NCLEX Medical-Surgical: Respiratory Conditions 2 — Questions and Answers
Question 1: A client with COPD has an oxygen saturation of 88%. What is the priority nursing action?
- Administer low-flow oxygen at 2 L/min via nasal cannula (Correct answer)
- Apply a non-rebreather mask at 15 L/min
- Encourage rapid deep breathing
- Withhold oxygen to preserve respiratory drive
Correct answer: Administer low-flow oxygen at 2 L/min via nasal cannula
Low-flow oxygen is appropriate for COPD clients to avoid suppressing the hypoxic respiratory drive while correcting hypoxemia.
Question 2: Which acid-base imbalance is most commonly seen in a client with acute respiratory failure from COPD exacerbation?
- Respiratory acidosis (Correct answer)
- Respiratory alkalosis
- Metabolic acidosis
- Metabolic alkalosis
Correct answer: Respiratory acidosis
CO2 retention from impaired gas exchange lowers pH, producing respiratory acidosis.
Question 3: A nurse is teaching pursed-lip breathing to a client with emphysema. What is the primary benefit?
- It prevents airway collapse and promotes CO2 elimination (Correct answer)
- It increases the respiratory rate
- It eliminates the need for oxygen therapy
- It strengthens the diaphragm permanently
Correct answer: It prevents airway collapse and promotes CO2 elimination
Pursed-lip breathing creates back-pressure that keeps airways open longer, improving exhalation of trapped CO2.
Question 4: Which finding indicates worsening status in a client with an acute asthma attack?
- A suddenly quiet chest with absent wheezing (Correct answer)
- Audible expiratory wheezing
- Use of a rescue inhaler
- Mild anxiety
Correct answer: A suddenly quiet chest with absent wheezing
A silent chest signals severely reduced airflow and impending respiratory failure, a medical emergency.
Question 5: A client is prescribed albuterol and beclomethasone inhalers. In what order should they be used?
- Albuterol first, then beclomethasone (Correct answer)
- Beclomethasone first, then albuterol
- Both at the same time
- Only one per day, alternating
Correct answer: Albuterol first, then beclomethasone
The bronchodilator (albuterol) is used first to open airways so the steroid (beclomethasone) can reach deeper.
Question 6: What is the most reliable nursing assessment of oxygenation in a client with respiratory distress?
- Arterial blood gas analysis (Correct answer)
- Respiratory rate alone
- Skin color inspection
- Client's report of comfort
Correct answer: Arterial blood gas analysis
ABG provides direct measurement of PaO2, PaCO2, and pH for accurate oxygenation and acid-base status.
Question 7: A client with chronic bronchitis is most likely to present with which characteristic finding?
- Chronic productive cough with copious sputum (Correct answer)
- Barrel chest with minimal sputum
- Sudden pleuritic chest pain
- Dry hacking cough only
Correct answer: Chronic productive cough with copious sputum
Chronic bronchitis is defined by a productive cough with excessive mucus for at least 3 months in 2 consecutive years.
NCLEX Medical-Surgical: Respiratory Conditions 2
A client with COPD has an oxygen saturation of 88%.
What is the priority nursing action?