Week 3 Quiz: NURS120 / NURS 120
ACTUAL EXAM 2026/2027 | Introduction to
Medical Surgical Nursing | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Respiratory Disorders (Questions 1-35)
Q1: A nurse assesses a patient with COPD who has a barrel chest and uses accessory muscles to breathe.
Which finding would the nurse expect to see on assessment?
A. Increased breath sounds throughout all lung fields
B. Prolonged expiratory phase with wheezes
C. Egophony in the lower lobes
D. Diminished breath sounds with no adventitious sounds
Correct Answer: B [CORRECT]
Rationale: In COPD, airflow obstruction during exhalation creates a prolonged expiratory phase, often
accompanied by wheezes due to narrowed airways.
Q2: A patient with emphysema asks the nurse why they are not getting enough oxygen despite
breathing rapidly. What is the nurse's best response regarding the pathophysiology of emphysema?
A. "Your lungs are producing too much mucus, which blocks the oxygen."
B. "The air sacs in your lungs are destroyed, reducing the surface area for gas exchange."
C. "Your airways are spasming, preventing air from reaching the lungs."
D. "You have fluid in your alveoli that is displacing the oxygen."
Correct Answer: B [CORRECT]
,Rationale: Emphysema is characterized by the permanent destruction of alveolar walls, leading to a
decreased surface area for oxygen and carbon dioxide exchange.
Q3: Which clinical manifestation is most characteristic of chronic bronchitis compared to emphysema?
A. Pink, "barrel-chested" appearance
B. Severe weight loss and muscle wasting
C. Chronic productive cough for at least three consecutive months in two consecutive years
D. Dyspnea that occurs primarily during exertion
Correct Answer: C [CORRECT]
Rationale: Chronic bronchitis is defined by a chronic productive cough lasting for at least three months
in two consecutive years, caused by excessive mucus production in the bronchial tree.
Q4: A nurse is caring for a patient with severe COPD. The provider has ordered oxygen at 4 L/min via
nasal cannula. What is the nurse's priority action?
A. Apply the oxygen as ordered and monitor the patient's respiratory rate.
B. Decrease the oxygen flow rate to 1 to 2 L/min to prevent suppressing the hypoxic drive.
C. Request an order for a simple mask to deliver a more precise FiO2.
D. Hold the oxygen and encourage the patient to cough and deep breathe.
Correct Answer: B [CORRECT]
Rationale: Patients with severe COPD often rely on a hypoxic drive to breathe; administering high
concentrations of oxygen can eliminate this stimulus, leading to respiratory failure.
Q5: The nurse is teaching a patient with COPD about pursed-lip breathing. What is the primary
therapeutic effect of this technique?
A. It increases the intake of oxygen during inhalation.
B. It helps keep the small airways open longer during exhalation to facilitate CO2 removal.
C. It prevents the development of a barrel chest.
,D. It stimulates the vagus nerve to reduce bronchospasms.
Correct Answer: B [CORRECT]
Rationale: Pursed-lip breathing creates positive end-expiratory pressure (PEEP) that prevents the
collapse of small airways during exhalation, promoting the expulsion of trapped carbon dioxide.
Q6: A patient with asthma is exposed to dust and begins experiencing acute dyspnea and wheezing.
Which type of medication should the nurse administer first?
A. An inhaled corticosteroid
B. A short-acting beta-agonist (SABA)
C. A leukotriene modifier
D. A long-acting muscarinic antagonist (LAMA)
Correct Answer: B [CORRECT]
Rationale: Short-acting beta-agonists (SABAs) like albuterol are rescue medications that rapidly
bronchodilate the airways during an acute asthma exacerbation.
Q7: The nurse is providing discharge teaching to a patient newly diagnosed with asthma. Which
statement by the patient indicates an understanding of controller medications?
