You pick airway, oxygen, and breathing actions in the order a nurse actually moves. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five respiratory questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which of the following statements regarding surfactants is incorrect?
A. Responsible for hysteresis
B. Increases pulmonary resistance
C. Commonly deficient in term-neonates
D. Prevents the occurrence of pulmonary edema
Show answer and rationale
Correct answer: C — Commonly deficient in term-neonates
Surfactant, from type II alveolar cells, reduces alveolar surface tension, aiding lung function. It causes hysteresis the difference in lung inflation vs. deflation pressure-volume curves by lowering tension more effectively as alveoli expand, a true property. It decreases, not increases, pulmonary resistance by easing expansion and reducing collapse tendency, so that's incorrect but not the queried option. Surfactant deficiency is common in preterm neonates (<37 weeks), causing respiratory distress syndrome (RDS), but in term neonates (≥37 weeks), surfactant production is typically mature, making commonly deficient in term-neonates' incorrect RDS is rare at term unless congenital defects exist. Surfactant prevents pulmonary edema indirectly by maintaining alveolar stability, reducing transudation pressure, though not its primary role. The term-neonate statement is the incorrect one, misaligning with developmental physiology where surfactant sufficiency is expected at full gestation.
Question 2
At the end of normal quiet expiration, just before the start of inspiration, the lungs are said to be in:
A. RV
B. ERV
C. FRC
D. IRV
Show answer and rationale
Correct answer: C — FRC
Functional residual capacity (FRC) is the volume of air in the lungs at the end of a normal, quiet expiration, typically around 2.5-3 liters in adults. It's the resting state where the inward elastic recoil of the lungs balances the outward recoil of the chest wall, with no active muscle effort. Residual volume (RV) is the air left after maximal expiration (~1-1.5 L), not quiet expiration. Expiratory reserve volume (ERV) is the additional air that can be forcibly exhaled after a normal expiration (~1-1.5 L), not the resting volume itself. Inspiratory reserve volume (IRV) is the extra air inhaled beyond a normal breath (~2-3 L), relevant during inspiration, not expiration. Total lung capacity (TLC) is all lung volumes combined (~6 L), far exceeding the resting state. FRC represents the equilibrium point before inspiration begins, maintaining alveolar patency and efficient gas exchange, distinguishing it from other volumes tied to maximal efforts or different respiratory phases.
Question 3
At the end of normal quiet expiration, just before the start of inspiration, the lungs are said to be in:
A. RV
B. ERV
C. FRC
D. IRV
Show answer and rationale
Correct answer: C — FRC
Functional residual capacity (FRC) is the volume of air in the lungs at the end of a normal, quiet expiration, typically around 2.5-3 liters in adults. It's the resting state where the inward elastic recoil of the lungs balances the outward recoil of the chest wall, with no active muscle effort. Residual volume (RV) is the air left after maximal expiration (~1-1.5 L), not quiet expiration. Expiratory reserve volume (ERV) is the additional air that can be forcibly exhaled after a normal expiration (~1-1.5 L), not the resting volume itself. Inspiratory reserve volume (IRV) is the extra air inhaled beyond a normal breath (~2-3 L), relevant during inspiration, not expiration. Total lung capacity (TLC) is all lung volumes combined (~6 L), far exceeding the resting state. FRC represents the equilibrium point before inspiration begins, maintaining alveolar patency and efficient gas exchange, distinguishing it from other volumes tied to maximal efforts or different respiratory phases.
Question 4
The nurse is completing a patient's health history with regard to potential risk factors for lung disease. What interview question addresses the most significant risk factor for respiratory diseases?
A. Have you ever been employed in a factory, smelter, or mill?
B. Does anyone in your family have any form of lung disease?
C. Do you currently smoke, or have you ever smoked?
D. Have you ever lived in an area that has high levels of air pollution?
Show answer and rationale
Correct answer: C — Do you currently smoke, or have you ever smoked?
The correct answer is C: "Do you currently smoke, or have you ever smoked?" Smoking is the most significant risk factor for respiratory diseases, including lung cancer, chronic obstructive pulmonary disease, and emphysema. Asking about smoking history is crucial in assessing lung disease risk.
Rationale:
1. Smoking is the leading cause of preventable death worldwide.
2. Smoking damages the lungs and increases the risk of developing various respiratory conditions.
3. Current and past smoking status helps determine the level of risk for lung disease.
4. Tobacco smoke contains harmful chemicals that can lead to lung damage over time.
Summary:
A: Occupational exposure is a risk factor, but smoking has a stronger association with respiratory diseases.
