NCM 103 END TERM EXAMINATION

1st Semester SY 2016-2017

INSTRUCTIONS : Use black pen. Read carefully and analyze your answer. Circle the letter that
corresponds to your correct answer. Erasures are not allowed. ( Pls. write your name at the LEFT
upper corner)

1. Which one of the following is NOT a function of the Upper airway?

A. For clearance mechanism such as coughing
B. Transport gases to the lower airways
C. Warming, Filtration and Humidification of inspired air
D. Protect the lower airway from foreign mater

2. This is the paranasal sinus found between the eyes and the nose that extends backward into the
skull
A. Ehtmoid C. Maxillary
B. Sphenoid D. Frontal

3. Gene De Vonne Katrouchuacheulujiki wants to change her surname to something shorter, The
court denied her request which depresses her and find herself binge eating. She accidentally
aspirate a large piece of nut and it passes the carina. Probabilty wise, Where will the nut go?
A. Right main stem bronchus C. Be dislodged in between the carina
B. Left main stem bronchus D. Be blocked by the closed epiglottis

4. Which cell secretes mucus that help protect the lungs by trapping debris in the respiratory
tract?
A. Type I pneumocytes C. Goblet cells
B. Type II pneumocytes D. Adipose cells

5. Refers to the extra air that can be inhaled beyond the normal tidal volume
A. Inspiratory reserve volume C. Functional residual capacity
B. Expiratory reserve volume D. Residual volume

6. Casssandra, A 22 year old grade Agnostic, Asked you, how many spikes of bones are there in
my ribs? Your best response is which of the following?
A. We have 13 pairs of ribs Cassandra
B. We have 12 pairs of ribs Cassandra
C. Humans have 16 pairs of ribs, and that was noted by Vesalius in 1543
D. Humans have 8 pairs of ribs. 4 of which are floating

7. Which of the following is considered as the main muscle of respiration?

A. Lungs C. Diaphragm
B. Intercostal Muscles D. Pectoralis major

8. All but one of the following is a purpose of steam inhalation

A. Mucolytic C. Administer medications
B. Warm and humidify air D. Promote bronchoconstriction

9. When should a nurse suction a client?

A. As desired
B. As needed
C. Every 1 hour
D. Every 4 hours

10. Ernest Arnold Hamilton, a 60 year old American client was mobbed by teen gangsters near
New york, Cubao. He was rushed to John Hopio Medical Center and was Unconscious. You
are his nurse and you are to suction his secretions. In which position should you place Mr.
Hamilton?
A. High fowlers C. Prone
B. Semi fowlers D. Side lying
11. There are four catheter sizes available for use, which one of these should you use for Mr.
Hamilton?
A. Fr. 18 C. Fr. 10
B. B. Fr. 12 D. Fr. 5

12. Which of the following is the initial sign of hypoxemia in an adult client?
A. Tachypnea and Tachycardia C. Tachycardia and Flaring of Nares
B. Tachycardia and Irritability D. Cyanosis and Pallor

13. Which of the following oxygen delivery method can deliver 100% Oxygen at 15 LPM?
A. Nasal Cannula C. Non Rebreather mask
B. Simple Face mask D. Partial Rebreather mask

14. Roberto San Andres, A new nurse in the hospital is about to administer oxygen on patient
with Respiratory distress. As his senior nurse, you should intervene if Roberto will:
A. Uses venture mask in oxygen administration
B. Put a non rebreather mask in the patient before opening the oxygen source
C. Use a partial rebreather mask to deliver oxygen
D. Check for the doctor’s order for Oxygen administration

15. Which of the following will alert the nurse as an early sign of hypoxia?
A. Client is tired and dyspneic C. The client’s heart rate is 50 BPM
B. The client is coughing out blood D. Client is frequently turning from side to side

