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 RN exams exam guide or more RN 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
Regarding pulmonary vascular resistance, which one of the following is true?
A. Is low at high lung volumes
B. Is low at low lung volumes
C. If increased, can cause right heart failure
D. Is measured through routine pulmonary function tests
Show answer and rationale
Correct answer: C — If increased, can cause right heart failure
Pulmonary vascular resistance (PVR) reflects opposition to blood flow in the pulmonary circulation, influenced by lung volume and vessel mechanics. At high lung volumes (near TLC), extra-alveolar vessels stretch and narrow, and alveolar capillaries compress, increasing PVR. At low volumes (near RV), these vessels are less stretched and more patent, lowering PVR, though this isn't the queried truth. The true statement is that increased PVR can lead to right heart failure, as seen in conditions like pulmonary hypertension or fibrosis, where elevated resistance overworks the right ventricle, causing cor pulmonale. PVR isn't measured by routine pulmonary function tests (e.g., spirometry), which assess airflow and volumes, not vascular pressures cardiac catheterization is required instead. The link to right heart failure is critical, as chronic high PVR elevates pulmonary artery pressure, straining the heart's ability to pump against it, a key pathophysiological consequence distinguishing this option as true amid the others' inaccuracies.
Question 2
A nurse obtains the health history of a client who is recently diagnosed with lung cancer and identifies that the client has a 60–pack-year smoking history. Which action is most important for the nurse to take when interviewing this client?
A. Tell the client that he or she needs to quit smoking to stop further cancer development.
B. Encourage the client to be completely honest about both tobacco and marijuana use.
C. Maintain a nonjudgmental attitude to avoid causing the client to feel guilty.
D. Avoid giving the client false hope regarding cancer treatment and prognosis.
Show answer and rationale
Correct answer: C — Maintain a nonjudgmental attitude to avoid causing the client to feel guilty.
The correct answer is C: Maintain a nonjudgmental attitude to avoid causing the client to feel guilty. This is important because the nurse needs to establish trust with the client to obtain accurate information about their health history. Being nonjudgmental creates a safe space for the client to share openly, which is crucial for effective assessment and planning of care.
Choice A is incorrect because while it is important for the client to quit smoking, addressing this issue at the first encounter may not be the most effective approach and could potentially alienate the client.
Choice B is also incorrect as the focus should be on building rapport and obtaining accurate information relevant to the client's current health status. Encouraging honesty about substance use is important but not the most critical action in this context.
Choice D is incorrect as the nurse should provide information and support to the client based on the client's needs and wishes, rather than making assumptions about their preferences or prognosis.
Question 3
A client with suspected tuberculosis will most likely relate which clinical manifestations?
A. Fatigue, weight loss, low grade fevers, night sweats.
B. Dyspnea, chest pain, cough.
C. Rapid shallow breathing, prolonged labored expiration, stridor.
D. Dyspnea, hypoxemia, decreased pulmonary compliance.
Show answer and rationale
Correct answer: A — Fatigue, weight loss, low grade fevers, night sweats.
The correct answer is A. A client with suspected tuberculosis is likely to experience fatigue, weight loss, low-grade fevers, and night sweats due to the chronic infection affecting the body. Fatigue and weight loss are common symptoms of active tuberculosis due to the systemic impact of the infection. Low-grade fevers and night sweats are characteristic of tuberculosis due to the body's immune response. These symptoms are key indicators of tuberculosis infection.
Choices B, C, and D are incorrect because they describe symptoms that are not typically associated with tuberculosis. Dyspnea, chest pain, and cough (Choice B) are more commonly seen in respiratory conditions such as pneumonia or bronchitis. Rapid shallow breathing, prolonged labored expiration, and stridor (Choice C) are indicative of airway obstruction rather than tuberculosis. Dyspnea, hypoxemia, and decreased pulmonary compliance (Choice D) are more characteristic of conditions such as chronic obstructive pulmonary disease (COPD) rather than tuberculosis.
Question 4
A client with suspected tuberculosis will most likely relate which clinical manifestations?
A. Fatigue, weight loss, low grade fevers, night sweats.
B. Dyspnea, chest pain, cough.
C. Rapid shallow breathing, prolonged labored expiration, stridor.
D. Dyspnea, hypoxemia, decreased pulmonary compliance.
Show answer and rationale
Correct answer: A — Fatigue, weight loss, low grade fevers, night sweats.
The correct answer is A. A client with suspected tuberculosis is likely to experience fatigue, weight loss, low-grade fevers, and night sweats due to the chronic infection affecting the body. Fatigue and weight loss are common symptoms of active tuberculosis due to the systemic impact of the infection. Low-grade fevers and night sweats are characteristic of tuberculosis due to the body's immune response. These symptoms are key indicators of tuberculosis infection.
