Med Surg Respiratory Quiz

Questions: 16 · 10 minutes
1. After a chest drainage system has been set up and connections checked, continuous bubbling appears in the water-seal chamber. What does this most likely indicate?
Normal lung re-expansion
Expected fluid drainage from the pleural space
An air leak somewhere in the patient or drainage system
Excessive suction pressure in the collection chamber
2. Which assessment findings are most consistent with a pleural effusion over the affected area?
Hyperresonance and loud bronchial breath sounds
Stridor and increased sounds over the trachea
Dullness to percussion and decreased breath sounds
Diffuse wheezing with prolonged expiration
3. Which new combination of findings is most consistent with a pulmonary embolism?
Sudden dyspnea, pleuritic chest pain, tachycardia, and low oxygen saturation
Gradual weight gain, ankle edema, and a productive cough
Fever, foul-smelling sputum, and symptoms worsening over several days
Slow respirations, pinpoint pupils, and reduced bowel sounds
4. A patient with asthma develops sudden wheezing and chest tightness. Which prescribed medication is intended for rapid relief of acute bronchospasm?
Inhaled fluticasone
Inhaled albuterol
Oral montelukast
Inhaled salmeterol
5. A patient is breathing shallowly on the first day after abdominal surgery. Which plan best helps prevent or improve postoperative atelectasis?
Limit movement and maintain continuous bed rest.
Suppress coughing to reduce pressure on the incision.
Use incentive spirometry, cough and deep-breathe, and mobilize as appropriate.
Restrict fluids and avoid changing position frequently.
6. An arterial blood gas shows pH 7.37, PaCO₂ 55 mm Hg, and HCO₃⁻ 31 mEq/L. Which interpretation is most accurate?
Compensated respiratory acidosis
Uncompensated metabolic acidosis
Compensated respiratory alkalosis
Uncompensated metabolic alkalosis
7. Which structural change is most characteristic of emphysema?
Destruction of alveolar walls with loss of elastic recoil
Fluid accumulation between the visceral and parietal pleura
Acute inflammation limited to the upper airway
Fibrous obstruction of the pulmonary arteries
8. An arterial blood gas shows pH 7.28, PaCO₂ 58 mm Hg, and HCO₃⁻ 25 mEq/L. Which acid-base disturbance is present?
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
Acute respiratory acidosis
9. Why is pursed-lip breathing commonly taught to a patient with COPD?
It increases inspiratory flow so the lungs fill more rapidly.
It prolongs exhalation and helps prevent small-airway collapse and air trapping.
It strengthens the diaphragm by creating resistance during inhalation.
It removes airway secretions by triggering a stronger cough reflex.
10. Shortly after placement of a central venous catheter, a patient develops sudden dyspnea and unilateral absent breath sounds. Which complication should be suspected first?
Postoperative atelectasis
Iatrogenic pneumothorax
Cardiogenic pulmonary edema
Hospital-acquired pneumonia
11. Which precautions are appropriate when entering the room of a patient with suspected active pulmonary tuberculosis?
Contact precautions with gown and gloves only
Droplet precautions with a standard surgical mask
Protective isolation with positive-pressure airflow
Airborne precautions with a fit-tested respirator and appropriate room controls
12. A patient needs a controlled, precise oxygen concentration. Which delivery device is designed for this purpose?
Standard nasal cannula
Simple face mask
Non-rebreather mask
Venturi mask
13. Which finding is especially characteristic of acute respiratory distress syndrome (ARDS)?
Severe hypoxemia that persists despite supplemental oxygen
Hypoxemia that quickly resolves with low-flow oxygen
A unilateral hyperresonant chest with absent breath sounds
Chronic hypercapnia with no acute respiratory distress
14. A patient with a severe asthma exacerbation initially has loud wheezing. The wheezing then becomes barely audible while breathing remains labored. What is the most concerning interpretation?
Bronchospasm is resolving because the airways are producing less sound.
Air movement may be critically reduced, indicating impending respiratory failure.
Secretions have shifted from the bronchi into the upper airway.
The patient is developing fluid in the pleural space.
15. A patient who recently had a stroke begins coughing and develops a wet voice while eating lunch. What is the most appropriate immediate response?
Continue the meal using smaller bites and a faster pace.
Offer thin liquids to help clear food from the throat.
Place the patient flat and encourage slow breathing.
Stop oral intake, keep the patient upright, and arrange further swallowing assessment.
16. A patient suddenly develops severe respiratory distress, hypotension, distended neck veins, and absent breath sounds on the right. Which condition is the priority concern?
Right-sided pleural effusion
Acute bronchitis
Tension pneumothorax
Lobar pneumonia
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