Respiratory System Practice Questions and Review
Get ready for your exam with high yield respiratory system NCLEX practice questions and review.
1: A 60-year-old male patient presents to the emergency department with a high fever, productive cough, and chest pain. His vital signs include a temperature of 101.8°F, blood pressure of 140/90 mmHg, heart rate of 110 bpm, and respiratory rate of 24 breaths per minute. What is the most likely diagnosis for this patient?
a. Pneumonia
b. Bronchitis
c. Asthma
d. Pulmonary embolism
2: A 65-year-old male patient presents to the clinic with shortness of breath and cough for the past 2 years. He reports that the cough is usually non-productive and he feels breathless even with mild activity. He has a history of smoking for 40 years. What is the most likely diagnosis for this patient?
a. Emphysema
b. Chronic bronchitis
c. Asthma
d. Pneumonia
3: A 25-year-old female patient with a history of asthma presents to the clinic for a routine check-up. She reports experiencing occasional symptoms of asthma, but they do not interfere with her daily activities. She currently uses an albuterol inhaler as needed for symptom relief. What does the nurse expect will be recommended for her mild intermittent asthma?
a. Inhaled corticosteroids
b. Short-acting beta-agonists as needed
c. Long-acting beta-agonists
d. Leukotriene receptor antagonists
4: A 55-year-old female patient presents to the emergency department with sudden onset shortness of breath and chest pain. She has a history of smoking, morbid obesity, COPD, and smoking. What is the most likely diagnosis for this patient?
a. Emphysema exacerbation
b. Acute bronchitis
c. Pulmonary embolism
d. Pneumonia
5: A 70-year-old male patient presents to the clinic with a persistent cough that has lasted for 3 months. He reports that the cough is usually productive with white sputum, and he experiences shortness of breath with activity. He has a history of smoking for 50 years. What is the most likely diagnosis for this patient?
a. Emphysema
b. Chronic bronchitis
c. Asthma
d. Pneumonia
6: A 60-year-old female patient presents to the clinic with shortness of breath and cough for the past year. You observe pursed lip breathing. She reports that the cough is usually non-productive and that she feels breathless even with mild activity. She has a history of smoking for 30 years. What is the most likely diagnosis for this patient?
a. Emphysema
b. Chronic bronchitis
c. Asthma
d. Pneumonia
7: A 45-year-old male patient presents to the clinic with shortness of breath and wheezing for the past 2 years. He reports that the symptoms are worse in the morning and during the winter months. He has a history of smoking for 10 years. What is the most likely diagnosis for this patient?
a. Emphysema
b. Chronic bronchitis
c. Asthma
d. Pneumonia
8: A 35-year-old female patient presents to the clinic with a persistent cough and fever for the past 2 weeks. She reports that the cough is usually non-productive and that she feels fatigued. She has a history of asthma. What is the most likely diagnosis for this patient?
a. Pneumonia
b. Bronchitis
c. Asthma exacerbation
d. Pulmonary embolism
9: A 35-year-old female patient presents to the clinic with a cough that has lasted for 3 weeks and resolving flu-like symptoms. She reports that the cough is productive of yellow-green sputum and is associated with mild shortness of breath. She has no history of asthma or chronic obstructive pulmonary disease (COPD). What is the most likely diagnosis for this patient?
a. Acute bronchitis
b. Pneumonia
c. Chronic bronchitis
d. Asthma exacerbation
10: A 50-year-old male patient with a history of smoking presents to the emergency department with severe shortness of breath and cough. He reports a productive cough with yellow sputum for the past 3 months. He has a history of COPD and takes inhalers as prescribed. What is the most likely diagnosis for this patient?
a. Acute bronchitis
b. Pneumonia
c. Chronic bronchitis
d. Asthma exacerbation
11: A 40-year-old male patient with a history of asthma presents to the emergency department with severe shortness of breath and wheezing. He is using accessory muscles to breathe, and his respiratory rate is 32 breaths/min. He reports that he has not been taking his asthma medications regularly. What does the nurse expect for the patient’s recommended initial treatment for his severe asthma exacerbation in this patient?
a. Inhaled corticosteroids
b. Short-acting beta-agonists
c. Long-acting beta-agonists
d. Systemic corticosteroids
12: A 42-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with sudden onset of chest pain and shortness of breath. The patient is found to have a collapsed left lung on chest X-ray. What is the most likely cause of the pneumothorax in this patient?
a. Trauma
b. Spontaneous rupture of a bleb
c. Lung cancer
d. Pulmonary embolism
13: A 15-year-old female patient with a history of asthma presents to the clinic for a follow-up visit. She reports experiencing symptoms of asthma more frequently, despite using her prescribed medications. She currently uses an inhaled corticosteroid and a long-acting beta-agonist. What does the nurse expect for the patient’s recommended treatment for her asthma?
