1. A patient who is having his tonsils removed asks the nurse what function the tonsils serve.

Which of the following would be the most accurate response? A) The tonsils aid in digestion. B) The tonsils help to guard the body from invasion of organisms. C) The tonsils contain nerves that provoke sneezing. D) The tonsils regulate the airflow to the bronchi. Ans: B Difficulty: Moderate 2. The nurse is analyzing a patient's laboratory data. Which of the following values of PaO2 in an adult would be considered normal? A) 75 mm Hg B) 50 mm Hg C) 35 mm Hg D) 80 mm Hg Ans: D Difficulty: Moderate 3. A nurse is assessing a newly admitted patient and observes that he has an irritated, high-pitched cough. The nurse suspects that the patient has: A) Stridor B) Laryngotracheitis C) Bronchitis D) Pneumonia Ans: B Difficulty: Moderate 4. A nurse caring for a hospitalized patient who has copious green sputum notifies the patient's physician because these symptoms are indicative of: A) Lung cancer B) Lung tumors C) Infection D) Pulmonary edema Ans: C Difficulty: Moderate 5. The patient is complaining of dyspnea. The nurse assesses the patient's chest and hears wheezing throughout the lung fields. What might this indicate? A) The patient is in bronchospasm. C) The patient needs physiotherapy. B) The patient has pneumonia. D) The patient has a hemothorax. Ans: A Difficulty: Moderate 6. During assessment of the patient admitted to the hospital for dehydration, the nurse notes that he has a barrel chest. Understanding this assessment finding, the nurse asks the patient if he has a history of: A) Emphysema B) Asthma C) Chronic bronchitis D) Pneumonia Ans: A Difficulty: Moderate 7. A patient has a bacterial pneumonia and is finding it very difficult to cough up secretions because they are too thick. What instructions should the nurse provide to the patient to assist in secretion removal? A) Increase fluid intake. C) Increase activity. B) Take analgesics to assist coughing. D) Increase meal size. Ans: A Difficulty: Moderate 8. A nurse assessing the chest of a patient with Marfan syndrome observes that there is an
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increase in the anteroposterior diameter, and the sternum is displaced. The nurse should document the presence of: A) Pigeon chest B) Barrel chest C) Scoliosis D) Clubbing Ans: A Difficulty: Moderate 9. The nurse observes that the patient has an abnormal respiratory pattern and has documented that the patient is demonstrating Cheyne-Stokes respirations. What respiratory pattern description is characteristic of a patient who has Cheyne-Stokes respirations? A) Rapid shallow breaths B) Low respiratory rate with hiccups C) Alternating periods of deep breathing and periods of apnea D) Increased rate and depth in breaths Ans: C Difficulty: Moderate 10. During assessment of a patient, a nurse percussing the anterior chest notes dullness over the right lower lung. What might this assessment indicate? A) Accumulation of fluid in the pleural space B) Overinflation of the lung tissue C) Bronchospasm D) Emphysema Ans: A Difficulty: Easy 11. A patient who is diagnosed with heart failure should be assessed by the nurse for which of the following breath sounds? A) Expiratory wheezes B) Inspiratory wheezes C) Rhonchi D) Crackles Ans: D Difficulty: Moderate 12. While percussing the thorax of an adult patient, the nurse detects dullness over the right lung. The patient may be exhibiting symptoms of: A) Lung tumor B) Pneumothorax C) Emphysema D) COPD Ans: A Difficulty: Moderate 13. A nurse is preparing to auscultate an adult patient's lungs. To hear bronchial breath sounds, the nurse should place the stethoscope on the patient's: A) Lungs B) Manubrium C) First intercostal space D) Scapulae Ans: B Difficulty: Difficult 14. A nurse assessing the respiratory system of an adult patient notes a significant decrease in respiratory breath sounds on the left side of the patient's chest. Percussion reveals

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resonant sounds. The nurse suspects that the patient is most likely exhibiting symptoms of: A) Pulmonary edema B) Bronchitis C) Pneumothorax D) Pneumonia Ans: B Difficulty: Difficult 15. A patient admitted with chronic obstructive pulmonary disease is experiencing a change in his respiratory and mental status. The nurse is aware that the most accurate measurement of the concentration of oxygen in the patient's blood is: A) A capillary blood sample C) An arterial blood gas studies B) Pulse oximetry D) Assessment of the patient's nail beds Ans: C Difficulty: Moderate 16. The patient has returned to the unit following a bronchoscopy. Which of the following criteria will determine when the nurse can allow the patient to drink fluids? A) Presence of a cough and gag reflex B) Absence of nausea C) Ability to demonstrate deep inspiration D) Ability to speak Ans: A Difficulty: Moderate 17. Which phrase is used to describe the volume of air inspired and expired with a normal breath? A) Total lung capacity C) Tidal volume B) Forced vital capacity D) Residual volume Ans: C Difficulty: Easy 18. What is the best procedure for the nurse to assess arterial oxygen saturation (SaO2)? A) Incentive spirometry B) Arterial blood gas (ABG) measurement C) Peak flow measurement D) Pulse oximetry Ans: D Difficulty: Easy 19. A patient is concerned about his inability to speak clearly due to an infection in the upper respiratory system. Which of the following structures serve as the patient's resonating chamber in speech? A) Trachea B) Pharynx C) Paranasal sinuses D) Larynx Ans: C Difficulty: Moderate 20. While caring for patients on the respiratory intensive care unit, the nurse is aware that

