RESPIRATORY
This acute respiratory condition involves airway inflammation, bronchospasm, and hyperresponsiveness, often triggered by environmental factors or exercise.
A) Chronic Obstructive Pulmonary Disease
B) Asthma
C) Pneumorenal Syndrome
D) Pulmonary Embolism
Answer: B) Asthma?
Rationale: Asthma is characterized by inflammation and bronchoconstriction that impair gas exchange and increase airway resistance
The primary pathophysiology of Type 1 Diabetes involves:
A. Insulin resistance in the muscles.
B. Excessive glucose production by the liver.
C. Autoimmune destruction of beta cells leading to absolute insulin deficiency.
D. Malabsorption of glucose in the small intestine
Answer: C. T1DM requires exogenous insulin for survival
A patient with Obstructive Sleep Apnea (OSA) is starting CPAP therapy. The nurse explains that the machine works by:
A. Delivering 100% oxygen to the patient.
B. Providing positive pressure to keep the airway open.
C. Suctioning secretions out of the throat.
D. Monitoring the patient's heart rate while they sleep.
Answer: B. CPAP acts as a "splint" for the upper airway
Albuterol is classified as which type of medication used for immediate relief of acute bronchospasm?
A) Inhaled Corticosteroid (ICS)
B) Short-Acting Beta-2 Agonist (SABA)
C) Long-Acting Muscarinic Antagonist (LAMA)
D) Leukotriene Receptor Antagonist
Answer: B) a Short-Acting Beta-2 Agonist (SABA)?
Rationale: SABAs stimulate beta-2 adrenergic receptors in smooth muscle, causing rapid bronchodilation.
The nurse understands that the primary goal for long-term glucose management is an A1C level of:
A. Less than 4%.
B. Less than 7%.
C. Exactly 8.5%.
D. Between 9% and 10%.
Answer: B. An A1C < 7% is the target for most adults with diabetes
A pediatric patient with an acute asthma exacerbation suddenly has no audible breath sounds upon auscultation ("silent chest"). The nurse recognizes this clue as indicating:
A) Resolution of the asthma attack
B) Severe airway obstruction / impending respiratory failure
C) Development of a pneumothorax
D) Mild bronchodilator response
Answer: B) severe airway obstruction / impending respiratory failure?
Rationale: The absence of wheezing or breath sounds ("silent chest") indicates minimal to no airflow, signaling a critical medical emergency requiring immediate ventilation intervention.
A diabetic patient presents with diaphoresis, tremors, tachycardia, and confusion. The nurse identifies these cues as signs of:
A) Hyperglycemic Hyperosmolar State (HHS)
B) Diabetic Ketoacidosis (DKA)
C) Hypoglycemia
D) Fluid volume overload
Answer: C) Hypoglycemia?
Rationale: Autonomic nervous system activation causes sweating, tremors, and tachycardia, while neuroglycopenia causes confusion when blood glucose drops below normal (< 70mg/dL).
Which cluster of clinical cues is most characteristic of Obstructive Sleep Apnea?
A) Productive cough, night sweats, and weight loss
B) Hemoptysis, chest pain, and dyspnea at rest
C) Inspiratory stridor, high fever, and drooling
D) Loud snoring, witnessed apnea, excessive daytime sleepiness, and morning headaches
Answer: D) loud snoring, witnessed apnea, excessive daytime sleepiness, and morning headaches?
Rationale: Nocturnal hypoxia and sleep fragmentation cause daytime somnolence and morning headaches due to hypercapnia-induced vasodilation.
Which long-acting insulin has no pronounced peak and provides a steady baseline of insulin over 24 hours?
A) Regular Insulin
B) Insulin Lyspro
C) Insulin Glargine
D) NPH Insulin
Answer: C) Insulin Glargine?
Rationale: Basal insulins mimic endogenous baseline insulin secretion and should not be mixed in the same syringe with other insulins.
Keeping open flames away from a patient receiving supplemental oxygen is essential because oxygen has which property?
A) It is highly explosive on its own
B) It supports combustion
C) It acts as a sedating gas
D) It causes carbon dioxide retention in all individuals
Answer: B) supporting combustion?
Rationale: Oxygen is not explosive by itself, but it rapidly accelerates burning/combustion in the presence of an ignition source.
A patient is having an asthma attack. The nurse hears high-pitched, musical sounds during expiration. This is documented as:
A. Crackles.
B. Friction rub.
C. Wheezing.
D. Stridor.
Answer: C. Wheezing is the hallmark respiratory sound of asthma
Prior to administering short-acting insulin (e.g., Regular insulin) before meals, which critical safety action must the nurse perform?
A) Check blood glucose levels and confirm meal availability
B) Administer the dose regardless of food delivery timing
C) Hold the insulin if the patient's blood pressure is normal
D) Encourage the patient to exercise vigorously immediately after injection
Answer: A) checking blood glucose levels and confirming meal availability?
Rationale: Giving short-acting insulin without verifying current blood glucose or ensuring the patient will eat shortly increases the risk of severe hypoglycemia.
Untreated Obstructive Sleep Apnea places a patient at high risk for developing which long-term complication? SATA
A) Hypertension
B) Type 1 Diabetes
C) Asthma
D) Pulmonary Fibrosis
E) Heart failure
Answer: A & E = Hypertension & HEART FAILURE?
