NR 283 Exam 2: (Latest 2026/2027 Update) Respiratory Disorders, Cardiac
Conditions, Hematology, Oncology | Q&A | Grade A | 100% Correct (Verified
Answers)
COMPREHENSIVE PATHOPHYSIOLOGY REVIEW
SUBJECT SOURCE FORMAT
Pathophysiology / Respiratory / NR 283 Exam 2 2026/2027 Q&A Guide with Clinical Rationale
Cardiac / Hematology / Oncology
Q1
In a burn injury, the Rule of Nines is used to estimate:
CORRECT ANSWER Total body surface area burned
CLINICAL RATIONALE
● The Rule of Nines assigns percentage values to body regions (head 9%, each arm 9%, each leg 18%, anterior trunk
18%, posterior trunk 18%, perineum 1%).
● Used to guide fluid resuscitation in burn patients (Parkland formula).
● Modified for pediatric patients due to proportionally larger head size.
Q2
The nurse is aware that hypercapnia can lead to which of the following?
CORRECT ANSWER Respiratory acidosis
CLINICAL RATIONALE
● Hypercapnia is elevated CO2 (>45 mmHg).
● CO2 is an acid; increased CO2 causes pH to drop (acidosis).
● Causes: hypoventilation (COPD, narcotic overdose, chest injury, neuromuscular disorders).
Q3
A patient's arterial blood gas reveals decreased carbon dioxide levels. What is the most likely cause of
this situation?
CORRECT ANSWER Hyperventilation
CLINICAL RATIONALE
● Hyperventilation decreases CO2 (respiratory alkalosis).
● Causes: anxiety/panic attack, pain, hypoxia, pulmonary embolism, mechanical overventilation.
● Symptoms: lightheadedness, perioral numbness, tingling of extremities.
, Q4
What lab value would the nurse expect in a patient who has sustained trauma to the lungs and chest wall
and is experiencing respiratory failure?
CORRECT ANSWER Elevated PaCO2
CLINICAL RATIONALE
● Respiratory failure is inability to maintain adequate gas exchange.
● Type II respiratory failure (hypercapnic): PaCO2 >45 with pH <7.35.
● Chest wall trauma (flail chest, rib fractures) impairs ventilation → CO2 retention.
Q5
A 10-year-old develops pneumonia. Physical exam reveals subcostal and intercostal contractions. The
child reports that breathing is difficult with feeling that "I cannot get enough air." What term should the
nurse use to document this condition?
CORRECT ANSWER Dyspnea
CLINICAL RATIONALE
● Dyspnea is subjective sensation of difficulty breathing (patient's perception).
● Retractions (subcostal, intercostal, suprasternal) indicate increased work of breathing.
● Pneumonia causes inflammation, consolidation, and decreased lung compliance.
Q6
A 50 year old presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that
the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these
assessment findings, what does the nurse suspect the patient is experiencing?
CORRECT ANSWER Tension Pneumothorax
CLINICAL RATIONALE
● Tension pneumothorax is life-threatening (air trapped in pleural space, shifting mediastinum).
● Hallmarks: tracheal deviation away from affected side, hypotension, distended neck veins.
● Immediate treatment: needle decompression (second intercostal space, midclavicular line).
Q7
A nurse is caring for a client who has emphysema. Which of the following findings should the nurse
expect to assess in this client?
CORRECT ANSWER Dyspnea, Barrel chest, and Hypocapnia (low CO2)
CLINICAL RATIONALE
● Emphysema causes air trapping → barrel chest (increased AP diameter).
● Early/mild emphysema causes hypocapnia due to hyperventilation (low CO2).
● Late/advanced emphysema may cause hypercapnia due to fatigue and hypoventilation.
Conditions, Hematology, Oncology | Q&A | Grade A | 100% Correct (Verified
Answers)
COMPREHENSIVE PATHOPHYSIOLOGY REVIEW
SUBJECT SOURCE FORMAT
Pathophysiology / Respiratory / NR 283 Exam 2 2026/2027 Q&A Guide with Clinical Rationale
Cardiac / Hematology / Oncology
Q1
In a burn injury, the Rule of Nines is used to estimate:
CORRECT ANSWER Total body surface area burned
CLINICAL RATIONALE
● The Rule of Nines assigns percentage values to body regions (head 9%, each arm 9%, each leg 18%, anterior trunk
18%, posterior trunk 18%, perineum 1%).
● Used to guide fluid resuscitation in burn patients (Parkland formula).
● Modified for pediatric patients due to proportionally larger head size.
Q2
The nurse is aware that hypercapnia can lead to which of the following?
CORRECT ANSWER Respiratory acidosis
CLINICAL RATIONALE
● Hypercapnia is elevated CO2 (>45 mmHg).
● CO2 is an acid; increased CO2 causes pH to drop (acidosis).
● Causes: hypoventilation (COPD, narcotic overdose, chest injury, neuromuscular disorders).
Q3
A patient's arterial blood gas reveals decreased carbon dioxide levels. What is the most likely cause of
this situation?
CORRECT ANSWER Hyperventilation
CLINICAL RATIONALE
● Hyperventilation decreases CO2 (respiratory alkalosis).
● Causes: anxiety/panic attack, pain, hypoxia, pulmonary embolism, mechanical overventilation.
● Symptoms: lightheadedness, perioral numbness, tingling of extremities.
, Q4
What lab value would the nurse expect in a patient who has sustained trauma to the lungs and chest wall
and is experiencing respiratory failure?
CORRECT ANSWER Elevated PaCO2
CLINICAL RATIONALE
● Respiratory failure is inability to maintain adequate gas exchange.
● Type II respiratory failure (hypercapnic): PaCO2 >45 with pH <7.35.
● Chest wall trauma (flail chest, rib fractures) impairs ventilation → CO2 retention.
Q5
A 10-year-old develops pneumonia. Physical exam reveals subcostal and intercostal contractions. The
child reports that breathing is difficult with feeling that "I cannot get enough air." What term should the
nurse use to document this condition?
CORRECT ANSWER Dyspnea
CLINICAL RATIONALE
● Dyspnea is subjective sensation of difficulty breathing (patient's perception).
● Retractions (subcostal, intercostal, suprasternal) indicate increased work of breathing.
● Pneumonia causes inflammation, consolidation, and decreased lung compliance.
Q6
A 50 year old presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that
the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these
assessment findings, what does the nurse suspect the patient is experiencing?
CORRECT ANSWER Tension Pneumothorax
CLINICAL RATIONALE
● Tension pneumothorax is life-threatening (air trapped in pleural space, shifting mediastinum).
● Hallmarks: tracheal deviation away from affected side, hypotension, distended neck veins.
● Immediate treatment: needle decompression (second intercostal space, midclavicular line).
Q7
A nurse is caring for a client who has emphysema. Which of the following findings should the nurse
expect to assess in this client?
CORRECT ANSWER Dyspnea, Barrel chest, and Hypocapnia (low CO2)
CLINICAL RATIONALE
● Emphysema causes air trapping → barrel chest (increased AP diameter).
● Early/mild emphysema causes hypocapnia due to hyperventilation (low CO2).
● Late/advanced emphysema may cause hypercapnia due to fatigue and hypoventilation.
