Respiratory NCLEX Questions
Which of these clients will the charge nurse on the medical unit assign to an RN who has floated
from the postanesthesia care unit (PACU)?
A. Client with allergic rhinitis scheduled for skin testing
B. Client with emphysema who needs teaching about pulmonary function testing
C. Client with pancreatitis who needs a preoperative chest x-ray
D. Client with pleural effusion who has had 1200 mL removed by thoracentesis - ANS-D) A
nurse working in the PACU would be familiar with assessing vital signs and respiratory status
after procedures such as thoracentesis.
An RN and an LPN/LVN are working together to provide care for a client hospitalized with
dyspnea who requires all of these nursing actions. Which of these actions is best accomplished
by the RN?
A. Administer the purified protein derivative (PPD) for tuberculosis testing.
B. Assess vital signs and the puncture site after thoracentesis.
C. Monitor oxygen saturation using pulse oximetry every 4 hours.
D. Plan client and family teaching regarding upcoming pulmonary function testing. - ANS-D)
Developing the teaching plan is the most complex of the skills listed and requires RN education
and licensure.
A client has returned to the postanesthesia care unit (PACU) after a bronchoscopy. Which of
these nursing tasks is best for the charge nurse to delegate to the experienced nursing assistant
working in PACU?
A. Assess breath sounds.
B. Check gag reflex.
C. Determine level of consciousness.
D. Monitor blood pressure and pulse. - ANS-D) A nursing assistant working in the PACU would
have experience in taking client vital signs after the client has had conscious sedation or
anesthesia.
The RN has received report about all of these clients. Which client needs the most immediate
assessment?
A. Client with acute asthma who has an oxygen saturation of 89% by pulse oximetry
B. Client admitted 3 hours ago for a scheduled thoracentesis in 30 minutes
C. Client with bronchogenic lung cancer who returned from bronchoscopy 3 hours ago
D. Client with pleural effusion who has decreased breath sounds at the right base - ANS-A) An
oxygen saturation level less than 91% indicates hypoxemia and requires immediate assessment
and intervention to improve blood and tissue oxygenation.
,The home health nurse is assigned to visit all of these clients when a change in agency staffing
requires that one of the clients should be rescheduled for a visit on the following day. Which of
these clients would be best to reschedule?
A. Client with emphysema who has been on home oxygen for a month and has SPO2 levels of
91% to 93%
B. Client with history of a cough, weight loss, and night sweats who has just had a positive
Mantoux test
C. Client with newly diagnosed pleural effusion who needs an admission visit and an initial
intake assessment
D. Client with percutaneous lung biopsy yesterday who called in to report increased dyspnea -
ANS-A) This client has an appropriate Spo2 for home oxygen use.
Which of these assessment findings will be of greatest concern when the nurse is assessing a
client with emphysema?
A. Barrel-shaped chest
B. Bronchial breath sounds heard at the bases
C. Hyperresonance to percussion of the chest
D. Ribs lying horizontal - ANS-B) Bronchial breath sounds are not normally heard in the
periphery and may indicate increased lung density, as in a tumor or an infective process such as
pneumonia.
People involved in which occupations or activities are encouraged to wear masks and to have
adequate ventilations? Select all that apply.
A. Bakers
B. Coal miners
C. Electricians
D. Furniture refinishers
E. Plumbers
F. Potters - ANS-Bakers
Coal miners
Furniture refinishers
Potters
A) Being exposed to flour as a baker for prolonged periods of time may cause a condition called
occupational asthma.
B) Coal miners are at risk to develop pneumoconiosis as the result of inhalation of coal dust.
D) Owing to the chemicals used to refinish furniture (paint strippers, solvents), masks and
adequate ventilation are essential for furniture refinishers. One of the main solvents involved will
metabolize in the body to carbon monoxide and will impair the ability of the tissue to extract
oxygen.
F) Silicosis or inhalation of silica dust is a hazard for professional and recreational potters.
Which nursing intervention is the priority in preparing the client for pulmonary function testing
(PFT)?
