Practice NCLEX Respiratory Practice Questions with Rationales. NCLEX breathing questions with clean rationales on COPD, asthma, pneumothorax, chest tubes, and oxygen remedy to reinforce examination confidence.
Explore NCLEX Respiratory Practice Questions with Rationales
Introduction
Respiratory issues can flip essential in minutes, and the NCLEX expects you to word that. Oxygenation, airway clearance, and air flow questions seem at some stage in the examination. This manual gives NCLEX breathing exercise questions with rationales so that you can construct safe, speedy scientific judgment.
Moreover, every motive explains why the right alternative works and why the distractors fail. That addiction turns exercise into actual understanding.
Why Respiratory Content Matters at the NCLEX
A Core Test of Prioritization
Breathing sits on the pinnacle of the ABCs, so breathing issues regularly outrank different concerns. Consequently, many questions ask which purchaser you must check first. Recognizing an airway or oxygenation chance speedy is a key examination skill.
Clinical Judgment in Respiratory Care
The Next Generation NCLEX rewards nurses who apprehend cues, interpret them, and act. Therefore, practising NCLEX breathing exercise questions builds the sample reputation you want. You learn how to join evaluation findings with the most secure subsequent step.
Practice Questions: Chronic Airway Disease
Question 1: COPD and Oxygen Therapy
A purchaser with continual obstructive pulmonary disease (COPD) has a breathing fee of 28 and an oxygen saturation of 84%. Which movement is maximum appropriate? Option A is to use oxygen at 10 L/min with the aid of using non-rebreather mask. Option B is to use low-float oxygen, which includes 1 to two L/min with the aid of using nasal cannula, and reassess. Option C is to withhold oxygen to guard the hypoxic drive. Option D is to area the purchaser supine.
Correct answer: B. Clients with COPD want oxygen, however at low float, with a goal saturation of approximately 88% to 92%. Excessive oxygen can get worse carbon dioxide retention. Withholding oxygen is unsafe, and mendacity flat will increase respiratory effort, so upright positioning is better.
Question 2: Acute Asthma Exacerbation
A consumer with bronchial allergies is wheezing and the usage of accent muscles. Which medicine ought to the nurse provide first? Option A is a long-performing beta agonist. Option B is an inhaled corticosteroid. Option C is a short-performing beta agonist which include albuterol. Option D is a leukotriene inhibitor.
Correct answer: C. Albuterol is the rescue medicine that relaxes bronchial clean muscle and opens airlines quickly. Long-performing sellers and inhaled steroids are controller drugs, so that they do now no longer deal with acute symptoms. A silent chest at some stage in an assault is ominous as it indicates little or no air movement.
Practice Questions: Acute Respiratory Emergencies
Question 3: Pneumothorax and Chest Tubes
A consumer with a chest tube related to a water-seal drainage device suggests non-stop effervescent withinside the water-seal chamber. What ought to the nurse suspect? Option A is everyday device function. Option B is an air leak. Option C is a complete series chamber. Option D is a clamped tube.
Correct answer: B. Continuous effervescent withinside the water-seal chamber indicates an air leak withinside the device or the consumer`s lung. The nurse ought to look at connections and notify the company if the leak persists. Gentle intermittent effervescent withinside the suction manage chamber is expected, and tidaling withinside the water seal displays everyday strain changes.
Question 4: Pulmonary Embolism
A postoperative consumer all at once develops sharp chest pain, dyspnea, and tachycardia. Which movement is the priority? Option A is to ambulate the consumer. Option B is to manage a laxative. Option C is to elevate the top of the bed, observe oxygen, and notify the company. Option D is to report the findings and recheck in an hour.
Correct answer: C. These cues endorse a pulmonary embolism, that’s an emergency. Raising the top of the bed, giving oxygen, and calling for assist deal with oxygenation first. Walking the consumer may want to dislodge greater clot, and ready delays lifesaving treatment.
Practice Questions: Infection and Gas Exchange
Question 5: Tuberculosis Precautions
A consumer is admitted with suspected energetic tuberculosis. Which precaution is required? Option A is preferred precautions only. Option B is touching precautions. Option C is droplet precautions with a surgical mask. Option D is airborne precautions in a negative-strain room with an N95 respirator.
