NCLEX Respiratory Practice Questions

15 free NCLEX-RN respiratory questions with answers and rationales — perfect for respiratory nclex questions practice. Want them as an interactive timed quiz?

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1. A patient with chronic obstructive pulmonary disease (COPD) is experiencing an exacerbation. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Increased sputum production.
- B. Decreased breath sounds in the right lower lobe. ✓
- C. Respiratory rate of 28 breaths per minute.
- D. Use of accessory muscles during breathing.
Answer: B. Decreased breath sounds in the right lower lobe. — Decreased breath sounds may indicate consolidation or pneumothorax, requiring immediate medical evaluation.
2. A patient with asthma is prescribed albuterol via nebulizer. What is the primary therapeutic effect the nurse should expect?
- A. Decrease in respiratory rate.
- B. Resolution of wheezing.
- C. Increase in peak expiratory flow rate. ✓
- D. Reduction in cough frequency.
Answer: C. Increase in peak expiratory flow rate. — Albuterol is a bronchodilator that primarily works to increase airway patency, improving peak expiratory flow rate.
3. A patient is admitted with pneumonia. Which laboratory result is most concerning to the nurse?
- A. White blood cell count of 15,000/mm³.
- B. PaO2 of 60 mmHg. ✓
- C. Hematocrit of 40%.
- D. BUN of 18 mg/dL.
Answer: B. PaO2 of 60 mmHg. — A PaO2 of 60 mmHg indicates significant hypoxemia, which is concerning and requires prompt intervention.
4. The nurse is caring for a patient with acute respiratory distress syndrome (ARDS). Which intervention should be prioritized to improve oxygenation?
- A. Increase the rate of IV fluids.
- B. Place the patient in a prone position. ✓
- C. Administer diuretics to reduce fluid overload.
- D. Encourage deep breathing exercises.
Answer: B. Place the patient in a prone position. — Prone positioning can improve ventilation-perfusion matching and oxygenation in patients with ARDS.
5. A nurse is caring for a patient with a chest tube. Which finding should be reported to the healthcare provider immediately?
- A. Continuous bubbling in the water seal chamber. ✓
- B. Serosanguinous drainage in the collection chamber.
- C. Tidaling in the water seal chamber.
- D. Chest tube output of 100 mL over 24 hours.
Answer: A. Continuous bubbling in the water seal chamber. — Continuous bubbling in the water seal chamber indicates an air leak, which requires immediate attention.
6. The nurse is reviewing arterial blood gas results for a patient. Which result indicates metabolic acidosis?
- A. pH 7.48, PaCO2 32 mmHg, HCO3- 25 mEq/L
- B. pH 7.30, PaCO2 40 mmHg, HCO3- 18 mEq/L ✓
- C. pH 7.36, PaCO2 45 mmHg, HCO3- 26 mEq/L
- D. pH 7.50, PaCO2 48 mmHg, HCO3- 30 mEq/L
Answer: B. pH 7.30, PaCO2 40 mmHg, HCO3- 18 mEq/L — A low pH and low HCO3- indicate metabolic acidosis.
7. A nurse is instructing a patient with asthma on the use of a peak flow meter. What is the best time for the patient to use the peak flow meter?
- A. Immediately before using a bronchodilator.
- B. After using a bronchodilator.
- C. Every morning before taking medications. ✓
- D. During an asthma attack.
Answer: C. Every morning before taking medications. — Peak flow meters should be used daily in the morning to establish a baseline measurement for asthma management.
8. A patient with COPD is receiving oxygen therapy. Which oxygen delivery device is most appropriate to maintain low-flow oxygen for this patient?
- A. Simple face mask.
- B. Venturi mask.
- C. Non-rebreather mask.
- D. Nasal cannula. ✓
Answer: D. Nasal cannula. — A nasal cannula is suitable for delivering low-flow oxygen therapy, which is often needed in COPD to prevent CO2 retention.
9. The nurse is assessing a patient with pneumonia who is experiencing difficulty breathing. What is the best initial action by the nurse?
- A. Administer prescribed antibiotics.
- B. Position the patient in high Fowler's position. ✓
- C. Perform chest physiotherapy.
- D. Obtain a sputum culture.
Answer: B. Position the patient in high Fowler's position. — Positioning the patient in high Fowler's position helps to improve lung expansion and ease breathing.
10. A patient with ARDS is on mechanical ventilation. Which parameter indicates the need for immediate adjustment of ventilator settings?
- A. PaCO2 of 45 mmHg.
- B. PaO2 of 55 mmHg. ✓
- C. pH of 7.35.
- D. HCO3- of 24 mEq/L.
Answer: B. PaO2 of 55 mmHg. — A PaO2 of 55 mmHg is significantly low, indicating inadequate oxygenation and the need for ventilator adjustment.
11. A patient with a recent thoracotomy has a chest tube in place. Which of the following should the nurse include in the patient's care plan?
- A. Clamp the chest tube when ambulating the patient.
- B. Keep the drainage system below chest level. ✓
- C. Empty the drainage chamber every shift.
- D. Milk the chest tube every 2 hours.
Answer: B. Keep the drainage system below chest level. — Keeping the drainage system below chest level prevents backflow of fluid into the chest cavity, which is critical for proper function.
12. The nurse notes that a patient with asthma has a silent chest during an exacerbation. What is the most appropriate action?
- A. Reassess the patient in 15 minutes.
- B. Administer epinephrine immediately.
- C. Call for immediate medical assistance. ✓
- D. Provide reassurance to the patient.
Answer: C. Call for immediate medical assistance. — A silent chest indicates severe obstruction or respiratory failure, necessitating immediate medical intervention.
13. A patient is receiving high-flow oxygen therapy for hypoxemia. Which complication is the nurse most concerned about?
- A. Oxygen toxicity. ✓
- B. Carbon dioxide retention.
- C. Nasal dryness.
- D. Hypoventilation.
Answer: A. Oxygen toxicity. — High-flow oxygen therapy can lead to oxygen toxicity, especially in patients receiving high concentrations for extended periods.
14. A patient with COPD reports worsening dyspnea. What is the most important initial assessment by the nurse?
- A. Review the patient's medication administration record.
- B. Check the patient's oxygen saturation level. ✓
- C. Auscultate lung sounds for wheezing.
- D. Assess for signs of anxiety and restlessness.
Answer: B. Check the patient's oxygen saturation level. — Assessing the patient's oxygen saturation provides immediate information about the adequacy of oxygenation, guiding further interventions.
15. The nurse is reviewing discharge instructions for a patient with pneumonia. Which instruction is most important to prevent recurrence?
- A. Increase fluid intake to thin secretions.
- B. Avoid smoking and exposure to secondhand smoke. ✓
- C. Use a humidifier to maintain airway moisture.
- D. Perform incentive spirometry every hour while awake.
Answer: B. Avoid smoking and exposure to secondhand smoke. — Avoiding smoking is critical in preventing respiratory infections and complications, including pneumonia recurrence.

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NCLEX Respiratory Practice Questions

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