Choices B, C, and D are incorrect because they describe symptoms that are not typically associated with tuberculosis. Dyspnea, chest pain, and cough (Choice B) are more commonly seen in respiratory conditions such as pneumonia or bronchitis. Rapid shallow breathing, prolonged labored expiration, and stridor (Choice C) are indicative of airway obstruction rather than tuberculosis. Dyspnea, hypoxemia, and decreased pulmonary compliance (Choice D) are more characteristic of conditions such as chronic obstructive pulmonary disease (COPD) rather than tuberculosis.
Question 5
In the presence of active surfactants, all of the following are expected to decrease EXCEPT?
A. Tendency of the lung to collapse
B. Lung compliance
C. Surface tension forces in the alveoli
D. Lymph flow in the lung
Show answer and rationale
Correct answer: B — Lung compliance
Surfactant, produced by type II alveolar cells, is a phospholipid mixture that reduces surface tension in alveoli, stabilizing them and aiding lung function. Normally, high surface tension from water molecules at the air-liquid interface promotes alveolar collapse, but active surfactant lowers this tension, decreasing the tendency of lungs to collapse (atelectasis). Reduced surface tension also lessens the work of breathing by making lung expansion easier and decreases lymph flow in the lung, as less fluid is forced into the interstitium due to lower alveolar pressure gradients. However, lung compliance the ease with which lungs expand increases with active surfactant, not decreases. Compliance is inversely related to surface tension; when tension drops, the lungs become less stiff, improving their ability to stretch per unit of pressure. Thus, lung compliance is the exception, as it rises while the other factors diminish, reflecting surfactant's critical role in maintaining alveolar stability and efficient ventilation.
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Question 6
Which of the following will decrease diffusion?
A. Decreased surface area
B. Increased fluid in the lung
C. Decreased pressure coefficient
D. All the above
Correct answer:
Diffusion of gases like O2 and CO2 across the alveolar-capillary membrane follows Fick's law: Rate = (A × D × ÃŽâ€P) / d. Decreased surface area (A), as in emphysema, reduces the available exchange area, lowering diffusion. Increased fluid in the lung (e.g., pulmonary edema) increases diffusion distance (d), as fluid thickens the barrier, impeding gas transfer and often adding proteinaceous debris that further slows diffusion. Decreased pressure coefficient' likely intends partial pressure gradient (ÃŽâ€P); reducing this (e.g., via hypoventilation) weakens the driving force for diffusion. All these factors surface area, distance, and gradient when altered as described, decrease diffusion rate. The diffusion coefficient (D) isn't directly mentioned, but the combined impact of the listed changes aligns with clinical scenarios (e.g., edema causing hypoxemia). Since each independently and collectively impairs diffusion, all contribute to a reduced gas exchange efficiency, critical for oxygenation and CO2 removal.
A female patient suffers acute respiratory distress syndrome as a consequence of shock. The patient's condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm?
A. Kinking of the ventilator tubing.
B. A disconnected ventilator tube.
C. An endotracheal cuff leak.
D. A change in the oxygen concentration without resetting the oxygen level alarm.
Correct answer:
The correct answer is A: Kinking of the ventilator tubing. This condition can cause a blockage in the airflow, leading to increased pressure in the ventilator circuit, triggering the high-pressure alarm. Kinking restricts the flow of air, causing a buildup of pressure in the system. This situation can lead to inadequate ventilation and potential harm to the patient.
Choice B, a disconnected ventilator tube, would trigger a low-pressure alarm rather than a high-pressure alarm because the disconnection would result in a loss of pressure. Choice C, an endotracheal cuff leak, would not directly cause an increase in pressure within the ventilator circuit. Choice D, a change in oxygen concentration without resetting the alarm, would not trigger the high-pressure alarm but rather an oxygen alarm if the concentration falls outside the set range.
In summary, kinking of the ventilator tubing is the correct answer as it directly leads to increased pressure in the ventilator circuit, triggering the high-pressure alarm.
A nurse educator is reviewing the implications of the oxyhemoglobin dissociation curve with regard to the case of a current patient. The patient currently has normal hemoglobin levels, but significantly decreased SaO2 and PaO2 levels. What is an implication of this physiological state?
A. The patient's tissue demands may be met, but she will be unable to respond to physiological stressors.
B. The patient's short-term oxygen needs will be met, but she will be unable to expel sufficient CO2.
C. The patient will experience tissue hypoxia with no sensation of shortness of breath or labored breathing.
D. The patient will experience respiratory alkalosis with no ability to compensate.
Correct answer:
The correct answer is A because even though the patient has normal hemoglobin levels, the significantly decreased SaO2 and PaO2 levels indicate that the hemoglobin is not effectively carrying oxygen to the tissues. This leads to a situation where the tissue demands for oxygen may be met at baseline, but the patient will be unable to respond to physiological stressors that require increased oxygen delivery.