a. Increase the dose of inhaled corticosteroids
b. Add a short-acting beta-agonist to the treatment regimen
c. Switch to a combination inhaler containing both inhaled corticosteroids and a long-acting beta-agonist
d. Add a leukotriene receptor antagonist to the treatment regimen
14: A 10-year-old boy with a history of asthma presents to the emergency department with shortness of breath and wheezing. His respiratory rate is 28 breaths/min, and he is using accessory muscles to breathe. He has a history of allergies and is not currently taking any asthma medications. What does the nurse expect for the patient’s recommended treatment for acute asthma exacerbation in this patient?
a. Inhaled corticosteroids
b. Short-acting beta-agonists
c. Long-acting beta-agonists
d. Leukotriene receptor antagonists
15: A 25-year-old male patient presents to the clinic with a cough that has lasted for 2 weeks. He reports that the cough is dry and non-productive and is associated with mild chest discomfort. He has no history of asthma or COPD. What is the most likely diagnosis for this patient?
a. Acute bronchitis
b. Pneumonia
c. Chronic bronchitis
d. Asthma exacerbation
16: A 60-year-old male patient presents to the clinic with a persistent cough that has lasted for 6 months. He reports that the cough is productive of white sputum and is associated with shortness of breath. He has a history of smoking and COPD and takes inhalers as prescribed. What is the most likely diagnosis for this patient?
a. Acute bronchitis
b. Pneumonia
c. Chronic bronchitis
d. Asthma exacerbation
17 A 40-year-old female patient presents to the clinic with a persistent cough that has lasted for 2 weeks. She reports that the cough is dry and non-productive and is associated with wheezing and shortness of breath. She has a history of asthma and takes inhalers as prescribed. What is the most likely diagnosis for this patient?
a. Acute bronchitis
b. Pneumonia
c. Chronic bronchitis
d. Asthma exacerbation
18: A 45-year-old male patient presents to the clinic with a cough and productive sputum for the past two weeks. He reports feeling fatigued and short of breath during physical activity. He has a history of smoking and has been experiencing recurrent respiratory infections. Which of the following is a common cause of acute bronchitis?
a. Bacterial infection
b. Fungal infection
c. Viral infection
d. Parasitic infection
19: Which of the following is a characteristic symptom of chronic bronchitis?
a. Wheezing
b. Chest pain
c. Productive cough
d. Hemoptysis
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20: Which of the following is a risk factor for developing chronic bronchitis?
a. Exposure to secondhand smoke
b. Outdoor air pollution
c. Occupational exposure to dust and chemicals
d. All of the above
21: A 45-year-old male patient is admitted to the hospital with a pulmonary embolism. He is started on anticoagulation therapy. What is the primary goal of anticoagulation therapy in a patient with a pulmonary embolism?
a. To dissolve the blood clot
b. To prevent the formation of new blood clots
c. To relieve symptoms
d. To prevent complications
22: A 70-year-old female patient is admitted to the ICU with a massive pulmonary embolism. She is hypotensive and requires vasopressor support. What is the primary complication of a massive pulmonary embolism?
a. Hemoptysis
b. Pulmonary edema
c. Hypotension
d. Respiratory failure
23: Which of the following diagnostic tests is used to confirm a diagnosis of bronchitis?
a. Chest X-ray
b. Pulmonary function tests
c. Sputum culture
d. All of the above
24: Which of the following medications may be used to manage symptoms of bronchitis?
a. Antibiotics
b. Inhaled corticosteroids
c. Short-acting beta-agonists
d. Antiviral medications
25: A 44-year-old female patient presents to the emergency department with complaints of wheezing and shortness of breath. She has a history of asthma and is currently not taking any medications. On examination, she has bilateral wheezing and a respiratory rate of 28 breaths per minute. Which of the following medications is the first-line treatment for acute exacerbations of asthma?
a. Inhaled corticosteroids
b. Short-acting beta-agonists
c. Leukotriene modifiers
d. Long-acting beta-agonists
26: Which of the following is a common trigger for asthma exacerbations?
a. Cold weather
b. Physical activity
c. Emotional stress
d. All of the above
27: A 45-year-old male patient is admitted to the ICU with severe pneumonia. He is intubated and mechanically ventilated. Over the next few days, his oxygenation deteriorates despite aggressive ventilation management. What is the most likely diagnosis for this patient?
