MEDICAL SURGICAL NURSING RESPIRATORY
DISORDERS PRACTICE EXAM STUDY GUIDE
UPDATED 2026/2027 | VERIFIED QUESTIONS AND
ANSWERS | NCLEX RN EXAM PREP |
COMPREHENSIVE REVIEW
MEDICAL SURGICAL NURSING: RESPIRATORY DISORDERS
PRACTICE EXAM STUDY GUIDE — UPDATED 2026/2027
VERIFIED QUESTIONS & ANSWERS | NCLEX RN EXAM PREP | COMPREHENSIVE
REVIEW
• This study guide features 200 verified, NCLEX-style multiple choice questions
with bolded correct answers and detailed EXPERT RATIONALE — designed to
reinforce clinical reasoning and help you master every core respiratory
disorder tested on the exam.
• Work through each question independently before reading the answer; use
the EXPERT RATIONALE to understand the "why" behind each correct choice,
revisit any topic where you miss two or more questions in a row.
SECTION 1: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
1. A nurse is caring for a patient with COPD who is receiving oxygen therapy.
Which oxygen delivery method is most appropriate to prevent oxygen-
induced hypercapnia?
A. Non-rebreather mask at 10–15 L/min
B. Simple face mask at 6–10 L/min
,C. Nasal cannula at 5–6 L/min
D. Venturi mask at 24–28%
E. Bag-valve mask at 15 L/min
✓ Correct Answer: D. Venturi mask at 24–28%
EXPERT RATIONALE: Patients with COPD rely on hypoxic drive to breathe. The
Venturi mask delivers a precise, controlled FiO₂, making it the safest option to
prevent both hypoxia and oxygen-induced hypercapnia (CO₂ retention).
2. A patient with COPD is using pursed-lip breathing. The nurse understands
this technique helps the patient by:
A. Increasing respiratory rate to expel CO₂ faster
B. Preventing alveolar collapse and reducing air trapping
C. Delivering more oxygen to the lower lobes
D. Stimulating the cough reflex for secretion clearance
E. Decreasing the work of the diaphragm
✓ Correct Answer: B. Preventing alveolar collapse and reducing air trapping
EXPERT RATIONALE: Pursed-lip breathing creates positive back pressure that
keeps airways open during exhalation, reduces air trapping, slows the respiratory
rate, and improves gas exchange in COPD patients.
,3. Which of the following arterial blood gas (ABG) results is most consistent
with a patient experiencing an acute exacerbation of COPD?
A. pH 7.50, PaCO₂ 30, HCO₃ 22
B. pH 7.38, PaCO₂ 40, HCO₃ 24
C. pH 7.30, PaCO₂ 58, HCO₃ 28
D. pH 7.46, PaCO₂ 38, HCO₃ 30
E. pH 7.52, PaCO₂ 42, HCO₃ 34
✓ Correct Answer: C. pH 7.30, PaCO₂ 58, HCO₃ 28
EXPERT RATIONALE: This ABG reflects respiratory acidosis with partial metabolic
compensation (elevated HCO₃). In acute COPD exacerbation, CO₂ is retained due to
impaired ventilation, causing the pH to drop and the PaCO₂ to rise.
4. A patient with emphysema is described as a "pink puffer." Which clinical
finding best supports this description?
A. Cyanosis, clubbing, and peripheral edema
B. Barrel chest, prolonged expiration, and thin build
C. Productive cough, crackles, and polycythemia
, D. Right-sided heart failure and jugular vein distension
E. Low PaO₂ with normal PaCO₂ and ruddy complexion
✓ Correct Answer: B. Barrel chest, prolonged expiration, and thin build
EXPERT RATIONALE: "Pink puffers" are typically thin emphysema patients who
maintain near-normal oxygenation through increased respiratory effort. They
exhibit a barrel chest (due to hyperinflation), prolonged expiration from air
trapping, and use of accessory muscles.
5. The nurse is teaching a patient with COPD about the proper sequence of
using a bronchodilator inhaler followed by a corticosteroid inhaler. Which
instruction is correct?
A. Use the corticosteroid first, wait 5 minutes, then use the bronchodilator
B. Use both inhalers simultaneously for maximum effect
C. Use the bronchodilator first, wait 5 minutes, then use the corticosteroid
D. Alternate inhalers on odd and even days of the week
E. Use the corticosteroid only during acute exacerbations
✓ Correct Answer: C. Use the bronchodilator first, wait 5 minutes, then use
the corticosteroid
EXPERT RATIONALE: The bronchodilator opens the airways first, allowing the
corticosteroid to penetrate deeper into the airways for maximum anti-
inflammatory effect when used afterward.