Choice B is incorrect because it focuses on short-term oxygen needs and CO2 expulsion, which are not directly related to the implications of the oxyhemoglobin dissociation curve in this case.
Choice C is incorrect because decreased SaO2 and PaO2 levels would lead to tissue hypoxia, which would likely result in sensations of shortness of breath or labored breathing as the body tries to compensate for the lack of oxygen.
Choice D is incorrect because decreased PaO2 levels would not lead to respiratory alkalosis. The body would likely try to compensate by increasing respiratory rate to improve oxygenation.
A female patient suffers acute respiratory distress syndrome as a consequence of shock. The patient's condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator, alarm sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm?
A. Kinking of the ventilator tubing.
B. A disconnected ventilator tube.
C. An endotracheal cuff leak.
D. A change in the oxygen concentration without resetting the oxygen level alarm.
Correct answer:
The correct answer is A: Kinking of the ventilator tubing. This condition can cause a blockage in the airflow, leading to increased pressure in the ventilator circuit, triggering the high-pressure alarm. Kinking restricts the flow of air, causing a buildup of pressure in the system. This situation can lead to inadequate ventilation and potential harm to the patient.
Choice B, a disconnected ventilator tube, would trigger a low-pressure alarm rather than a high-pressure alarm because the disconnection would result in a loss of pressure. Choice C, an endotracheal cuff leak, would not directly cause an increase in pressure within the ventilator circuit. Choice D, a change in oxygen concentration without resetting the alarm, would not trigger the high-pressure alarm but rather an oxygen alarm if the concentration falls outside the set range.
In summary, kinking of the ventilator tubing is the correct answer as it directly leads to increased pressure in the ventilator circuit, triggering the high-pressure alarm.
A nurse educator is reviewing the implications of the oxyhemoglobin dissociation curve with regard to the case of a current patient. The patient currently has normal hemoglobin levels, but significantly decreased SaO2 and PaO2 levels. What is an implication of this physiological state?
A. The patient's tissue demands may be met, but she will be unable to respond to physiological stressors.
B. The patient's short-term oxygen needs will be met, but she will be unable to expel sufficient CO2.
C. The patient will experience tissue hypoxia with no sensation of shortness of breath or labored breathing.
D. The patient will experience respiratory alkalosis with no ability to compensate.
Correct answer:
The correct answer is A because even though the patient has normal hemoglobin levels, the significantly decreased SaO2 and PaO2 levels indicate that the hemoglobin is not effectively carrying oxygen to the tissues. This leads to a situation where the tissue demands for oxygen may be met at baseline, but the patient will be unable to respond to physiological stressors that require increased oxygen delivery.
Choice B is incorrect because it focuses on short-term oxygen needs and CO2 expulsion, which are not directly related to the implications of the oxyhemoglobin dissociation curve in this case.
Choice C is incorrect because decreased SaO2 and PaO2 levels would lead to tissue hypoxia, which would likely result in sensations of shortness of breath or labored breathing as the body tries to compensate for the lack of oxygen.
Choice D is incorrect because decreased PaO2 levels would not lead to respiratory alkalosis. The body would likely try to compensate by increasing respiratory rate to improve oxygenation.
In normal individual, regarding gas exchange across pulmonary capillaries during mild exercise, which of the following statements is TRUE?
A. CO2 crosses the membrane easier than O2
B. Diffusing capacity of the lung for O2 is more than for CO2, the most important factor to play role is the molecular weight of both gases
C. The length of capillary required for gas equilibrium is shorter during exercise
D. ABGs become grossly abnormal
Correct answer:
During mild exercise, pulmonary gas exchange adapts to increased O2 demand and CO2 production. CO2 diffuses ~20 times faster than O2 across the alveolar-capillary membrane due to its higher solubility (0.51 vs. 0.024 ml/mmHg/L), despite a slightly higher molecular weight (44 vs. 32), per Fick's law (D ∠solubility / √MW) making it cross easier, a true statement. Diffusing capacity (DL) for O2 is less than for CO2 normally, and while exercise increases DL for both (recruiting capillaries), CO2's advantage persists, not O2's, and molecular weight is secondary to solubility. Capillary equilibrium length shortens for O2 and CO2 as blood flow rises, but this is nuanced and not uniquely true without context. Arterial blood gases (ABGs) remain normal in healthy individuals during mild exercise (e.g., PaO2 ~100 mmHg, PaCO2 ~40 mmHg), as ventilation matches perfusion. CO2's easier diffusion is the standout truth, rooted in its physicochemical properties, critical for efficient CO2 elimination.
The greatest increase in the physiological dead space would be expected with?