16. Miguelito de balboa, An OFW presents at the admission with an A:P Diameter ratio of 2:1,
Which of the following associated finding should the nurse expect?
A. Pancytopenia C. Fingers are Club-like
B. Anemia D. Hematocrit of client is decreased

17. The best method of oxygen administration for client with COPD uses:
A. Cannula C. Non rebreather mask
B. Simple Face mask D. Venturi mask

18. Mang Dagul, a 50 year old chronic smoker was brought to the E.R because of difficulty in
breathing. Pleural effusion was the diagnosis and CTT was ordered. What does C.T.T Stands
for?
A. Chest tube thoracotomy C. Closed tube thoracotomy
B. Chest tube thoracostomy D. Closed tube thoracostmy

19. Where will the CTT be inserted if we are to drain fluids accumulated in Mang dagul’s pleura?
A. 2nd ICS C. 5th ICS
B. 4th ICS D. 8th ICS

20. There is a continuous bubbling in the water sealed drainage system with suction. And
oscillation is observed. As a nurse, what should you do?
A. Consider this as normal findings C. Check for tube leak
B. Notify the physician D. Prepare a petrolatum gauze dressing

21. An elderly client with pneumonia may appear with which of the following symptoms first?
A. Altered mental status and dehydration
B. fever and chills
C. Hemoptysis and dyspnea
D. Pleuretic chest pain and cough
22. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma
allows pneumonia to develop?
A. Atelectasis C. Effusion
B. Bronchiectasis D. Inflammation
23. A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a respiratory
rate of 36 breaths/minute and a nonproductive cough. He recently had a cold. From his history,
the client may have which of the following?
A. Acute asthma C. Chronic obstructive pulmonary disease (COPD)
B. Bronchial pneumonia D. Emphysema
24. Which of the following assessment findings would help confirm a diagnosis of asthma in a
client suspected of having the disorder?
A. Circumoral cyanosis C. Inspiratory and expiratory wheezing
B. Increased forced expiratory volume D. Normal breath sounds
25. Which of the following types of asthma involves an acute asthma attack brought on by an
upper respiratory infection?
A. Emotional C. Intrinsic
B. Extrinsic D. Mediated
26. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased
expiratory volume should be treated with which of the following classes of medication right
away?
a. Beta-adrenergic blockers c. Inhaled steroids
b. Bronchodilators d. Oral steroids
27. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is
44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following
actions should be taken first?
a. Take a full medication history
b. Give a bronchodilator by neubulizer
c. Apply a cardiac monitor to the client
d. Provide emotional support to the client.
28. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day has
a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on
this information, he most likely has which of the following conditions?
a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
29. The term “blue bloater” refers to which of the following conditions?
a. Adult respiratory distress syndrome (ARDS)
b. Asthma
c. Chronic obstructive bronchitis
d. Emphysema
30. The term “pink puffer” refers to the client with which of the following conditions?
a. ARDS c. Chronic obstructive bronchitis
b. Asthma d. Emphysema
31. A 66-year-old client has marked dyspnea at rest, is thin, and uses accessory muscles to breathe.
He’s tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with
his arms braced on his knees to support his chest and shoulders for breathing. This client has
symptoms of which of the following respiratory disorders?
a. ARDS c. Chronic obstructive bronchitis
b. Asthma d. Emphysema
32. It’s highly recommended that clients with asthma, chronic bronchitis, and emphysema have
Pneumovax and flu vaccinations for which of the following reasons?
a. All clients are recommended to have these vaccines
b. These vaccines produce bronchodilation and improve oxygenation.
c. These vaccines help reduce the tachypnea these clients experience.
d. Respiratory infections can cause severe hypoxia and possibly death in these clients.
33. Exercise has which of the following effects on clients with asthma, chronic bronchitis, and
