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Quizzes > Health & Medicine > Human Anatomy & Medicine

Free NCLEX Respiratory 3.0 Practice Quiz

Ready to master your respiratory system NCLEX quiz? Take the Respiratory 3.0 Test now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration of respiratory quiz elements lungs stethoscope notes NCLEX practice test on golden yellow background

This NCLEX respiratory 3.0 test helps you practice airway care, oxygenation, ABGs, and ventilator basics with scored, case-style questions and instant feedback. Use it to spot gaps and build speed before the exam. If you want a warm‑up, review core pulmonary topics , or practice pediatric respiratory cases .

Which peak flow meter reading indicates the green zone for a patient with asthma?
Greater than 80% of personal best
Exactly 100% of personal best
Less than 50% of personal best
50 - 79% of personal best
The green zone is defined as 80% - 100% of the patient's personal best peak flow and indicates good asthma control. Patients in the green zone can continue their usual therapy. Readings in yellow or red zones require intervention. .
What is the normal respiratory rate for a healthy adult at rest?
20 - 24 breaths per minute
12 - 20 breaths per minute
24 - 30 breaths per minute
8 - 12 breaths per minute
A normal adult respiratory rate at rest ranges from 12 to 20 breaths per minute. Rates below or above this range may indicate respiratory compromise or compensatory mechanisms. Always assess in context of the patient's overall status. .
Which muscle is the primary muscle of inspiration?
Abdominal muscles
Diaphragm
Sternocleidomastoid
Intercostal muscles
The diaphragm is the main muscle of inspiration, contracting and flattening to increase thoracic volume. Intercostals assist but are accessory muscles. Abdominals are primary expiratory muscles. Diaphragm function.
What is the normal arterial blood gas PaO2 range for a healthy adult?
80 - 100 mmHg
100 - 120 mmHg
60 - 80 mmHg
40 - 60 mmHg
A normal PaO2 in arterial blood gases is 80 - 100 mmHg, reflecting adequate oxygenation. Values below indicate hypoxemia; values above may occur with supplemental oxygen. .
Tachypnea is best defined as which of the following respiratory rates?
12 - 20 breaths per minute
Less than 12 breaths per minute
Greater than 30 breaths per minute
Greater than 20 breaths per minute
Tachypnea is defined as a respiratory rate exceeding 20 breaths per minute in adults. It may be a sign of hypoxia, fever, or metabolic acidosis. Assessment should include oxygen saturation and work of breathing. .
What is the primary purpose of chest physiotherapy in pulmonary patients?
Improve pulmonary perfusion
Measure lung capacity
Mobilize and clear secretions
Maintain acid-base balance
Chest physiotherapy techniques such as percussion and postural drainage mobilize secretions for expectoration. This improves airway patency and gas exchange. It does not directly measure capacity or alter perfusion. .
At high altitudes, the primary cause of hypoxemia is:
Ventilation-perfusion mismatch
Right-to-left shunt
Diffusion limitation across alveolar membrane
Decreased atmospheric pressure and reduced alveolar O?
At high altitude, barometric pressure falls, reducing alveolar and arterial O? tensions. This leads to hypoxemia despite normal lung function. V/Q mismatch and shunts are not the primary issues in healthy individuals at altitude. .
What term describes difficulty breathing when lying flat?
Apnea
Dyspnea
Eupnea
Orthopnea
Orthopnea is dyspnea that occurs when lying flat and is relieved by sitting up. It is common in heart failure and pulmonary edema. General dyspnea can occur in any position. .
Stridor is best described as:
Musical wheezing on expiration
Fine crackling on inspiration
A low-pitched expiratory sound
A high-pitched inspiratory sound
Stridor is a harsh, high-pitched sound heard primarily during inspiration, indicating upper airway obstruction. Wheezes are musical and often expiratory. Crackles are heard with alveolar fluid. .
What is the primary function of the mucociliary escalator in the respiratory tract?
Facilitate gas exchange across alveoli
Maintain acid-base homeostasis
Produce surfactant to reduce surface tension
Trap and transport inhaled particles out of the airway