Correct answer: D. Tuberculosis spreads thru airborne particles, so the consumer wishes a negative-strain room. Staff ought to put on a geared up N95 respirator. A surgical mask by myself does now no longer defend towards such small particles.
Question 6: Reading Arterial Blood Gases
A client`s ABG indicates pH 7.30, PaCO2 fifty-six mm Hg, and HCO3 24 mEq/L. What does this indicate? Option A is breathing acidosis. Option B is breathing alkalosis. Option C is metabolic acidosis. Option D is metabolic alkalosis.
Correct answer: A. The pH is low and the PaCO2 is high, so the trouble is breathing acidosis. The regular bicarbonate indicates the kidneys have now no longer but compensated. A short reminiscence useful resource is ROME: breathing opposite, metabolic equal.
Study Strategies for Respiratory Content
Review the Rationales Thoroughly
After every set of NCLEX breathing exercise questions, have a look at why each alternative is proper or wrong. This famous patterns, which includes whilst oxygen is useful and whilst it’s far risky. Over time, you may spot distractors tons faster.
Memorize Key Values
These numbers seem once more and once more:
- Normal PaO2: 80 to 100 mm Hg.
- Normal PaCO2: 35 to 45 mm Hg.
- Normal pH: 7.35 to 7.45.
- COPD goal oxygen saturation: approximately 88% to 92%.
Furthermore, exercise each day in brief periods in preference to cramming. Steady repetition builds velocity and accuracy.
Conclusion
Strong breathing information rests on 3 habits: positioned airway and respiration first, research the important thing values, and have a look at each rationale. The questions above display how the examination combines assessment, remedy safety, and emergency response. Keep practicing, and your scientific judgment will develop with every set.
If this manual helped, percentage it together along with your have a look at group, go away a remark with the breathing subject matter you locate hardest, and discover extra NCLEX assets on our platform.
NCLEX Respiratory Practice Questions In 5 Domains
NCLEX Respiratory Practice Questions 1–10: Assessment, ABGs and oxygen therapy
1. A client’s arterial blood gas shows pH 7.30, PaCO2 55 mmHg, HCO3 25 mEq/L. How should the nurse interpret these results?
A. Metabolic acidosis, uncompensated
B. Respiratory acidosis, uncompensated
C. Respiratory alkalosis, partially compensated
D. Metabolic alkalosis, fully compensated
Answer: B. The pH is low (acidosis) and PaCO2 is high, so the cause is respiratory. HCO3 is normal (22–26), so the kidneys have not yet compensated. Metabolic acidosis would show a low HCO3.
2. A client with COPD has an SpO2 of 89% on 2 L/min nasal cannula and is alert and talking. What is the nurse’s best action?
A. Increase oxygen to 6 L/min
B. Apply a non-rebreather mask
C. Continue the current oxygen and monitor
D. Notify the rapid response team
Answer: C. The usual target for many clients with chronic CO2 retention is 88–92%. This client is within target and stable. High-flow oxygen can worsen hypercapnia in some COPD clients.
3. The nurse auscultates high-pitched, musical sounds on expiration in a client with asthma. How should the nurse document this finding?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural friction rub
Answer: C. Wheezes are high-pitched, musical sounds from narrowed airways, usually loudest on expiration. Crackles are popping sounds from fluid in alveoli. Rhonchi are low-pitched snoring sounds from secretions in large airways. A friction rub is a grating sound with breathing.
4. Which early sign of hypoxia should the nurse recognize first?
A. Cyanosis of the lips
B. Restlessness and tachycardia
C. Bradycardia
D. Clubbing of the fingers
Answer: B. Restlessness, anxiety, confusion, tachycardia and tachypnea are early signs. Cyanosis and bradycardia are late signs. Clubbing reflects long-term chronic hypoxia, not an acute change.
5. A client is receiving oxygen at 4 L/min by nasal cannula. Which approximate FiO2 is the client receiving?
A. 24%
B. 36%
C. 50%
D. 60%
Answer: B. Each 1 L/min by nasal cannula adds about 4% above room air (21%). At 4 L/min the FiO2 is about 33–37%. Nasal cannula flow should not exceed 6 L/min (about 44%).
