HCR 240 Final Actual Exam Questions
And Answers Practice Questions with
Solutions Newest | Already Graded A+
Topics: Respiratory system, oxygenation, acid-base balance, cardiovascular, renal,
neurological, endocrine, infectious diseases, immunology, and pathophysiology of
common disorders.
Section 1: Oxygenation & Gas Exchange (20 Questions)
1. A patient asks why they need to wear oxygen in the hospital and how it works
with blood cells. Which is the best response?
• Blood cells passing through the arteries in the lungs are oxygenated and
then carry oxygen to the body
Rationale: Oxygen diffuses from alveoli into pulmonary capillaries, binding
to hemoglobin.
2. How does severe hypoxia develop with pneumonia?
• Oxygen diffusion is impaired by the congestion
Rationale: Inflammatory exudate fills alveoli, thickening the diffusion
barrier.
3. The nurse is discussing pulse oximetry with a student. What measurement is
acceptable for a healthy adult?
• 97-100%
*Rationale: Normal SpO2 is 95-100%; below 90% is hypoxemia.*
4. What causes the expanded anteroposterior (A-P) thoracic diameter (barrel chest)
in patients with emphysema?
• Air trapping and hyperinflation
Rationale: Loss of elastic recoil leads to overinflation of alveoli.
,5. What is an early sign of lung cancer?
• Chronic cough
Rationale: Persistent cough is often the first symptom; weight loss and bone
pain are late.
6. Which of the following describes lobar pneumonia?
• Sudden onset fever and chills with crackles and rusty sputum
Rationale: Classic presentation of pneumococcal pneumonia affecting an
entire lobe.
7. One of the functions of the pulmonary system is the:
• Exchange of gases between the environment and blood
Rationale: Primary function: oxygenation and carbon dioxide removal.
8. A patient with COPD has a PaO2 of 55 mmHg and PaCO2 of 65 mmHg. Which
acid-base disturbance is expected?
• Respiratory acidosis
Rationale: Hypercapnia (high CO2) leads to decreased pH.
9. The oxyhemoglobin dissociation curve shifts to the right under which condition?
• Increased temperature, increased CO2, decreased pH (acidosis)
*Rationale: Right shift = increased O2 release to tissues.*
10. A patient with chronic hypoxemia has polycythemia. The mechanism is:
• Increased erythropoietin production due to low renal oxygen
Rationale: Compensatory response to increase oxygen-carrying capacity.
11. Which finding is characteristic of a tension pneumothorax?
• Tracheal deviation away from the affected side
Rationale: Air trapping increases pressure, shifting mediastinum.
12. A patient with pulmonary embolism most likely presents with:
• Sudden dyspnea, pleuritic chest pain, and tachycardia
Rationale: Classic triad; may also have hemoptysis.
13. The most common cause of community-acquired pneumonia is:
, • Streptococcus pneumoniae
*Rationale: Accounts for 30-50% of cases.*
14. A patient with severe asthma has an SpO2 of 85% and no wheezing on
auscultation. This indicates:
• Severe airway obstruction (“silent chest”) – impending respiratory
failure
Rationale: Lack of wheezing indicates minimal air movement.
15. A nurse assesses a patient with pulmonary edema. Which finding is expected?
• Pink, frothy sputum and crackles in lung bases
Rationale: Left heart failure causes fluid transudation into alveoli.
16. The primary stimulus to breathe in a healthy person is:
• Increased PaCO2 (via central chemoreceptors)
Rationale: CO2 levels regulate ventilation; hypoxia is secondary.
17. A patient with COPD and chronic hypercapnia relies on what stimulus to
breathe?
• Hypoxemia (low PaO2)
Rationale: CO2 drive is blunted; low oxygen becomes the driver.
18. A pleural effusion is best assessed by:
• Dullness to percussion and decreased breath sounds
Rationale: Fluid replaces air, causing flatness/dullness.
19. Which chest x-ray finding is classic for a large pleural effusion?
• Homogeneous opacification with meniscus sign
Rationale: Fluid levels with upward concavity.
20. A patient with pulmonary fibrosis has a decreased:
• Diffusing capacity of the lung for carbon monoxide (DLCO)
Rationale: Thickened alveolar-capillary membrane impairs gas exchange.