a. Pulmonary embolism
b. Asthma exacerbation
c. Acute respiratory distress syndrome (ARDS)
d. Chronic obstructive pulmonary disease (COPD)
28: A 65-year-old female patient is admitted to the ICU after a motor vehicle accident. She sustained multiple injuries, including a traumatic brain injury, and is intubated and mechanically ventilated. What is the most likely risk factor for developing ARDS in this patient?
a. Traumatic brain injury
b. Age
c. Gender
d. Smoking history
29: A 30-year-old pregnant female patient is admitted to the ICU with sepsis due to an intrauterine infection. She is intubated and mechanically ventilated. What is the most likely complication of ARDS in a pregnant patient?
a. Increased risk of sepsis
b. Increased risk of fetal distress
c. Increased risk of preterm labor
d. Increased risk of maternal mortality
30: A 55-year-old male patient is admitted to the ICU with severe pneumonia. He develops ARDS and is started on mechanical ventilation with high levels of positive end-expiratory pressure (PEEP). What is the primary goal of using high PEEP in a patient with ARDS?
a. To decrease the work of breathing
b. To decrease the risk of barotrauma
c. To improve oxygenation
d. To prevent hypotension
31: A 40-year-old male patient is admitted to the ICU with septic shock. He is intubated and mechanically ventilated with low tidal volumes and high PEEP. What is the primary reason for using low tidal volumes in a patient with ARDS?
a. To decrease the risk of barotrauma
b. To decrease the work of breathing
c. To improve oxygenation
d. To prevent hypotension
32: A 60-year-old female patient presents to the emergency department with shortness of breath and chest pain. She has a history of deep vein thrombosis and is currently taking warfarin. What is the most likely diagnosis for this patient?
a. Myocardial infarction
b. Pulmonary embolism
c. Asthma exacerbation
d. Pneumonia
33: A 55-year-old male patient is diagnosed with a pulmonary embolism and is started on heparin therapy. He develops bleeding complications, with a significant drop in hemoglobin levels. What is the primary antidote for heparin-induced bleeding?
a. Protamine sulfate
b. Vitamin K
c. Fresh frozen plasma
d. Tranexamic acid
34: 1: A 28-year-old male patient presents to the emergency department with sudden onset of chest pain and shortness of breath. Upon examination, the patient is found to have decreased breath sounds on the right side of the chest. A chest X-ray reveals a collapsed right lung. What is the most likely diagnosis?
a. Pneumothorax
b. Pulmonary embolism
c. Myocardial infarction
d. Asthma exacerbation
35: A 35-year-old female patient with a history of smoking presents to the clinic with chest pain and difficulty breathing. The patient reports that she has been experiencing these symptoms for several days, but they have gradually worsened. Upon examination, the patient has decreased breath sounds on the left side of the chest. What diagnostic test would be most appropriate to confirm the diagnosis of pneumothorax?
a. Electrocardiogram
b. Chest X-ray
c. Computed tomography (CT) scan
d. Pulmonary function test
36: Which of the following is a potential side effect of long-term use of inhaled corticosteroids?
a. Osteoporosis
b. Weight gain
c. Hypertension
d. Hypoglycemia
37: Which of the following medications is used as a rescue therapy for severe asthma exacerbations?
a. Inhaled corticosteroids
b. Short-acting beta-agonists
c. Leukotriene modifiers
d. Long-acting beta-agonists
38: Which of the following is a key component of asthma self-management?
a. Avoiding all triggers
b. Using rescue medication only during exacerbations
c. Keeping a written asthma action plan
d. Taking inhaled corticosteroids only when symptoms are present
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1 Answer: A – Pneumonia Rationale: The patient’s symptoms of productive cough, chest pain, and fever are consistent with pneumonia, an infection of the lungs.
2 Answer: A – Emphysema Rationale: The patient’s symptoms of chronic cough, dyspnea, and smoking history suggest emphysema, which is a type of chronic obstructive pulmonary disease (COPD) characterized by the destruction of the lung tissue.
3 Answer: B – Short-acting beta-agonists as needed Rationale: According to the asthma treatment guidelines, the recommended treatment for mild intermittent asthma is short-acting beta-agonists as needed for symptom relief.
4 Answer: C – Pulmonary embolism Rationale: The patient’s sudden onset of dyspnea and chest pain, along with a history of smoking and COPD, raise concern for pulmonary embolism, which is a potentially life-threatening condition.
5 Answer: B – Chronic bronchitis Rationale: The patient’s symptoms of persistent productive cough, dyspnea with activity, and smoking history suggest chronic bronchitis, a type of COPD characterized by inflammation of the bronchial tubes.
