NUR 210 | Exam Questions (100+ Qs) | Respiratory,
Integumentary, Neuro, MSK, GI| NUR 210 Comprehensive
Final Exam!!
NUR 210 Comprehensive Final Exam
Respiratory System (Questions 1-25)
1. A nurse assesses a client with chronic obstructive pulmonary disease (COPD) who has a
barrel chest and tachypnea. Which acid-base imbalance is most likely?
• A) Metabolic acidosis
• B) Metabolic alkalosis
• C) Respiratory acidosis
• D) Respiratory alkalosis
Answer: C) Respiratory acidosis
Rationale: In COPD, chronic hypercapnia (elevated PaCO2) leads to respiratory acidosis due
to inadequate alveolar ventilation. Barrel chest indicates air trapping.
2. A client with pneumonia has a fever, productive cough, and pleuritic chest pain. The
nurse should place the client in which position to optimize ventilation?
• A) Supine
• B) High Fowler’s
• C) Left lateral
• D) Trendelenburg
Answer: B) High Fowler’s
Rationale: High Fowler’s position (90 degrees) maximizes lung expansion and reduces
pressure on the diaphragm, improving oxygenation.
3. Which assessment finding in a client with a chest tube requires immediate intervention?
• A) 200 mL of drainage in the first 6 hours
• B) Continuous bubbling in the water seal chamber
• C) Tidaling in the water seal chamber with inspiration
, • D) Serosanguinous drainage
Answer: B) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling indicates an air leak, which can lead to pneumothorax.
Tidaling is normal; drainage amount is expected post-insertion.
4. A client is prescribed albuterol via nebulizer. The nurse evaluates the medication as
effective if which finding occurs?
• A) Heart rate decreases from 110 to 80 bpm
• B) Wheezing diminishes and SpO2 rises from 88% to 94%
• C) Respiratory rate increases from 18 to 24 breaths/min
• D) Client reports dry mouth
Answer: B) Wheezing diminishes and SpO2 rises from 88% to 94%
Rationale: Albuterol is a beta-2 agonist bronchodilator. Effectiveness is shown by decreased
wheezing and improved oxygenation.
5. A nurse auscultates crackles in a client with heart failure. These sounds are caused by:
• A) Air moving through narrowed bronchi
• B) Inflamed pleural surfaces rubbing together
• C) Sudden opening of deflated alveoli
• D) Secretions in the trachea
Answer: C) Sudden opening of deflated alveoli
Rationale: Crackles (rales) occur when deflated or fluid-filled alveoli pop open during
inspiration. Common in heart failure and pneumonia.
6. A client with a pulmonary embolism (PE) has a sudden onset of dyspnea and
tachycardia. Which laboratory finding is most consistent with PE?
• A) Elevated D-dimer
• B) Decreased troponin
• C) Elevated hemoglobin
• D) Decreased BNP
Answer: A) Elevated D-dimer
Rationale: D-dimer is a fibrin degradation fragment. Elevated levels indicate clot formation
and breakdown, highly sensitive for PE (but not specific).
7. Which oxygen delivery device provides the most precise FiO2?
, • A) Nasal cannula at 2 L/min
• B) Simple face mask at 8 L/min
• C) Non-rebreather mask
• D) Venturi mask
Answer: D) Venturi mask
Rationale: Venturi masks deliver a fixed, precise FiO2 (24-50%) regardless of the client’s
breathing pattern, making them ideal for COPD with CO2 retention.
8. A client with tuberculosis (TB) is started on rifampin. The nurse should teach that this
drug causes which harmless side effect?
• A) Blue-gray skin discoloration
• B) Orange-red urine and tears
• C) Photosensitivity rash
• D) Metallic taste
Answer: B) Orange-red urine and tears
Rationale: Rifampin causes benign orange-red discoloration of body fluids (urine, sweat,
tears). Patients must be warned to avoid contact lens staining.
9. The nurse suspects a tension pneumothorax in a client after chest trauma. Which
finding is most indicative?
• A) Bilateral crackles
• B) Hypotension and tracheal deviation
• C) Bradycardia and wheezing
• D) Pink frothy sputum
Answer: B) Hypotension and tracheal deviation
Rationale: Tension pneumothorax causes mediastinal shift (tracheal deviation away from
affected side), hypotension (impaired venous return), and distended neck veins.