A. "I will take my inhaled corticosteroid every day to prevent inflammation, even when I feel fine."
B. "I will use my corticosteroid inhaler only when I start to feel wheezy."
C. "I will substitute my rescue inhaler with my controller inhaler if I run out of the rescue one."
D. "Controller medications work immediately to open up my airways."
Correct Answer: A [CORRECT]
Rationale: Controller medications, such as inhaled corticosteroids, must be taken daily to reduce airway
inflammation and prevent exacerbations, regardless of symptom presence.
Q8: A patient uses a peak flow meter at home and records a reading in the yellow zone (50% to 79% of
personal best). What action should the nurse teach the patient to take?
A. Go to the emergency department immediately.
, B. Take a dose of the quick-relief medication and recheck peak flow after 15 to 20 minutes.
C. Stop all medications and rest.
D. Take the controller medication twice instead of once.
Correct Answer: B [CORRECT]
Rationale: The yellow zone indicates caution; the standard action is to administer a quick-relief (rescue)
bronchodilator and reassess peak flow after a short waiting period.
Q9: A patient in status asthmaticus is unresponsive to initial bronchodilator therapy. Which assessment
finding indicates an impending need for intubation?
A. Heart rate of 110 beats per minute
B. PaCO2 of 48 mm Hg
C. Presence of diffuse expiratory wheezes
D. Oxygen saturation of 92% on room air
Correct Answer: B [CORRECT]
Rationale: In an acute asthma attack, the patient typically hyperventilates and has a low PaCO2; a rising
or normal PaCO2 (like 48 mm Hg) indicates severe fatigue and impending respiratory failure requiring
intubation.
Q10: A patient is admitted with community-acquired pneumonia. Which assessment finding is most
consistent with this diagnosis?
A. Dry, nonproductive cough and diffuse rhonchi
B. Productive cough with yellow-green sputum and localized crackles
C. Sharp, pleuritic chest pain that worsens on inspiration and bilateral wheezing
D. Hemoptysis and stridor
Correct Answer: B [CORRECT]
Rationale: Bacterial pneumonia typically presents with a productive cough yielding purulent (yellow-
green) sputum and localized crackles over the affected lung segment due to alveolar fluid.
ACTUAL EXAM 2026/2027 | Introduction to
Medical Surgical Nursing | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1: Respiratory Disorders (Questions 1-35)
Q1: A nurse assesses a patient with COPD who has a barrel chest and uses accessory muscles to breathe.
Which finding would the nurse expect to see on assessment?
A. Increased breath sounds throughout all lung fields
B. Prolonged expiratory phase with wheezes
C. Egophony in the lower lobes
D. Diminished breath sounds with no adventitious sounds
Correct Answer: B [CORRECT]
Rationale: In COPD, airflow obstruction during exhalation creates a prolonged expiratory phase, often
accompanied by wheezes due to narrowed airways.
Q2: A patient with emphysema asks the nurse why they are not getting enough oxygen despite
breathing rapidly. What is the nurse's best response regarding the pathophysiology of emphysema?
A. "Your lungs are producing too much mucus, which blocks the oxygen."
B. "The air sacs in your lungs are destroyed, reducing the surface area for gas exchange."
C. "Your airways are spasming, preventing air from reaching the lungs."
D. "You have fluid in your alveoli that is displacing the oxygen."
Correct Answer: B [CORRECT]
,Rationale: Emphysema is characterized by the permanent destruction of alveolar walls, leading to a
decreased surface area for oxygen and carbon dioxide exchange.
Q3: Which clinical manifestation is most characteristic of chronic bronchitis compared to emphysema?
A. Pink, "barrel-chested" appearance
B. Severe weight loss and muscle wasting
C. Chronic productive cough for at least three consecutive months in two consecutive years
D. Dyspnea that occurs primarily during exertion
Correct Answer: C [CORRECT]
Rationale: Chronic bronchitis is defined by a chronic productive cough lasting for at least three months
in two consecutive years, caused by excessive mucus production in the bronchial tree.
Q4: A nurse is caring for a patient with severe COPD. The provider has ordered oxygen at 4 L/min via
nasal cannula. What is the nurse's priority action?
