NR 226 Adult Health I - Exam 5 Study Guide 2026 |Chamberlain
College
1. A nurse is caring for a patient with COPD who is experiencing dyspnea. Which
position should the nurse encourage to improve breathing?
A. Orthopneic or Tripod position
B. High-Fowler’s with arms at side
C. Supine
D. Lateral recumbent
Answer: A
Rationale: The orthopneic or tripod position allows the patient to lean over a bedside
table, which helps expand the chest and facilitates the use of accessory muscles.
2. When assessing a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What does this indicate?
A. Normal functioning
B. A leak in the system
C. The lung has fully expanded
D. Suction is too high
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak.
Intermittent bubbling is expected in a patient with a pneumothorax.
,3. A patient is diagnosed with pulmonary tuberculosis. Which type of isolation
precautions should the nurse implement?
A. Airborne
B. Contact
C. Droplet
D. Standard
Answer: A
Rationale: Tuberculosis is transmitted through small droplets that remain suspended in
the air, requiring airborne precautions, including a negative-pressure room and N95
masks.
4. Which clinical manifestation is a hallmark sign of a tension pneumothorax?
A. Increased breath sounds on the affected side
B. Tracheal deviation to the unaffected side
C. Flattened neck veins
D. Resonance on percussion
Answer: B
Rationale: Tension pneumothorax causes a shift in the mediastinum, leading to tracheal
deviation toward the healthy lung (unaffected side) and distended neck veins.
5. A nurse is teaching a patient about using an incentive spirometer. What is the
primary purpose of this device?
A. To measure peak expiratory flow
B. To clear mucus from the upper airway
C. To deliver bronchodilator medication
D. To promote alveolar expansion and prevent atelectasis
Answer: D
Rationale: Incentive spirometry encourages deep breathing, which helps open collapsed
alveoli (atelectasis) and improves gas exchange post-operatively.
, 6. What is the first-line medication used for an acute asthma attack?
A. Albuterol
B. Salmeterol
C. Prednisone
D. Theophylline
Answer: A
Rationale: Albuterol is a short-acting beta2-agonist (SABA) that provides rapid
bronchodilation during an acute exacerbation.
7. A patient with pneumonia has a pulse oximetry reading of 88%. Which action
should the nurse take first?
A. Administer an analgesic
B. Apply oxygen as prescribed
C. Notify the physician immediately
D. Encourage the patient to cough and deep breathe
Answer: B
Rationale: Priority is to improve oxygenation. The nurse should apply oxygen to address
hypoxemia while also encouraging deep breathing.
8. Which assessment finding is most characteristic of chronic obstructive
pulmonary disease (COPD)?
A. Increased tactile fremitus
B. Inspiratory stridor
C. Barrel chest
D. Narrowed intercostal spaces
Answer: C
Rationale: Hyperinflation of the lungs over time leads to an increased anteroposterior
diameter, known as a barrel chest.
College
1. A nurse is caring for a patient with COPD who is experiencing dyspnea. Which
position should the nurse encourage to improve breathing?
A. Orthopneic or Tripod position
B. High-Fowler’s with arms at side
C. Supine
D. Lateral recumbent
Answer: A
Rationale: The orthopneic or tripod position allows the patient to lean over a bedside
table, which helps expand the chest and facilitates the use of accessory muscles.
2. When assessing a patient with a chest tube, the nurse notes continuous
bubbling in the water-seal chamber. What does this indicate?
A. Normal functioning
B. A leak in the system
C. The lung has fully expanded
D. Suction is too high
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak.
Intermittent bubbling is expected in a patient with a pneumothorax.
,3. A patient is diagnosed with pulmonary tuberculosis. Which type of isolation
precautions should the nurse implement?
A. Airborne
B. Contact
C. Droplet
D. Standard
Answer: A
Rationale: Tuberculosis is transmitted through small droplets that remain suspended in
the air, requiring airborne precautions, including a negative-pressure room and N95
masks.
4. Which clinical manifestation is a hallmark sign of a tension pneumothorax?
A. Increased breath sounds on the affected side
B. Tracheal deviation to the unaffected side
C. Flattened neck veins
D. Resonance on percussion
Answer: B
Rationale: Tension pneumothorax causes a shift in the mediastinum, leading to tracheal
deviation toward the healthy lung (unaffected side) and distended neck veins.
5. A nurse is teaching a patient about using an incentive spirometer. What is the
primary purpose of this device?
A. To measure peak expiratory flow
B. To clear mucus from the upper airway
C. To deliver bronchodilator medication
D. To promote alveolar expansion and prevent atelectasis
Answer: D
Rationale: Incentive spirometry encourages deep breathing, which helps open collapsed
alveoli (atelectasis) and improves gas exchange post-operatively.
, 6. What is the first-line medication used for an acute asthma attack?
A. Albuterol
B. Salmeterol
C. Prednisone
D. Theophylline
Answer: A
Rationale: Albuterol is a short-acting beta2-agonist (SABA) that provides rapid
bronchodilation during an acute exacerbation.
7. A patient with pneumonia has a pulse oximetry reading of 88%. Which action
should the nurse take first?
A. Administer an analgesic
B. Apply oxygen as prescribed
C. Notify the physician immediately
D. Encourage the patient to cough and deep breathe
Answer: B
Rationale: Priority is to improve oxygenation. The nurse should apply oxygen to address
hypoxemia while also encouraging deep breathing.
8. Which assessment finding is most characteristic of chronic obstructive
pulmonary disease (COPD)?
A. Increased tactile fremitus
B. Inspiratory stridor
C. Barrel chest
D. Narrowed intercostal spaces
Answer: C
Rationale: Hyperinflation of the lungs over time leads to an increased anteroposterior
diameter, known as a barrel chest.
