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Quizzes > Health & Medicine

Your medical surgical respiratory practice quiz

Quick, free med surg respiratory quiz. Instant results and clear explanations.

Editorial: Review CompletedCreated By: Angy BayonUpdated Aug 26, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Cut paper lungs stethoscope bronchoscopy shapes and quiz title on coral background

This quiz helps you review med-surg respiratory care, including breath sounds, bronchoscopy care, and oxygen safety. Get instant feedback, simple rationales, and tips you can use on the floor or before an exam. When you want more practice, try our rn med-surg respiratory practice quiz, explore an oxygenation quiz, or build confidence with NCLEX respiratory practice.

What is the primary muscle of respiration?
Pectoralis major
Diaphragm
Latissimus dorsi
Intercostal muscles
The diaphragm is the main muscle responsible for inspiration, contracting to increase thoracic volume and draw air into the lungs. It separates the thoracic and abdominal cavities. Intercostal muscles assist but are secondary contributors to breathing.
Which structure prevents food from entering the trachea?
Epiglottis
Soft palate
Uvula
Thyroid cartilage
The epiglottis is a flap of cartilage that covers the glottis during swallowing to direct food to the esophagus and prevent aspiration. The uvula and soft palate help seal the nasopharynx, but do not protect the airway. Thyroid cartilage forms the Adam's apple.
Which term describes the movement of air in and out of the lungs?
Perfusion
Ventilation
Diffusion
Compliance
Ventilation refers to the mechanical process of moving air in and out of the lungs. Diffusion is the gas exchange at the alveolar-capillary membrane. Perfusion is blood flow through pulmonary circulation. Compliance is lung distensibility.
What is the normal respiratory rate for a resting adult?
20-30 breaths per minute
12-20 breaths per minute
30-40 breaths per minute
8-12 breaths per minute
A normal resting adult respiratory rate ranges from 12 to 20 breaths per minute. Rates below or above this range suggest hypoventilation or tachypnea, respectively. Vital sign assessment uses this range as a standard.
Which artery is most commonly used for arterial blood gas sampling?
Carotid artery
Radial artery
Brachial artery
Femoral artery
The radial artery is preferred for ABG sampling because of its superficial location and collateral circulation via the ulnar artery. Allen's test confirms adequate collateral flow before puncture. The brachial and femoral arteries are alternatives with higher complication risks.
Which breath sound is commonly heard in pneumonia?
Stridor
Wheezes
Crackles (rales)
Pleural friction rub
Crackles are fine, discontinuous sounds produced by fluid in the alveoli, commonly heard in pneumonia. Wheezes are musical sounds associated with airway narrowing. Pleural friction rub indicates pleural inflammation, and stridor is a high-pitched sound from upper airway obstruction.
Which gas law describes the inverse relationship between pressure and volume during breathing?
Henry's law
Charles's law
Boyle's law
Dalton's law
Boyle's law states that at constant temperature, pressure and volume are inversely proportional, which underlies lung inflation and deflation. Charles's law relates volume and temperature, Henry's law governs gas solubility, and Dalton's law covers partial pressures.
What is the normal arterial PaO2 range in a healthy adult?
80-100 mmHg
60-80 mmHg
20-40 mmHg
100-120 mmHg
Normal arterial PaO2 ranges from 80 to 100 mmHg. Values below this range indicate hypoxemia, while higher values are uncommon without supplemental oxygen. Clinical decisions about oxygen therapy rely on these thresholds.
Which clinical sign is most indicative of hypoxia?
Diaphoresis
Bradycardia
Cyanosis
Hypertension
Cyanosis, a bluish discoloration of skin and mucous membranes, indicates significant desaturation and tissue hypoxia. Hypertension and diaphoresis are nonspecific stress responses, and bradycardia is more typical in severe hypoxia but less specific.
Which device measures the volume of air inhaled and exhaled by the lungs?
Peak flow meter
Pulse oximeter
Bronchoscope
Spirometer
A spirometer measures lung volumes and capacities by recording the volume of air inhaled and exhaled. A pulse oximeter measures oxygen saturation, a peak flow meter measures peak expiratory flow rate, and a bronchoscope visualizes airways.
What term describes the collapse of alveoli in the lung?
Emphysema
Pneumothorax
Pulmonary edema
Atelectasis
Atelectasis refers to alveolar collapse or incomplete expansion, reducing gas exchange. Pulmonary edema is fluid accumulation, pneumothorax is air in the pleural space, and emphysema is destruction of alveolar walls.
Which patient position maximizes chest expansion and facilitates breathing?
High Fowler's position
Prone position
Supine position
Trendelenburg position
High Fowler's position (sitting at 60 - 90 degrees) allows maximum lung expansion by lowering abdominal pressure on the diaphragm. Supine and Trendelenburg positions can restrict diaphragmatic movement. Prone may improve oxygenation in ARDS but is not primary for general breathing ease.