6. Which ABG result indicates respiratory alkalosis in a client who is hyperventilating during a panic attack?
A. pH 7.48, PaCO2 30, HCO3 24
B. pH 7.32, PaCO2 50, HCO3 26
C. pH 7.50, PaCO2 40, HCO3 32
D. pH 7.30, PaCO2 38, HCO3 18
Answer: A. Hyperventilation blows off CO2, lowering PaCO2 and raising pH. Option B is respiratory acidosis, C is metabolic alkalosis, and D is metabolic acidosis.
7. The nurse is preparing to obtain an arterial blood gas from the radial artery. Which action should the nurse perform first?
A. Apply a pressure dressing
B. Perform the Allen test
C. Place the sample on ice
D. Ask the client to hold their breath
Answer: B. The Allen test confirms collateral circulation through the ulnar artery before radial puncture. Pressure is applied for at least 5 minutes after the puncture (longer if anticoagulated).
8. Which oxygen delivery device provides the most precise FiO2?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C. A Venturi mask uses color-coded adapters to deliver an exact FiO2 (24–60%), which makes it useful for clients with COPD. Nasal cannula and simple masks vary with the client’s breathing pattern.
9. A client is wearing a non-rebreather mask. The nurse notes the reservoir bag collapses completely on inspiration. What should the nurse do?
A. Remove the mask and apply a nasal cannula
B. Increase the oxygen flow rate
C. Document this as an expected finding
D. Decrease the oxygen flow rate
Answer: B. The reservoir bag should stay at least one-third to one-half full during inspiration. A collapsing bag means the flow (usually 10–15 L/min) is too low to meet the client’s demand.
10. Which findings would the nurse expect in a client with a tension pneumothorax? Select all that apply.
A. Tracheal deviation toward the unaffected side
B. Absent breath sounds on the affected side
C. Hypotension
D. Bradypnea
E. Distended neck veins
F. Hyperresonance on the affected side
Answer: A, B, C, E, F. Rising pressure on the affected side shifts the mediastinum and trachea away from it, compresses the great vessels (hypotension, JVD) and leaves the side hyperresonant without breath sounds. Clients are tachypneic, not bradypneic. This is an emergency needing needle decompression.
NCLEX Respiratory Practice Questions 11–20: Asthma and COPD
11. A client with an acute asthma attack suddenly has diminished breath sounds and no audible wheezing. What does this finding most likely indicate?
A. The attack is resolving
B. The bronchodilator is working
C. Severe airway obstruction with poor air movement
D. The client is falling asleep
Answer: C. A “silent chest” means so little air is moving that wheezes can no longer be heard. It signals impending respiratory failure and needs immediate intervention.
12. A client with asthma has prescriptions for albuterol and fluticasone by inhaler. Which instruction is correct?
A. Use fluticasone first, then albuterol
B. Use albuterol first, wait about 5 minutes, then use fluticasone
C. Use both inhalers only during an attack
D. Swallow after each fluticasone puff
Answer: B. The bronchodilator opens the airways so the corticosteroid reaches deeper. After the steroid, the client should rinse the mouth and spit to prevent oral candidiasis.
13. Which teaching about pursed-lip breathing should the nurse give a client with COPD?
A. Inhale through the mouth and exhale through the nose
B. Inhale through the nose and exhale slowly through pursed lips
C. Hold the breath for 10 seconds after each inhalation
D. Exhale quickly to empty the lungs
Answer: B. Exhaling slowly through pursed lips, about twice as long as inhalation, creates back-pressure that keeps small airways open and reduces air trapping.
14. Which assessment findings are expected in a client with long-standing emphysema? Select all that apply.
A. Barrel chest
B. Use of accessory muscles
C. Prolonged expiratory phase
D. Weight gain and peripheral edema as the main feature
E. Thin body build
F. Tripod positioning
Answer: A, B, C, E, F. Emphysema (“pink puffer”) causes hyperinflation, air trapping, work of breathing and weight loss. Marked edema and weight gain are more typical of chronic bronchitis with right-sided heart failure (cor pulmonale).
15. A client with COPD asks how to manage meals. Which recommendation is best?
A. Eat three large meals a day
B. Drink large amounts of fluid with meals
C. Eat small, frequent, high-calorie, high-protein meals
D. Follow a high-carbohydrate diet
Answer: C. Small meals limit abdominal fullness that pushes on the diaphragm. High-calorie, high-protein foods meet the high energy cost of breathing. Large carbohydrate loads raise CO2 production. Fluids are best taken between meals.