emphysema?
a. It enhances cardiovascular fitness.
b. It improves respiratory muscle strength.
c. It reduces the number of acute attacks.
d. It worsens respiratory function and is discouraged.
34. Clients with chronic obstructive bronchitis are given diuretic therapy. Which of the following
reasons best explains why?
 a. Reducing fluid volume reduces oxygen demand.
b. Reducing fluid volume improves clients’ mobility.
c. Restricting fluid volume reduces sputum production.
d. Reducing fluid volume improves respiratory function.
35. A 69-year-old client appears thin and cachectic. He’s short of breath at rest and his dyspnea
increases with the slightest exertion. His breath sounds are diminished even with deep
inspiration. These signs and symptoms fit which of the following conditions?
a. ARDS c. Chronic obstructive bronchitis
b. Asthma d. Emphysema
36. A client with emphysema should receive only 1 to 3 L/minute of oxygen, if needed, or he may
lose his hypoxic drive. Which of the following statements is correct about hypoxic drive?
a. The client doesn’t notice he needs to breathe.
b. The client breathes only when his oxygen levels climb above a certain point.
c. The client breathes only when his oxygen levels dip below a certain point.
d. The client breathes only when his carbon dioxide level dips below a certain point.
37. Teaching for a client with chronic obstructive pulmonary disease (COPD) should include
which of the following topics?
a. How to have his wife learn to listen to his lungs with a stethoscope from Wal-Mart.
b. How to increase his oxygen therapy.
c. How to treat respiratory infections without going to the physician.
d. How to recognize the signs of an impending respiratory infection.
38. Which of the following respiratory disorders is most common in the first 24 to 48 hours after
surgery?
a. Atelectasis c. Pneumonia
b. Bronchitis d. Pneumothorax
39. Which of the following measures can reduce or prevent the incidence of atelectasis in a post-
operative client?
a. Chest physiotherapy c. Reducing oxygen requirements
b. Mechanical ventilation d. Use of an incentive spirometer
40. Emergency treatment of a client in status asthmaticus includes which of the following
medications?
a. Inhaled beta-adrenergic agents c. I.V. beta-adrenergic agents
b. Inhaled corticosteroids d. Oral corticosteroids
41. Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnose
asthma. When teaching the patient about this drug, the nurse should explain that it may
cause:
A. Nasal congestion C. Lethargy
B. Nervousness D. Hyperkalemia
42. Miriam, a college student with acute rhinitis sees the campus nurse because of excessive nasal
drainage. The nurse asks the patient about the color of the drainage. In a acute rhinitis, nasal
drainage normally is:
A. Yellow C. Clear
B. Green D. Gray
43. A male adult patient hospitalized for treatment of a pulmonary embolism develops respiratory
alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
A. Nausea or vomiting C. Hallucinations or tinnitus
B. Abdominal pain or diarrhea D. Lightheadedness or paresthesia
44. Before administering ephedrine, Nurse Tony assesses the patient’s history. Because of ephedrine’s
central nervous system (CNS) effects, it is not recommended for:
A. Patients with an acute asthma attack C. Patients under age 6
B. Patients with narcolepsy D. Elderly patients
45. A female patient suffers adult 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
46. A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01
mg/kg I.V. as needed. Which assessment finding indicates that the patient needs
another pancuronium dose?
A. Leg movement
B. Finger movement
C. Lip movement
D. Fighting the ventilator
47. On auscultation, which finding suggests a right pneumothorax?
A. Bilateral inspiratory and expiratory crackles
B. Absence of breaths sound in the right thorax
C. Inspiratory wheezes in the right thorax
D. Bilateral pleural friction rub.
48. Rhea, confused and short breath, is brought to the emergency department by a family member. The
medical history reveals chronic bronchitis and hypertension. To learn more about the current
respiratory problem, the doctor orders a chest x-ray and arterial blood gas (ABG) analysis. When