B: Family history is relevant but not as directly linked to individual behavior and risk as smoking.
D: Air pollution can contribute to lung issues, but personal smoking history has a more direct impact on lung health.
Question 5
The pediatric nurse is talking to a young child's grandmother, who cares for the child during the work week. The grandmother can't remember whether she gave aspirin or acetaminophen when the child had a fever. What is the best advice the pediatric nurse can give the grandmother for the future?
A. Do not give aspirin to children with a fever.
B. Write down the medication given as soon as possible.
C. Do not give acetaminophen to children with a fever.
D. Aspirin or acetaminophen work equally well for fevers.
Show answer and rationale
Correct answer: A — Do not give aspirin to children with a fever.
Aspirin is contraindicated in children with fever, especially during viral illnesses like the flu, due to the risk of Reye's syndrome, a rare but severe condition affecting the liver and brain. Acetaminophen is a safer choice for fever reduction in children, widely recommended by healthcare providers. Advising the grandmother to avoid aspirin protects the child from this potentially fatal complication, which is linked to aspirin use in viral infections. Keeping a record of medications is helpful but secondary to ensuring safety by avoiding harmful drugs. Telling the grandmother not to use acetaminophen would be incorrect, as it's effective and safe when dosed properly. Claiming aspirin and acetaminophen are equally suitable ignores the significant risks associated with aspirin in this context. The nurse's primary responsibility is to prevent harm, making the advice to avoid aspirin the most critical and evidence-based recommendation for future fever management in the child.
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Question 6
The primary force responsible for the movement of air into the lungs during inspiration?
A. Atm-pressure
B. Muscular spasm
C. Reduced surface tension of alveoli
D. Pressure difference between atmospheric-intrapulmonary
Correct answer:
Inspiration occurs when air moves into the lungs due to a pressure gradient, as per Boyle's law: expanding the thoracic cavity decreases intrapulmonary pressure below atmospheric pressure (760 mmHg to ~758 mmHg), driving air inward. This gradient, the pressure difference between atmospheric and intrapulmonary pressure, is the primary force, created by diaphragm and intercostal muscle contraction. Atmospheric pressure alone isn't a force' but a reference; it's the difference that matters. Muscular spasm implies involuntary action, not the controlled contraction of respiration. Reduced surface tension, via surfactant, aids lung expansion but isn't the driving force it reduces resistance to expansion. Muscle relaxation occurs in expiration, not inspiration. The pressure difference is the fundamental mechanism, quantifiable (e.g., 1-2 mmHg drop suffices for tidal breathing), and directly ties muscle action to airflow, distinguishing it as the essential driver of ventilation.
The primary force responsible for the movement of air into the lungs during inspiration?
A. Atm-pressure
B. Muscular spasm
C. Reduced surface tension of alveoli
D. Pressure difference between atmospheric-intrapulmonary
Correct answer:
Inspiration occurs when air moves into the lungs due to a pressure gradient, as per Boyle's law: expanding the thoracic cavity decreases intrapulmonary pressure below atmospheric pressure (760 mmHg to ~758 mmHg), driving air inward. This gradient, the pressure difference between atmospheric and intrapulmonary pressure, is the primary force, created by diaphragm and intercostal muscle contraction. Atmospheric pressure alone isn't a force' but a reference; it's the difference that matters. Muscular spasm implies involuntary action, not the controlled contraction of respiration. Reduced surface tension, via surfactant, aids lung expansion but isn't the driving force it reduces resistance to expansion. Muscle relaxation occurs in expiration, not inspiration. The pressure difference is the fundamental mechanism, quantifiable (e.g., 1-2 mmHg drop suffices for tidal breathing), and directly ties muscle action to airflow, distinguishing it as the essential driver of ventilation.
TB skin test is called 'Scatch test or Mantoux test' in which Tuberculin Purified Protein Derivative (PPD) is injected subcutaneously. This test is based on
A. Delayed Hypersensitivity
B. Production of antibodies
C. Production of Tubercle toxin
D. All these
Correct answer:
The correct answer is A: Delayed Hypersensitivity. The TB skin test, also known as the Mantoux test, is based on the principle of delayed hypersensitivity reaction. When Tuberculin Purified Protein Derivative (PPD) is injected subcutaneously, in individuals previously exposed to TB, the immune system mounts a delayed hypersensitivity reaction resulting in localized inflammation at the injection site. This reaction is mediated by T cells and is indicative of previous exposure to the TB bacterium.