16. Which statement by a client with asthma shows correct understanding of a peak flow meter?
A. “I use it only when I feel short of breath.”
B. “A reading in the red zone means I take my medicine and seek help right away.”
C. “The yellow zone means my asthma is well controlled.”
D. “I record the lowest of three readings.”
Answer: B. Red zone (below 50% of personal best) is a medical alert. Green (80–100%) is good control; yellow (50–79%) means caution. The client records the highest of three readings, and measures regularly, not only with symptoms.
17. A client with COPD has a resting PaCO2 of 50 mmHg and SpO2 of 90%. Which finding needs the nurse’s immediate follow-up?
A. Barrel chest
B. Clubbing of the fingers
C. New confusion and drowsiness
D. Productive cough in the morning
Answer: C. Barrel chest, clubbing and morning cough are chronic, expected findings. New confusion or drowsiness suggests rising CO2 (CO2 narcosis) or worsening hypoxia.
18. Which client statement shows a need for more teaching about using a metered-dose inhaler with a spacer?
A. “I shake the inhaler before each use.”
B. “I breathe in slowly and deeply after pressing the canister.”
C. “I hold my breath for about 10 seconds after inhaling.”
D. “I take both puffs quickly, one right after the other.”
Answer: D. The client should wait about 1 minute between puffs of the same medication. The other statements are correct technique.
19. Which position is best for a client with COPD who is short of breath?
A. Supine with legs elevated
B. Sitting up and leaning forward with arms on an overbed table
C. Prone
D. Trendelenburg
Answer: B. The tripod or orthopneic position lowers the diaphragm and lets accessory muscles work, which makes breathing easier.
20. A client with severe persistent asthma is prescribed montelukast. Which statement shows correct understanding?
A. “I will use this to stop an asthma attack.”
B. “I take it every day, even when I feel well.”
C. “I can stop it once my symptoms go away.”
D. “I take it only before exercise.”
Answer: B. Montelukast is a leukotriene modifier for long-term control. It does not relieve an acute attack; a short-acting beta-2 agonist does. The client should also report mood or behavior changes, a known warning with this drug.
NCLEX Respiratory Practice Questions 21–30: Pneumonia, TB, pulmonary embolism and ARDS
21. A client is admitted with suspected bacterial pneumonia. Which order should the nurse complete first?
A. Start the IV antibiotic
B. Obtain a sputum culture
C. Schedule a chest x-ray for tomorrow
D. Give acetaminophen for fever
Answer: B. Cultures are collected before the first antibiotic dose so the results are not altered. The antibiotic is then started promptly, without unnecessary delay.
22. Which older adult with pneumonia shows the most typical early sign of the illness in this age group?
A. Temperature of 39.5 °C (103.1 °F)
B. New-onset confusion
C. Severe pleuritic chest pain
D. Rust-colored sputum
Answer: B. Older adults often have a blunted fever response. New confusion or a change in mental status is frequently the first sign of infection, including pneumonia.
23. Which nursing actions help prevent hospital-acquired pneumonia? Select all that apply.
A. Elevate the head of the bed 30–45 degrees
B. Perform regular oral care
C. Encourage incentive spirometer use
D. Keep the client on bed rest
E. Perform hand hygiene
F. Encourage early ambulation
Answer: A, B, C, E, F. Head elevation reduces aspiration, oral care reduces bacteria that can be aspirated, and spirometry and ambulation expand the lungs. Prolonged bed rest increases the risk of atelectasis and pneumonia.
24. Which type of isolation is required for a client with active pulmonary tuberculosis?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions in a negative-pressure room
D. Standard precautions only
Answer: C. TB spreads by airborne droplet nuclei. The client needs a negative-pressure airborne infection isolation room; staff wear a fit-tested N95 respirator, and the client wears a surgical mask when leaving the room.
25. A staff nurse’s tuberculin skin test shows 12 mm of induration at 48 hours. How should this result be interpreted?
A. Negative result
B. Positive result; further evaluation such as a chest x-ray is needed
C. Proof of active TB disease
D. The test must be read again at 1 week
Answer: B. For health care workers, 10 mm or more is positive. Cutoffs: 5 mm or more for people with HIV, immunosuppression or recent close contact; 10 mm or more for health care workers and other higher-risk groups; 15 mm or more for people with no risk factors. A positive test shows infection, not active disease, so a chest x-ray and symptom assessment follow.