Which chest assessment finding is characteristic of chronic COPD?
Kyphosis
Pigeon chest
Barrel chest
Funnel chest
Barrel chest occurs in COPD due to hyperinflation and increased anterior-posterior diameter. Pigeon chest (pectus carinatum) and funnel chest (pectus excavatum) are congenital chest wall deformities. Kyphosis is spinal curvature, not specific to COPD.
An ABG shows pH 7.30, PaCO2 50 mmHg, HCO3 - 24 mEq/L. What acid-base disturbance is present?
Metabolic alkalosis
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
An elevated PaCO2 with a low pH indicates respiratory acidosis. HCO3 - is within normal limits, showing no metabolic compensation. Metabolic disturbances involve primary bicarbonate changes.
During bronchoscopy, what is the priority nursing intervention?
Encourage increased oral fluids immediately
Maintain NPO status until gag reflex returns
Teach incentive spirometry beforehand
Assess pedal pulses regularly
After bronchoscopy, patients must remain NPO until the gag reflex returns to prevent aspiration. Oral fluids and foods are withheld until safe swallowing is confirmed. Pedal pulses and spirometry teaching are less urgent immediately postprocedure.
Which breath sound is continuous and musical, often heard in asthma?
Wheezes
Pleural friction rub
Crackles
Rhonchi
Wheezes are high-pitched, continuous musical sounds produced by narrowed airways, common in asthma and COPD. Crackles are discontinuous. Rhonchi are low-pitched snoring sounds. Pleural friction rub arises from inflamed pleura.
Which SpO2 reading on a pulse oximeter indicates hypoxemia?
Exactly 100%
Below 90%
Between 90% and 95%
Above 95%
An SpO2 below 90% indicates hypoxemia requiring intervention. Readings between 90 - 95% may be acceptable in some patients but require monitoring. Above 95% is normal in healthy individuals.
What is the primary indication for chest physiotherapy?
Hypotension
Hypovolemia
Ineffective airway clearance
Hyperthermia
Chest physiotherapy, including percussion and postural drainage, is used to mobilize secretions in patients with ineffective airway clearance. It is not indicated for volume depletion, low blood pressure, or fever alone.
Which parameter suggests successful weaning from mechanical ventilation?
FiO2 >60%
Respiratory rate >30 breaths/min
PEEP >10 cm H2O
Tidal volume >5 mL/kg
A spontaneous tidal volume >5 mL/kg predicted body weight indicates adequate ventilation for weaning. High FiO2 and PEEP needs and tachypnea (RR >30) suggest ongoing respiratory support.
Which medication is first-line for relief of acute bronchospasm in asthma?
Long-acting beta2 agonist
Leukotriene receptor antagonist
Short-acting beta2 agonist
Inhaled corticosteroid
Short-acting beta2 agonists (e.g., albuterol) provide rapid bronchodilation and are the treatment of choice for acute asthma exacerbations. Long-acting agents and leukotriene modifiers are maintenance therapies, and corticosteroids reduce inflammation but have slower onset.
Use of accessory muscles during breathing indicates:
Normal breathing
Hypoventilation
Hyperventilation
Increased work of breathing
Accessory muscle use (e.g., sternocleidomastoids) signals increased respiratory effort and possible respiratory distress. It is not typical of normal breathing nor a direct sign of hyper- or hypoventilation without further data.
What is the best indicator of overall oxygen delivery to tissues?
Arterial HCO3 -
Pulse oximetry (SpO2)
Arterial PaO2
Mixed venous oxygen saturation (SvO2)
Mixed venous oxygen saturation reflects the balance of oxygen delivery and consumption and is the best indicator of global tissue oxygenation. PaO2 and SpO2 measure oxygenation of arterial blood, while HCO3 - is a metabolic parameter.
After chest tube insertion for pneumothorax, bubbling in the water-seal chamber should cease when:
Suction is turned off
Drainage exceeds 50 mL/hr
The lung has fully re-expanded
The tube is clamped
Bubbling in the water seal stops when air leak resolves, usually after the lung re-expands. Turning off suction or clamping the tube would artificially alter bubbling, and drainage volume is unrelated to air leaks.
What is the most common complication following bronchoscopy?
Bleeding
Infection
Pneumothorax
Laryngeal spasm
Mild bleeding at the biopsy or sampling site is the most common complication of bronchoscopy. Pneumothorax and laryngeal spasm are less common, and infection risk is low with sterile technique.
Which PaO2/FiO2 ratio is consistent with a diagnosis of acute respiratory distress syndrome (ARDS)?
Less than 300
Greater than 500
400 - 500
300 - 400
ARDS is defined by a PaO2/FiO2 ratio below 300, reflecting a significant gas exchange defect. Ratios above 300 suggest milder or no ARDS. Berlin criteria use specific cutoffs for mild, moderate, and severe ARDS.
A ventilated patient shows elevated peak airway pressure but normal plateau pressure. This suggests:
Decreased lung compliance
Patient-ventilator asynchrony
Leak in the ventilator circuit
Increased airway resistance
High peak pressure with normal plateau pressure indicates increased airway resistance (e.g., bronchospasm or secretions). Decreased compliance raises both pressures. Circuit leaks usually lower pressures. Asynchrony affects flow patterns.
