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
At the end of quiet respiration, muscles are relaxed and lungs content represents.
A. RV
B. ERV
C. FRC
D. IRV
Show answer and rationale
Correct answer: C — FRC
At the end of quiet expiration, respiratory muscles (diaphragm, intercostals) relax, and the lungs reach functional residual capacity (FRC), typically 2.5-3 liters. FRC is the resting volume where lung inward recoil balances chest wall outward recoil, maintaining equilibrium without active effort. Residual volume (RV, ~1-1.5 L) is the air left after maximal expiration, not quiet breathing. Expiratory reserve volume (ERV, ~1-1.5 L) is the extra air forcibly exhaled beyond quiet expiration, not present at rest. Inspiratory reserve volume (IRV, ~2-3 L) is additional air inhaled beyond a normal breath, irrelevant post-expiration. Total lung capacity (TLC, ~6 L) includes all volumes, not the resting state. FRC's role as the baseline volume after passive expiration reflects the natural relaxation point, critical for continuous gas exchange, distinguishing it from volumes tied to forced maneuvers or inspiration.
Question 2
A nurse observes that a client's anteroposterior (AP) chest diameter is the same as the lateral chest diameter. Which question would the nurse ask the client in response to this finding?
A. Are you taking any medications or herbal supplements?
B. Do you have any chronic breathing problems?
C. How often do you perform aerobic exercise?
D. What is your occupation and what are your hobbies?
Show answer and rationale
Correct answer: B — Do you have any chronic breathing problems?
The correct answer is B: Do you have any chronic breathing problems? This question is appropriate because equal AP and lateral chest diameters could indicate barrel chest, which is often associated with chronic obstructive pulmonary disease (COPD) or other chronic breathing problems. Asking about chronic breathing problems can help the nurse further assess the client's respiratory health.
Incorrect answers:
A: Are you taking any medications or herbal supplements? This question is not directly related to the observed chest diameter findings.
C: How often do you perform aerobic exercise? This question is not relevant to the physical assessment findings and does not address the potential respiratory issue.
D: What is your occupation and what are your hobbies? This question does not directly address the equal AP and lateral chest diameters and does not help in assessing the respiratory status of the client.
Question 3
The single most effective health promotion activity that a nurse could teach a group of community-dwelling senior citizens that would most likely help them prevent influenza and pneumonia would be which of the following?
A. Participating in indoor exercise programs during winter months
B. Using effective hand washing techniques
C. Getting an annual influenza vaccine
D. Avoiding crowds of people
Show answer and rationale
Correct answer: C — Getting an annual influenza vaccine
The annual influenza vaccine is the most effective health promotion activity for preventing influenza and its complication, pneumonia, especially in senior citizens who are at higher risk due to age-related immune decline. The vaccine primes the immune system to recognize and fight specific flu strains, reducing infection risk by up to 60% when well-matched, and lowering severity if infected. Hand washing reduces transmission but doesn't provide direct immunity. Avoiding crowds limits exposure but isn't as proactive or reliable as vaccination. Exercise boosts general health but lacks the specific protective effect of the vaccine against flu viruses. For seniors, who face increased morbidity from flu and pneumonia, the nurse's focus on vaccination aligns with public health priorities, offering a targeted, evidence-based strategy to prevent these respiratory illnesses and their potentially fatal outcomes.
Question 4
Inhibition of medulla oblongata chemoreceptors and respiratory muscles has what effect on respiratory rate, elimination of CO2 at alveoli, and arterial PCO2?
A. increased respiratory rate, increased elimination of CO2 at alveoli, and increased arterial
PCO2
B. increased respiratory rate, decreased elimination of CO2 at alveoli, and decreased arterial
PCO2
C. increased respiratory rate, increased elimination of CO2 at alveoli, and decreased arterial
PCO2
D. decreased respiratory rate, decreased elimination of CO2 at alveoli, and increased arterial
PCO2
Show answer and rationale
Correct answer: D — decreased respiratory rate, decreased elimination of CO2 at alveoli, and increased arterial
PCO2
The correct answer is D. Inhibition of medulla oblongata chemoreceptors and respiratory muscles would decrease respiratory rate, leading to decreased elimination of CO2 at alveoli. This would cause an increase in arterial PCO2 due to less CO2 being removed from the body. Therefore, choice D is correct.
