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Quizzes > Health & Medicine

RN medical-surgical respiratory quiz for Med-Surg nurses

Quick, free RN respiratory practice quiz. Instant results.

Editorial: Review CompletedCreated By: Divyanshu SrivastavUpdated Aug 25, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art lungs and stethoscope icons on coral background for RN respiratory practice quiz

This RN med-surg respiratory quiz helps you check core concepts and practice quick clinical judgment on common nursing scenarios. Keep learning with the medical surgical respiratory practice quiz, sharpen exam prep in the NCLEX respiratory practice, or review gas exchange basics in the respiratory gas exchange quiz.

Which structure is primarily responsible for gas exchange in the lungs?
Alveoli
Bronchioles
Trachea
Pleura
The alveoli are tiny air sacs in the lungs where oxygen and carbon dioxide are exchanged between air and blood. Their thin walls and extensive capillary network allow efficient gas diffusion. Bronchioles, trachea, and pleura are involved in air conduction or protection but not primary gas exchange. Lung Function and Structure.
A normal PaO2 value on an arterial blood gas analysis for a healthy adult at sea level is approximately:
40-60 mm Hg
80-100 mm Hg
60-80 mm Hg
100-120 mm Hg
Normal arterial oxygen tension (PaO2) ranges between 80 and 100 mm Hg in healthy adults breathing room air at sea level. Values below this range typically indicate hypoxemia. Reference ranges can vary slightly by source. .
Which device measures the percentage of hemoglobin saturated with oxygen?
Pulse oximeter
Peak flow meter
Spirometer
Blood gas analyzer
A pulse oximeter uses light absorption through a perfused tissue bed to estimate hemoglobin oxygen saturation (SpO2). Arterial blood gas analyzers also measure SaO2 but are invasive. Peak flow meters measure expiratory flow, and spirometers assess lung volumes. .
What is the primary muscle used during quiet inspiration?
Diaphragm
Scalenes
External oblique
Internal intercostals
The diaphragm is the main muscle of inspiration at rest, contracting to increase thoracic volume. External intercostals assist, but internal intercostals are more active in forced expiration. Scalenes play a minor role in deep or labored breathing. .
Which value is considered a normal respiratory rate for a resting adult?
10-14 breaths per minute
20-28 breaths per minute
8-12 breaths per minute
12-20 breaths per minute
A normal resting respiratory rate in adults ranges from 12 to 20 breaths per minute. Rates below or above this range may indicate respiratory depression or distress, respectively. Monitoring rate aids in early detection of respiratory compromise. .
What does the term 'tidal volume' refer to in respiratory physiology?
Maximum air exhaled after a deep breath
Air remaining after maximal exhalation
Air inhaled or exhaled during normal breathing
Additional air inhaled with a forced breath
Tidal volume (Vt) is the amount of air inhaled or exhaled during a normal, restful breath. It typically averages 500 mL in adults. Inspiratory reserve and residual volumes represent additional phases of lung capacity. .
Which home device helps a patient with asthma monitor peak expiratory flow?
Spirometer
Peak flow meter
Nebulizer
Venturi mask
A peak flow meter measures peak expiratory flow rate (PEFR) to monitor airway obstruction in asthma. Spirometers measure multiple lung volumes in clinical settings. Nebulizers deliver medications, and Venturi masks regulate oxygen delivery. .
What is the primary purpose of a chest tube in respiratory care?
Administer antibiotics directly to the pleural space
Deliver high-flow oxygen
Measure intrapulmonary pressures
Evacuate air or fluid from the pleural cavity
A chest tube is inserted into the pleural space to remove air (pneumothorax) or fluid (pleural effusion), allowing the lung to re-expand. It also monitors pleural drainage. It is not used for intrapulmonary pressure measurement or medication delivery directly. .
An arterial blood gas shows pH 7.25, PaCO2 55 mm Hg, HCO3- 24 mEq/L. Which acid-base imbalance is present?
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
A pH below 7.35 indicates acidosis. Elevated PaCO2 (>45 mm Hg) with normal HCO3- suggests primary respiratory acidosis. In metabolic acidosis, HCO3- would be decreased. .
Which change in the lungs is characteristic of chronic obstructive pulmonary disease (COPD)?
Destruction of alveolar walls
Excessive surfactant production
Thickening of alveolar capillaries
Bronchial cartilage hypertrophy
Emphysema, a form of COPD, involves destruction of alveolar walls, resulting in decreased surface area for gas exchange. Chronic bronchitis, another form, features mucous gland hyperplasia. Neither thickened capillaries nor surfactant excess characterize COPD. .
A patient with asthma reports waking at night with shortness of breath. This pattern most likely indicates:
Respiratory alkalosis
Early airway obstruction
Nocturnal asthma
Status asthmaticus
Nocturnal asthma is characterized by worsening symptoms at night due to circadian variations in airway tone and inflammation. Status asthmaticus is a severe, unrelenting asthma attack. Nighttime awakening reflects poor asthma control. .
Which compensatory mechanism occurs in chronic respiratory acidosis?
Renal retention of bicarbonate
Excretion of bicarbonate
Respiratory center depression
Increased ventilation