DISORDERS PRACTICE EXAM STUDY GUIDE
UPDATED 2026/2027 | VERIFIED QUESTIONS AND
ANSWERS | NCLEX RN EXAM PREP |
COMPREHENSIVE REVIEW
MEDICAL SURGICAL NURSING: RESPIRATORY DISORDERS
PRACTICE EXAM STUDY GUIDE — UPDATED 2026/2027
VERIFIED QUESTIONS & ANSWERS | NCLEX RN EXAM PREP | COMPREHENSIVE
REVIEW
• This study guide features 200 verified, NCLEX-style multiple choice questions
with bolded correct answers and detailed EXPERT RATIONALE — designed to
reinforce clinical reasoning and help you master every core respiratory
disorder tested on the exam.
• Work through each question independently before reading the answer; use
the EXPERT RATIONALE to understand the "why" behind each correct choice,
revisit any topic where you miss two or more questions in a row.
SECTION 1: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
1. A nurse is caring for a patient with COPD who is receiving oxygen therapy.
Which oxygen delivery method is most appropriate to prevent oxygen-
induced hypercapnia?
A. Non-rebreather mask at 10–15 L/min
B. Simple face mask at 6–10 L/min
,C. Nasal cannula at 5–6 L/min
D. Venturi mask at 24–28%
E. Bag-valve mask at 15 L/min
✓ Correct Answer: D. Venturi mask at 24–28%
EXPERT RATIONALE: Patients with COPD rely on hypoxic drive to breathe. The
Venturi mask delivers a precise, controlled FiO₂, making it the safest option to
prevent both hypoxia and oxygen-induced hypercapnia (CO₂ retention).
2. A patient with COPD is using pursed-lip breathing. The nurse understands
this technique helps the patient by:
A. Increasing respiratory rate to expel CO₂ faster
B. Preventing alveolar collapse and reducing air trapping
C. Delivering more oxygen to the lower lobes
D. Stimulating the cough reflex for secretion clearance
E. Decreasing the work of the diaphragm
✓ Correct Answer: B. Preventing alveolar collapse and reducing air trapping
EXPERT RATIONALE: Pursed-lip breathing creates positive back pressure that
keeps airways open during exhalation, reduces air trapping, slows the respiratory
rate, and improves gas exchange in COPD patients.
,3. Which of the following arterial blood gas (ABG) results is most consistent
with a patient experiencing an acute exacerbation of COPD?
A. pH 7.50, PaCO₂ 30, HCO₃ 22
B. pH 7.38, PaCO₂ 40, HCO₃ 24
C. pH 7.30, PaCO₂ 58, HCO₃ 28
D. pH 7.46, PaCO₂ 38, HCO₃ 30
E. pH 7.52, PaCO₂ 42, HCO₃ 34
✓ Correct Answer: C. pH 7.30, PaCO₂ 58, HCO₃ 28
EXPERT RATIONALE: This ABG reflects respiratory acidosis with partial metabolic
compensation (elevated HCO₃). In acute COPD exacerbation, CO₂ is retained due to
impaired ventilation, causing the pH to drop and the PaCO₂ to rise.
4. A patient with emphysema is described as a "pink puffer." Which clinical
finding best supports this description?
A. Cyanosis, clubbing, and peripheral edema
B. Barrel chest, prolonged expiration, and thin build
C. Productive cough, crackles, and polycythemia
, D. Right-sided heart failure and jugular vein distension
E. Low PaO₂ with normal PaCO₂ and ruddy complexion
✓ Correct Answer: B. Barrel chest, prolonged expiration, and thin build
EXPERT RATIONALE: "Pink puffers" are typically thin emphysema patients who
maintain near-normal oxygenation through increased respiratory effort. They
exhibit a barrel chest (due to hyperinflation), prolonged expiration from air
trapping, and use of accessory muscles.
5. The nurse is teaching a patient with COPD about the proper sequence of
using a bronchodilator inhaler followed by a corticosteroid inhaler. Which
instruction is correct?
A. Use the corticosteroid first, wait 5 minutes, then use the bronchodilator
B. Use both inhalers simultaneously for maximum effect
C. Use the bronchodilator first, wait 5 minutes, then use the corticosteroid
D. Alternate inhalers on odd and even days of the week
E. Use the corticosteroid only during acute exacerbations
✓ Correct Answer: C. Use the bronchodilator first, wait 5 minutes, then use
the corticosteroid
EXPERT RATIONALE: The bronchodilator opens the airways first, allowing the
corticosteroid to penetrate deeper into the airways for maximum anti-
inflammatory effect when used afterward.
