ATI MED SURG RN Critical Alterations in Gas Exchange Assessment in
Gas Exchange Assessment
Question: 1 of 28
A nurse is planning care for an unstable client who has a possible tension pneumothorax. The
nurse should expect that which of the following imaging studies will be used to confirm the
diagnosis?
a. Magnetic resonance imaging
b. Ultrasound
c. Chest x-ray
d. Computerized tomography
Answer: b. Ultrasound
Question: 2 of 28
A nurse is providing teaching to a client admitted who has a flail chest. Which of the
following will the nurse include in the teaching to prevent respiratory complications? Select
all that apply.
a. Use of incentive spirometer
b. Avoiding constipation
c. Requesting pain medications
d. Cough and deep breathing exercises
e. Ambulation
f. Taking sedatives to sleep
Answer: a. Use of incentive spirometer
d. Cough and deep breathing exercises
e. Ambulation
Question: 3 of 28
A nurse is providing discharge teaching to a client who experienced a tension pneumothorax.
Which of the following recommendations should the nurse make? Select all that apply.
a. Join a smoking cessation program
b. Avoid extended car travel
c. Do not scuba dive until pneumothorax completely resolves
d. Avoid air travel until pneumothorax completely resolves
e. Do not snorkel for at least two months following surgery
Answer: a. Join a smoking cessation program
c. Do not scuba dive until pneumothorax completely resolves
d. Avoid air travel until pneumothorax completely resolves
Question: 4 of 28
A nurse is analyzing the ABG results for a client who has tension pneumothorax. The nurse
should identify that which of the following findings is indicative of uncompensated
respiratory acidosis?
a. Low pH, high PaCO2, normal bicarbonate
b. Low pH, normal PaCO2, low bicarbonate
c. Low pH, high PaCO2, high bicarbonate
d. Normal pH, high PaCO2, high bicarbonate
Answer: a. Low pH, high PaCO2, normal bicarbonate
Question: 5 of 28
A nurse is assessing a client who has respiratory failure due to a pulmonary condition. Which
of the following comorbidities should the nurse expect?
a. Brain tumor
b. Multiple sclerosis
c. Cystic fibrosis
d. Acetaminophen overdose
Answer: c. Cystic fibrosis
Question: 6 of 28
A nurse is teaching an older adult client about how to maintain optimal respiratory function.
Which of the following recommendations should the nurse make? Select all that apply.
a. Take shallow breaths to preserve energy
b. Use an incentive spirometer daily
c. Avoid taking frequent rest breaks throughout the day
d. Exercise every day
e. Perform oral hygiene routinely
Answer: b. Use an incentive spirometer daily
d. Exercise every day
e. Perform oral hygiene routinely
Question: 7 of 28
A nurse is assessing a client who has a transudative effusion. Which of the following
conditions should the nurse expect the client to have?
a. Lung cancer
b. Pneumonia
c. Cirrhosis
d. Pulmonary embolism
Answer: c. Cirrhosis
Question: 8 of 28
A nurse is evaluating a client who has a tension pneumothorax and received a tube
thoracostomy placed to water seal. Which of the following findings should the nurse identify
as an abnormality that should be reported?
a. Bubbling during expiration
b. A rise in fluid level with inspiration
c. Absence of bubbling
d. Pain at the insertion site
Answer: c. Absence of bubbling
Question: 9 of 28
A nurse is assessing a client who has COPD. Which of the following abnormalities should the
nurse expect?
a. Increased elastin
b. Hyperventilation
c. Hypocapnia
d. Decreased lung recoil
Answer: d. Decreased lung recoil
Question: 10 of 28
A nurse is caring for an older adult client. The nurse should identify which of the following
age-related changes places the client at increased risk for respiratory-associated infection?
a. Decreased air spaces
b. Decreased anteroposterior diameter
c. Decreased chest wall compliance
d. Decreased air trapping
Answer: c. Decreased chest wall compliance
Question: 11 of 28
A nurse is teaching a client who has respiratory failure about how to maintain optimal health.
Which of the following recommendations should the nurse make? Select all that apply.
a. Continue using oxygen at home
b. Use pursed lip breathing
c. Avoid live vaccines
d. Wash hands frequently
e. Join a smoking cessation program
Answer: a. Continue using oxygen at home
b. Use pursed lip breathing
d. Wash hands frequently
e. Join a smoking cessation program
Question: 12 of 28
A nurse is teaching a client who has a pulmonary embolism about modifiable risk factors to
prevent a future embolism. Which of the following acquired risk factors should the nurse
include?
a. Protein C deficiency
b. Bed rest greater than 1 day
c. Air travel greater than 1 hr
d. Cigarette smoking
Answer: d. Cigarette smoking
Question: 13 of 28
A nurse is caring for a client who has a pulmonary embolism. Which of the following
pathologic alterations should the nurse expect? Select all that apply.