A. Apply the oxygen as ordered and monitor the patient's respiratory rate.
B. Decrease the oxygen flow rate to 1 to 2 L/min to prevent suppressing the hypoxic drive.
C. Request an order for a simple mask to deliver a more precise FiO2.
D. Hold the oxygen and encourage the patient to cough and deep breathe.
Correct Answer: B [CORRECT]
Rationale: Patients with severe COPD often rely on a hypoxic drive to breathe; administering high
concentrations of oxygen can eliminate this stimulus, leading to respiratory failure.
Q5: The nurse is teaching a patient with COPD about pursed-lip breathing. What is the primary
therapeutic effect of this technique?
A. It increases the intake of oxygen during inhalation.
B. It helps keep the small airways open longer during exhalation to facilitate CO2 removal.
C. It prevents the development of a barrel chest.
,D. It stimulates the vagus nerve to reduce bronchospasms.
Correct Answer: B [CORRECT]
Rationale: Pursed-lip breathing creates positive end-expiratory pressure (PEEP) that prevents the
collapse of small airways during exhalation, promoting the expulsion of trapped carbon dioxide.
Q6: A patient with asthma is exposed to dust and begins experiencing acute dyspnea and wheezing.
Which type of medication should the nurse administer first?
A. An inhaled corticosteroid
B. A short-acting beta-agonist (SABA)
C. A leukotriene modifier
D. A long-acting muscarinic antagonist (LAMA)
Correct Answer: B [CORRECT]
Rationale: Short-acting beta-agonists (SABAs) like albuterol are rescue medications that rapidly
bronchodilate the airways during an acute asthma exacerbation.
Q7: The nurse is providing discharge teaching to a patient newly diagnosed with asthma. Which
statement by the patient indicates an understanding of controller medications?
A. "I will take my inhaled corticosteroid every day to prevent inflammation, even when I feel fine."
B. "I will use my corticosteroid inhaler only when I start to feel wheezy."
C. "I will substitute my rescue inhaler with my controller inhaler if I run out of the rescue one."
D. "Controller medications work immediately to open up my airways."
Correct Answer: A [CORRECT]
Rationale: Controller medications, such as inhaled corticosteroids, must be taken daily to reduce airway
inflammation and prevent exacerbations, regardless of symptom presence.
Q8: A patient uses a peak flow meter at home and records a reading in the yellow zone (50% to 79% of
personal best). What action should the nurse teach the patient to take?
A. Go to the emergency department immediately.
, B. Take a dose of the quick-relief medication and recheck peak flow after 15 to 20 minutes.
C. Stop all medications and rest.
D. Take the controller medication twice instead of once.
Correct Answer: B [CORRECT]
Rationale: The yellow zone indicates caution; the standard action is to administer a quick-relief (rescue)
bronchodilator and reassess peak flow after a short waiting period.
Q9: A patient in status asthmaticus is unresponsive to initial bronchodilator therapy. Which assessment
finding indicates an impending need for intubation?
A. Heart rate of 110 beats per minute
B. PaCO2 of 48 mm Hg
C. Presence of diffuse expiratory wheezes
D. Oxygen saturation of 92% on room air
Correct Answer: B [CORRECT]
Rationale: In an acute asthma attack, the patient typically hyperventilates and has a low PaCO2; a rising
or normal PaCO2 (like 48 mm Hg) indicates severe fatigue and impending respiratory failure requiring
intubation.
Q10: A patient is admitted with community-acquired pneumonia. Which assessment finding is most
consistent with this diagnosis?
A. Dry, nonproductive cough and diffuse rhonchi
B. Productive cough with yellow-green sputum and localized crackles
C. Sharp, pleuritic chest pain that worsens on inspiration and bilateral wheezing
D. Hemoptysis and stridor
Correct Answer: B [CORRECT]
Rationale: Bacterial pneumonia typically presents with a productive cough yielding purulent (yellow-
green) sputum and localized crackles over the affected lung segment due to alveolar fluid.