26. A client taking rifampin for TB reports orange urine and tears. What is the nurse’s best response?
A. “Stop the medication and call your provider.”
B. “This is an expected effect and is harmless.”
C. “This is a sign of liver damage.”
D. “You should drink less water.”
Answer: B. Rifampin turns body fluids orange-red. It can permanently stain soft contact lenses. The client should still report jaundice, dark urine or abdominal pain, which suggest hepatotoxicity.
27. Which statement by a client starting TB treatment needs follow-up?
A. “I will take my medicines for at least 6 months.”
B. “I can stop the pills once I stop coughing.”
C. “I will avoid alcohol while on these drugs.”
D. “I will cover my mouth when I cough.”
Answer: B. Stopping early leads to relapse and drug-resistant TB. Treatment continues for the full course, often 6 to 9 months or longer, even after symptoms improve.
28. A client 2 days after hip surgery suddenly reports sharp chest pain and shortness of breath. Heart rate is 122/min and SpO2 is 86%. What is the nurse’s first action?
A. Obtain a 12-lead ECG
B. Raise the head of the bed and apply oxygen
C. Call the provider
D. Give the prescribed oral analgesic
Answer: B. These findings suggest a pulmonary embolism. Positioning and oxygen address breathing first. The nurse then calls the rapid response team or provider and prepares for diagnostic tests and anticoagulation.
29. A client is receiving a continuous heparin infusion for a pulmonary embolism. Which laboratory value should the nurse monitor?
A. PT/INR
B. aPTT or anti-Xa level
C. Platelet count only
D. Serum potassium
Answer: B. Unfractionated heparin is monitored with aPTT or anti-Xa levels. PT/INR monitors warfarin. Platelets should also be checked for heparin-induced thrombocytopenia, but they do not guide the dose. The antidote is protamine sulfate.
30. A client with sepsis develops severe hypoxemia that does not improve with 100% oxygen by non-rebreather mask. The chest x-ray shows bilateral infiltrates. What is the nurse’s priority concern?
A. Pneumothorax
B. Acute respiratory distress syndrome (ARDS)
C. Asthma exacerbation
D. Pleural effusion
Answer: B. Refractory hypoxemia despite high oxygen, with bilateral infiltrates and no cardiac cause, is the hallmark of ARDS. Sepsis is its most common cause. The client usually needs intubation with PEEP and may benefit from prone positioning.
NCLEX Respiratory Practice Questions 31–40: Chest tubes, tracheostomy, suctioning and ventilators
31. A client’s chest tube accidentally disconnects from the drainage system. What is the nurse’s immediate action?
A. Clamp the chest tube near the insertion site for several hours
B. Remove the chest tube
C. Call the provider and wait for orders
D. Place the end of the tube in a container of sterile water
Answer: D. Submerging the tube end about 2–3 cm in sterile water creates a temporary water seal that stops air from entering the pleural space. Then a new drainage system is attached. Prolonged clamping can cause a tension pneumothorax.
32. The nurse notes continuous bubbling in the water seal chamber of a client’s chest drainage system. What should the nurse do first?
A. Check the system for an air leak, starting at the client and moving toward the drainage unit
B. Document this as an expected finding
C. Add more water to the suction control chamber
D. Milk the chest tube
Answer: A. Continuous bubbling in the water seal chamber means an air leak. The nurse checks the dressing, insertion site and connections. Gentle, continuous bubbling belongs in the suction control chamber of a wet-suction system, not the water seal chamber.
33. The water level in the water seal chamber rises with inspiration and falls with expiration. How should the nurse interpret this?
A. The tube is blocked
B. There is a large air leak
C. This is tidaling, an expected finding
D. The suction is set too high
Answer: C. Tidaling reflects normal pressure changes in the pleural space. If tidaling stops, the lung may have re-expanded or the tube may be kinked or blocked.
34. What is the maximum time the nurse should apply suction during each pass when suctioning a tracheostomy?
A. 30 seconds
B. 20–25 seconds
C. 5 seconds
D. 10–15 seconds
Answer: D. Suction is applied only while withdrawing the catheter and for no more than 10–15 seconds per pass to prevent hypoxia, bradycardia and mucosal injury.