6 Answer: A – Emphysema Rationale: The patient’s symptoms of chronic cough, dyspnea, and smoking history suggest emphysema, a type of COPD characterized by destruction of the lung tissue.
7 Answer: C – Asthma Rationale: The patient’s symptoms of wheezing and dyspnea that are worse in the morning and during the winter months suggest asthma, which is a chronic inflammatory condition of the airways. Smoking history is a risk factor for asthma development.
8 Answer: A – Pneumonia Rationale: The patient’s persistent cough, fever, and fatigue are suggestive of pneumonia. The history of asthma may increase the risk of developing pneumonia.
9 Answer: A – Acute bronchitis Rationale: The symptoms reported by the patient are consistent with acute bronchitis, which is an inflammation of the bronchial tubes that usually follows a viral respiratory infection.
10 Answer: C – Chronic bronchitis Rationale: The patient’s symptoms of chronic productive cough and shortness of breath for the past 3 months are consistent with chronic bronchitis, which is a type of COPD characterized by a chronic cough and mucus production.
11 Answer: D – Systemic corticosteroids Rationale: The initial treatment for severe asthma exacerbation is systemic corticosteroids, such as prednisone, to reduce airway inflammation and improve symptoms. Short-acting beta-agonists are also used to relieve bronchoconstriction. Inhaled corticosteroids and long-acting beta-agonists are used for long-term asthma control.
12 Answer: b. Spontaneous rupture of a bleb Rationale: In patients with COPD, the most common cause of pneumothorax is a spontaneous rupture of a bleb, which is a small sac of air in the lung tissue that can rupture and cause air to enter the pleural space. Trauma, lung cancer, and pulmonary embolism can also cause pneumothorax, but they are less likely causes in this patient population.
13 Answer: A – Increase the dose of inhaled corticosteroids Rationale: According to the asthma treatment guidelines, step-up therapy for patients with poorly controlled asthma includes increasing the dose of inhaled corticosteroids. If symptoms persist, adding a long-acting beta-agonist or switching to a combination inhaler containing both inhaled corticosteroids and a long-acting beta-agonist may be considered. Short-acting beta-agonists are used for symptom relief, not for long-term asthma control. Leukotriene receptor antagonists are not recommended as first-line therapy for step-up therapy.
14 Answer: B – Short-acting beta-agonists Rationale: The initial treatment for acute asthma exacerbation is a short-acting beta-agonist, such as albuterol, to relieve bronchoconstriction and improve airflow. Inhaled corticosteroids and leukotriene receptor antagonists are used for long-term management of asthma. Long-acting beta-agonists are used in combination with inhaled corticosteroids for long-term asthma control.
15 Answer: A – Acute bronchitis Rationale: The patient’s symptoms of dry cough and chest discomfort for 2 weeks are consistent with acute bronchitis, which can be caused by viral or bacterial infections.
17 Answer: D – Asthma exacerbation Rationale: The patient’s symptoms of wheezing, shortness of breath, and dry cough in the setting of a history of asthma are consistent with an asthma exacerbation.
18 Answer: C – Viral infection Rationale: Acute bronchitis is commonly caused by viral infections, such as the common cold or influenza. Bacterial, fungal, and parasitic infections are less common causes.
19 Answer: C – Productive cough Rationale: Chronic bronchitis is defined as a persistent cough with sputum production for at least three months in two consecutive years. Wheezing and chest pain may occur, but they are not characteristic symptoms of chronic bronchitis. Hemoptysis, or coughing up blood, may occur in advanced stages of chronic bronchitis.
20 Answer: D – All of the above Rationale: Exposure to secondhand smoke, outdoor air pollution, and occupational exposure to dust and chemicals are all risk factors for developing chronic bronchitis. Smoking is the most common cause of chronic bronchitis.
21 Answer: B – To prevent the formation of new blood clots Rationale: Anticoagulation therapy is used to prevent the formation of new blood clots in patients with pulmonary embolism. It does not dissolve the existing clot, but allows the body to gradually break it down.
22 Answer: C – Hypotension Rationale: A massive pulmonary embolism can lead to decreased cardiac output and systemic hypotension, which can be life-threatening and require vasopressor support.
23 Answer: D – All of the above Rationale: Chest X-ray, pulmonary function tests, and sputum culture may be used to confirm a diagnosis of bronchitis. Chest X-ray can help rule out other conditions, such as pneumonia. Pulmonary function tests can assess lung function and detect airflow obstruction. Sputum culture can identify the presence of bacteria or other microorganisms.
