NUR125 Exam 4 Joyce University
Questions with Correct Solutions, Already
Passed!!(130 Detailed Questions) Updated
2026.
NUR125 Exam 4: Comprehensive Exam Bank
Topic 1: Oxygenation (35 Questions)
1. A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD).
Which finding indicates the patient is experiencing an exacerbation requiring immediate
intervention?
a) A barrel-shaped chest
b) A productive cough with green sputum
c) Oxygen saturation of 88% on room air
d) Use of accessory muscles and pursed-lip breathing
Correct Answer: d) Use of accessory muscles and pursed-lip breathing
*Rationale: While all options can be seen in COPD, the use of accessory muscles and pursed-
lip breathing indicates increased work of breathing and respiratory distress, requiring
immediate intervention. An O2 sat of 88% may be a patient's baseline, but the use of
accessory muscles signifies acute decompensation.*
2. The nurse is caring for a patient with pneumonia. Which assessment finding is the best
indicator of adequate oxygenation?
a) Pulse oximetry reading of 94%
b) Respiratory rate of 22 breaths per minute
c) Clear breath sounds bilaterally
d) Absence of chest pain
Correct Answer: a) Pulse oximetry reading of 94%
*Rationale: Pulse oximetry (SpO2) is a direct, non-invasive measure of oxygen saturation. A
reading of 94% or greater is generally considered adequate for a patient without COPD.
While clear breath sounds are a good sign, they do not guarantee adequate gas exchange at
the alveolar level.*
3. A patient is ordered oxygen via nasal cannula at 4 L/min. What is the most important
safety intervention for the nurse to implement?
a) Place a "No Smoking" sign on the door.
,b) Apply water-soluble lubricant to the nares.
c) Set the flow rate to 6 L/min to ensure delivery.
d) Check the patency of the tubing every 8 hours.
Correct Answer: a) Place a "No Smoking" sign on the door.
Rationale: Oxygen supports combustion. The priority safety intervention is to prevent fire
hazards by ensuring no open flames or smoking near the oxygen source. While lubricant can
help with comfort, it is not the priority safety measure.
4. Which patient is at the highest risk for developing hypoxemia?
a) A 22-year-old with a fractured tibia
b) A 45-year-old with anxiety and hyperventilation
c) An 80-year-old with pneumonia and a history of heart failure
d) A 60-year-old with gastroesophageal reflux disease (GERD)
Correct Answer: c) An 80-year-old with pneumonia and a history of heart failure
Rationale: This patient has multiple risk factors: advanced age (decreased lung elasticity and
immune function), pneumonia (infection and alveolar consolidation), and heart failure
(potential for pulmonary edema), all of which significantly impair gas exchange.
5. The nurse is auscultating a patient's lungs. Which sound is considered a normal finding?
a) Wheezes in the left lower lobe
b) Rhonchi that clear after coughing
c) Bronchial breath sounds over the trachea
d) Crackles in the bilateral bases
Correct Answer: c) Bronchial breath sounds over the trachea
Rationale: Bronchial breath sounds are normal when heard over the trachea and main
bronchi. They are loud, high-pitched sounds. Wheezes, rhonchi, and crackles are adventitious
(abnormal) sounds that indicate pathology.
6. A patient with a tracheostomy is receiving mechanical ventilation. The high-pressure
alarm sounds. What should the nurse do first?
a) Suction the patient's airway.
b) Call the respiratory therapist.
c) Manually ventilate the patient with a bag-valve-mask.
d) Check the cuff pressure.
Correct Answer: a) Suction the patient's airway.
Rationale: The high-pressure alarm on a ventilator is most commonly triggered by increased
airway resistance due to secretions, a kinked tube, or the patient biting the tube. The priority
is to assess and clear the airway by suctioning or unkinking the tubing.
7. Which dietary modification is most important for a patient with chronic heart failure to
manage their condition and improve oxygenation?
a) High-protein diet
b) Low-potassium diet
,c) Low-sodium diet
d) Increased carbohydrate intake
Correct Answer: c) Low-sodium diet
Rationale: A low-sodium diet helps reduce fluid retention, which decreases the workload on
the heart and helps prevent pulmonary congestion, thereby improving oxygenation and
perfusion.