What is the primary mechanism of action of positive end-expiratory pressure (PEEP) in mechanical ventilation?
Prevents alveolar collapse at end expiration
Increases respiratory rate
Reduces airway secretions
Promotes bronchodilation
PEEP maintains positive pressure in the lungs at end expiration to keep alveoli open, improve oxygenation, and reduce shunt. It does not affect respiratory rate directly or act as a bronchodilator.
A patient with suspected pulmonary embolism has an elevated D-dimer. Which is the next best diagnostic test?
Repeat D-dimer
Pulmonary function test
Ventilation-perfusion scan (V/Q scan)
CT pulmonary angiography
CT pulmonary angiography is the gold standard for PE diagnosis after an elevated D-dimer, providing direct visualization of clots. V/Q scans are used when CT is contraindicated. Repeat D-dimer and PFTs are not appropriate next steps.
Which lung volume is most accurately measured by the nitrogen washout technique?
Functional residual capacity
Total lung capacity
Vital capacity
Residual volume
Nitrogen washout measures functional residual capacity by having the patient breathe 100% oxygen and calculating nitrogen volume exhaled. Total lung capacity includes inspired and residual volumes. Vital capacity and residual volume are measured by other methods.
Which condition increases physiological shunt fraction?
Pulmonary edema
High altitude
Hypoventilation
Pulmonary embolism
Pulmonary edema floods alveoli with fluid, preventing ventilation and increasing shunt. Hypoventilation elevates PaCO2 but not shunt fraction. Pulmonary embolism reduces perfusion, and high altitude lowers FiO2 but not true shunt.
A patient exhibits tracheal deviation, hypotension, and distended neck veins. What is the immediate intervention?
Thoracentesis
Chest tube insertion
Needle decompression
High-flow oxygen
These signs indicate tension pneumothorax, requiring immediate needle decompression to relieve pressure. Chest tube placement follows stabilization. Oxygen alone is insufficient, and thoracentesis is for pleural effusion.
In ARDS management, which positioning strategy has been shown to improve oxygenation?
Prone positioning
Reverse Trendelenburg
Supine positioning
Trendelenburg position
Prone positioning redistributes perfusion, improves alveolar recruitment, and enhances oxygenation in ARDS. Supine and Trendelenburg positions can worsen ventilation-perfusion mismatch. Reverse Trendelenburg has minimal effect in severe ARDS.
Which pulmonary function test pattern characterizes restrictive lung disease?
Decreased total lung capacity
Elevated FEV1/FVC ratio
Increased diffusing capacity
Increased residual volume
Restrictive lung diseases reduce lung compliance and total lung capacity. Residual volume may be normal or decreased. FEV1/FVC ratio is often normal or increased, and diffusing capacity is usually reduced or variable.
Which anti-inflammatory agent is administered intravenously in status asthmaticus?
Beta blockers
Leukotriene inhibitors
Methylxanthines
Corticosteroids
Intravenous corticosteroids are used in status asthmaticus to reduce airway inflammation and swelling. Leukotriene inhibitors and methylxanthines are less effective acutely, and beta blockers are contraindicated in asthma exacerbations.
Which heart sound component may be accentuated in pulmonary hypertension?
Split S1
S3 gallop
P2 component of S2
S4 gallop
In pulmonary hypertension, the pulmonary valve closure (P2) is louder, accentuating the S2 component. S3 and S4 gallops are more related to left heart dysfunction. Split S1 is uncommon.
Which electrolyte imbalance can lead to respiratory muscle weakness and hypoventilation?
Hypokalemia
Hypermagnesemia
Hypercalcemia
Hypernatremia
Hypokalemia impairs neuromuscular function and can cause respiratory muscle weakness and hypoventilation. Hypermagnesemia and hypercalcemia also affect muscles but are less common causes of hypoventilation. Hypernatremia primarily affects neurologic status.
According to Light's criteria, which pleural fluid/serum protein ratio indicates an exudative pleural effusion?
Greater than 0.5
Between 0.3 and 0.5
Exactly 1.0
Less than 0.3
Light's criteria define an exudate if pleural fluid protein/serum protein ratio exceeds 0.5. Transudates have ratios below this threshold. Other criteria include LDH ratios.
What is the mechanism of action of dornase alfa in cystic fibrosis care?
Cleaves extracellular DNA to reduce sputum viscosity
Stimulates ciliary motility
Blocks histamine receptors
Inhibits neutrophil elastase
Dornase alfa is recombinant human DNase I, which cleaves extracellular DNA in purulent sputum, reducing viscosity and aiding clearance. It does not inhibit elastase or affect histamine or cilia directly.
What initial tidal volume is recommended for lung-protective ventilation in ARDS?
6 mL/kg predicted body weight
12 mL/kg predicted body weight
10 mL/kg predicted body weight
8 mL/kg predicted body weight
Lung-protective ventilation in ARDS uses low tidal volumes of about 6 mL/kg predicted body weight to reduce ventilator-induced lung injury. Higher volumes increase barotrauma and volutrauma risk.
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Study Outcomes

