CMSRN Respiratory and Pulmonary Care 1 — Questions and Answers
Question 1: A patient with COPD has an SpO2 of 88% and is on 2L/min nasal cannula. What is the most appropriate nursing action?
- Increase oxygen to 4L/min immediately
- Notify the physician and monitor closely
- Maintain current settings as 88% is acceptable for COPD patients (Correct answer)
- Apply a non-rebreather mask at 15L/min
Correct answer: Maintain current settings as 88% is acceptable for COPD patients
COPD patients often retain CO2 and rely on hypoxic drive; SpO2 of 88–92% is the target range to avoid suppressing respiratory drive.
Question 2: Which finding on a chest X-ray is most consistent with pneumothorax?
- Diffuse bilateral infiltrates
- Absence of lung markings on one side (Correct answer)
- Hyperinflation with flattened diaphragm
- Consolidation in the lower lobes
Correct answer: Absence of lung markings on one side
Pneumothorax appears on chest X-ray as absence of lung markings with a visible pleural line on the affected side.
Question 3: A patient develops sudden severe dyspnea, tracheal deviation to the left, and absent breath sounds on the right. What condition does the nurse suspect?
- Pulmonary embolism
- Hemothorax
- Tension pneumothorax (Correct answer)
- Pleural effusion
Correct answer: Tension pneumothorax
Tension pneumothorax presents with severe dyspnea, tracheal deviation away from the affected side, and absent breath sounds — a life-threatening emergency.
Question 4: When performing deep tracheal suctioning, the nurse should limit each suction pass to no more than:
- 5 seconds
- 10–15 seconds (Correct answer)
- 20 seconds
- 30 seconds
Correct answer: 10–15 seconds
Each suction pass should be limited to 10–15 seconds to minimize hypoxia and mucosal trauma.
Question 5: A patient is prescribed incentive spirometry post-operatively. What is the primary goal of this intervention?
- Reduce post-operative pain
- Prevent atelectasis and promote lung expansion (Correct answer)
- Drain pleural effusion
- Improve cardiac output
Correct answer: Prevent atelectasis and promote lung expansion
Incentive spirometry encourages deep breathing to expand alveoli and prevent post-operative atelectasis.
Question 6: Which arterial blood gas (ABG) result indicates respiratory acidosis?
- pH 7.50, PaCO2 30, HCO3 22
- pH 7.30, PaCO2 55, HCO3 24 (Correct answer)
- pH 7.48, PaCO2 40, HCO3 30
- pH 7.35, PaCO2 40, HCO3 22
Correct answer: pH 7.30, PaCO2 55, HCO3 24
Respiratory acidosis is characterized by low pH and elevated PaCO2 due to inadequate ventilation and CO2 retention.
CMSRN Respiratory and Pulmonary Care 1
A patient with COPD has an SpO2 of 88% and is on 2L/min nasal cannula.
What is the most appropriate nursing action?