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A) B)

several respiratory conditions can affect the compliance of the lung tissue. Which condition leads to an increase in lung compliance? Emphysema C) Pleural effusion Pulmonary fibrosis D) Acute respiratory distress syndrome Ans: A Difficulty: Moderate

21. The nurse enters a patient's room and assesses that the patient is exhibiting signs of dyspnea. The nurse will place the patient in which of the following positions? A) Supine B) High-Fowler's C) Trendelenburg D) Lithotomy Ans: B Difficulty: Moderate 22. The cause of a patient's cough may be determined after careful assessment of the characteristics of the cough. A brassy cough may be caused by which of the following conditions? A) Bronchogenic carcinoma C) Sinusitis B) Tracheal lesions D) A side effect of ACE inhibitor therapy Ans: B Difficulty: Moderate 23. Upon collection of a patient's sputum sample, the nurse documents that the sputum is pink and frothy. Sputum with these characteristics often indicates a diagnosis of: A) Pulmonary edema B) Bronchiectasis C) Viral bronchitis D) A lung abscess Ans: A Difficulty: Difficult 24. A patient diagnosed with multiple sclerosis has decreased vital lung capacity. The nurse is aware that vital capacity measures: A) The volume of air inhaled and exhaled with each breath B) The volume of air in the lungs after a maximum inspiration C) The maximum volume of air inhaled after normal expiration D) The maximum volume of air exhaled from the point of maximum inspiration Ans: D Difficulty: Moderate 25. While assessing the patient's respiratory rate, the nurse assesses 4 normal breaths followed by an episode of apnea lasting 20 seconds. The nurse will describe this breathing pattern in her documentation as: A) Eupnea B) Apnea C) Biot's respiration D) Cheyne-Stokes Ans: C Difficulty: Difficult 26. What approach should the nurse take to assess the lung fields of a patient who is in a recumbent position?

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A) B) C) D)

Inform that physician that the patient is in a recumbent position and anticipate an order for a portable chest x-ray. Turn the patient to assess all lung fields so that dependent areas can be assessed for breath sounds. Avoid turning the patient, and assess the accessible breath sounds from the anterior chest wall. Obtain a pulse oximetry reading and if the reading is low, reposition the patient and auscultate breath sounds. Ans: B Difficulty: Moderate

27. Which of the following respiratory findings will the nurse expect to find upon assessment of a patient with a pleural effusion? A) Increased tactile fremitus, egophony, and a dull sound upon percussion of the chest wall B) Decreased tactile fremitus, wheezes, and a hyperresonant sound upon percussion of the chest wall C) Absent tactile fremitus, bronchial breath sounds, and a flat sound upon percussion of the chest wall D) Normal tactile fremitus, decreased breath sounds, and a resonant sound upon percussion of the chest wall Ans: C Difficulty: Moderate 28. The nurse notices a sputum specimen sitting on the bedside table in a patient's room. After asking the patient when he produced the sputum specimen, he learns the specimen is about 4 hours old. Knowing this information, the nurse: A) Immediately takes the sputum specimen to the laboratory B) Discards the specimen and assists the patient in obtaining another specimen C) Refrigerates the sputum specimen D) Waits an additional 2 hours before sending the specimen to the laboratory Ans: B Difficulty: Difficult 29. The nurse caring for an elderly patient in the PACU after a bronchoscopy is monitoring for complications related to the administration of lidocaine. The nurse recognizes the complications related to the administration of large doses of lidocaine in the elderly as: A) Decreased urine output and hypertension B) Headache and vision changes C) Confusion and lethargy D) Jaundice and elevated liver enzymes Ans: C Difficulty: Difficult 30. A patient admitted with a heart murmur is noted to have a depression in the lower portion of the sternum. This type of chest deformity is called:

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A) A barrel chest B) A funnel chest Ans: B Difficulty: Moderate

C) A pigeon chest D) Kyphoscoliosis

31. The nurse instructs the patient to repeat the letter E, while assessing voice sounds. Upon auscultation, the nurse notes that the voice sounds are distorted and she hears the letter A instead of the letter E. The nurse will document this voice sound as: A) Bronchophony C) Whispered pectoriloquy B) Egophony D) Sonorous wheezes Ans: B Difficulty: Moderate 32. Auscultation of the lung fields provides the nurse with information on the type of breath sound the patient is exhibiting. While listening over the manubrium, the nurse auscultates loud expiratory sounds that last longer than inspiratory sounds. The nurse will document her findings as: A) Vesicular breath sounds C) Bronchial breath sounds B) Bronchovesicular breath sounds D) Tracheal breath sounds Ans: C Difficulty: Moderate 33. A patient with a pleural friction rub has presented to the emergency room. Upon initial assessment, the nurse is aware that a pleural friction rub is best heard: A) Over the lower lateral anterior surface of the thorax B) Over the upper medial posterior surface of the thorax C) Over the trachea D) Over the mediastinum Ans: A Difficulty: Moderate

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