness
(the others come later)
1. In a long-term care facility, the nurse is working with a patient who has been suffering
from COPD with a predominance of pulmonary emphysema. Which of the following are
symptoms that correspond with pulmonary emphysema? Select all that apply.
a. Barrel chest
b. Cyanosis
c. Dyspnea
d. Respiratory Acidosis
e. Thin appearance
f. Ineffective cough - Answers :a. Barrel chest
c. Dyspnea
e. Thin appearance
f. Ineffective cough
(described as a "pink puffer"; trapped air in enlarged airspaces = barrel)
2. A 43 year-old male patient is at a high risk for developing COPD. Which of these
lifestyle factors mentioned by the patient does not contribute to his likelihood of
developing COPD?
a. The patient states has been smoking for the past 14 years
b. He bought a gym membership and has been going 5 times per week
c. His father died from COPD 7 years ago
d. Recently, he developed an infection in his hand from a work injury - Answers :b. He
bought a gym membership and has been going 5 times per week
(a recent infection contributes to the likelihood of getting COPD)
1. Which of the following are used for the diagnosis of asthma? Select all that apply.
a. Peak flow monitoring
b. Assessment of patient's cough
c. Chest x-ray
d. Pulmonary function test
e. Severity of wheezing
f. Health history - Answers :a. Peak flow monitoring
c. Chest x-ray
d. Pulmonary function test
f. Health history
2. A patient was just diagnosed with acute, intermittent asthma. What medication would
you suspect the patient was prescribed as a "reliever" during periods of exacerbation?
a. short-acting β2 -adrenergic agonists (SABA)
b. long-acting β2 -adrenergic agonists (LABA)
,c. Inhaled glucocorticoid (IGC)
d. Anticholinergic inhalers - Answers :a. short-acting β2 -adrenergic agonists (SABA)
(SABA's are the "gold standard" and most effective for short-term meds)
1. During the palpation phase of the respiratory assessment, the nurse notices a strong
tactile fremitus when the patient speaks. It is observed symmetrically throughout the
intercostal spaces. What might be the reason or cause of this?
a. The patient may have an obstructed airway and needs to be further assessed.
b. Asthma is a common cause of this condition.
c. The patient is healthy, and this is normal.
d. This results from a buildup of mucus, but it will go away if the patient coughs. -
Answers :c. The patient is healthy, and this is normal.
(tactile or vocal fremitus = vibration that can be palpated externally, caused by sound
waves in the vocal cords)
2. A patient states to their nurse that they have been coughing a lot frequently. During
auscultation of the thorax and lungs, the nurse noticed a loud, bubbly sound during
inspiration. The sound is short, low-pitched, and heard when auscultating over the
trachea and large bronchi. When the patient coughed, upon request from the nurse, the
sound remained the same. What adventitious sound is the nurse hearing?
a. Coarse crackles
b. Wheezes
c. Fine crackles
d. Rhonchi - Answers :a. Coarse crackles
(coarse crackles are loud, low-pitched, bubbling sounds caused by air meeting
secretions; fine crackles are high-pitched crackles at end of inspiration)
3. A 21 year-old college student visits her campus' health clinic due to lingering cold
symptoms. She mentions to her nurse that she is constantly coughing up mucus that is
yellow and green in color. When the nurse is auscultating the patient's lungs, there is a
continuous, low-pitched snoring sound audible in the bronchi region that the nurse
suspects is caused by the excess mucus. What sound is the nurse hearing?
a. Coarse crackles
b. Wheezes
c. Fine crackles
d. Rhonchi - Answers :d. Rhonchi
(rhonchi = continuous, low-pitched snoring sounds caused by obstruction from
secretions, muscular constriction, or masses)
4. A client in a long term care facility following a car accident that caused cognitive
impairment is eating dinner with other residents. The patient spontaneously gets silent
and starts breathing abnormally. The client appears to signal to his friends that he is
, fine, but they call over for help. The nurse on call assesses the client and ascultates his
respiratory system. The nurse hears a loud, continuous, crowing sound in his upper
airway and immediately calls for help. What did the nurse hear?
a. Increased breath sounds
b. Stridor
c. Decreased breath sounds
d. Pleural friction rub - Answers :b. Stridor
(Stridor is a loud, continuous, high-pitched, crowing sound that is caused by upper
airway obstruction. It is considered the most serious adventitious sound and requires
immediate attention. The patient in this situation was probably choking on something he
ate, but, due to his impairment, was unable to ask for help.)
