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COMPREHENSIVE PHASE WORKBOOK RESPI HEMA NOVEMBER 2025 Philippine Nurse Licensure Examination Review 1. A client was admitted to the intensive care unit 36 hours ago following extensive pulmonary traumA. Which clinical manifestation would first alert the nurse that the client is experiencing adult respiratory distress syndrome (ARDS)? A. Blood-tinged, frothy sputum B. Dense pulmonary infiltrates with a “whited-out” appearance C. An increase in respiratory rate D. Increasing hypoxemia 2. A client with a history of asthma presents in the physician’s office with complaints of difficulty breathing. While performing the initial assessment, the nurse becomes concerned that the client’s respiratory status has worsened based on which of the following? A. Wheezing throughout the lung fields B. Noticeably diminished breath sounds C. Loud wheezing only on expiration D. Mild wheezing on inspiration 3. A home health nurse is visiting a client with severe chronic obstructive pulmonary disease (COPD) who is complaining of increased shortness of air. The client is on home oxygen at 2 L/min via an oxygen concentrator with a respiratory rate of 23 breaths/min. The most appropriate nursing action is to A. call emergency services to come to the home. B. reassure the client of being unnecessarily anxious. C. conduct further assessment of the client’s respiratory status. D. consider increasing the oxygen to 4 L/min during the home visit. 4. The nurse is admitting a client with suspected tuberculosis (TB) to the acute care unit. The nurse places the client in airborne precautions until a confirmed diagnosis of active TB can be made. Which of the following tests is a priority to confirm the diagnosis? A. Chest x-ray that is positive for lung lesions B. Positive purified protein derivative (PPD) test C. Sputum positive for blood (hemoptysis) D. Sputum culture positive for Mycobacterium tuberculosis 5. A student health nurse is conducting tuberculosis (TB) testing. Students who had the purified protein derivative (PPD) test 48 hours ago have returned to have the results read and documented. The nurse determines that the test is positive if which of the following is present? A. The client complains of itching at the site B. There is a large area of erythema C. There is an induration of 10 mm or greater D. A bruise is present at the site of injection 6. The nurse is aware that the optimal tidal volume for ventilator weaning is what setting? A. 1-2 ml/kg B. 3-5 ml/kg C. 5-8 ml/kg D. 8-10 ml/kg 7. A client with no history of respiratory disease has a sudden onset of dyspnea, chest pain, and tachycardia. A pulmonary embolism is suspected. The nurse anticipates which set of therapeutic orders to be prescribed for this client? Select all that apply: 1. Semi-Fowler’s position 2. Oxygen at 2 L/min 3. High-Fowler’s position 4. Nonsteroidal antiiflammatory 5. Oxygen at 4 L/min 6. Anti-coagulant therapy A. 1, 2, 3 B. 1, 2, 3, 4 C. 2, 3, 6 D. 1, 4, 5, 6 8. A client with pulmonary edema is currently receiving 6 L/min of oxygen per nasal cannulA. The most recent arterial blood gas (ABG) results indicate the following: pH= 7.30, pCO2=50 mm Hg, pO2 = 56 mm Hg, HCO3 = 24 mm Hg. The nurse anticipates that the physician will order which of the following? A. Change nasal cannula to face mask at 6 L/min oxygen B. Add one ampule of sodium bicarbonate to the client’s current intravenous fluids C. Change nasal cannula to partial rebreather mask at 8 L/min oxygen D. Intubate the client and place on mechanical ventilation 9. A registered nurse is planning the schedule for the day. Which of the following nursing tasks may the nurse delegate to a licensed practical nurse? A. Develop instructions for the client on pursed-lip breathing B. Clarify an order with the physician C. Instruct a client on a bronchoscopy D. Administer a purified protein derivative (PPD) to a client 10. The nurses assesses a Mantoux test to be positive when the induration is 10 mm or more when read at what time frame? A. 6-12 hours B. 12-24 hours C. 24-48 hours D. 48-72 hours 11. The nurse has just received orders to provide chest physiotherapy for a client two times per day. The nurse evaluates which schedule to be most therapeutic? A. 7:00 A.m. and 1:00 p.m. B. 6:00 A.m. and 4:00 p.m. C. 9:00 A.m. and 5:00 p.m. D. 8:00 A.m. and 8:00 p.m. 12. The nurse assesses fluctuations in the water seal chamber of a client’s closed chest drainage system. The nurse evaluates this finding as indicating A. the system is functioning properly. B. an air leak is present. C. the tubing is kinked. D. the lung has re-expanded. 13. The nurse assesses a college-age client complaining of shortness of breath after jogging and tightness in his chest. Upon further questioning, the client denies a sore throat, TOP RANK REVIEW ACADEMY, INC. Page 1 | 7


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