35. Which action should the nurse take immediately before suctioning a client with a tracheostomy?
A. Hyperoxygenate the client with 100% oxygen
B. Instill normal saline into the tube
C. Apply suction while inserting the catheter
D. Deflate the cuff
Answer: A. Hyperoxygenation reduces suction-induced hypoxemia. Routine saline instillation is not recommended. Suction is applied only on withdrawal.
36. Which items should be kept at the bedside of a client with a new tracheostomy? Select all that apply.
A. Obturator
B. Spare tracheostomy tube of the same size
C. Spare tracheostomy tube one size smaller
D. Suction equipment
E. Water pitcher for oral fluids
F. Bag-valve mask with oxygen
Answer: A, B, C, D, F. These items allow rapid reinsertion and ventilation if the tube is dislodged. A new tracheostomy client may need a swallow assessment before oral fluids.
37. The high-pressure alarm sounds on a client’s mechanical ventilator. What is the most likely cause, and the nurse’s first action?
A. Disconnected tubing; reconnect the circuit
B. A leak in the cuff; inflate the cuff
C. Secretions in the airway; assess and suction the client
D. Low oxygen supply; change the tank
Answer: C. High-pressure alarms come from increased resistance: secretions, a kinked tube, coughing, biting the tube or bronchospasm. Low-pressure alarms suggest a disconnection or cuff leak.
38. A ventilator alarm keeps sounding and the nurse cannot find the cause. The client is becoming cyanotic. What should the nurse do?
A. Silence the alarm and call the respiratory therapist
B. Increase the FiO2 on the ventilator
C. Wait for the provider to arrive
D. Disconnect the client from the ventilator and ventilate with a bag-valve mask
Answer: D. The client comes first, not the machine. Manual ventilation with 100% oxygen supports the client while the respiratory therapist troubleshoots the ventilator.
39. Which action by an assistive staff member caring for a client with a chest tube requires the nurse to intervene?
A. Keeping the drainage unit below chest level
B. Clamping the chest tube before helping the client walk
C. Keeping the tubing free of dependent loops
D. Reporting that the dressing is wet
Answer: B. A chest tube is not clamped for ambulation; clamping can cause a tension pneumothorax. It is clamped only briefly and by provider order, such as when checking for an air leak or changing the unit.
40. After endotracheal intubation, the nurse hears breath sounds on the right side but not on the left. What does this most likely mean?
A. The tube is in the right mainstem bronchus
B. The tube is in the esophagus
C. The client has a left-sided pneumonia
D. The tube is correctly placed
Answer: A. The right mainstem bronchus is shorter, wider and straighter, so a tube advanced too far usually enters it. The tube must be pulled back slightly by the provider or therapist. Placement is confirmed with end-tidal CO2 and a chest x-ray.
NCLEX Respiratory Practice Questions 41–50: Pediatrics, pharmacology, prioritization and delegation
41. A 4-year-old arrives with a high fever, drooling, muffled voice and sitting in the tripod position. Which action should the nurse avoid?
A. Keeping the child upright in a position of comfort
B. Having emergency airway equipment at the bedside
C. Examining the throat with a tongue depressor
D. Letting the parent stay with the child to keep them calm
Answer: C. These are signs of epiglottitis. Inspecting the throat can trigger laryngospasm and complete airway obstruction. Keep the child calm and upright, and prepare for intubation or tracheostomy.
42. A child with cystic fibrosis is prescribed pancreatic enzymes. Which instruction is correct?
A. Give the enzymes with every meal and snack
B. Give the enzymes only at bedtime
C. Mix the capsule contents into hot food
D. Crush the enteric-coated beads before giving them
Answer: A. Enzymes must be present when food is eaten to digest fat and protein. Beads can be sprinkled on a small amount of soft, acidic, room-temperature food, such as applesauce, but are not crushed or chewed. Effective dosing shows as fewer fatty, foul-smelling stools.
43. An infant with respiratory syncytial virus (RSV) bronchiolitis has thick nasal secretions and is feeding poorly. Which intervention is the priority?