a. Increased right ventricular preload
b. Increased right ventricular afterload
c. Right ventricular dilation
d. Increased left ventricular filling
e. Left ventricular dilation
f. Systemic hypotension
Answer: b. Increased right ventricular afterload
c. Right ventricular dilation
f. Systemic hypotension
Question: 14 of 28
A nurse is assessing a client who has pulmonary embolism. Which of the following most
common clinical manifestations should the nurse expect? Select all that apply.
a. Chest pain
b. Cough
c. Hemoptysis
d. Dyspnea
e. Arrhythmia
f. Hemodynamic collapse
Answer: a. Chest pain
b. Cough
d. Dyspnea
Question: 15 of 28
A nurse is assessing a client who has tension pneumothorax. Which of the following findings
is a sign of distress that may compress the heart?
a. Increased heart rate
b. Decreased heart rate
c. Tracheal deviation toward the affected lung
d. Tracheal deviation away from the affected lung
Answer: d. Tracheal deviation away from the affected lung
Question: 16 of 28
A nurse is caring for a client who has a chronic condition. The nurse should identify which of
the following factors as placing the client at higher risk of developing a pleural effusion?
a. Receiving peritoneal dialysis
b. Tuberculosis
c. Right sided heart failure
d. Malignancy
e. Diabetes without kidney damage
Answer: a. Receiving peritoneal dialysis
b. Tuberculosis
d. Malignancy
Question: 17 of 28
A nurse is caring for a client who has clinical manifestations of a pleural effusion. The nurse
should identify that which of the following evaluation methods will likely be implemented
first to diagnose pleural effusion?
a. Pleural fluid analysis
b. Thoracentesis
c. A chest x-ray
d. A CT scan
Answer: c. A chest x-ray
Question: 18 of 28
A nurse is educating a client who has a pleural effusion about ways to prevent a recurrence.
Which of the following statements indicates a need for further teaching?
a. "I should avoid exercise for a few weeks."
b. "I should avoid second-hand smoke."
c. "I should drink plenty of fluids."
d. "I should include rest periods in my day."
Answer: a. "I should avoid exercise for a few weeks."
Question: 19 of 28
A nurse is educating a client who was treated for acute respiratory distress syndrome (ARDS)
and is preparing for discharge. Which of the following information should the nurse provide?
Select all that apply.
a. Tracheostomy care
b. Gastric tube care
c. Techniques for managing exercise intolerance
d. High-Intensity exercise recommendations
e. Techniques for managing exertional dyspnea
Answer: a. Tracheostomy care
b. Gastric tube care
c. Techniques for managing exercise intolerance
e. Techniques for managing exertional dyspnea
Question: 20 of 28
A nurse is caring for a client who has a pleural effusion. The nurse should identify which of
the following pathologic alterations may be responsible for this condition?
a. Negative intrapleural pressure
b. Lymphatic obstruction
c. Decreased pleural fluid production
d. Increased lymphatic absorption of pleural fluid
Answer: b. Lymphatic obstruction
Question: 21 of 28
A nurse is planning care for a client who has flail chest. The nurse should identity which
condition is associated with flail chest and may contribute to mortality?
a. Pneumonia
b. Pneumothorax
c. Hemothorax
d. Pulmonary contusion
e. Femur fracture
Answer: b. Pneumothorax
c. Hemothorax
d. Pulmonary contusion
Question: 22 of 28
A nurse is caring for a client who has flail chest. The nurse should identify that ineffective
ventilation occurs because of which of the following pathologic changes?
a. Increased intrathoracic pressure
b. Hyperventilation
c. Increased dead space
d. Increased lung compliance
Answer: c. Increased dead space
Question: 23 of 28
A nurse is coordinating care for a client who has acute respiratory distress syndrome (ARDS).
Which of the following healthcare team members may be included in the client's care? Select
all that apply.
a. Respiratory therapist
b. Case manager
c. Dietitian
d. Nephrologist
e. Nephrologist
f. Urologist
Answer: a. Respiratory therapist
b. Case manager
c. Dietitian
d. Nephrologist
e. Nephrologist
Question: 24 of 28
A nurse is assessing a client who has an intermediate-risk pulmonary embolism. Which of the
following findings should the nurse expect?
a. Lack of symptoms
b. Low blood pressure that does not improve with fluids
c. Lack of hemodynamic instability
d. Right ventricular dysfunction
Answer: d. Right ventricular dysfunction
Question: 25 of 28
A nurse is caring for a client who has a low ventilation-perfusion ratio (V/Q ratio). The nurse
should identify that this pathologic change may be the result of which of the following
conditions?
a. Interstitial lung disease
b. Reduced CO2 levels
c. Decreased perfusion in the lungs
d. Decreased arterial blood content
Answer: a. Interstitial lung disease
Question: 26 of 28
Question: 27 of 28
Question: 28 of 28