10. A client with asthma has a peak expiratory flow rate (PEFR) of 50% of personal best.
The nurse interprets this as:
• A) Green zone – well controlled
• B) Yellow zone – caution, need for rescue medication
• C) Red zone – medical emergency
• D) Normal variation
, Answer: B) Yellow zone – caution, need for rescue medication
Rationale: Green zone = 80-100% (good control); Yellow zone = 50-79% (caution, use rescue
inhaler); Red zone = <50% (severe, seek emergency care).
11. Which intervention is most important for a nurse to implement during a severe acute
asthma exacerbation?
• A) Encourage oral fluids
• B) Administer nebulized albuterol and ipratropium
• C) Place in supine position
• D) Provide warm, humidified oxygen at 10 L/min via non-rebreather
Answer: B) Administer nebulized albuterol and ipratropium
Rationale: Rapid bronchodilation is priority. Combined beta-agonist + anticholinergic
(DuoNeb) is first-line. Oxygen is given, but not at high flow without caution.
12. A nurse notes a client’s ABG results: pH 7.30, PaCO2 55 mm Hg, HCO3- 24 mEq/L.
Which condition is consistent?
• A) Uncompensated respiratory acidosis
• B) Compensated metabolic alkalosis
• C) Uncompensated metabolic acidosis
• D) Compensated respiratory acidosis
Answer: A) Uncompensated respiratory acidosis
Rationale: Low pH (<7.35) + high PaCO2 (>45) = respiratory acidosis. HCO3- is normal (24),
indicating no renal compensation yet.
13. A client with cystic fibrosis (CF) is prescribed dornase alfa (Pulmozyme). The nurse
explains that this drug:
• A) Reduces inflammation in airways
• B) Thins mucus by breaking down DNA
• C) Kills Pseudomonas bacteria
• D) Dilates constricted bronchi
Answer: B) Thins mucus by breaking down DNA
Rationale: Dornase alfa is a recombinant DNase that cleaves DNA from degraded neutrophils
in CF sputum, reducing viscosity and improving clearance.
14. During endotracheal suctioning, the nurse should limit each suction pass to no more
than:
Integumentary, Neuro, MSK, GI| NUR 210 Comprehensive
Final Exam!!
NUR 210 Comprehensive Final Exam
Respiratory System (Questions 1-25)
1. A nurse assesses a client with chronic obstructive pulmonary disease (COPD) who has a
barrel chest and tachypnea. Which acid-base imbalance is most likely?
• A) Metabolic acidosis
• B) Metabolic alkalosis
• C) Respiratory acidosis
• D) Respiratory alkalosis
Answer: C) Respiratory acidosis
Rationale: In COPD, chronic hypercapnia (elevated PaCO2) leads to respiratory acidosis due
to inadequate alveolar ventilation. Barrel chest indicates air trapping.
2. A client with pneumonia has a fever, productive cough, and pleuritic chest pain. The
nurse should place the client in which position to optimize ventilation?
• A) Supine
• B) High Fowler’s
• C) Left lateral
• D) Trendelenburg
Answer: B) High Fowler’s
Rationale: High Fowler’s position (90 degrees) maximizes lung expansion and reduces
pressure on the diaphragm, improving oxygenation.
3. Which assessment finding in a client with a chest tube requires immediate intervention?
• A) 200 mL of drainage in the first 6 hours
• B) Continuous bubbling in the water seal chamber
• C) Tidaling in the water seal chamber with inspiration
, • D) Serosanguinous drainage
Answer: B) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling indicates an air leak, which can lead to pneumothorax.
Tidaling is normal; drainage amount is expected post-insertion.
4. A client is prescribed albuterol via nebulizer. The nurse evaluates the medication as
effective if which finding occurs?
• A) Heart rate decreases from 110 to 80 bpm
• B) Wheezing diminishes and SpO2 rises from 88% to 94%
• C) Respiratory rate increases from 18 to 24 breaths/min
• D) Client reports dry mouth
Answer: B) Wheezing diminishes and SpO2 rises from 88% to 94%
Rationale: Albuterol is a beta-2 agonist bronchodilator. Effectiveness is shown by decreased
wheezing and improved oxygenation.