, A. Administer bronchodilator medication on call.
B. Encourage clear fluid intake 12 hours before the procedure.
C. Ensure no smoking 6 hours before the test.
D. Provide supplemental oxygen as testing begins. - ANS-C) If the client has been smoking,
this may alter parts of the PFT (diffusing capacity [DlCO]), yielding inaccurate results.
The nurse is performing a client assessment for the client's potential employer. The client
reports dyspnea when climbing stairs but is not dyspneic at rest. Which dyspnea classification
does the nurse assign to this client in the report to the employer?
A. Class I, can perform perform manual labor
B. Class II, can perform desk job
C. Class III, minimally employable
D. Class IV, must remain at home - ANS-B) This client is dyspneic when climbing stairs or
walking on an incline but not on level walking. Therefore, this client is employable only for a
sedentary job or under special circumstances.
A client comes to the emergency department with a productive cough. Which symptom does the
nurse look for that will require immediate attention?
A. Blood in the sputum
B. Mucoid sputum
C. Pink frothy sputum
D. Yellow sputum - ANS-C) Pink frothy sputum is common with pulmonary edema and requires
immediate attention and intervention to prevent the client's condition from getting worse.
A client with asthma reports shortness of breath. What is the nurse assessing when auscultating
this client's chest?
A. Adventitious breath sounds
B. Fremitus
C. Oxygenation status
D. Respiratory excursion - ANS-A) Adventitious sounds are additional breath sounds
superimposed on normal sounds. They indicate pathologic changes in the lung.
Four clients are sent back to the emergency department from triage at the same time. Which
client requires the nurse's immediate attention?
A. Client with acute allergic reaction
B. Client with dyspnea on exertion
C. Client with lung cancer with cough
D. Client with sinus infection with fever - ANS-A) An acute allergic reaction can lead to
immediate respiratory distress. This is an emergent situation that requires the immediate
attention of the nurse.
The nurse auscultates popping, discontinuous sounds over the client's anterior chest. How does
the nurse classify these sounds?
A. Crackles
Which of these clients will the charge nurse on the medical unit assign to an RN who has floated
from the postanesthesia care unit (PACU)?
A. Client with allergic rhinitis scheduled for skin testing
B. Client with emphysema who needs teaching about pulmonary function testing
C. Client with pancreatitis who needs a preoperative chest x-ray
D. Client with pleural effusion who has had 1200 mL removed by thoracentesis - ANS-D) A
nurse working in the PACU would be familiar with assessing vital signs and respiratory status
after procedures such as thoracentesis.
An RN and an LPN/LVN are working together to provide care for a client hospitalized with
dyspnea who requires all of these nursing actions. Which of these actions is best accomplished
by the RN?
A. Administer the purified protein derivative (PPD) for tuberculosis testing.
B. Assess vital signs and the puncture site after thoracentesis.
C. Monitor oxygen saturation using pulse oximetry every 4 hours.
D. Plan client and family teaching regarding upcoming pulmonary function testing. - ANS-D)
Developing the teaching plan is the most complex of the skills listed and requires RN education
and licensure.
A client has returned to the postanesthesia care unit (PACU) after a bronchoscopy. Which of
these nursing tasks is best for the charge nurse to delegate to the experienced nursing assistant
working in PACU?
A. Assess breath sounds.
B. Check gag reflex.
C. Determine level of consciousness.
D. Monitor blood pressure and pulse. - ANS-D) A nursing assistant working in the PACU would
have experience in taking client vital signs after the client has had conscious sedation or
anesthesia.
The RN has received report about all of these clients. Which client needs the most immediate
assessment?
A. Client with acute asthma who has an oxygen saturation of 89% by pulse oximetry
B. Client admitted 3 hours ago for a scheduled thoracentesis in 30 minutes
C. Client with bronchogenic lung cancer who returned from bronchoscopy 3 hours ago
D. Client with pleural effusion who has decreased breath sounds at the right base - ANS-A) An
oxygen saturation level less than 91% indicates hypoxemia and requires immediate assessment
and intervention to improve blood and tissue oxygenation.