Choices A, B, and C are incorrect because they do not align with the physiological effects of inhibiting the medulla oblongata chemoreceptors and respiratory muscles. Option A suggests an increase in respiratory rate and elimination of CO2, which goes against the expected decrease in these parameters. Option B proposes an increase in respiratory rate but a decrease in CO2 elimination and arterial PCO2, which is inconsistent with the expected outcomes. Option C suggests an increase in respiratory rate and CO2 elimination but a decrease in arterial PCO2, which does not follow the logic of the question.
Question 5
Inhibition of medulla oblongata chemoreceptors and respiratory muscles has what effect on respiratory rate, elimination of CO2 at alveoli, and arterial PCO2?
A. increased respiratory rate, increased elimination of CO2 at alveoli, and increased arterial
PCO2
B. increased respiratory rate, decreased elimination of CO2 at alveoli, and decreased arterial
PCO2
C. increased respiratory rate, increased elimination of CO2 at alveoli, and decreased arterial
PCO2
D. decreased respiratory rate, decreased elimination of CO2 at alveoli, and increased arterial
PCO2
Show answer and rationale
Correct answer: D — decreased respiratory rate, decreased elimination of CO2 at alveoli, and increased arterial
PCO2
The correct answer is D. Inhibition of medulla oblongata chemoreceptors and respiratory muscles would decrease respiratory rate, leading to decreased elimination of CO2 at alveoli. This would cause an increase in arterial PCO2 due to less CO2 being removed from the body. Therefore, choice D is correct.
Choices A, B, and C are incorrect because they do not align with the physiological effects of inhibiting the medulla oblongata chemoreceptors and respiratory muscles. Option A suggests an increase in respiratory rate and elimination of CO2, which goes against the expected decrease in these parameters. Option B proposes an increase in respiratory rate but a decrease in CO2 elimination and arterial PCO2, which is inconsistent with the expected outcomes. Option C suggests an increase in respiratory rate and CO2 elimination but a decrease in arterial PCO2, which does not follow the logic of the question.
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Question 6
After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage. When caring for this patient, the nurse must:
A. Monitor fluctuations in the water-seal chamber.
B. Clamp the chest tube once every shift.
C. Encourage coughing and deep breathing.
D. Milk the chest tube every 2 hours.
Correct answer:
Step-by-step rationale for why "Encourage coughing and deep breathing" (Choice C) is the correct answer:
1. After pneumonectomy, patient is at risk for lung complications.
2. Encouraging coughing and deep breathing helps prevent atelectasis and pneumonia.
3. It promotes lung expansion and clears secretions.
4. This intervention supports respiratory function and aids in recovery.
Summary of why the other choices are incorrect:
A. Monitoring fluctuations in the water-seal chamber (Choice A) is important for assessing the status of the chest tube drainage, but not the immediate priority for patient care post-pneumonectomy.
B. Clamping the chest tube once every shift (Choice B) is not recommended as it can lead to complications like tension pneumothorax.
D. Milking the chest tube every 2 hours (Choice D) is unnecessary and can cause trauma to the lung tissue and increase the risk of infection.
If dead space is one third of the tidal volume and arterial PCO2 is 45 mmHg, what is the mixed expired pCO2?
A. 20 mmHg
B. 30 mmHg
C. 40 mmHg
D. 45 mmHg
Correct answer:
Mixed expired PCO2 (PECO2) reflects CO2 in exhaled air, diluted by dead space ventilation. Given dead space (VD) is one-third of tidal volume (VT), VD/VT = 1/3. The Bohr equation relates physiological dead space to CO2: VD/VT = (PaCO2 - PECO2) / PaCO2, where PaCO2 (arterial PCO2) is 45 mmHg. Substituting: 1/3 = (45 - PECO2) / 45. Solving: 45 / 3 = 45 - PECO2, so 15 = 45 - PECO2, and PECO2 = 45 - 15 = 30 mmHg. This assumes physiological dead space equals anatomic here, as no alveolar dead space is specified. Intuitively, if one-third of each breath doesn't participate in gas exchange (PCO2 ~0 mmHg in inspired air), the expired CO2 is diluted from arterial levels (45 mmHg) to two-thirds strength (30 mmHg), matching the calculation. Options like 45 mmHg imply no dead space effect, while 20 mmHg overestimates dilution. Thus, 30 mmHg aligns with the given ratio and respiratory physiology principles.
All of the following lab-values are consistent with Pulmonary fibrosis except?