  1. Identify Adventitious Breath Sounds -

    Learn to recognize and differentiate crackles, wheezes, rhonchi, and stridor on auscultation to enhance your med surg respiratory assessment skills.

  2. Distinguish Types of Atelectasis -

    Understand the pathophysiology and clinical manifestations of compression, absorption, and contraction atelectasis within the respiratory system med surg context.

  3. Interpret Bronchoscopy Findings -

    Analyze visual and laboratory results from bronchoscopy procedures to make informed decisions about airway management and patient care.

  4. Apply Respiratory Interventions -

    Master techniques such as chest physiotherapy, incentive spirometry, and suctioning to prevent and manage respiratory complications effectively.

  5. Evaluate Oxygenation and Ventilation Strategies -

    Assess and select appropriate oxygen delivery systems and ventilator settings based on patient-specific data and med surg respiratory guidelines.

  6. Integrate Clinical Knowledge for Decision-Making -

    Synthesize quiz feedback and evidence-based practices to strengthen critical thinking and boost confidence in real-world respiratory care scenarios.

Cheat Sheet

  1. Adventitious Breath Sounds -

    Identifying crackles, wheezes, and pleural friction rubs is a cornerstone of med surg respiratory assessment (American Thoracic Society). Use the mnemonic "CRaP" (Crackles, Rhonchi, Pleural rub) to recall adventitious sounds and link each to common pathologies like pulmonary edema or bronchospasm.

  2. Atelectasis Prevention and Management -

    Atelectasis occurs when alveoli collapse, reducing gas exchange and risking hypoxemia (NCBI). Incorporate incentive spirometry (10 breaths/hour), early ambulation, and proper positioning - remember "IS, Ambulate, Turn" as a quick respiratory system med surg checklist.

  3. Bronchoscopy Indications and Care -

    Bronchoscopy provides direct airway visualization for biopsy or secretion removal but requires strict pre-procedure NPO status and post-procedure monitoring for hemorrhage (American College of Chest Physicians). Always assess gag reflex return before resuming oral intake and watch for signs of respiratory distress.

  4. Arterial Blood Gas Analysis (ROME) -

    Master ABG interpretation with the ROME mnemonic: Respiratory Opposite (pH↑, PaCO2↓) and Metabolic Equal (pH↑, HCO3↑). For example, pH 7.25, PaCO2 55 mmHg, HCO3 24 mEq/L indicates respiratory acidosis in respiratory med surg contexts.

  5. Oxygen Delivery Devices & FiO2 -

    Choose the correct device based on required FiO2: nasal cannula (1 - 6 L/min yields ~24 - 44% FiO2), Venturi mask (24 - 50%), or non-rebreather (up to 90%) (AACN). Remember "N-V-N" (Nasal, Venturi, Non-rebreather) for quick med surg respiratory quizlet recall.

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