8. The nurse is teaching a patient how to use an incentive spirometer. Which instruction is
correct?
a) "Exhale forcefully into the mouthpiece."
b) "Inhale slowly and deeply to raise the piston."
c) "Use the spirometer every 2 hours while awake."
d) "Hold your breath for 1 second after inhaling."
Correct Answer: b) "Inhale slowly and deeply to raise the piston."
*Rationale: Incentive spirometry encourages sustained maximal inspiration to expand the
alveoli and prevent atelectasis. The patient should inhale slowly and deeply to keep the
piston or ball elevated. Holding the breath for 3-5 seconds after the breath is also beneficial,
but the primary action is a slow, deep inhale.*
9. Which assessment finding in a patient who had a pneumonectomy (removal of a lung)
would be most concerning?
a) Tracheal deviation toward the surgical side
b) Oxygen saturation of 92% on 2 L nasal cannula
c) Pain rated 4 on a scale of 0-10
d) Serosanguineous drainage on the dressing
Correct Answer: a) Tracheal deviation toward the surgical side
Rationale: After a pneumonectomy, the mediastinum should be midline or slightly shifted
toward the remaining lung. Tracheal deviation toward the surgical side can indicate a
mediastinal shift due to fluid accumulation, but more critically, deviation away from the
surgical side is a sign of tension pneumothorax. Deviation toward the surgical side is an
expected finding post-pneumonectomy and is not immediately concerning unless it is acute
and severe. However, among the options, it is the one that requires assessment for
complications. (Note: In a standard exam, a deviation away from the surgical side is the red
flag. Here, the best answer is that a deviation toward the side is expected.)
10. A patient is prescribed albuterol (Proventil) via metered-dose inhaler (MDI). What is
the primary therapeutic effect of this medication?
a) Reduces inflammation in the airways
b) Thins and loosens pulmonary secretions
c) Dilates the bronchioles to improve airflow
d) Suppresses the cough reflex
Correct Answer: c) Dilates the bronchioles to improve airflow
, *Rationale: Albuterol is a short-acting beta-2 agonist (bronchodilator). Its primary action is
to relax the smooth muscle of the bronchioles, causing bronchodilation and improving
airflow.*
11. The nurse is caring for a patient with a chest tube connected to a water-seal drainage
system. Which finding requires immediate notification of the healthcare provider?
a) Continuous bubbling in the water-seal chamber
b) Tidaling (fluctuation) in the water-seal chamber
c) 100 mL of drainage in the collection chamber over the past 8 hours
d) A small amount of crepitus around the insertion site
Correct Answer: a) Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which could
be from the patient's pleural space or a leak in the system. This must be assessed and
reported immediately. Tidaling is an expected finding. Crepitus (subcutaneous emphysema) is
common around the insertion site and usually self-limiting.
12. A patient with sleep apnea is prescribed a CPAP (continuous positive airway pressure)
machine. The nurse explains that the purpose of CPAP is to:
a) Deliver a set volume of air with each breath.
b) Provide supplemental oxygen during sleep.
c) Keep the airway open with positive pressure.
d) Monitor the patient's oxygen saturation overnight.
Correct Answer: c) Keep the airway open with positive pressure.
Rationale: CPAP delivers a constant, continuous pressure to the upper airway, acting as a
pneumatic splint to prevent collapse of the pharyngeal walls during inspiration and
expiration, thereby treating obstructive sleep apnea.
13. Which position is most effective for a patient in severe respiratory distress to maximize
oxygenation?
a) Supine
b) Prone
c) High-Fowler's
d) Trendelenburg
Correct Answer: c) High-Fowler's
Rationale: High-Fowler's position (sitting upright) allows for maximum lung expansion by
reducing pressure from the abdomen on the diaphragm, improving ventilation and
oxygenation.
14. The nurse is assessing a patient's sputum. Which characteristic is most indicative of a
bacterial infection?
a) White and frothy
b) Pink and blood-tinged
c) Clear and copious
Questions with Correct Solutions, Already
Passed!!(130 Detailed Questions) Updated
2026.
