NR 226 Respiratory Disorders: COPD and Pneumonia Practice Quiz
2026 |Chamberlain College
1. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which clinical finding should the nurse expect to observe?
A. Increased chest excursion
B. A shortened expiratory phase
C. Pursed-lip breathing
D. Oxygen saturation of 98% on room air
Answer: C
Rationale: Pursed-lip breathing is a common compensatory mechanism in COPD patients
to maintain airway pressure and prevent alveolar collapse during expiration.
2. A client is admitted with a diagnosis of bacterial pneumonia. The nurse notes
the client has a productive cough with rust-colored sputum. Which organism is
most likely responsible?
A. Klebsiella pneumoniae
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Haemophilus influenzae
Answer: C
Rationale: Rust-colored sputum is a classic clinical manifestation of pneumonia caused by
Streptococcus pneumoniae.
,3. The nurse is teaching a client with COPD about the purpose of ‘tripod
positioning.’ Which statement by the client indicates understanding?
A. It helps me sleep better at night.
B. It decreases the work of breathing by using accessory muscles.
C. It prevents the development of deep vein thrombosis.
D. It helps clear secretions from my upper airways.
Answer: B
Rationale: The tripod position (leaning forward with hands on knees) helps the client use
accessory muscles more effectively to enhance gas exchange and reduce the work of
breathing.
4. Which arterial blood gas (ABG) result would the nurse expect to see in a client
with compensated respiratory acidosis due to chronic COPD?
A. pH 7.35, PaCO2 35, HCO3 20
B. pH 7.30, PaCO2 55, HCO3 24
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.35, PaCO2 50, HCO3 30
Answer: D
Rationale: In chronic COPD, the pH is often at the low end of normal (compensated), while
PaCO2 is high (acidosis) and HCO3 is high (compensatory metabolic alkalosis).
5. A nurse is caring for a client with pneumonia. Which of the following is the
highest priority nursing intervention?
A. Administering ordered analgesics for chest pain
B. Encouraging oral fluid intake up to 3 liters per day
C. Maintaining a patent airway and adequate oxygenation
D. Teaching the client how to use the incentive spirometer
Answer: C
, Rationale: Airway and breathing (ABC) take priority over comfort and long-term
education.
6. A client with emphysema is being discharged. Which instruction regarding
oxygen therapy is most important?
A. Increase the flow rate if you feel short of breath.
B. Oxygen should be used at 5-6 L/min to keep saturation at 100%.
C. Only use the oxygen when you are exercising.
D. Keep the oxygen flow rate at the prescribed 1-2 L/min.
Answer: D
Rationale: High levels of oxygen can suppress the hypoxic drive in some COPD patients,
leading to carbon dioxide narcosis.
7. Which diagnostic test is the gold standard for confirming the diagnosis of
COPD?
A. Chest X-ray
B. Sputum culture
C. Arterial blood gas analysis
D. Pulmonary function tests (Spirometry)
Answer: D
Rationale: Spirometry is required to confirm the diagnosis of COPD by showing airflow
obstruction that is not fully reversible.
8. A nurse is auscultating the lungs of a client with pneumonia. What sound is
the nurse most likely to hear over the consolidated lung tissue?
A. Wheezes
B. Stridor
C. Crackles
D. Absent breath sounds
Answer: C
2026 |Chamberlain College
1. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which clinical finding should the nurse expect to observe?
A. Increased chest excursion
B. A shortened expiratory phase
C. Pursed-lip breathing
D. Oxygen saturation of 98% on room air
Answer: C
Rationale: Pursed-lip breathing is a common compensatory mechanism in COPD patients
to maintain airway pressure and prevent alveolar collapse during expiration.
2. A client is admitted with a diagnosis of bacterial pneumonia. The nurse notes
the client has a productive cough with rust-colored sputum. Which organism is
most likely responsible?
A. Klebsiella pneumoniae
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Haemophilus influenzae
Answer: C
Rationale: Rust-colored sputum is a classic clinical manifestation of pneumonia caused by
Streptococcus pneumoniae.
,3. The nurse is teaching a client with COPD about the purpose of ‘tripod
positioning.’ Which statement by the client indicates understanding?
A. It helps me sleep better at night.
B. It decreases the work of breathing by using accessory muscles.
C. It prevents the development of deep vein thrombosis.
D. It helps clear secretions from my upper airways.
Answer: B
Rationale: The tripod position (leaning forward with hands on knees) helps the client use
accessory muscles more effectively to enhance gas exchange and reduce the work of
breathing.
4. Which arterial blood gas (ABG) result would the nurse expect to see in a client
with compensated respiratory acidosis due to chronic COPD?
A. pH 7.35, PaCO2 35, HCO3 20
B. pH 7.30, PaCO2 55, HCO3 24
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.35, PaCO2 50, HCO3 30
Answer: D
Rationale: In chronic COPD, the pH is often at the low end of normal (compensated), while
PaCO2 is high (acidosis) and HCO3 is high (compensatory metabolic alkalosis).
5. A nurse is caring for a client with pneumonia. Which of the following is the
highest priority nursing intervention?
A. Administering ordered analgesics for chest pain
B. Encouraging oral fluid intake up to 3 liters per day
C. Maintaining a patent airway and adequate oxygenation
D. Teaching the client how to use the incentive spirometer
Answer: C
, Rationale: Airway and breathing (ABC) take priority over comfort and long-term
education.
6. A client with emphysema is being discharged. Which instruction regarding
oxygen therapy is most important?
A. Increase the flow rate if you feel short of breath.
B. Oxygen should be used at 5-6 L/min to keep saturation at 100%.
C. Only use the oxygen when you are exercising.
D. Keep the oxygen flow rate at the prescribed 1-2 L/min.
Answer: D
Rationale: High levels of oxygen can suppress the hypoxic drive in some COPD patients,
leading to carbon dioxide narcosis.
7. Which diagnostic test is the gold standard for confirming the diagnosis of
COPD?
A. Chest X-ray
B. Sputum culture
C. Arterial blood gas analysis
D. Pulmonary function tests (Spirometry)
Answer: D
Rationale: Spirometry is required to confirm the diagnosis of COPD by showing airflow
obstruction that is not fully reversible.
8. A nurse is auscultating the lungs of a client with pneumonia. What sound is
the nurse most likely to hear over the consolidated lung tissue?
A. Wheezes
B. Stridor
C. Crackles
D. Absent breath sounds
Answer: C