The mucociliary escalator uses mucus and ciliary action to trap and move inhaled debris upward toward the throat for removal. It does not produce surfactant or directly handle gas exchange. Mucociliary function.
A COPD patient presents with a barrel chest. What does this finding indicate?
Diaphragmatic paralysis
Acute pulmonary edema
Chronic air trapping and hyperinflation
Pleural effusion
Barrel chest occurs due to chronic air trapping and increased chest diameter in COPD. It reflects hyperinflation of the lungs. It is not seen in acute edema or pleural effusions. .
Interpret these ABG values: pH 7.30, PaCO2 55 mmHg, HCO3- 24 mEq/L.
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
Primary respiratory acidosis
A low pH with elevated PaCO2 indicates primary respiratory acidosis. The HCO3- is within normal range, showing no metabolic compensation. This often results from hypoventilation. .
Which drug class does albuterol belong to in asthma management?
Leukotriene receptor antagonist
Inhaled corticosteroid
Long-acting muscarinic antagonist
Short-acting beta2 agonist
Albuterol is a short-acting beta2 agonist that relaxes bronchial smooth muscle to relieve acute bronchospasm. It is not a steroid or leukotriene modifier. .
Which is an early clinical sign of hypoxia?
Cyanosis
Hypotension
Bradycardia
Tachycardia
Tachycardia is often an early compensatory response to tissue hypoxia. Bradycardia and cyanosis are late signs. Hypotension may occur with severe hypoxia but not early. .
Which finding is characteristic of acute respiratory distress syndrome (ARDS)?
Noncardiogenic pulmonary edema
Elevated left atrial pressure
High PaO2 on room air
Increased lung compliance
ARDS features noncardiogenic pulmonary edema due to increased alveolar-capillary permeability. Left atrial pressure is normal. Lung compliance decreases and hypoxemia worsens. .
What is the recommended maximum suction pressure for an adult endotracheal suctioning?
100 - 120 mmHg
140 - 160 mmHg
60 - 80 mmHg
200 - 220 mmHg
Adult suctioning should use 100 - 120 mmHg to prevent mucosal trauma while effectively clearing secretions. Lower pressures may be inadequate, and higher pressures can cause tissue damage. .
Which confirms correct endotracheal tube placement?
Presence of gag reflex
Bilateral breath sounds and end-tidal CO? detection
Low oxygen saturation
Equal chest rise alone
Correct placement is confirmed by bilateral breath sounds and presence of end-tidal CO? on capnography. Chest rise alone is insufficient. Gag reflex and low O? do not confirm tube location. .
What is the primary goal of incentive spirometry?
Measure daily oxygen needs
Encourage sustained maximal inspiration
Deliver aerosol medications
Assess diaphragm strength
Incentive spirometry promotes sustained maximal inspiration to prevent atelectasis and improve lung expansion after surgery. It does not deliver medication or directly measure oxygen requirements. .
Which breathing technique is correct for a patient using a metered-dose inhaler with a spacer?
Rapid sniffing breaths
Exhale forcefully after actuation
Slow deep inhalation and hold breath for 5 - 10 seconds
Normal tidal breathing only
Using a spacer, the patient should inhale slowly and deeply, then hold breath for 5 - 10 seconds to maximize drug deposition. Rapid sniffing or forceful exhalation reduces efficacy. .
Where should the chest tube drainage system be placed relative to the patient's chest?
Below the level of the patient's chest
At the level of the patient's heart
At the same level as the patient's chest
Above the patient's head
The chest tube drainage system must be below the patient's chest level to use gravity for effective drainage and prevent backflow. Level with the chest or above risks air or fluid entry. .
Interpret these ABG values: pH 7.45, PaCO2 30 mmHg, HCO3- 18 mEq/L.
Respiratory acidosis, compensated
Respiratory alkalosis, partially compensated
Metabolic acidosis, uncompensated
Metabolic alkalosis, fully compensated
A pH of 7.45 indicates alkalosis. The low PaCO? suggests primary respiratory alkalosis, and the decreased HCO?? shows partial metabolic compensation. This is not metabolic in origin. .
A ventilated patient has hypoxemia despite FiO? of 100%. Which adjustment is most appropriate?
Switch to volume-controlled mode
Increase positive end-expiratory pressure (PEEP)
Decrease tidal volume
Increase inspiratory flow rate
