NR 324 Adult Health II Exam 1 Practice Questions 2026 |Chamberlain
College
1. A patient with a history of COPD presents with a pH of 7.33, PaCO2 of 52
mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is occurring?
A. Metabolic Acidosis, uncompensated
B. Respiratory Alkalosis, fully compensated
C. Respiratory Acidosis, partially compensated
D. Metabolic Alkalosis, partially compensated
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
high (compensatory mechanism), indicating partial compensation.
2. Which assessment finding should the nurse report immediately for a patient
who just underwent a bronchoscopy?
A. Dry, non-productive cough
B. Sore throat and hoarseness
C. Small amount of blood-tinged sputum
D. Absence of a gag reflex
Answer: D
Rationale: The absence of a gag reflex is expected post-procedure due to anesthesia, but it
must be monitored closely; however, if it persists or respiratory distress occurs, it is a
priority. Actually, in NCLEX-style, we wait for the gag reflex before feeding. If the patient
has stridor or shortness of breath, that is the emergency. Among these, the absence of gag
reflex determines safety for intake, but usually, new-onset stridor is the worst. Here, B is
the standard ‘waiting’ check.
,3. A patient with tuberculosis (TB) is prescribed Rifampin. Which side effect
should the nurse include in the teaching?
A. Blurred vision and color blindness
B. Peripheral neuropathy and tingling
C. Severe joint pain and gout
D. Orange discoloration of urine and tears
Answer: D
Rationale: Rifampin causes a harmless orange-red discoloration of body fluids, such as
urine, sweat, and tears.
4. A nurse is caring for a patient with a chest tube. The nurse notes continuous
bubbling in the water-seal chamber. What does this indicate?
A. There is an air leak in the system.
B. The lung has fully re-expanded.
C. This is a normal finding during expiration.
D. The suction pressure is set too high.
Answer: A
Rationale: Intermittent bubbling is normal in a pneumothorax, but continuous bubbling in
the water-seal chamber indicates a leak in the drainage system or the patient’s pleural
space.
5. Which intervention is most effective for a patient with thick secretions and
pneumonia?
A. Increasing oral fluid intake to 2-3 liters per day
B. Encouraging the use of a cough suppressant
C. Restricting fluid intake to 1 liter per day
D. Administering oxygen via nasal cannula at 6L/min
Answer: A
, Rationale: Hydration helps liquefy secretions, making them easier to expectorate.
Restricting fluids or using suppressants would hinder secretion clearance.
6. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic
test is considered the ‘gold standard’ for confirmation?
A. Chest X-ray
B. Arterial Blood Gas (ABG)
C. Spiral CT Scan (CT Angiography)
D. D-dimer assay
Answer: C
Rationale: Spiral CT (CTPA) is the most commonly used gold standard for diagnosing PE.
D-dimer is a screening tool but not confirmatory.
7. When teaching a patient how to use a Peak Flow Meter, the nurse should
instruct the patient to:
A. Inhale as deeply as possible through the meter.
B. Perform the test while lying flat in bed.
C. Exhale as hard and fast as possible through the meter.
D. Take the average of five consecutive readings.
Answer: C
Rationale: A peak flow meter measures the maximum speed of expiration. The patient
should stand, take a deep breath, and blow out as hard and fast as possible.
8. Which medication is classified as a ‘rescue’ inhaler for acute asthma
symptoms?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Tiotropium
Answer: C
College
1. A patient with a history of COPD presents with a pH of 7.33, PaCO2 of 52
mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is occurring?
A. Metabolic Acidosis, uncompensated
B. Respiratory Alkalosis, fully compensated
C. Respiratory Acidosis, partially compensated
D. Metabolic Alkalosis, partially compensated
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
high (compensatory mechanism), indicating partial compensation.
2. Which assessment finding should the nurse report immediately for a patient
who just underwent a bronchoscopy?
A. Dry, non-productive cough
B. Sore throat and hoarseness
C. Small amount of blood-tinged sputum
D. Absence of a gag reflex
Answer: D
Rationale: The absence of a gag reflex is expected post-procedure due to anesthesia, but it
must be monitored closely; however, if it persists or respiratory distress occurs, it is a
priority. Actually, in NCLEX-style, we wait for the gag reflex before feeding. If the patient
has stridor or shortness of breath, that is the emergency. Among these, the absence of gag
reflex determines safety for intake, but usually, new-onset stridor is the worst. Here, B is
the standard ‘waiting’ check.
,3. A patient with tuberculosis (TB) is prescribed Rifampin. Which side effect
should the nurse include in the teaching?
A. Blurred vision and color blindness
B. Peripheral neuropathy and tingling
C. Severe joint pain and gout
D. Orange discoloration of urine and tears
Answer: D
Rationale: Rifampin causes a harmless orange-red discoloration of body fluids, such as
urine, sweat, and tears.
4. A nurse is caring for a patient with a chest tube. The nurse notes continuous
bubbling in the water-seal chamber. What does this indicate?
A. There is an air leak in the system.
B. The lung has fully re-expanded.
C. This is a normal finding during expiration.
D. The suction pressure is set too high.
Answer: A
Rationale: Intermittent bubbling is normal in a pneumothorax, but continuous bubbling in
the water-seal chamber indicates a leak in the drainage system or the patient’s pleural
space.
5. Which intervention is most effective for a patient with thick secretions and
pneumonia?
A. Increasing oral fluid intake to 2-3 liters per day
B. Encouraging the use of a cough suppressant
C. Restricting fluid intake to 1 liter per day
D. Administering oxygen via nasal cannula at 6L/min
Answer: A
, Rationale: Hydration helps liquefy secretions, making them easier to expectorate.
Restricting fluids or using suppressants would hinder secretion clearance.
6. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic
test is considered the ‘gold standard’ for confirmation?
A. Chest X-ray
B. Arterial Blood Gas (ABG)
C. Spiral CT Scan (CT Angiography)
D. D-dimer assay
Answer: C
Rationale: Spiral CT (CTPA) is the most commonly used gold standard for diagnosing PE.
D-dimer is a screening tool but not confirmatory.
7. When teaching a patient how to use a Peak Flow Meter, the nurse should
instruct the patient to:
A. Inhale as deeply as possible through the meter.
B. Perform the test while lying flat in bed.
C. Exhale as hard and fast as possible through the meter.
D. Take the average of five consecutive readings.
Answer: C
Rationale: A peak flow meter measures the maximum speed of expiration. The patient
should stand, take a deep breath, and blow out as hard and fast as possible.
8. Which medication is classified as a ‘rescue’ inhaler for acute asthma
symptoms?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Tiotropium
Answer: C