reviewing the ABG report, the nurses sees many abbreviations. What does a lowercase “a” in
ABG value present?
A. Acid-base balance
B. Arterial Blood
C. Arterial oxygen saturation
D. Alveoli
49. A male patient is admitted to the health care facility for treatment of chronic obstructive
pulmonary disease. Which nursing diagnosis is most important for this patient?
A. Activity intolerance related to fatigue
B. Anxiety related to actual threat to health status
C. Risk for infection related to retained secretions
D. Impaired gas exchange related to airflow obstruction
50. Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate
toward the:
A. Contralateral side in a simple pneumothorax
B. Affected side in a hemothorax
C. Affected side in a tension pneumothorax
D. Contralateral side in hemothorax
51. 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
52. When caring for a male patient who has just had a total laryngectomy, the nurse should plan to:
A. Encourage oral feeding as soon as possible
B. Develop an alternative communication method
C. Keep the tracheostomy cuff fully inflated
D. Keep the patient flat in bed
53. A male patient has a sucking stab wound to the chest. Which action should the nurse take first?
A. Drawing blood for a hematocrit and hemoglobin level
B. Applying a dressing over the wound and taping it on three sides
C. Preparing a chest tube insertion tray
D. Preparing to start an I.V. line
54. For a patient with advance chronic obstructive pulmonary disease (COPD), which nursing action
best promotes adequate gas exchange?
A. Encouraging the patient to drink three glasses of fluid daily
B. Keeping the patient in semi-fowler’s position
C. Using a high-flow venture mask to deliver oxygen as prescribe
D. Administering a sedative, as prescribe
55. A male patient’s X-ray result reveals bilateral white-outs, indicating adult respiratory distress
syndrome (ARDS). This syndrome results from:
A. Cardiogenic pulmonary edema
B. Respiratory alkalosis
C. Increased pulmonary capillary permeability
D. Renal failure
56. For a female patient with chronic obstructive pulmonary disease, which nursing intervention
would help maintain a patent airway?
A. Restricting fluid intake to 1,000 ml per day
B. Enforcing absolute bed rest
C. Teaching the patient how to perform controlled coughing
D. Administering prescribe sedatives regularly and in large amounts
57. Nurse Lei caring for a client with a pneumothorax and who has had a chest tube inserted notes
continues gentle bubbling in the suction control chamber. What action is appropriate?
A. Do nothing, because this is an expected finding
B. Immediately clamp the chest tube and notify the physician
C. Check for an air leak because the bubbling should be intermittent
D. Increase the suction pressure so that the bubbling becomes vigorous
58. Nurse Maureen has assisted a physician with the insertion of a chest tube. The nurse monitors the
client and notes fluctuation of the fluid level in the water seal chamber after the tube is inserted.
Based on this assessment, which action would be appropriate?
A. Inform the physician
B. Continue to monitor the client
C. Reinforce the occlusive dressing
D. Encourage the client to deep-breathe
59. Nurse Reynolds caring for a client with a chest tube turns the client to the side, and the chest tube
accidentally disconnects. The initial nursing action is to:
A. Call the physician
B. Place the tube in bottle of sterile water
C. Immediately replace the chest tube system
D. Place a sterile dressing over the disconnection site
60. A nurse is assisting a physician with the removal of a chest tube. The nurse should instruct the
client to:
A. Exhale slowly
B. Stay very still
C. Inhale and exhale quickly
D. Perform the Valsalva maneuver
61. While changing the tapes on a tracheostomy tube, the male client coughs and tube is dislodged.
The initial nursing action is to:
A. Call the physician to reinsert the tube
B. Grasp the retention sutures to spread the opening
C. Call the respiratory therapy department to reinsert the tracheotomy
D. Cover the tracheostomy site with a sterile dressing to prevent infection
62. Nurse Oliver is caring for a client immediately after removal of the endotracheal tube. The nurse
reports which of the following signs immediately if experienced by the client?