5. Which of the following is not a way a patient may report shortness of breath?
a. "I had to stop climbing the stairs to catch my breath"
b. "I have to sleep sitting up at night or else I wake up uncomfortable"
c. "I have the tendency to get very lightheaded throughout the day"
d. "I find it more comfortable to sleep on my side at night" - Answers :d. "I find it more
comfortable to sleep on my side at night"
(pt.'s with SOB need to sit up not on the side)
1. A nurse is caring for a group of patients in an urgent care unit. Which of the following
clients has the highest risk of developing a pulmonary embolism?
a. An obese older adult with a leg trauma
b. A 13 year-old immunocompromised client with a persistent cough
c. A pregnant woman with asthma
d. A young adult with a laceration on their lip - Answers :a. An obese older adult with a
leg trauma
(2 risk factors; pregnancy is also one, but not asthma; the others are not risk factors for
pulmonary embolism)
2. A patient with local impaired tissue perfusion is prescribed anticoagulants to help
improve blood flow. The nurse educates the patient on important things to take into
consideration following this new diagnosis and prescription. Which of the following
statements made by the patient indicates a need for further education?
a. "I really should try to quit smoking."
b. "I am going to stay away from processed foods and artificial sweeteners."
c. "If and when the pain returns in my leg I should take Ibuprofen."
d. "I'm going to encourage my family to join a gym with me." - Answers :c. "If and when
the pain returns in my leg I should take Ibuprofen."
(bc pt. is taking an anticoagulant, NSAIDs should be avoided)
1. A patient has been facing consecutive gas exchange impairment due to unmanaged
asthma. Pronounced issues with ventilation can cause a buildup of acid that will most
likely present itself through what condition?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Respiratory acidosis - Answers :d. Respiratory acidosis
2. A 30 year-old patient is suffering from 2 fractured ribs following a motor vehicle
accident. In addition to the pain experienced from injury, the patient is also experiencing
an impairment of gas exchange most likely to do what?
a. Inadequate perfusion
b. Ineffective ventilation
c. Inability to transport O2 .
d. Reduced capacity for gas transportation - Answers :b. Ineffective ventilation
3. A young adult patient is being assessed for gas exchange impairment. The patient
states that she was diagnosed with mild asthma in her adolescence, however has been
facing a recent increased difficulty breathing during exercise and stress. The nurse
decides to educate the patient on individual risk factors that could be playing a role on
her gas exchange ability. What statement made by the patient indicates a need for
further education?
a. "I am going to quit smoking cigarettes and using other tobacco products."
b. "As I get older, it is understandable that my breathing may get worse."
c. "The more active I am, the more complications I am going to have breathing."
d. "When I am sick, my immune system is impaired and might play a role in my regular
gas exchange ability." - Answers :c. "The more active I am, the more complications I am
going to have breathing."
4. The nurse is responsible for monitoring during the first 24 hours after the birth of a
neonate at 38 weeks' gestation. What is the most important parameter for the nurse to
monitor?
a. Duration of cry
b. Decreased body temperature
c. Sleep patterns
d. Respiratory distress - Answers :d. Respiratory distress
(ABC's always come first)
5. What is considered the earliest sign of decreased tissue oxygenation?
a. Unexplained restlessness
b. Blue-ish nail beds
,c. Cold skin
d. Cyanosis - Answers :a. Unexplained restlessness
(the others come later)
1. In a long-term care facility, the nurse is working with a patient who has been suffering
from COPD with a predominance of pulmonary emphysema. Which of the following are
symptoms that correspond with pulmonary emphysema? Select all that apply.
a. Barrel chest
b. Cyanosis
c. Dyspnea
d. Respiratory Acidosis
e. Thin appearance
f. Ineffective cough - Answers :a. Barrel chest
c. Dyspnea
e. Thin appearance
f. Ineffective cough
(described as a "pink puffer"; trapped air in enlarged airspaces = barrel)
2. A 43 year-old male patient is at a high risk for developing COPD. Which of these
lifestyle factors mentioned by the patient does not contribute to his likelihood of
developing COPD?
a. The patient states has been smoking for the past 14 years
b. He bought a gym membership and has been going 5 times per week
c. His father died from COPD 7 years ago
d. Recently, he developed an infection in his hand from a work injury - Answers :b. He
bought a gym membership and has been going 5 times per week
(a recent infection contributes to the likelihood of getting COPD)
1. Which of the following are used for the diagnosis of asthma? Select all that apply.
a. Peak flow monitoring
b. Assessment of patient's cough
c. Chest x-ray
d. Pulmonary function test
e. Severity of wheezing
f. Health history - Answers :a. Peak flow monitoring
c. Chest x-ray
d. Pulmonary function test
f. Health history
2. A patient was just diagnosed with acute, intermittent asthma. What medication would
you suspect the patient was prescribed as a "reliever" during periods of exacerbation?