5. A nurse auscultates crackles in a client with heart failure. These sounds are caused by:
• A) Air moving through narrowed bronchi
• B) Inflamed pleural surfaces rubbing together
• C) Sudden opening of deflated alveoli
• D) Secretions in the trachea
Answer: C) Sudden opening of deflated alveoli
Rationale: Crackles (rales) occur when deflated or fluid-filled alveoli pop open during
inspiration. Common in heart failure and pneumonia.
6. A client with a pulmonary embolism (PE) has a sudden onset of dyspnea and
tachycardia. Which laboratory finding is most consistent with PE?
• A) Elevated D-dimer
• B) Decreased troponin
• C) Elevated hemoglobin
• D) Decreased BNP
Answer: A) Elevated D-dimer
Rationale: D-dimer is a fibrin degradation fragment. Elevated levels indicate clot formation
and breakdown, highly sensitive for PE (but not specific).
7. Which oxygen delivery device provides the most precise FiO2?
, • A) Nasal cannula at 2 L/min
• B) Simple face mask at 8 L/min
• C) Non-rebreather mask
• D) Venturi mask
Answer: D) Venturi mask
Rationale: Venturi masks deliver a fixed, precise FiO2 (24-50%) regardless of the client’s
breathing pattern, making them ideal for COPD with CO2 retention.
8. A client with tuberculosis (TB) is started on rifampin. The nurse should teach that this
drug causes which harmless side effect?
• A) Blue-gray skin discoloration
• B) Orange-red urine and tears
• C) Photosensitivity rash
• D) Metallic taste
Answer: B) Orange-red urine and tears
Rationale: Rifampin causes benign orange-red discoloration of body fluids (urine, sweat,
tears). Patients must be warned to avoid contact lens staining.
9. The nurse suspects a tension pneumothorax in a client after chest trauma. Which
finding is most indicative?
• A) Bilateral crackles
• B) Hypotension and tracheal deviation
• C) Bradycardia and wheezing
• D) Pink frothy sputum
Answer: B) Hypotension and tracheal deviation
Rationale: Tension pneumothorax causes mediastinal shift (tracheal deviation away from
affected side), hypotension (impaired venous return), and distended neck veins.
10. A client with asthma has a peak expiratory flow rate (PEFR) of 50% of personal best.
The nurse interprets this as:
• A) Green zone – well controlled
• B) Yellow zone – caution, need for rescue medication
• C) Red zone – medical emergency
• D) Normal variation
, Answer: B) Yellow zone – caution, need for rescue medication
Rationale: Green zone = 80-100% (good control); Yellow zone = 50-79% (caution, use rescue
inhaler); Red zone = <50% (severe, seek emergency care).
11. Which intervention is most important for a nurse to implement during a severe acute
asthma exacerbation?
• A) Encourage oral fluids
• B) Administer nebulized albuterol and ipratropium
• C) Place in supine position
• D) Provide warm, humidified oxygen at 10 L/min via non-rebreather
Answer: B) Administer nebulized albuterol and ipratropium
Rationale: Rapid bronchodilation is priority. Combined beta-agonist + anticholinergic
(DuoNeb) is first-line. Oxygen is given, but not at high flow without caution.
12. A nurse notes a client’s ABG results: pH 7.30, PaCO2 55 mm Hg, HCO3- 24 mEq/L.
Which condition is consistent?
• A) Uncompensated respiratory acidosis
• B) Compensated metabolic alkalosis
• C) Uncompensated metabolic acidosis
• D) Compensated respiratory acidosis
Answer: A) Uncompensated respiratory acidosis
Rationale: Low pH (<7.35) + high PaCO2 (>45) = respiratory acidosis. HCO3- is normal (24),
indicating no renal compensation yet.
13. A client with cystic fibrosis (CF) is prescribed dornase alfa (Pulmozyme). The nurse
explains that this drug:
• A) Reduces inflammation in airways
• B) Thins mucus by breaking down DNA
• C) Kills Pseudomonas bacteria
• D) Dilates constricted bronchi
Answer: B) Thins mucus by breaking down DNA
Rationale: Dornase alfa is a recombinant DNase that cleaves DNA from degraded neutrophils
in CF sputum, reducing viscosity and improving clearance.
14. During endotracheal suctioning, the nurse should limit each suction pass to no more
than:
