NURS 120 | Respiratory Disorders & Oxygenation | High Difficulty
Quiz 2026 |WCU
1. A client is admitted with an acute exacerbation of COPD. The arterial blood
gas (ABG) results show: pH 7.31, PaCO2 58 mmHg, PaO2 55 mmHg, and HCO3 28
mEq/L. How should the nurse interpret these findings?
A. Compensated metabolic acidosis
B. Fully compensated respiratory acidosis
C. Uncompensated respiratory alkalosis
D. Partially compensated respiratory acidosis
Answer: D
Rationale: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45), indicating
a respiratory cause. The HCO3 is slightly elevated (> 26), suggesting the kidneys have
started to compensate, but since the pH is not yet in the normal range, it is partially
compensated.
2. The nurse is caring for a client who underwent a thoracentesis 2 hours ago.
Which assessment finding requires immediate notification of the healthcare
provider?
A. Diminished breath sounds on the affected side
B. Small amount of serosanguinous drainage on the dressing
C. Patient reporting mild pain at the puncture site
D. Asymmetrical chest wall expansion
Answer: D
Rationale: Asymmetrical chest expansion, along with sudden dyspnea or tachypnea, can
indicate a pneumothorax, which is a significant complication of thoracentesis.
,3. A nurse is teaching a client with chronic obstructive pulmonary disease
(COPD) about the purpose of pursed-lip breathing. Which statement by the
nurse is most accurate?
A. It helps to strengthen the intercostal muscles.
B. It increases the respiratory rate to improve oxygenation.
C. It promotes the use of accessory muscles for inspiration.
D. It prevents airway collapse by maintaining positive airway pressure.
Answer: D
Rationale: Pursed-lip breathing creates back-pressure in the airways, keeping them open
longer during exhalation and allowing for more CO2 to be expelled.
4. A client with a pulmonary embolism is receiving a continuous heparin
infusion. The nurse notes the client’s aPTT is 95 seconds (control is 25 seconds).
What is the nurse’s priority action?
A. Increase the infusion rate as per hospital protocol.
B. Stop the infusion and prepare to administer protamine sulfate.
C. Continue the infusion and recheck the aPTT in 4 hours.
D. Stop the infusion and notify the healthcare provider.
Answer: D
Rationale: A therapeutic aPTT is typically 1.5 to 2.5 times the control (37.5 to 62.5
seconds). An aPTT of 95 is too high (critically high), so the infusion must be stopped to
prevent hemorrhage and the provider notified.
, 5. Which oxygen delivery device should the nurse use for a client who requires a
precise concentration of oxygen, such as 24% or 28%?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C
Rationale: The Venturi mask is the most accurate device for delivering a specific, fixed
concentration of oxygen, which is crucial for patients with chronic lung disease.
6. A nurse is assessing a client with a chest tube connected to a water-seal
drainage system. The nurse observes constant bubbling in the water-seal
chamber. What does this finding indicate?
A. There is an air leak in the system or at the insertion site.
B. The system is functioning normally for a pneumothorax.
C. The suction pressure is set too high.
D. The lung has fully re-expanded.
Answer: A
Rationale: Intermittent bubbling is expected in a pneumothorax, but constant bubbling in
the water-seal chamber indicates a leak in the closed system.
7. A client is diagnosed with active Tuberculosis (TB). Which type of isolation
precautions must the nurse implement?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions
D. Standard precautions only
Answer: A
Quiz 2026 |WCU
1. A client is admitted with an acute exacerbation of COPD. The arterial blood
gas (ABG) results show: pH 7.31, PaCO2 58 mmHg, PaO2 55 mmHg, and HCO3 28
mEq/L. How should the nurse interpret these findings?
A. Compensated metabolic acidosis
B. Fully compensated respiratory acidosis
C. Uncompensated respiratory alkalosis
D. Partially compensated respiratory acidosis
Answer: D
Rationale: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45), indicating
a respiratory cause. The HCO3 is slightly elevated (> 26), suggesting the kidneys have
started to compensate, but since the pH is not yet in the normal range, it is partially
compensated.
2. The nurse is caring for a client who underwent a thoracentesis 2 hours ago.
Which assessment finding requires immediate notification of the healthcare
provider?
A. Diminished breath sounds on the affected side
B. Small amount of serosanguinous drainage on the dressing
C. Patient reporting mild pain at the puncture site
D. Asymmetrical chest wall expansion
Answer: D
Rationale: Asymmetrical chest expansion, along with sudden dyspnea or tachypnea, can
indicate a pneumothorax, which is a significant complication of thoracentesis.
,3. A nurse is teaching a client with chronic obstructive pulmonary disease
(COPD) about the purpose of pursed-lip breathing. Which statement by the
nurse is most accurate?
A. It helps to strengthen the intercostal muscles.
B. It increases the respiratory rate to improve oxygenation.
C. It promotes the use of accessory muscles for inspiration.
D. It prevents airway collapse by maintaining positive airway pressure.
Answer: D
Rationale: Pursed-lip breathing creates back-pressure in the airways, keeping them open
longer during exhalation and allowing for more CO2 to be expelled.
4. A client with a pulmonary embolism is receiving a continuous heparin
infusion. The nurse notes the client’s aPTT is 95 seconds (control is 25 seconds).
What is the nurse’s priority action?
A. Increase the infusion rate as per hospital protocol.
B. Stop the infusion and prepare to administer protamine sulfate.
C. Continue the infusion and recheck the aPTT in 4 hours.
D. Stop the infusion and notify the healthcare provider.
Answer: D
Rationale: A therapeutic aPTT is typically 1.5 to 2.5 times the control (37.5 to 62.5
seconds). An aPTT of 95 is too high (critically high), so the infusion must be stopped to
prevent hemorrhage and the provider notified.
, 5. Which oxygen delivery device should the nurse use for a client who requires a
precise concentration of oxygen, such as 24% or 28%?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C
Rationale: The Venturi mask is the most accurate device for delivering a specific, fixed
concentration of oxygen, which is crucial for patients with chronic lung disease.
6. A nurse is assessing a client with a chest tube connected to a water-seal
drainage system. The nurse observes constant bubbling in the water-seal
chamber. What does this finding indicate?
A. There is an air leak in the system or at the insertion site.
B. The system is functioning normally for a pneumothorax.
C. The suction pressure is set too high.
D. The lung has fully re-expanded.
Answer: A
Rationale: Intermittent bubbling is expected in a pneumothorax, but constant bubbling in
the water-seal chamber indicates a leak in the closed system.
7. A client is diagnosed with active Tuberculosis (TB). Which type of isolation
precautions must the nurse implement?
A. Airborne precautions
B. Contact precautions
C. Droplet precautions
D. Standard precautions only
Answer: A