a. short-acting β2 -adrenergic agonists (SABA)
b. long-acting β2 -adrenergic agonists (LABA)
,c. Inhaled glucocorticoid (IGC)
d. Anticholinergic inhalers - Answers :a. short-acting β2 -adrenergic agonists (SABA)
(SABA's are the "gold standard" and most effective for short-term meds)
1. During the palpation phase of the respiratory assessment, the nurse notices a strong
tactile fremitus when the patient speaks. It is observed symmetrically throughout the
intercostal spaces. What might be the reason or cause of this?
a. The patient may have an obstructed airway and needs to be further assessed.
b. Asthma is a common cause of this condition.
c. The patient is healthy, and this is normal.
d. This results from a buildup of mucus, but it will go away if the patient coughs. -
Answers :c. The patient is healthy, and this is normal.
(tactile or vocal fremitus = vibration that can be palpated externally, caused by sound
waves in the vocal cords)
2. A patient states to their nurse that they have been coughing a lot frequently. During
auscultation of the thorax and lungs, the nurse noticed a loud, bubbly sound during
inspiration. The sound is short, low-pitched, and heard when auscultating over the
trachea and large bronchi. When the patient coughed, upon request from the nurse, the
sound remained the same. What adventitious sound is the nurse hearing?
a. Coarse crackles
b. Wheezes
c. Fine crackles
d. Rhonchi - Answers :a. Coarse crackles
(coarse crackles are loud, low-pitched, bubbling sounds caused by air meeting
secretions; fine crackles are high-pitched crackles at end of inspiration)
3. A 21 year-old college student visits her campus' health clinic due to lingering cold
symptoms. She mentions to her nurse that she is constantly coughing up mucus that is
yellow and green in color. When the nurse is auscultating the patient's lungs, there is a
continuous, low-pitched snoring sound audible in the bronchi region that the nurse
suspects is caused by the excess mucus. What sound is the nurse hearing?
a. Coarse crackles
b. Wheezes
c. Fine crackles
d. Rhonchi - Answers :d. Rhonchi
(rhonchi = continuous, low-pitched snoring sounds caused by obstruction from
secretions, muscular constriction, or masses)
4. A client in a long term care facility following a car accident that caused cognitive
impairment is eating dinner with other residents. The patient spontaneously gets silent
and starts breathing abnormally. The client appears to signal to his friends that he is
, fine, but they call over for help. The nurse on call assesses the client and ascultates his
respiratory system. The nurse hears a loud, continuous, crowing sound in his upper
airway and immediately calls for help. What did the nurse hear?
a. Increased breath sounds
b. Stridor
c. Decreased breath sounds
d. Pleural friction rub - Answers :b. Stridor
(Stridor is a loud, continuous, high-pitched, crowing sound that is caused by upper
airway obstruction. It is considered the most serious adventitious sound and requires
immediate attention. The patient in this situation was probably choking on something he
ate, but, due to his impairment, was unable to ask for help.)
5. Which of the following is not a way a patient may report shortness of breath?
a. "I had to stop climbing the stairs to catch my breath"
b. "I have to sleep sitting up at night or else I wake up uncomfortable"
c. "I have the tendency to get very lightheaded throughout the day"
d. "I find it more comfortable to sleep on my side at night" - Answers :d. "I find it more
comfortable to sleep on my side at night"
(pt.'s with SOB need to sit up not on the side)
1. A nurse is caring for a group of patients in an urgent care unit. Which of the following
clients has the highest risk of developing a pulmonary embolism?
a. An obese older adult with a leg trauma
b. A 13 year-old immunocompromised client with a persistent cough
c. A pregnant woman with asthma
d. A young adult with a laceration on their lip - Answers :a. An obese older adult with a
leg trauma
(2 risk factors; pregnancy is also one, but not asthma; the others are not risk factors for
pulmonary embolism)
2. A patient with local impaired tissue perfusion is prescribed anticoagulants to help
improve blood flow. The nurse educates the patient on important things to take into
consideration following this new diagnosis and prescription. Which of the following
statements made by the patient indicates a need for further education?
a. "I really should try to quit smoking."
b. "I am going to stay away from processed foods and artificial sweeteners."
c. "If and when the pain returns in my leg I should take Ibuprofen."
d. "I'm going to encourage my family to join a gym with me." - Answers :c. "If and when
the pain returns in my leg I should take Ibuprofen."
(bc pt. is taking an anticoagulant, NSAIDs should be avoided)