A. Stridor
B. Occasional pink-tinged sputum
C. A few basilar lung crackles on the right
D. Respiratory rate 24 breaths/min
63. An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest
wall. Which of these signs would indicate the presence of a pneumothorax in this client?
A. A low respiratory rate
B. Diminished breath sounds
C. The presence of a barrel chest
D. A sucking sound at the site of injury
64. Nurse Reese is caring for a client hospitalized with acute exacerbation of chronic obstructive
pulmonary disease. Which of the following would the nurse expect to note on assessment of this
client?
A. Hypocapnia
B. A hyperinflated chest noted on the chest x-ray
C. Increased oxygen saturation with exercise
D. A widened diaphragm noted on the chest x-ray
65. An oxygen delivery system is prescribed for a male client with chronic obstructive pulmonary
disease to deliver a precise oxygen concentration. Which of the following types of
oxygen delivery systems would the nurse anticipate to be prescribed?
A. Face tent
B. Venturi mask
 C. Aerosol mask
D. Tracheostomy collar
66. Blessy, a community health nurse is conducting an educational session with community members
regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with
tuberculosis is:
A. Dyspnea
B. Chest pain
C. A bloody, productive cough
D. A cough with the expectoration of mucoid sputum
67. A nurse performs an admission assessment on a female client with a diagnosis of tuberculosis. The
nurse reviews the result of which diagnosis test that will confirm this diagnosis?
A. Bronchoscopy
B. Sputum culture
C. Chest x-ray
D. Tuberculin skin test
68. A nurse is caring for a male client with emphysema who is receiving oxygen. The nurse assesses
the oxygen flow rate to ensure that it does not exceed:
A. 1 L/min
B. 2 L/min
C. 6 L/min
D. 10 L/min
69. A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the
nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary
purpose of pursed-lip breathing is to:
A. Promote oxygen intake
B. Strengthen the diaphragm
C. Strengthen the intercostal muscles
D. Promote carbon dioxide elimination
70. A nurse is caring for a male client with acute respiratory distress syndrome. Which of the
following would the nurse expect to note in the client?
A. Pallor
B. Low arterial PaO2
C. Elevated arterial PaO2
D. Decreased respiratory rate
71. A nurse is preparing to obtain a sputum specimen from a male client. Which of the following
nursing actions will facilitate obtaining the specimen?
A. Limiting fluid
B. Having the client take deep breaths
C. Asking the client to spit into the collection container
D. Asking the client to obtain the specimen after eating
72. Nurse Joy is caring for a client after a bronchoscopy and biopsy. Which of the following signs, if
noticed in the client, should be reported immediately to the physician?
A. Dry cough
B. Hermaturia
C. Bronchospasm
D. Blood-streaked sputum
73. A nurse is suctioning fluids from a male client via a tracheostomy tube. When suctioning, the
nurse must limit the suctioning time to a maximum of:
A. 1 minute
B. 5 seconds
C. 10 seconds
D. 30 seconds
74. A nurse is suctioning fluids from a female client through an endotracheal tube. During the
suctioning procedure, the nurse notes on the monitor that the heart rate is decreasing. Which if the
following is the appropriate nursing intervention?
A. Continue to suction
B. Notify the physician immediately
C. Stop the procedure and reoxygenate the client
D. Ensure that the suction is limited to 15 seconds
75. A male adult client is suspected of having a pulmonary embolus. A nurse assesses the client,
knowing that which of the following is a common clinical manifestation of pulmonary embolism?
 A. Dyspnea
B. Bradypnea
C. Bradycardia
D. Decreased respirations
76. A slightly obese female client with a history of allergy-induced asthma,hypertension, and mitral
valve prolapse is admitted to an acute care facility for elective surgery. The nurse obtains a
complete history and performs a thorough physical examination, paying special attention to the
cardiovascular and respiratory systems. When percussing the client’s chest wall, the nurse expects
to elicit:
A. Resonant sounds.
B. Hyperresonant sounds.