A. Normal or above FEV1/FVC ratio
B. Increased vascular resistance
C. Normal or above normal peak expiratory flow (corrected for lung volume)
D. Increased residual volume (RV)
Correct answer:
Pulmonary fibrosis, a restrictive disease, stiffens lungs with interstitial scarring. The FEV1/FVC ratio is normal or high (≥80%) because both FEV1 and FVC decrease proportionally, unlike obstructive diseases. Increased pulmonary vascular resistance occurs as fibrosis compresses capillaries, raising resistance. Peak expiratory flow (PEF), when corrected for reduced lung volume, can remain normal or above, as airflow isn't obstructed, just limited by volume. However, residual volume (RV) decreases in pulmonary fibrosis (e.g., from 1.5 L to <1 L) due to stiff lungs limiting all volumes, contrasting with obstructive diseases (e.g., COPD) where RV increases from air trapping. Increased RV doesn't fit fibrosis's restrictive pattern, where reduced elasticity shrinks residual air, not expands it, making this the inconsistent value among the set, reflecting the disease's impact on lung mechanics.
What is the primary function of carbonic anhydrase in the human body?
A. Breakdown of carbohydrates
B. Regulation of blood sugar levels
C. Facilitation of gas exchange in the lungs
D. Catalyzing the conversion of carbon dioxide and water to bicarbonate and hydrogen ions
Correct answer:
The correct answer is D: Catalyzing the conversion of carbon dioxide and water to bicarbonate and hydrogen ions. Carbonic anhydrase helps maintain acid-base balance in the body by catalyzing the reversible reaction between carbon dioxide and water to form bicarbonate and hydrogen ions. This process is crucial in regulating pH levels in various bodily fluids.
A: Breakdown of carbohydrates - This is not the primary function of carbonic anhydrase. Carbohydrate breakdown is primarily carried out by enzymes like amylase and sucrase.
B: Regulation of blood sugar levels - Carbonic anhydrase does not play a direct role in regulating blood sugar levels, which is mainly controlled by insulin and glucagon.
C: Facilitation of gas exchange in the lungs - While carbonic anhydrase indirectly affects gas exchange by regulating blood pH, its primary function is not to facilitate gas exchange in the lungs.
Regarding bronchial asthma, all the following statements are true EXCEPT?
A. Cough suppressants are highly indicated
B. Airway resistance is increased
C. During the attack, FEV 1.0/FVC is < 80%
D. Bronchodilators can be given to asthmatic patients
Correct answer:
Bronchial asthma involves reversible airway obstruction from inflammation, bronchoconstriction, and mucus. Airway resistance increases due to narrowed bronchi, reducing airflow. During an attack, FEV1/FVC drops below 80% (e.g., 50-60%) as FEV1 falls more than FVC, reflecting obstruction. Bronchodilators (e.g., albuterol) are standard treatment, relaxing smooth muscle to relieve constriction. Allergies (e.g., pollen) often trigger attacks, a common feature. However, cough suppressants aren't highly indicated asthma's productive cough clears mucus, and suppressing it worsens obstruction and infection risk. Therapy focuses on bronchodilation and inflammation control (e.g., corticosteroids), not cough suppression, which could exacerbate symptoms. This statement contradicts asthma management principles, making it the exception among true descriptions of the condition's pathophysiology and treatment.
The infection control nurse is talking about the history of the H1N1 influenza. The nurse points out that the virus had genes from more than one source. What sources contributed to the H1N1 virus? (Select all that apply.)
A. Genes from flu viruses found in pigs
B. Bird genes
C. Genes from flu viruses found in cats
D. Human genes
Correct answer:
The 2009 H1N1 influenza virus was a reassortant strain with genes from pig (swine flu viruses), bird (avian influenza), and human sources, reflecting its zoonotic origins. Pigs act as ‘mixing vessels,' allowing genetic exchange between flu strains from different species, which occurred here, creating a novel virus that jumped to humans. Bird genes contributed via prior avian flu strains, while human genes enabled efficient human-to-human transmission, fueling the pandemic. Cat-derived flu genes aren't documented in H1N1's makeup felines aren't typical influenza reservoirs. Pig genes alone don't tell the full story; it's the combination that matters. The nurse educates on this multi-species origin to highlight how influenza evolves, emphasizing vigilance for zoonotic threats, a key infection control lesson from H1N1's global spread, informing strategies like surveillance and vaccination.