A. Encourage large feedings every 4 hours
B. Place the infant prone to sleep
C. Give antibiotics as first-line treatment
D. Suction nasal secretions before feedings and sleep
Answer: D. Infants are obligate nose breathers, so clearing the nose improves breathing and feeding. RSV is viral, so antibiotics do not treat it. Infants should sleep on their backs. Small, frequent feedings are easier to manage.
44. A toddler with croup has a barking cough. Which finding should the nurse report immediately?
A. Hoarse voice
B. Inspiratory stridor at rest
C. Low-grade fever
D. Cough that is worse at night
Answer: B. Stridor at rest signals significant upper airway narrowing. Hoarseness, low-grade fever and a nighttime cough are typical of mild croup.
45. A client taking theophylline has a heart rate of 130/min, nausea and restlessness. What should the nurse suspect?
A. An expected therapeutic response
B. Hypoglycemia
C. Theophylline toxicity
D. An allergic reaction
Answer: C. Theophylline has a narrow therapeutic range (commonly cited as 10–20 mcg/mL). Toxicity causes tachycardia, nausea, vomiting, restlessness and, at higher levels, dysrhythmias and seizures. Caffeine, smoking changes and some drugs alter its levels.
46. Which side effect should the nurse teach a client to expect from inhaled ipratropium?
A. Dry mouth
B. Bradycardia
C. Excess salivation
D. Diarrhea
Answer: A. Ipratropium is an anticholinergic bronchodilator. Dry mouth is common; sucking sugar-free candy or sipping water helps. Clients should also avoid spraying it in the eyes.
47. Which finding should the nurse expect shortly after a client receives a nebulized albuterol treatment?
A. Bradycardia
B. Drowsiness
C. Hypertension above 180/110
D. Mild tremor and a slight rise in heart rate
Answer: D. Albuterol is a beta-2 agonist that also causes some beta-1 stimulation. Mild tremor, nervousness and tachycardia are common. Chest pain or a very rapid heart rate should be reported.
48. The nurse receives report on four clients. Which client should the nurse see first?
A. A client with COPD whose SpO2 is 90% on 2 L/min
B. A client with asthma who is using accessory muscles and can speak only one or two words at a time
C. A client with pneumonia who has a temperature of 38.2 °C (100.8 °F)
D. A client with TB who has questions about medication schedules
Answer: B. Accessory muscle use and inability to speak in full sentences mean severe respiratory distress, an airway and breathing priority. The other clients are stable or have expected findings.
49. Which task can the nurse delegate to assistive personnel for a client with pneumonia who is stable?
A. Auscultating lung sounds
B. Teaching the client to use an incentive spirometer
C. Measuring vital signs and pulse oximetry
D. Evaluating the client’s response to a nebulizer treatment
Answer: C. Routine data collection on a stable client can be delegated. Assessment, teaching and evaluation remain the registered nurse’s responsibility. Assistive personnel can remind the client to use the spirometer after the nurse has taught it.
50. Which findings indicate respiratory distress in an infant? Select all that apply.
A. Nasal flaring
B. Expiratory grunting
C. Intercostal retractions
D. Respiratory rate of 40/min while asleep
E. Head bobbing
F. Pink, moist mucous membranes
Answer: A, B, C, E. Flaring, grunting, retractions and head bobbing show increased work of breathing. A rate of 40/min is within the normal infant range (about 30–60/min), and pink, moist membranes are normal.
FAQs
What breathing subjects are at the NCLEX?
The exam normally covers COPD, asthma, pneumonia, tuberculosis, pulmonary embolism, pneumothorax, and chest tube care. It moreover exams oxygen treatment and arterial blood fueloline interpretation. Expect every records question and prioritization scenario.
How have to I use NCLEX respiration exercise questions?
Complete them in small, timed units and study each reason afterward. Track which subjects you miss, then overview the ones regions again. This technique turns exercise into lasting understanding.
What oxygen saturation is secure for a customer with COPD?
Most customers with COPD purpose for a saturation of approximately 88% to 92%. Higher oxygen tiers can get worse carbon dioxide retention. Always comply with the provider`s order and display the customer closely.
How do I interpret ABGs for the NCLEX?
Check the pH first, then see whether the PaCO2 or HCO3 fits the change. An excessive PaCO2 with low pH manner respiration acidosis, at the same time as a low HCO3 with low pH manner metabolic acidosis. Finally, search for symptoms and symptoms of compensation.
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