,The home health nurse is assigned to visit all of these clients when a change in agency staffing
requires that one of the clients should be rescheduled for a visit on the following day. Which of
these clients would be best to reschedule?
A. Client with emphysema who has been on home oxygen for a month and has SPO2 levels of
91% to 93%
B. Client with history of a cough, weight loss, and night sweats who has just had a positive
Mantoux test
C. Client with newly diagnosed pleural effusion who needs an admission visit and an initial
intake assessment
D. Client with percutaneous lung biopsy yesterday who called in to report increased dyspnea -
ANS-A) This client has an appropriate Spo2 for home oxygen use.
Which of these assessment findings will be of greatest concern when the nurse is assessing a
client with emphysema?
A. Barrel-shaped chest
B. Bronchial breath sounds heard at the bases
C. Hyperresonance to percussion of the chest
D. Ribs lying horizontal - ANS-B) Bronchial breath sounds are not normally heard in the
periphery and may indicate increased lung density, as in a tumor or an infective process such as
pneumonia.
People involved in which occupations or activities are encouraged to wear masks and to have
adequate ventilations? Select all that apply.
A. Bakers
B. Coal miners
C. Electricians
D. Furniture refinishers
E. Plumbers
F. Potters - ANS-Bakers
Coal miners
Furniture refinishers
Potters
A) Being exposed to flour as a baker for prolonged periods of time may cause a condition called
occupational asthma.
B) Coal miners are at risk to develop pneumoconiosis as the result of inhalation of coal dust.
D) Owing to the chemicals used to refinish furniture (paint strippers, solvents), masks and
adequate ventilation are essential for furniture refinishers. One of the main solvents involved will
metabolize in the body to carbon monoxide and will impair the ability of the tissue to extract
oxygen.
F) Silicosis or inhalation of silica dust is a hazard for professional and recreational potters.
Which nursing intervention is the priority in preparing the client for pulmonary function testing
(PFT)?
, A. Administer bronchodilator medication on call.
B. Encourage clear fluid intake 12 hours before the procedure.
C. Ensure no smoking 6 hours before the test.
D. Provide supplemental oxygen as testing begins. - ANS-C) If the client has been smoking,
this may alter parts of the PFT (diffusing capacity [DlCO]), yielding inaccurate results.
The nurse is performing a client assessment for the client's potential employer. The client
reports dyspnea when climbing stairs but is not dyspneic at rest. Which dyspnea classification
does the nurse assign to this client in the report to the employer?
A. Class I, can perform perform manual labor
B. Class II, can perform desk job
C. Class III, minimally employable
D. Class IV, must remain at home - ANS-B) This client is dyspneic when climbing stairs or
walking on an incline but not on level walking. Therefore, this client is employable only for a
sedentary job or under special circumstances.
A client comes to the emergency department with a productive cough. Which symptom does the
nurse look for that will require immediate attention?
A. Blood in the sputum
B. Mucoid sputum
C. Pink frothy sputum
D. Yellow sputum - ANS-C) Pink frothy sputum is common with pulmonary edema and requires
immediate attention and intervention to prevent the client's condition from getting worse.
A client with asthma reports shortness of breath. What is the nurse assessing when auscultating
this client's chest?
A. Adventitious breath sounds
B. Fremitus
C. Oxygenation status
D. Respiratory excursion - ANS-A) Adventitious sounds are additional breath sounds
superimposed on normal sounds. They indicate pathologic changes in the lung.
Four clients are sent back to the emergency department from triage at the same time. Which
client requires the nurse's immediate attention?
A. Client with acute allergic reaction
B. Client with dyspnea on exertion
C. Client with lung cancer with cough
D. Client with sinus infection with fever - ANS-A) An acute allergic reaction can lead to
immediate respiratory distress. This is an emergent situation that requires the immediate
attention of the nurse.
The nurse auscultates popping, discontinuous sounds over the client's anterior chest. How does
the nurse classify these sounds?
A. Crackles