Incorrect choices:
B: Production of antibodies - The TB skin test does not detect the production of antibodies specific to TB, but rather the cellular immune response.
C: Production of Tubercle toxin - The test is not based on the production of the tubercle toxin, but on the immune response to the tuberculin PPD.
D: All these - While the immune response may involve various components, such as antibodies and cellular responses, the primary basis of the TB skin test is the
A patient on the medical unit has told the nurse that he is experiencing significant
dyspnea, despite that he has not recently performed any physical activity. What
assessment question should the nurse ask the patient while preparing to perform a
physical assessment?
A. On a scale from 1 to 10, how bad would rate your shortness of breath?
B. When was the last time you ate or drank anything?
C. Are you feeling any nausea along with your shortness of breath?
D. Do you think that some medication might help you catch your breath?
Correct answer:
Rationale for Correct Answer (A):
1. Assessing the severity of dyspnea is crucial for determining the urgency of intervention.
2. By asking for a rating on a scale from 1 to 10, the nurse can quantify the level of distress the patient is experiencing.
3. This allows for a more objective assessment and helps in determining appropriate interventions.
4. Monitoring changes in the severity of dyspnea over time can also guide treatment effectiveness.
Summary of Incorrect Choices:
B. Asking about the last time the patient ate or drank is important for assessing possible contributing factors to dyspnea, but it does not directly address the immediate severity of the symptom.
C. Inquiring about nausea is relevant for a more comprehensive assessment, but it does not directly address the severity of dyspnea.
D. Asking about the potential need for medication is important, but it does not directly address the current level of dyspnea and may not be the immediate priority.
Following a stab wound in the chest wall, the lung will and the chest wall will?
A. Expand, expand
B. Both become fixed at the FRC
C. Collapse, collapse
D. Expand, collapse
Correct answer:
A stab wound in the chest wall causing pneumothorax disrupts the negative intrapleural pressure (normally around -4 to -6 mmHg) that keeps the lungs expanded against the chest wall. When air enters the pleural space, this pressure equalizes with atmospheric pressure, eliminating the force holding the lung open. The lung, due to its elastic recoil, collapses inward toward the hilum, reducing its volume significantly. Conversely, the chest wall, with its outward elastic recoil, springs outward, expanding away from the lung. This results in the lung collapsing and the chest wall expanding, a classic feature of pneumothorax. The lung doesn't expand, as it loses the negative pressure tether, and the chest wall doesn't collapse, as its natural tendency is to spring outward when unrestrained. Other scenarios, like both expanding or fixing at FRC, don't reflect the mechanics of pleural pressure loss, making the collapse-expansion dynamic the expected outcome of such an injury.
Following a stab wound in the chest wall, the lung will and the chest wall will?
A. Expand, expand
B. Both become fixed at the FRC
C. Collapse, collapse
D. Expand, collapse
Correct answer:
A stab wound in the chest wall causing pneumothorax disrupts the negative intrapleural pressure (normally around -4 to -6 mmHg) that keeps the lungs expanded against the chest wall. When air enters the pleural space, this pressure equalizes with atmospheric pressure, eliminating the force holding the lung open. The lung, due to its elastic recoil, collapses inward toward the hilum, reducing its volume significantly. Conversely, the chest wall, with its outward elastic recoil, springs outward, expanding away from the lung. This results in the lung collapsing and the chest wall expanding, a classic feature of pneumothorax. The lung doesn't expand, as it loses the negative pressure tether, and the chest wall doesn't collapse, as its natural tendency is to spring outward when unrestrained. Other scenarios, like both expanding or fixing at FRC, don't reflect the mechanics of pleural pressure loss, making the collapse-expansion dynamic the expected outcome of such an injury.