C. Dull sounds.
D. Flat sounds.
77. A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophyllin) (400 mg in
500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The nurse calls the
physician who instructs the nurse to change the dosage to 0.45 mg/kg/hour. The nurse should:
A. Question the order because it’s too low.
B. Question the order because it’s too high.
C. Set the pump at 45 ml/hour.
D. Stop the infusion and have the laboratory repeat the theophylline measurement.
78. The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the
following should the nurse include in the teaching?
A. Make inhalation longer than exhalation.
B. Exhale through an open mouth.
C. Use diaphragmatic breathing.
D. Use chest breathing.
79. Which phrase is used to describe the volume of air inspired and expired with a normal breath?
A. Total lung capacity
B. Forced vital capacity
C. Tidal volume
D. Residual volume
80. A male client abruptly sits up in bed, reports having difficulty breathing and has an arterial oxygen
saturation of 88%. Which mode of oxygen delivery would most likely reverse the manifestations?
A. Simple mask
B. Non-rebreather mask
C. Face tent
D. Nasal cannula
81. A female client must take streptomycin for tuberculosis. Before therapy begins, the nurse should
instruct the client to notify the physician if which health concern occurs?
A. Impaired color discrimination
B. Increased urinary frequency
C. Decreased hearing acuity
D. Increased appetite
82. A male client is asking the nurse a question regarding the Mantoux test for tuberculosis. The nurse
should base her response on the fact that the:
A. Area of redness is measured in 3 days and determines whether tuberculosis is present.
B. Skin test doesn’t differentiate between active and dormant tuberculosis infection.
C. Presence of a wheal at the injection site in 2 days indicates active tuberculosis.
D. Test stimulates a reddened response in some clients and requires a second test in 3 months.
83. A female adult client has a tracheostomy but doesn’t require continuous mechanical ventilation.
When weaning the client from the tracheostomy tube, the nurse initially should plug the opening
in the tube for:
A. 15 to 60 seconds.
B. 5 to 20 minutes.
C. 30 to 40 minutes.
D. 45 to 60 minutes.
84. Nurse Oliver observes constant bubbling in the water-seal chamber of a closed chest drainage
system. What should the nurse conclude?
A. The system is functioning normally
B. The client has a pneumothorax.
C. The system has an air leak.
D. The chest tube is obstructed.
85. A black client with asthma seeks emergency care for acute respiratory distress. Because of this
client’s dark skin, the nurse should assess for cyanosis by inspecting the:
A. Lips.
B. Mucous membranes.
C. Nail beds.
D. Earlobes.
86. For a male client with an endotracheal (ET) tube, which nursing action is most essential?
A. Auscultating the lungs for bilateral breath sounds
B. Turning the client from side to side every 2 hours
C. Monitoring serial blood gas values every 4 hours
D. Providing frequent oral hygiene
87. The nurse assesses a male client’s respiratory status. Which observation indicates that the client is
experiencing difficulty breathing?
A. Diaphragmatic breathing
B. Use of accessory muscles
C. Pursed-lip breathing
D. Controlled breathing
88. A female client is undergoing a complete physical examination as a requirement for college. When
checking the client’s respiratory status, the nurse observes respiratory excursion to help assess:
A. Lung vibrations.
B. Vocal sounds.
C. Breath sounds.
D. Chest movements.
89. A male client comes to the emergency department complaining of sudden onset of diarrhea,
anorexia, malaise, cough, headache, and recurrent chills. Based on the client’s history and physical
findings, the physician suspects legionnaires’ disease. While awaiting diagnostic test results, the
client is admitted to the facility and started on antibiotic therapy. What is the drug of choice for
treating legionnaires’ disease?
A. Erythromycin (Erythrocin)
B. Rifampin (Rifadin)
C. Amantadine (Symmetrel)
D. Amphotericin B (Fungizone)
90. A male client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial
infarction. Because the client is extremely weak and can’t produce an effective cough, the nurse