Section 2: Acid-Base & Electrolyte Disorders (15 Questions)
And Answers Practice Questions with
Solutions Newest | Already Graded A+
Topics: Respiratory system, oxygenation, acid-base balance, cardiovascular, renal,
neurological, endocrine, infectious diseases, immunology, and pathophysiology of
common disorders.
Section 1: Oxygenation & Gas Exchange (20 Questions)
1. A patient asks why they need to wear oxygen in the hospital and how it works
with blood cells. Which is the best response?
• Blood cells passing through the arteries in the lungs are oxygenated and
then carry oxygen to the body
Rationale: Oxygen diffuses from alveoli into pulmonary capillaries, binding
to hemoglobin.
2. How does severe hypoxia develop with pneumonia?
• Oxygen diffusion is impaired by the congestion
Rationale: Inflammatory exudate fills alveoli, thickening the diffusion
barrier.
3. The nurse is discussing pulse oximetry with a student. What measurement is
acceptable for a healthy adult?
• 97-100%
*Rationale: Normal SpO2 is 95-100%; below 90% is hypoxemia.*
4. What causes the expanded anteroposterior (A-P) thoracic diameter (barrel chest)
in patients with emphysema?
• Air trapping and hyperinflation
Rationale: Loss of elastic recoil leads to overinflation of alveoli.
,5. What is an early sign of lung cancer?
• Chronic cough
Rationale: Persistent cough is often the first symptom; weight loss and bone
pain are late.
6. Which of the following describes lobar pneumonia?
• Sudden onset fever and chills with crackles and rusty sputum
Rationale: Classic presentation of pneumococcal pneumonia affecting an
entire lobe.
7. One of the functions of the pulmonary system is the:
• Exchange of gases between the environment and blood
Rationale: Primary function: oxygenation and carbon dioxide removal.
8. A patient with COPD has a PaO2 of 55 mmHg and PaCO2 of 65 mmHg. Which
acid-base disturbance is expected?
• Respiratory acidosis
Rationale: Hypercapnia (high CO2) leads to decreased pH.
9. The oxyhemoglobin dissociation curve shifts to the right under which condition?
• Increased temperature, increased CO2, decreased pH (acidosis)
*Rationale: Right shift = increased O2 release to tissues.*
10. A patient with chronic hypoxemia has polycythemia. The mechanism is:
• Increased erythropoietin production due to low renal oxygen
Rationale: Compensatory response to increase oxygen-carrying capacity.
11. Which finding is characteristic of a tension pneumothorax?
• Tracheal deviation away from the affected side
Rationale: Air trapping increases pressure, shifting mediastinum.
12. A patient with pulmonary embolism most likely presents with:
• Sudden dyspnea, pleuritic chest pain, and tachycardia
Rationale: Classic triad; may also have hemoptysis.
13. The most common cause of community-acquired pneumonia is:
, • Streptococcus pneumoniae
*Rationale: Accounts for 30-50% of cases.*
14. A patient with severe asthma has an SpO2 of 85% and no wheezing on
auscultation. This indicates:
• Severe airway obstruction (“silent chest”) – impending respiratory
failure
Rationale: Lack of wheezing indicates minimal air movement.
15. A nurse assesses a patient with pulmonary edema. Which finding is expected?
• Pink, frothy sputum and crackles in lung bases
Rationale: Left heart failure causes fluid transudation into alveoli.
16. The primary stimulus to breathe in a healthy person is:
• Increased PaCO2 (via central chemoreceptors)
Rationale: CO2 levels regulate ventilation; hypoxia is secondary.
17. A patient with COPD and chronic hypercapnia relies on what stimulus to
breathe?
• Hypoxemia (low PaO2)
Rationale: CO2 drive is blunted; low oxygen becomes the driver.
18. A pleural effusion is best assessed by:
• Dullness to percussion and decreased breath sounds
Rationale: Fluid replaces air, causing flatness/dullness.
19. Which chest x-ray finding is classic for a large pleural effusion?
• Homogeneous opacification with meniscus sign
Rationale: Fluid levels with upward concavity.
20. A patient with pulmonary fibrosis has a decreased:
• Diffusing capacity of the lung for carbon monoxide (DLCO)
Rationale: Thickened alveolar-capillary membrane impairs gas exchange.
Section 2: Acid-Base & Electrolyte Disorders (15 Questions)