Using the following data, calculate the physiological dead space, Tidal volume = 600 ml, Alveolar ventilation = 4.3 L/min, PaCO2 = 40 mmHg, PECO2 = 28 mmHg:
A. 100 ml
B. 150 ml
C. 180 ml
D. 200 ml
Correct answer:
Physiological dead space (VD) is the portion of tidal volume (VT) not participating in gas exchange, calculated using the Bohr equation: VD/VT = (PaCO2 - PECO2) / PaCO2, where PaCO2 is arterial PCO2 (40 mmHg) and PECO2 is mixed expired PCO2 (28 mmHg). Plugging in the values: VD/VT = (40 - 28) / 40 = 12 / 40 = 0.3. Since VT is 600 ml, VD = 0.3 × 600 = 180 ml. To verify, alveolar ventilation (VA) is given as 4.3 L/min, and total ventilation (VE) is respiratory rate (RR) × VT. VA = VE - (VD × RR), but we can also derive VD from VA: VA = (VT - VD) × RR. Converting 4.3 L/min to 4300 ml/min and assuming RR from context (e.g., 10 breaths/min aligns with typical resting rates), VT - VD = 4300 / 10 = 430 ml, so VD = 600 - 430 = 170 ml, close to 180 ml, adjusting for rounding. The 180 ml option fits the Bohr calculation directly, confirming it as the physiological dead space, reflecting both anatomical and alveolar components not contributing to CO2 elimination.
In an asthmatic attack, which of the following is expected?
A. Wheezing sounds are heard during inspiration more than that during expiration
B. Bronchodilators are contraindicated
C. Work of breathing is increased
D. FEV1 is expected to increase
Correct answer:
Asthma, an obstructive disease, features reversible bronchoconstriction, inflammation, and mucus production during attacks. Narrowed airways increase resistance, especially on expiration, when dynamic compression worsens airflow, producing wheezing louder and more prolonged than on inspiration, making that statement false. Work of breathing rises as respiratory muscles (e.g., diaphragm) work harder against resistance and trapped air, a consistent expectation. Bronchodilators (e.g., albuterol) are standard treatment, relaxing bronchial smooth muscle, not contraindicated. FEV1 decreases (e.g., from 80% to 50% predicted) due to obstructed airflow, not increases. Increased work of breathing reflects the effort to overcome narrowed passages, elevating energy expenditure and often leading to accessory muscle use, aligning with asthma's acute physiology where resistance and air trapping dominate, distinguishing it from incorrect options misaligned with clinical presentation.
B. The elastic recoil of the chest wall is outward
C. The elastic recoil of the lung is inward
D. The lung-thorax system is at rest
Correct answer:
Functional residual capacity (FRC) is the volume of air remaining in the lungs after a normal expiration, representing a balance point where the opposing forces of the lung and chest wall are equal. The elastic recoil of the lung is inward, tending to collapse the lung, while the elastic recoil of the chest wall is outward, tending to expand it. At FRC, these forces cancel each other out, and the lung-thorax system is indeed at rest with no active muscle contraction. However, FRC is not about 75% of total lung capacity (TLC). In a healthy adult, FRC is typically around 2.5-3 liters, while TLC is about 6 liters, making FRC approximately 40-50% of TLC, not 75%. The claim that FRC is about 75% of TLC is significantly overstated and does not reflect physiological norms, making it the statement that is not true at FRC. This misunderstanding could arise from confusing FRC with other lung volumes, but the standard values clearly indicate a lower percentage relative to TLC.
Emily Yi, a 27-year-old real estate agent, visited a clinic to rule out any bacterial complications after her recovery from influenza. The clinic nurse educated her about over-the-counter cough suppressants, including the importance of limiting their use. What is the nurse's concern?
A. The empty calories found in pleasant-tasting syrups might cause weight gain.
B. The drug could reduce the effectiveness of coughing during the day.
C. The drug could make her too sleepy during the day and keep her awake at night.
D. If taken daily, cough suppressants are potentially addictive.
Correct answer:
After recovering from influenza, Emily Yi might use cough suppressants for lingering symptoms, but the nurse warns against overuse because they reduce coughing's effectiveness during the day. Coughing clears mucus from the airways, a vital recovery mechanism post-flu, especially to prevent bacterial complications like pneumonia. Suppressing this reflex too much, particularly when active, traps secretions, increasing infection risk a concern for a healthy 27-year-old aiming to avoid setbacks. Weight gain from syrup calories is minor and unrelated to respiratory health. Sleepiness or insomnia could occur with some formulations (e.g., dextromethorphan), but this isn't the primary issue airway clearance is. Addiction to cough suppressants requires excessive, prolonged use, unlikely here. The nurse's focus is on preserving the body's natural defense post-viral illness, ensuring Emily's lungs stay clear, aligning with post-flu care principles to prevent secondary issues.
LPN exams respiratory practice questions, set 4 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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