LATEST UPDATED NUR 265 EXAM 2 - MED
SURG 2 INTERMEDIATE | COMPLETE EXAM
WITH CORRECT ANSWERS AND RATIONALES.
A+ GUARANTEED SUCCESS
1. A nurse is caring for a client with acute
exacerbation of chronic obstructive pulmonary
disease (COPD). Which arterial blood gas
(ABG) finding is expected in a client with
COPD?
A) pH 7.38, PaCO2 40, PaO2 85, HCO3 24
B) pH 7.30, PaCO2 58, PaO2 65, HCO3 28
C) pH 7.48, PaCO2 30, PaO2 70, HCO3 22
D) pH 7.35, PaCO2 45, PaO2 90, HCO3 24
Correct answer: B
Rationale: COPD exacerbation typically causes
respiratory acidosis (pH below 7.35, PaCO2
above 45) with possible metabolic
compensation (elevated HCO3). Option B
shows respiratory acidosis with partial
compensation.
,2. A nurse is assessing a client with
community-acquired pneumonia. Which finding
is most consistent with this diagnosis?
A) Dry, nonproductive cough and wheezing
B) Fever, productive cough with green sputum,
and crackles
C) Night sweats, hemoptysis, and weight loss
D) Sudden onset of severe dyspnea and
pleuritic chest pain
Correct answer: B
Rationale: Pneumonia typically presents with
fever, productive cough with purulent sputum,
and crackles on auscultation. Dry cough
suggests asthma. Night sweats and
hemoptysis suggest tuberculosis. Sudden
dyspnea and pleuritic pain suggest pulmonary
embolism.
3. A nurse is providing discharge teaching to a
client with a new diagnosis of asthma. Which
statement by the client indicates
understanding of rescue versus controller
medications?
A) I will use my albuterol inhaler every day to
prevent attacks
,B) I will use my fluticasone inhaler when I feel
short of breath
C) I will use my albuterol inhaler before
exercise if I have exercise-induced symptoms
D) I will stop my fluticasone when my
symptoms improve
Correct answer: C
Rationale: Albuterol is a rescue medication
used for acute symptoms or before exercise to
prevent bronchospasm. Fluticasone is a
controller used daily for prevention, not for
acute symptoms. Controller medications
should not be stopped without provider
guidance.
4. A nurse is caring for a client with a chest
tube after a thoracotomy. The nurse notes
continuous bubbling in the water seal
chamber. What is the priority action?
A) Document the finding as normal
B) Clamp the chest tube near the insertion site
C) Assess the system for an air leak
D) Increase the suction pressure
Correct answer: C
, Rationale: Continuous bubbling in the water
seal chamber indicates an air leak. The nurse
should assess the system for the source of the
leak (loose connections, cracked drainage
system). Clamping is not recommended.
Increasing suction will not resolve an air leak.
5. A nurse is assessing a client with chronic
obstructive pulmonary disease (COPD). Which
finding is most characteristic of emphysema?
A) Chronic cough with copious sputum
production
B) Barrel chest and pursed-lip breathing
C) Right-sided heart failure (cor pulmonale)
D) Clubbing of the fingers
Correct answer: B
Rationale: Emphysema is characterized by
barrel chest (hyperinflation) and pursed-lip
breathing (to prolong expiration). Chronic
cough with copious sputum is more typical of
chronic bronchitis. Cor pulmonale and
clubbing occur in both but are not the most
characteristic findings.
SURG 2 INTERMEDIATE | COMPLETE EXAM
WITH CORRECT ANSWERS AND RATIONALES.
A+ GUARANTEED SUCCESS
1. A nurse is caring for a client with acute
exacerbation of chronic obstructive pulmonary
disease (COPD). Which arterial blood gas
(ABG) finding is expected in a client with
COPD?
A) pH 7.38, PaCO2 40, PaO2 85, HCO3 24
B) pH 7.30, PaCO2 58, PaO2 65, HCO3 28
C) pH 7.48, PaCO2 30, PaO2 70, HCO3 22
D) pH 7.35, PaCO2 45, PaO2 90, HCO3 24
Correct answer: B
Rationale: COPD exacerbation typically causes
respiratory acidosis (pH below 7.35, PaCO2
above 45) with possible metabolic
compensation (elevated HCO3). Option B
shows respiratory acidosis with partial
compensation.
,2. A nurse is assessing a client with
community-acquired pneumonia. Which finding
is most consistent with this diagnosis?
A) Dry, nonproductive cough and wheezing
B) Fever, productive cough with green sputum,
and crackles
C) Night sweats, hemoptysis, and weight loss
D) Sudden onset of severe dyspnea and
pleuritic chest pain
Correct answer: B
Rationale: Pneumonia typically presents with
fever, productive cough with purulent sputum,
and crackles on auscultation. Dry cough
suggests asthma. Night sweats and
hemoptysis suggest tuberculosis. Sudden
dyspnea and pleuritic pain suggest pulmonary
embolism.
3. A nurse is providing discharge teaching to a
client with a new diagnosis of asthma. Which
statement by the client indicates
understanding of rescue versus controller
medications?
A) I will use my albuterol inhaler every day to
prevent attacks
,B) I will use my fluticasone inhaler when I feel
short of breath
C) I will use my albuterol inhaler before
exercise if I have exercise-induced symptoms
D) I will stop my fluticasone when my
symptoms improve
Correct answer: C
Rationale: Albuterol is a rescue medication
used for acute symptoms or before exercise to
prevent bronchospasm. Fluticasone is a
controller used daily for prevention, not for
acute symptoms. Controller medications
should not be stopped without provider
guidance.
4. A nurse is caring for a client with a chest
tube after a thoracotomy. The nurse notes
continuous bubbling in the water seal
chamber. What is the priority action?
A) Document the finding as normal
B) Clamp the chest tube near the insertion site
C) Assess the system for an air leak
D) Increase the suction pressure
Correct answer: C
, Rationale: Continuous bubbling in the water
seal chamber indicates an air leak. The nurse
should assess the system for the source of the
leak (loose connections, cracked drainage
system). Clamping is not recommended.
Increasing suction will not resolve an air leak.
5. A nurse is assessing a client with chronic
obstructive pulmonary disease (COPD). Which
finding is most characteristic of emphysema?
A) Chronic cough with copious sputum
production
B) Barrel chest and pursed-lip breathing
C) Right-sided heart failure (cor pulmonale)
D) Clubbing of the fingers
Correct answer: B
Rationale: Emphysema is characterized by
barrel chest (hyperinflation) and pursed-lip
breathing (to prolong expiration). Chronic
cough with copious sputum is more typical of
chronic bronchitis. Cor pulmonale and
clubbing occur in both but are not the most
characteristic findings.