Increasing PEEP helps recruit collapsed alveoli and improve oxygenation in refractory hypoxemia. Decreasing tidal volume or changing flow rate does not directly improve PaO? in this scenario. .
What is the immediate intervention for a tension pneumothorax in a ventilated patient?
Administer high-dose steroids
Increase ventilator rate
Needle decompression in the second intercostal space
Obtain chest X-ray before intervention
Tension pneumothorax is a life-threatening emergency requiring immediate needle decompression in the 2nd intercostal space to relieve mediastinal shift. Imaging delays can be fatal. .
A patient on mechanical ventilation develops acute hypotension and distended neck veins. What is the likely cause?
Pulmonary embolism
Tension pneumothorax
Right ventricular infarction
Hypovolemia
Sudden hypotension with jugular venous distension in a ventilated patient strongly suggests tension pneumothorax causing decreased venous return. Hypovolemia would show flat neck veins. .
Which ABG pattern is consistent with acute respiratory distress syndrome (ARDS)?
Low PaO?, normal PaCO?, pH near normal
High PaO?, high PaCO?, alkalotic pH
Low PaO?, high PaCO?, acidotic pH
Normal PaO?, low PaCO?, alkalotic pH
ARDS is characterized by severe hypoxemia (low PaO?) with near-normal PaCO? initially, as hyperventilation maintains CO?. pH remains near normal. CO? elevation occurs later. .
Which indicator suggests successful weaning from mechanical ventilation?
PaCO? rising above 50 mmHg
Persistent accessory muscle use
Spontaneous tidal volume >5 mL/kg and RR <30
FiO? requirement >60%
Successful weaning criteria include spontaneous tidal volume >5 mL/kg and respiratory rate <30 breaths/min. High FiO? needs, hypercapnia, or accessory muscle use indicate weaning failure. .
A patient with pneumonia shows consolidation on percussion and bronchial breath sounds. What underlying process explains these findings?
Pleural thickening
Alveolar filling with exudate
Hyperinflation of alveoli
Interstitial fibrosis
Consolidation and bronchial breath sounds occur when alveoli fill with exudate during pneumonia. This increases density, enhancing sound transmission. Pleural issues and fibrosis present differently. .
Which ventilator setting best helps reduce risk of ventilator-induced lung injury in ARDS?
Rapid inspiratory time
Zero PEEP
High tidal volume (>10 mL/kg)
Low tidal volume (4 - 6 mL/kg)
Using low tidal volumes (4 - 6 mL/kg of ideal body weight) reduces overdistension and ventilator-induced lung injury in ARDS. High volumes or zero PEEP worsen injury. .
Which finding on chest X-ray is most consistent with pulmonary edema?
Hyperlucent lung fields
Bilateral perihilar "bat wing" opacities
Pleural thickening
Unilateral lobar consolidation
Pulmonary edema often presents as bilateral perihilar or "bat wing" opacities due to fluid accumulation. Lobar consolidation suggests pneumonia, and hyperlucency suggests emphysema. .
A patient with ARDS on low tidal volume ventilation develops worsening hypoxemia. PEEP is at 10 cm H?O and FiO? 0.8. What is the next best step?
Decrease PEEP to 5 cm H?O
Reduce FiO? to 0.5
Switch to SIMV mode
Prone positioning to improve ventilation-perfusion matching
Prone positioning improves oxygenation in severe ARDS by recruiting dorsal lung regions and improving V/Q matching. Lowering PEEP or FiO? would worsen hypoxemia. SIMV mode change is not first-line. .
A ventilated patient on high PEEP shows decreased cardiac output and hypotension. Which action is most appropriate?
Switch to pressure support mode
Decrease PEEP to optimize hemodynamics
Increase tidal volume
Administer corticosteroids
High PEEP can reduce venous return and cardiac output, leading to hypotension. Lowering PEEP can help restore hemodynamics. Increasing tidal volume or changing mode does not address preload issues. .
A patient with severe acute asthma exacerbation is unresponsive to inhaled bronchodilators and corticosteroids. Which therapy should be considered next?
Intravenous magnesium sulfate
Inhaled ipratropium bromide
Continuous albuterol nebulization at low flow
Subcutaneous epinephrine
IV magnesium sulfate is recommended for life-threatening asthma unresponsive to initial therapy, as it causes smooth muscle relaxation. Ipratropium and continuous albuterol are adjuncts but less effective, and subcutaneous epinephrine is not first-line. .
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Study Outcomes