In chronic respiratory acidosis, kidneys compensate by retaining bicarbonate and excreting hydrogen ions to raise pH. Increased ventilation addresses acute respiratory acidosis, not chronic. Excreting bicarbonate would worsen acidosis. .
What is the primary action of a beta-2 agonist inhaler in asthma management?
Inhibit leukotriene synthesis
Reduce mucus production
Suppress inflammatory cells
Cause bronchodilation
Beta-2 agonists stimulate beta-2 receptors on bronchial smooth muscle, causing relaxation and bronchodilation. They do not directly reduce mucus or suppress inflammation; corticosteroids do. Leukotriene inhibitors have a different mechanism. .
Which sputum characteristic is most commonly associated with bacterial pneumonia?
Streaked with blood
Green and foul-smelling
Rust-colored
Clear and frothy
Rust-colored sputum is classically linked to Streptococcus pneumoniae infection. Green sputum may indicate Pseudomonas or other bacteria, but color alone is nonspecific. Clear frothy sputum suggests pulmonary edema. .
Which early sign indicates that a patient may be developing hypoxia?
Hypotension
Confusion
Bradycardia
Cyanosis
Mental status changes like confusion often appear early in hypoxia due to inadequate cerebral oxygenation. Cyanosis is a late sign. Hypotension and bradycardia are less sensitive early indicators. .
Incentive spirometry is primarily used to:
Assist in bronchodilation
Measure peak expiratory flow
Deliver aerosolized medications
Prevent atelectasis
Incentive spirometers encourage sustained maximal inspiration to inflate alveoli and prevent atelectasis, especially postoperatively. They do not deliver medications or measure flow. Bronchodilation is achieved via inhalers. .
Which finding is a hallmark of acute respiratory distress syndrome (ARDS)?
Hyperreflexia
Elevated pulmonary capillary wedge pressure
Increased lung compliance
Noncardiogenic pulmonary edema
ARDS is characterized by increased capillary permeability leading to noncardiogenic pulmonary edema despite normal wedge pressures. Lung compliance decreases due to stiff, fluid-filled alveoli. Hyperreflexia is unrelated. .
Positive end-expiratory pressure (PEEP) in mechanical ventilation primarily helps to:
Reduce airway resistance
Decrease respiratory rate
Increase tidal volume
Recruit collapsed alveoli
PEEP maintains positive pressure in the lungs at end expiration, preventing alveolar collapse and improving oxygenation. It does not directly change tidal volume or airway resistance. .
Where is the chest tube placed to evacuate air from a pneumothorax?
Second intercostal space, midclavicular line
Seventh intercostal space, posterior axillary line
Fifth intercostal space, midaxillary line
Fourth intercostal space, anterior axillary line
For a pneumothorax (air removal), the chest tube is typically placed in the 2nd intercostal space at the midclavicular line. Lower placements are used for fluid removal. Proper positioning ensures effective evacuation. .
Which medication is classified as a mucolytic?
Fluticasone
Montelukast
Ipratropium bromide
Acetylcysteine
Acetylcysteine breaks disulfide bonds in mucus, reducing viscosity and aiding clearance. Ipratropium is an anticholinergic bronchodilator, montelukast is a leukotriene antagonist, and fluticasone is an inhaled corticosteroid. .
Which combination of drugs is the initial treatment for active tuberculosis?
Pyrazinamide, linezolid, isoniazid, rifampin
Isoniazid, amikacin, ciprofloxacin, rifabutin
Rifampin, doxycycline, ethambutol, streptomycin
Isoniazid, rifampin, pyrazinamide, ethambutol
The standard initial TB regimen includes isoniazid, rifampin, pyrazinamide, and ethambutol for two months. Other drugs are used for resistant cases or intolerance. .
What pattern on pulmonary function tests indicates a restrictive lung disease?
Normal FEV1/FVC with reduced lung volumes
Decreased FEV1/FVC ratio
Increased total lung capacity
Elevated residual volume
Restrictive lung diseases show reduced total lung capacity and vital capacity with a normal or elevated FEV1/FVC ratio. Obstructive patterns lower the FEV1/FVC ratio. .
Which patient scenario is most appropriate for bilevel positive airway pressure (BiPAP)?
Airway protection in altered mental status
Hypoventilation with hypercapnia in COPD exacerbation
Severe hypoxemia in ARDS requiring high PEEP
Immediate post-extubation airway edema
BiPAP provides different pressures for inspiration and expiration, supporting ventilation and reducing PaCO2 in hypercapnic respiratory failure, such as COPD exacerbation. ARDS often requires invasive ventilation with high PEEP. .
A patient in the ICU has a PaO2 of 55 mm Hg while receiving 0.5 FiO2 on the ventilator. What is the PaO2/FiO2 ratio and what does it indicate?
220, moderate ARDS
150, severe ARDS
110, mild ARDS
275, normal oxygenation
PaO2/FiO2 = 55/0.5 = 110. A ratio between 100 and 200 indicates moderate ARDS. Ratios <100 indicate severe ARDS; 200 - 300 mild. This metric guides severity classification. .
In ARDS management, limiting tidal volume to 6 mL/kg of predicted body weight primarily helps to:
Reduce barotrauma and volutrauma
Eliminate need for PEEP
Increase cardiac output
Prevent ventilator-associated pneumonia
Low tidal volume ventilation (6 mL/kg) minimizes alveolar overdistension, reducing barotrauma and volutrauma in ARDS. It does not directly affect pneumonia risk or cardiac output, and PEEP remains essential. .
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Study Outcomes

