NR 226 Adult Health I Week 7 Study Guide - Respiratory and Acid-Base
Balance 2026 |Chamberlain College
1. A nurse is caring for a patient with COPD who is experiencing mild shortness
of breath. Which oxygen delivery device is most appropriate for delivering a
precise concentration of oxygen?
A. Simple face mask
B. Venturi mask
C. Nasal cannula
D. Non-rebreather mask
Answer: B
Rationale: The Venturi mask is the most accurate device for delivering a fixed, precise
concentration of oxygen, which is critical for patients with COPD to avoid suppressing their
hypoxic drive.
2. When assessing a patient with a suspected tension pneumothorax, which of
the following is a hallmark clinical manifestation?
A. Bradypnea
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Hypertension
Answer: C
Rationale: Tension pneumothorax causes a shift of mediastinal structures, leading to
tracheal deviation toward the unaffected (healthy) side, which is a medical emergency.
,3. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
normal, indicating uncompensated respiratory acidosis.
4. Which of the following is an early sign of hypoxia that a nurse should monitor
for?
A. Cyanosis
B. Bradycardia
C. Hypotension
D. Restlessness
Answer: D
Rationale: Restlessness, anxiety, and agitation are early signs of hypoxia. Cyanosis and
bradycardia are considered late signs.
5. The nurse is educating a patient on the use of an incentive spirometer. What
is the primary purpose of this device?
A. To measure peak expiratory flow
B. To promote alveolar expansion and prevent atelectasis
C. To deliver bronchodilators into the lungs
D. To clear secretions from the upper airway
Answer: B
Rationale: Incentive spirometry encourages deep breathing (sustained maximal
inspiration), which helps keep the alveoli open and prevents lung collapse (atelectasis).
, 6. A patient with asthma is prescribed Albuterol via a metered-dose inhaler
(MDI). Which side effect should the nurse instruct the patient to anticipate?
A. Drowsiness
B. Bradycardia
C. Hypoglycemia
D. Tachycardia
Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that can cause sympathetic
nervous system stimulation, leading to tachycardia and tremors.
7. During a thoracentesis, in what position should the nurse place the patient?
A. Supine with head of bed flat
B. Side-lying on the affected side
C. Prone with a pillow under the chest
D. Sitting on the edge of the bed leaning over a bedside table
Answer: D
Rationale: Sitting upright and leaning forward spreads the ribs and provides the best
access to the pleural space for fluid removal.
8. A nurse is monitoring a patient with a chest tube. The nurse notes continuous
bubbling in the water-seal chamber. What does this finding indicate?
A. Normal functioning of the system
B. The lung has fully re-expanded
C. The suction pressure is too high
D. There is an air leak in the system
Answer: D
Rationale: Intermittent bubbling in the water-seal chamber is normal with expiration or
coughing, but continuous bubbling indicates a leak in the chest tube system.
Balance 2026 |Chamberlain College
1. A nurse is caring for a patient with COPD who is experiencing mild shortness
of breath. Which oxygen delivery device is most appropriate for delivering a
precise concentration of oxygen?
A. Simple face mask
B. Venturi mask
C. Nasal cannula
D. Non-rebreather mask
Answer: B
Rationale: The Venturi mask is the most accurate device for delivering a fixed, precise
concentration of oxygen, which is critical for patients with COPD to avoid suppressing their
hypoxic drive.
2. When assessing a patient with a suspected tension pneumothorax, which of
the following is a hallmark clinical manifestation?
A. Bradypnea
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Hypertension
Answer: C
Rationale: Tension pneumothorax causes a shift of mediastinal structures, leading to
tracheal deviation toward the unaffected (healthy) side, which is a medical emergency.
,3. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
normal, indicating uncompensated respiratory acidosis.
4. Which of the following is an early sign of hypoxia that a nurse should monitor
for?
A. Cyanosis
B. Bradycardia
C. Hypotension
D. Restlessness
Answer: D
Rationale: Restlessness, anxiety, and agitation are early signs of hypoxia. Cyanosis and
bradycardia are considered late signs.
5. The nurse is educating a patient on the use of an incentive spirometer. What
is the primary purpose of this device?
A. To measure peak expiratory flow
B. To promote alveolar expansion and prevent atelectasis
C. To deliver bronchodilators into the lungs
D. To clear secretions from the upper airway
Answer: B
Rationale: Incentive spirometry encourages deep breathing (sustained maximal
inspiration), which helps keep the alveoli open and prevents lung collapse (atelectasis).
, 6. A patient with asthma is prescribed Albuterol via a metered-dose inhaler
(MDI). Which side effect should the nurse instruct the patient to anticipate?
A. Drowsiness
B. Bradycardia
C. Hypoglycemia
D. Tachycardia
Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that can cause sympathetic
nervous system stimulation, leading to tachycardia and tremors.
7. During a thoracentesis, in what position should the nurse place the patient?
A. Supine with head of bed flat
B. Side-lying on the affected side
C. Prone with a pillow under the chest
D. Sitting on the edge of the bed leaning over a bedside table
Answer: D
Rationale: Sitting upright and leaning forward spreads the ribs and provides the best
access to the pleural space for fluid removal.
8. A nurse is monitoring a patient with a chest tube. The nurse notes continuous
bubbling in the water-seal chamber. What does this finding indicate?
A. Normal functioning of the system
B. The lung has fully re-expanded
C. The suction pressure is too high
D. There is an air leak in the system
Answer: D
Rationale: Intermittent bubbling in the water-seal chamber is normal with expiration or
coughing, but continuous bubbling indicates a leak in the chest tube system.