24 Answer: C – Short-acting beta-agonists Rationale: Short-acting beta-agonists, such as albuterol, may be used to manage symptoms of bronchitis, such as wheezing and shortness of breath. Antibiotics are not recommended for viral bronchitis unless there is a secondary bacterial infection. Inhaled corticosteroids are used for long-term management of chronic bronchitis, but they are not effective for acute exacerbations. Antiviral medications may be used for severe cases of influenza-associated bronchitis.
25 Answer: B – Short-acting beta-agonists Rationale: Short-acting beta-agonists, such as albuterol, are the first-line treatment for acute exacerbations of asthma. They work by relaxing the smooth muscles of the airways, which can quickly relieve bronchospasm and improve airflow. Inhaled corticosteroids are used for long-term management of asthma and are not effective for acute exacerbations. Leukotriene modifiers and long-acting beta-agonists are also not recommended for acute exacerbations.
26 Answer: D – All of the above Rationale: Asthma exacerbations can be triggered by a variety of factors, including cold weather, physical activity, and emotional stress. Other common triggers include allergens, respiratory infections, and exposure to irritants such as smoke and pollution.
27 Answer: C – Acute respiratory distress syndrome (ARDS) Rationale: ARDS is a life-threatening lung condition that can develop in patients with severe pneumonia, sepsis, or other underlying conditions. It is characterized by severe oxygenation impairment despite mechanical ventilation.
28 Answer: A – Traumatic brain injury Rationale: Trauma, especially to the lungs or head, is a common risk factor for developing ARDS. The injury can cause inflammation and fluid buildup in the lungs, leading to impaired oxygenation.
29 Answer: B – Increased risk of fetal distress Rationale: ARDS can lead to decreased oxygenation, which can affect fetal well-being. Pregnant patients with ARDS should be closely monitored for fetal distress and may require delivery if the risk to the fetus is too high.
30 Answer: C – To improve oxygenation Rationale: High levels of PEEP can help recruit collapsed alveoli in the lungs, leading to improved oxygenation. It is a key component of the management of ARDS.
31 Answer: A – To decrease the risk of barotrauma Rationale: Low tidal volumes can reduce the risk of barotrauma, such as pneumothorax or lung injury, in patients with ARDS. It is a key component of the management of ARDS.
32 Answer: B – Pulmonary embolism Rationale: Patients with a history of deep vein thrombosis are at increased risk for pulmonary embolism, which is characterized by shortness of breath and chest pain.
33 Answer: A – Protamine sulfate Rationale: Protamine sulfate is the primary antidote for heparin-induced bleeding. Protamine sulfate works by binding to heparin molecules, which neutralizes their anticoagulant effects. By neutralizing heparin’s anticoagulant effects, protamine sulfate helps to prevent or reverse bleeding complications that may occur as a result of heparin therapy.
34 Answer: a. Pneumothorax Rationale: The clinical presentation of sudden onset chest pain and shortness of breath, along with decreased breath sounds and a collapsed lung on chest X-ray, is consistent with pneumothorax. Pneumothorax occurs when air enters the pleural space, causing the lung to collapse. Other potential causes of chest pain and shortness of breath, such as pulmonary embolism, myocardial infarction, and asthma exacerbation, can be ruled out based on the clinical presentation and diagnostic tests.
35 Answer: b. Chest X-ray Rationale: A chest X-ray is the diagnostic test of choice for pneumothorax, as it can visualize the collapsed lung and any associated air in the pleural space. Electrocardiogram, pulmonary function test, and CT scan may be useful in ruling out other potential causes of chest pain and difficulty breathing, but they are not the most appropriate initial diagnostic tests for pneumothorax.
36 Answer: A – Osteoporosis Rationale: Long-term use of inhaled corticosteroids can increase the risk of osteoporosis, a condition that weakens bones and increases the risk of fractures. Weight gain, hypertension, and hypoglycemia are not common side effects of inhaled corticosteroids.
37 Answer: B – Short-acting beta-agonists Rationale: Short-acting beta-agonists, such as albuterol, are used as a rescue therapy for severe asthma exacerbations. They work by quickly relaxing the smooth muscles of the airways, which can improve breathing and reduce the severity of symptoms. Inhaled corticosteroids, leukotriene modifiers, and long-acting beta-agonists are not used as rescue therapy for severe exacerbations.
38 Answer: C – Keeping a written asthma action plan Rationale: A key component of asthma self-management is keeping a written asthma action plan. This plan should outline the patient’s daily medication regimen, as well as instructions for managing exacerbations. It should also include a list of triggers and steps the patient can take to avoid them. Using rescue medication only during exacerbations and taking inhaled corticosteroids only when symptoms are present are not recommended strategies for asthma management. Avoiding all triggers may be unrealistic and difficult to achieve.
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