  1. Understand Respiratory Physiology -

    Describe the mechanisms of oxygenation and ventilation, and identify how alterations impact patient outcomes in the respiratory system med surg context.

  2. Analyze Arterial Blood Gases -

    Interpret ABG values to recognize acid - base imbalances and assess gas exchange status in med surg respiratory cases.

  3. Apply Nursing Interventions -

    Implement evidence-based interventions for conditions such as hypoxia, COPD, and acute respiratory distress within med surg respiratory system care.

  4. Evaluate Clinical Scenarios -

    Use critical-thinking skills in the rn learning system medical surgical respiratory practice quiz to determine appropriate priorities and interventions in simulated patient cases.

  5. Differentiate Respiratory Disorders -

    Distinguish between acute and chronic respiratory conditions, including common causes, manifestations, and nursing priorities.

  6. Recall Pharmacologic Principles -

    Identify key medications used in med surg respiratory management and their mechanisms of action, indications, and potential side effects.

Cheat Sheet

  1. Optimizing Oxygenation Parameters -

    Accurate oxygenation is vital in med surg respiratory system care. Monitor PaO2 and SpO2 regularly and adjust FiO2 to maintain PaO2 above 80 mm Hg or SpO2 above 92%, a frequent focus on the rn learning system medical-surgical: respiratory practice quiz. Tracking trends on arterial blood gases (ABGs) helps pinpoint hypoxemia early (American Association for Respiratory Care).

  2. Applying Ventilation Formulas -

    Calculate minute ventilation (Ve = RR × Vt) to assess alveolar ventilation and detect hypoventilation early when studying respiratory system med surg concepts. Use the alveolar ventilation formula (Va = [tidal volume - dead space] × RR) to evaluate effective gas exchange (Guyton's Physiology).

  3. Interpreting ABGs with ROME Mnemonic -

    Apply "Respiratory Opposite, Metabolic Equal" (ROME) to quickly classify acid-base imbalances on the med surg respiratory system quiz. For example, a low pH with elevated PaCO2 indicates respiratory acidosis, while low pH with low HCO3 - suggests metabolic acidosis (Ham's Clinical Chemistry).

  4. Recognizing COPD Exacerbation Management -

    Follow GOLD guidelines for acute COPD flares, including short”acting bronchodilators, systemic corticosteroids, and antibiotics as needed, a core med surg respiratory topic. Teach pursed”lip breathing ("Lips Puckered, Pressure Controlled") to reduce air trapping and improve dyspnea (Global Initiative for Chronic Obstructive Lung Disease).

  5. Conducting a Thorough Respiratory Assessment -

    Use the IPPA sequence - Inspection, Palpation, Percussion, Auscultation - to identify abnormalities like crackles or wheezes during the rn learning system medical surgical respiratory practice quiz preparation. Correlate findings with patient symptoms to guide nursing interventions effectively (Bates' Guide to Physical Examination).

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