  1. Apply Respiratory Assessment Techniques -

    Perform systematic respiratory assessments to identify normal and abnormal lung sounds, ventilation patterns, and oxygenation status.

  2. Interpret Arterial Blood Gas Results -

    Analyze ABG values to determine acid-base imbalances and guide appropriate nursing interventions in respiratory care.

  3. Differentiate Common Respiratory Disorders -

    Recognize key pathophysiological features of asthma, COPD, pneumonia, and other conditions to prioritize patient care decisions.

  4. Implement Evidence-Based Interventions -

    Apply best-practice nursing interventions, including pharmacologic therapies and oxygen delivery methods, for effective respiratory management.

  5. Evaluate Ventilator Settings and Weaning -

    Assess ventilator parameters and weaning criteria to support patients transitioning from mechanical ventilation.

  6. Enhance NCLEX Respiratory Test Readiness -

    Build confidence through realistic, scored practice questions tailored to the Respiratory 3.0 test format and challenge your knowledge.

Cheat Sheet

  1. Alveolar Gas Equation & A - a Gradient -

    Use the alveolar gas equation (PAO2 = FiO2×[Patm - PH2O] - PaCO2/R) to calculate alveolar oxygen and then find the A - a gradient (PAO2 - PaO2). A normal A - a gradient is <15 mmHg at sea level, so an elevated value can help you pinpoint diffusion defects in your respiratory assessment NCLEX review.

  2. ABG Interpretation with ROME Mnemonic -

    Mnemonic ROME (Respiratory Opposite, Metabolic Equal) streamlines acid - base analysis on the respiratory 3.0 test by showing whether pH and PaCO2 move in opposite directions (respiratory) or the same direction (metabolic). For instance, pH 7.25 with PaCO2 55 mmHg indicates respiratory acidosis.

  3. Oxygen Transport & Delivery Formula -

    Master DO2 = CO × (1.34×Hb×SaO2 + 0.003×PaO2) × 10 to understand how cardiac output, hemoglobin, and saturation drive oxygen delivery. For example, CO 5 L/min with Hb 15 g/dL and SaO2 98% yields DO2 ≈1000 mL O2/min - a key concept in respiratory nursing questions.

  4. Bronchodilator Classes Mnemonic "BAC" -

    Remember "BAC" for Bronchodilators: Beta-agonists, Anticholinergics, Corticosteroids, which keeps your NCLEX respiratory practice test prep organized. For example, albuterol (short-acting beta2-agonist) is a go-to for acute bronchospasm and appears frequently in questions.

  5. Oxygen Delivery Devices & FiO2 Ranges -

    Memorize device-to-FiO2 mappings: Nasal cannula 24-44%, Venturi mask 24-50%, non-rebreather 60-90% using the "N-V-N" increasing FiO2 mnemonic. Confidently distinguishing these on a respiratory system NCLEX quiz will boost your test readiness.

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