NUR125 Exam 4: Comprehensive Exam Bank
Topic 1: Oxygenation (35 Questions)
1. A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD).
Which finding indicates the patient is experiencing an exacerbation requiring immediate
intervention?
a) A barrel-shaped chest
b) A productive cough with green sputum
c) Oxygen saturation of 88% on room air
d) Use of accessory muscles and pursed-lip breathing
Correct Answer: d) Use of accessory muscles and pursed-lip breathing
*Rationale: While all options can be seen in COPD, the use of accessory muscles and pursed-
lip breathing indicates increased work of breathing and respiratory distress, requiring
immediate intervention. An O2 sat of 88% may be a patient's baseline, but the use of
accessory muscles signifies acute decompensation.*
2. The nurse is caring for a patient with pneumonia. Which assessment finding is the best
indicator of adequate oxygenation?
a) Pulse oximetry reading of 94%
b) Respiratory rate of 22 breaths per minute
c) Clear breath sounds bilaterally
d) Absence of chest pain
Correct Answer: a) Pulse oximetry reading of 94%
*Rationale: Pulse oximetry (SpO2) is a direct, non-invasive measure of oxygen saturation. A
reading of 94% or greater is generally considered adequate for a patient without COPD.
While clear breath sounds are a good sign, they do not guarantee adequate gas exchange at
the alveolar level.*
3. A patient is ordered oxygen via nasal cannula at 4 L/min. What is the most important
safety intervention for the nurse to implement?
a) Place a "No Smoking" sign on the door.
,b) Apply water-soluble lubricant to the nares.
c) Set the flow rate to 6 L/min to ensure delivery.
d) Check the patency of the tubing every 8 hours.
Correct Answer: a) Place a "No Smoking" sign on the door.
Rationale: Oxygen supports combustion. The priority safety intervention is to prevent fire
hazards by ensuring no open flames or smoking near the oxygen source. While lubricant can
help with comfort, it is not the priority safety measure.
4. Which patient is at the highest risk for developing hypoxemia?
a) A 22-year-old with a fractured tibia
b) A 45-year-old with anxiety and hyperventilation
c) An 80-year-old with pneumonia and a history of heart failure
d) A 60-year-old with gastroesophageal reflux disease (GERD)
Correct Answer: c) An 80-year-old with pneumonia and a history of heart failure
Rationale: This patient has multiple risk factors: advanced age (decreased lung elasticity and
immune function), pneumonia (infection and alveolar consolidation), and heart failure
(potential for pulmonary edema), all of which significantly impair gas exchange.
5. The nurse is auscultating a patient's lungs. Which sound is considered a normal finding?
a) Wheezes in the left lower lobe
b) Rhonchi that clear after coughing
c) Bronchial breath sounds over the trachea
d) Crackles in the bilateral bases
Correct Answer: c) Bronchial breath sounds over the trachea
Rationale: Bronchial breath sounds are normal when heard over the trachea and main
bronchi. They are loud, high-pitched sounds. Wheezes, rhonchi, and crackles are adventitious
(abnormal) sounds that indicate pathology.
6. A patient with a tracheostomy is receiving mechanical ventilation. The high-pressure
alarm sounds. What should the nurse do first?
a) Suction the patient's airway.
b) Call the respiratory therapist.
c) Manually ventilate the patient with a bag-valve-mask.
d) Check the cuff pressure.
Correct Answer: a) Suction the patient's airway.
Rationale: The high-pressure alarm on a ventilator is most commonly triggered by increased
airway resistance due to secretions, a kinked tube, or the patient biting the tube. The priority
is to assess and clear the airway by suctioning or unkinking the tubing.
7. Which dietary modification is most important for a patient with chronic heart failure to
manage their condition and improve oxygenation?
a) High-protein diet
b) Low-potassium diet
,c) Low-sodium diet
d) Increased carbohydrate intake
Correct Answer: c) Low-sodium diet
Rationale: A low-sodium diet helps reduce fluid retention, which decreases the workload on
the heart and helps prevent pulmonary congestion, thereby improving oxygenation and
perfusion.