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?
A. Warm, dry skin
B. Decreased wheezing
C. Pulse rate of 90 beats/minute
D. Respirations of 18 breaths/minute
Correct answer:
Decreased wheezing in a child with asthma during an acute exacerbation can signal worsening, not improvement. Asthma, a chronic inflammatory airway disease, causes bronchoconstriction, typically producing wheezing as air squeezes through narrowed passages. If wheezing diminishes without treatment resolving the attack, it may indicate a 'silent chest' severe airflow obstruction where air movement is too restricted to produce sound, risking respiratory failure. Warm, dry skin suggests improvement, as exacerbations often cause diaphoresis. A pulse of 90 beats/minute (normal: 70-110 for a 10-year-old) and respirations of 18 breaths/minute (normal: 16-20) are within expected ranges and not alarming. Monitoring for decreased wheezing is critical, as it prompts urgent intervention like bronchodilators to restore airflow, a key nursing priority in asthma management to prevent hypoxia and escalation.
After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage. When caring for this patient, the nurse must:
A. Monitor fluctuations in the water-seal chamber.
B. Clamp the chest tube once every shift.
C. Encourage coughing and deep breathing.
D. Milk the chest tube every 2 hours.
Correct answer:
Step-by-step rationale for why "Encourage coughing and deep breathing" (Choice C) is the correct answer:
1. After pneumonectomy, patient is at risk for lung complications.
2. Encouraging coughing and deep breathing helps prevent atelectasis and pneumonia.
3. It promotes lung expansion and clears secretions.
4. This intervention supports respiratory function and aids in recovery.
Summary of why the other choices are incorrect:
A. Monitoring fluctuations in the water-seal chamber (Choice A) is important for assessing the status of the chest tube drainage, but not the immediate priority for patient care post-pneumonectomy.
B. Clamping the chest tube once every shift (Choice B) is not recommended as it can lead to complications like tension pneumothorax.
D. Milking the chest tube every 2 hours (Choice D) is unnecessary and can cause trauma to the lung tissue and increase the risk of infection.
What is the primary function of carbonic anhydrase in the human body?
A. Breakdown of carbohydrates
B. Regulation of blood sugar levels
C. Facilitation of gas exchange in the lungs
D. Catalyzing the conversion of carbon dioxide and water to bicarbonate and hydrogen ions
Correct answer:
The correct answer is D: Catalyzing the conversion of carbon dioxide and water to bicarbonate and hydrogen ions. Carbonic anhydrase helps maintain acid-base balance in the body by catalyzing the reversible reaction between carbon dioxide and water to form bicarbonate and hydrogen ions. This process is crucial in regulating pH levels in various bodily fluids.
A: Breakdown of carbohydrates - This is not the primary function of carbonic anhydrase. Carbohydrate breakdown is primarily carried out by enzymes like amylase and sucrase.
B: Regulation of blood sugar levels - Carbonic anhydrase does not play a direct role in regulating blood sugar levels, which is mainly controlled by insulin and glucagon.
C: Facilitation of gas exchange in the lungs - While carbonic anhydrase indirectly affects gas exchange by regulating blood pH, its primary function is not to facilitate gas exchange in the lungs.
Which of the following values is above normal in-patient suffering from severe respiratory muscle weakness?
A. Tidal volume
B. Oxyhemoglobin saturation
C. Vital capacity
D. Arterial pH
Correct answer:
Severe respiratory muscle weakness (e.g., in myasthenia gravis) impairs ventilation by weakening inspiratory and expiratory muscles. Tidal volume (VT, ~500 ml normally) decreases due to limited inspiratory force, reducing breath size. Vital capacity (VC, ~4-5 L) drops as maximal inhalation and exhalation are compromised. Oxyhemoglobin saturation falls (e.g., from 95-100% to <90%) as hypoventilation lowers PaO2, causing hypoxemia. Arterial pH may decrease (acidosis) if CO2 retention raises PCO2, but this isn't specified as above normal. However, PCO2 itself (normal 35-45 mmHg) rises above normal (e.g., 50-60 mmHg) due to inadequate CO2 expulsion, a direct result of weak ventilation. Though not listed, if B intended PCO2 (a common mix-up), it fits; otherwise, none are above normal' assuming intent, PCO2's rise is the key abnormality, reflecting ventilatory failure's impact on gas exchange.
RN exams respiratory practice questions, set 6 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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