West Coast University Advanced Medical Surgical RN Respiratory

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Sample questions from West Coast University Advanced Medical Surgical RN Respiratory

This material has 75 questions with answers and rationales. Here are the first 5.

1. 1.Which finding is the earliest indication that an adult client's respiratory status may be deteriorating?

   • A.A respiratory rate of 8 breaths/min
   • B.Cyanosis around the lips
   • C.Restlessness and difficulty concentrating
   • D.A drop in oxygen saturation to 75%

   Rationale: Restlessness and difficulty concentrating can be early signs of inadequate oxygenation and may appear before more obvious changes. Cyanosis, severe bradypnea, and a saturation of 75% indicate more advanced or substantial deterioration rather than an early warning. Assess trends and the client's overall presentation instead of waiting for late signs.

2. 2.A client's arterial blood gas results are pH 7.30, PaCO2 52 mm Hg, and HCO3 24 mEq/L. Which interpretation is most accurate?

   • A.Uncompensated respiratory alkalosis
   • B.Uncompensated respiratory acidosis
   • C.Uncompensated metabolic alkalosis
   • D.Uncompensated metabolic acidosis

   Rationale: The low pH indicates acidemia, and the elevated PaCO2 identifies a respiratory cause; the normal bicarbonate indicates that metabolic compensation is not evident. Metabolic acidosis would involve a low bicarbonate, while respiratory alkalosis would involve a low PaCO2. Metabolic alkalosis would produce an elevated pH and bicarbonate.

3. 3.During a home visit, a client with asthma reports new chest tightness and has a peak flow of 280 L/min. The client's personal best is 400 L/min, and the written action plan identifies green as 80% to 100%, yellow as 50% to less than 80%, and red as less than 50% of personal best. Which interpretations or actions are appropriate? Select all that apply.

   • A.A peak flow of 280 L/min is reassuring because it is above 200 L/min.
   • B.The client should follow the yellow-zone instructions in the written action plan.
   • C.The peak flow is in the yellow zone.
   • D.The peak flow is in the red zone.
   • E.The result should be interpreted in relation to the client's personal best and action plan.

   Rationale: A peak flow of 280 L/min is 70% of the 400 L/min personal best, placing it in the stated yellow zone. Peak-flow values are interpreted relative to the individual client's personal best and action-plan zones, not an isolated number such as 200 L/min. The red-zone threshold is less than 200 L/min for this client, so the red-zone option is incorrect.

4. 4.A newborn has a pulse oximeter reading of 97% but becomes increasingly difficult to arouse. Which interpretation is most appropriate?

   • A.The saturation confirms adequate ventilation and carbon-dioxide clearance.
   • B.The reading confirms that arterial oxygen and tissue oxygen delivery are normal.
   • C.The newborn's altered alertness is unrelated to respiratory status when saturation is normal.
   • D.The saturation estimates oxygenation but does not establish adequate ventilation.

   Answer and rationale are in the full material.

5. 5.In an urgent care clinic, a child has a pulse oximeter reading that varies from 88% to 96% while the child is moving. Which action should the nurse take first to obtain a more reliable measurement?

   • A.Reposition the probe on a warm, still site and confirm a stable signal.
   • B.Average the displayed values over several minutes while the child continues moving.
   • C.Document the lowest displayed value as the child's oxygen saturation.
   • D.Increase the oxygen flow rate before repeating the measurement.

   Answer and rationale are in the full material.