Rationale: Repeated nocturnal hypoxemia and sympathetic nervous system activation increase vascular resistance and strain the heart.
A patient prescribed an inhaled corticosteroid (e.g., Fluticasone) must be instructed to take which step after each dose to prevent oral candidiasis?
A) Rinse the mouth with water and spit it out
B) Drink a warm beverage
C) Avoid eating or drinking for 4 hours
D) Use a cough suppressant
Answer: A) rinsing the mouth with water and spitting it out?
Rationale: Local steroid deposition in the oral cavity suppresses local immunity, increasing oral thrush risk if not rinsed.
The nurse identifies which medication as a "rescue" inhaler for acute asthma symptoms?
A. Albuterol
B. Inhaled corticosteroids
C. Long-acting beta agonists
D. Oral prednisone
Answer: A) Albuterol (short-acting beta agonist) provides rapid bronchodilation
An arterial blood gas (ABG) drawn early during an acute asthma attack typically reveals which primary acid-base imbalance due to hyperventilation?
A) Metabolic Acidosis
B) Metabolic Alkalosis
C) Respiratory Acidosis
D) Respiratory Alkalosis
Answer: D) Respiratory Alkalosis?
Rationale: Hyperventilation driven by hypoxia causes excessive blowing off of CO₂ (PaCO2 < 35mmHg), leading to respiratory alkalosis.
A patient with Type 1 Diabetes presents with Kussmaul respirations, a fruity breath odor, and blood glucose of 450 mg/dL. These clinical cues indicate:
A) Respiratory Acidosis
B) Diabetic Ketoacidosis
C) Metabolic Alkalosis
D) Acute Asthma Attack
Answer: B) Diabetic Ketoacidosis (DKA)?
Rationale: Absence of insulin causes lipid breakdown into ketones, creating metabolic acidosis. The lungs compensate by hyperventilating (Kussmaul breathing) to blow off CO₂.
Which first-line non-invasive device delivers positive pressure to maintain upper airway patency during sleep?
A) Simple Face Mask
B) CPAP
C) Nasal Cannula at 2 L/min
D) Incentive Spirometer
Answer: B) a CPAP (Continuous Positive Airway Pressure)Machine?
Rationale: CPAP acts as a pneumatic splint, holding the pharyngeal airway open throughout the respiratory cycle.
When administering high doses of nebulized Albuterol or intravenous Regular insulin, the nurse monitors for which electrolyte drop in the blood?
A) Hypercalcemia
B) Hypernatremia
C) Hypokalemia
D) Hypomagnesemia
Answer: C) Hypokalemia?
Rationale: Both beta-2 agonists and insulin drive potassium from extracellular fluid into cells, lowering serum potassium levels.
A patient with Type 1 Diabetes has a blood glucose of 580 mg/dL and is breathing deeply and rapidly. The nurse identifies this respiratory pattern as:
A. Cheyne-Stokes respirations.
B. Apneic breathing.
C. Kussmaul respirations.
D. Bradypnea.
Answer: C. Kussmaul breathing is the body's attempt to blow off CO2 to compensate for metabolic acidosis in DKA
The nurse provides teaching on the use of a Peak Flow Meter. The patient should use the meter:
A. Daily to determine their personal best and monitor control.
B. Only when they feel short of breath.
C. Once a year during their physical exam.
D. While they are sleeping to check for apnea.
Answer: A. Daily peak flow monitoring helps identify early airway narrowing before symptoms become severe.
A nurse evaluating outcomes for a diabetic patient on insulin therapy notes a HbA1c of 6.2%. This lab value indicates:
A) Poor long-term glucose control requiring immediate intervention
B) Acute renal failure secondary to diabetes
C) Severe hypoglycemia requiring IV dextrose
D) Effective long-term glycemic control
Answer: D) effective long-term glycemic control?
Rationale: An HbA1c below 7.0% indicates good average blood glucose levels over the preceding 2 to 3 months, reducing the risk of microvascular and macrovascular complications.
When generating solutions for a patient diagnosed with OSA, which lifestyle modification provides significant risk reduction?
A) High-carbohydrate diet
B) ncreasing sedative use at bedtime
C) Weight loss and avoiding alcohol before bedI
D) Sleeping strictly in a supine position
Answer: C) weight loss and avoiding alcohol before bed?
Rationale: Excessive adipose tissue around the neck compresses the airway, and alcohol relaxes pharyngeal muscles; weight reduction and avoiding sedatives/alcohol decrease airway collapse risk.
Prior to administering the first dose of IV antibiotics for a patient admitted with pneumonia, which step must be completed first?
A) Administer a dose of oral acetaminophen
B) Perform a arterial blood gas draw
C) Place the patient on strict bed rest for 24 hours
D) Obtain sputum and/or blood cultures
Answer: B) obtaining sputum and/or blood cultures?
Rationale: Collecting cultures before starting antibiotics ensures accurate identification of the pathogen without drug interference.
A patient is experiencing the Somogyi Effect. The nurse should expect:
A. Hyperglycemia all night long.
B. Hypoglycemia at 3 AM followed by rebound hyperglycemia in the morning.
C. Hyperglycemia at 3 AM due to a lack of insulin.
D. Normal blood glucose throughout the night.
Answer: B. Rebound hyperglycemia occurs after an undetected nighttime hypoglycemic event