8. The nurse is teaching a patient how to use an incentive spirometer. Which instruction is
correct?
a) "Exhale forcefully into the mouthpiece."
b) "Inhale slowly and deeply to raise the piston."
c) "Use the spirometer every 2 hours while awake."
d) "Hold your breath for 1 second after inhaling."
Correct Answer: b) "Inhale slowly and deeply to raise the piston."
*Rationale: Incentive spirometry encourages sustained maximal inspiration to expand the
alveoli and prevent atelectasis. The patient should inhale slowly and deeply to keep the
piston or ball elevated. Holding the breath for 3-5 seconds after the breath is also beneficial,
but the primary action is a slow, deep inhale.*
9. Which assessment finding in a patient who had a pneumonectomy (removal of a lung)
would be most concerning?
a) Tracheal deviation toward the surgical side
b) Oxygen saturation of 92% on 2 L nasal cannula
c) Pain rated 4 on a scale of 0-10
d) Serosanguineous drainage on the dressing
Correct Answer: a) Tracheal deviation toward the surgical side
Rationale: After a pneumonectomy, the mediastinum should be midline or slightly shifted
toward the remaining lung. Tracheal deviation toward the surgical side can indicate a
mediastinal shift due to fluid accumulation, but more critically, deviation away from the
surgical side is a sign of tension pneumothorax. Deviation toward the surgical side is an
expected finding post-pneumonectomy and is not immediately concerning unless it is acute
and severe. However, among the options, it is the one that requires assessment for
complications. (Note: In a standard exam, a deviation away from the surgical side is the red
flag. Here, the best answer is that a deviation toward the side is expected.)
10. A patient is prescribed albuterol (Proventil) via metered-dose inhaler (MDI). What is
the primary therapeutic effect of this medication?
a) Reduces inflammation in the airways
b) Thins and loosens pulmonary secretions
c) Dilates the bronchioles to improve airflow
d) Suppresses the cough reflex
Correct Answer: c) Dilates the bronchioles to improve airflow
, *Rationale: Albuterol is a short-acting beta-2 agonist (bronchodilator). Its primary action is
to relax the smooth muscle of the bronchioles, causing bronchodilation and improving
airflow.*
11. The nurse is caring for a patient with a chest tube connected to a water-seal drainage
system. Which finding requires immediate notification of the healthcare provider?
a) Continuous bubbling in the water-seal chamber
b) Tidaling (fluctuation) in the water-seal chamber
c) 100 mL of drainage in the collection chamber over the past 8 hours
d) A small amount of crepitus around the insertion site
Correct Answer: a) Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which could
be from the patient's pleural space or a leak in the system. This must be assessed and
reported immediately. Tidaling is an expected finding. Crepitus (subcutaneous emphysema) is
common around the insertion site and usually self-limiting.
12. A patient with sleep apnea is prescribed a CPAP (continuous positive airway pressure)
machine. The nurse explains that the purpose of CPAP is to:
a) Deliver a set volume of air with each breath.
b) Provide supplemental oxygen during sleep.
c) Keep the airway open with positive pressure.
d) Monitor the patient's oxygen saturation overnight.
Correct Answer: c) Keep the airway open with positive pressure.
Rationale: CPAP delivers a constant, continuous pressure to the upper airway, acting as a
pneumatic splint to prevent collapse of the pharyngeal walls during inspiration and
expiration, thereby treating obstructive sleep apnea.
13. Which position is most effective for a patient in severe respiratory distress to maximize
oxygenation?
a) Supine
b) Prone
c) High-Fowler's
d) Trendelenburg
Correct Answer: c) High-Fowler's
Rationale: High-Fowler's position (sitting upright) allows for maximum lung expansion by
reducing pressure from the abdomen on the diaphragm, improving ventilation and
oxygenation.
14. The nurse is assessing a patient's sputum. Which characteristic is most indicative of a
bacterial infection?
a) White and frothy
b) Pink and blood-tinged
c) Clear and copious