should monitor closely for:
A. Pleural effusion.
B. Pulmonary edema.
C. Atelectasis.
D. Oxygen toxicity.
91. The nurse in charge is teaching a client with emphysema how to perform pursed-lip breathing. The
client asks the nurse to explain the purpose of this breathing technique. Which explanation should
the nurse provide?
A. It helps prevent early airway collapse.
B. It increases inspiratory muscle strength.
C. It decreases use of accessory breathing muscles.
D. It prolongs the inspiratory phase of respiration.
92. After receiving an oral dose of codeine for an intractable cough, the male client asks the nurse,
“How long will it take for this drug to work?” How should the nurse respond?
A. In 30 minutes
B. In 1 hour
C. In 2.5 hours
D. In 4 hours
93. A male client suffers adult respiratory distress syndrome as a consequence of shock. The client’s
condition deteriorates rapidly, and endotracheal (ET) intubation and mechanical ventilation are
initiated. When the high-pressure alarm on the mechanical ventilator 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 ET cuff leak
D. A change in the oxygen concentration without resetting the oxygen level alarm
94. A female client with chronic obstructive pulmonary disease (COPD) takes anhydrous theophylline,
200 mg P.O. every 8 hours. During a routine clinic visit, the client asks the nurse how the drug
 works. What is the mechanism of action of anhydrous theophylline in treating a nonreversible
obstructive airway disease such as COPD?
A.It makes the central respiratory center more sensitive to carbon dioxide and stimulates the
respiratory drive.
B. It inhibits the enzyme phosphodiesterase, decreasing degradation of cyclic adenosine
monophosphate, a bronchodilator.
C. It stimulates adenosine receptors, causing bronchodilation.
D. It alters diaphragm movement, increasing chest expansion and enhancing the lung’s
capacity for gas exchange.
95. A male client with pneumococcal pneumonia is admitted to an acute care facility. The client in the
next room is being treated for mycoplasmal pneumonia. Despite the different causes of the various
types of pneumonia, all of them share which feature?
A. Inflamed lung tissue
B. Sudden onset
C. Responsiveness to penicillin.
D. Elevated white blood cell (WBC) count
96. A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar
ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?
A. pH, 5.0; PaCO2 30 mm Hg
B. pH, 7.40; PaCO2 35 mm Hg
C. pH, 7.35; PaCO2 40 mm Hg
D. pH, 7.25; PaCO2 50 mm Hg
97. A male client admitted to an acute care facility with pneumonia is receiving supplemental oxygen,
2 L/minute via nasal cannula. The client’s history includes chronic obstructive pulmonary disease
(COPD) and coronary artery disease. Because of these history findings, the nurse closely monitors
the oxygen flow and the client’s respiratory status. Which complication may arise if the client
receives a high oxygen concentration?
A. Apnea
B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
98. At 11 p.m., a male client is admitted to the emergency department. He has a respiratory rate of 44
breaths/minute. He’s anxious, and wheezes are audible. The client is immediately given oxygen by
face mask and methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the client’s arterial blood
oxygen saturation is 86% and he’s still wheezing. The nurse should plan to administer:
A. Alprazolam (Xanax).
B. Propranolol (Inderal)
C. Morphine.
D. Albuterol (Proventil).
99. After undergoing a thoracotomy, a male client is receiving epidural analgesia. Which assessment
finding indicates that the client has developed the most serious complication of epidural analgesia?
A. Heightened alertness
B. Increased heart rate
C. Numbness and tingling of the extremities
D. Respiratory depression
100. The nurse in charge formulates a nursing diagnosis of Activity intolerance related to
inadequate oxygenation and dyspnea for a client with chronic bronchitis. To minimize this
problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such
conditions include:
A. Drinking more than 1,500 ml of fluid daily.
B. Being overweight.
C. Eating a high-protein snack at bedtime.
D. Eating more than three large meals a day.