A. Pulmonary embolism
B. Atelectasis
C. Pneumothorax
D. Bronchoconstriction
Correct answer:
Physiological dead space (VD) is the volume of ventilated air not participating in gas exchange, comprising anatomic dead space (conducting airways) and alveolar dead space (non-perfused alveoli). Pulmonary embolism (PE) blocks pulmonary arteries, reducing perfusion to ventilated alveoli, markedly increasing alveolar dead space and thus physiological VD (e.g., from 150 ml to 300+ ml), as large lung regions become wasted ventilation.' Atelectasis collapses alveoli, reducing ventilation and dead space, as unventilated areas don't contribute to VD. Pneumothorax collapses lung tissue, decreasing ventilated volume, not increasing dead space. Bronchoconstriction narrows airways, potentially reducing anatomic dead space slightly, and doesn't directly increase alveolar dead space unless severe hypoxia ensues. PE's perfusion defect creates the greatest VD rise, measurable via increased PaCO2-PECO2 difference, distinguishing it as the most impactful condition among these, reflecting a high V/Q mismatch.
The nurse is caring for a patient admitted with an acute exacerbation of chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing increased dyspnea. What is the most accurate measurement of the concentration of oxygen in the patient's blood?
A. A capillary blood sample
B. Pulse oximetry
C. An arterial blood gas (ABG) study
D. A complete blood count (CBC)
Correct answer:
The correct answer is C: An arterial blood gas (ABG) study. This is the most accurate measurement of the concentration of oxygen in the patient's blood because ABG provides direct measurement of oxygen levels, including partial pressure of oxygen (PaO2). It also gives information on other important parameters like pH and carbon dioxide levels. Arterial blood is the best representation of oxygenation status.
Choice A (A capillary blood sample) may provide some information on oxygen saturation but is not as accurate as an ABG for measuring oxygen levels in the blood.
Choice B (Pulse oximetry) measures oxygen saturation in peripheral blood and can give a quick estimate of oxygen levels, but it is not as accurate as an ABG for determining the actual oxygen concentration in the blood.
Choice D (A complete blood count) does not provide direct information on oxygen levels in the blood, as it mainly focuses on the cellular components of blood such as red blood cells, white blood cells, and
Which person would be expected to have the largest PAO2-PaO2 gradient? (A stands for alveolar and a-stands for arterial)
A. Normal person during exercise
B. Person with pulmonary fibrosis
C. Person with anemia but normal lungs
D. Person at 5000 meter above the sea level
Correct answer:
The PAO2-PaO2 gradient measures the difference between alveolar oxygen (PAO2) and arterial oxygen (PaO2), normally small (~5-10 mmHg) due to efficient diffusion. In pulmonary fibrosis, thickened alveolar walls from scarring impair O2 diffusion, lowering PaO2 (e.g., 60 mmHg) while PAO2 (calculated via the alveolar gas equation, ~100 mmHg at sea level) remains closer to normal, widening the gradient (e.g., 40 mmHg). During exercise in a normal person, increased cardiac output and ventilation match perfusion, keeping the gradient minimal despite higher O2 demand. Anemia reduces oxygen-carrying capacity (low hemoglobin), not diffusion, so PaO2 approximates PAO2, maintaining a normal gradient. At 5000 meters, low atmospheric PO2 reduces both PAO2 and PaO2 proportionately (e.g., PAO2 ~50 mmHg, PaO2 ~45 mmHg), keeping the gradient small. Pulmonary fibrosis uniquely disrupts diffusion, causing the largest gradient, as fibrotic barriers hinder O2 transfer more than ventilation or perfusion issues.
The nurse is caring for a patient admitted with an acute exacerbation of chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing increased dyspnea. What is the most accurate measurement of the concentration of oxygen in the patient's blood?
A. A capillary blood sample
B. Pulse oximetry
C. An arterial blood gas (ABG) study
D. A complete blood count (CBC)
Correct answer:
The correct answer is C: An arterial blood gas (ABG) study. This is the most accurate measurement of the concentration of oxygen in the patient's blood because ABG provides direct measurement of oxygen levels, including partial pressure of oxygen (PaO2). It also gives information on other important parameters like pH and carbon dioxide levels. Arterial blood is the best representation of oxygenation status.
Choice A (A capillary blood sample) may provide some information on oxygen saturation but is not as accurate as an ABG for measuring oxygen levels in the blood.
Choice B (Pulse oximetry) measures oxygen saturation in peripheral blood and can give a quick estimate of oxygen levels, but it is not as accurate as an ABG for determining the actual oxygen concentration in the blood.
Choice D (A complete blood count) does not provide direct information on oxygen levels in the blood, as it mainly focuses on the cellular components of blood such as red blood cells, white blood cells, and
RN exams respiratory practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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