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NCLEX Respiratory Practice Questions

Airway and breathing sit at the top of every priority framework, so respiratory content appears in prioritization questions as often as in med-surg ones.

Use these questions to check how well you recognise respiratory distress and choose the right first action.

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What the NCLEX tests in respiratory

5 respiratory practice questions with rationales

Answer each one before opening the rationale. Every option is explained, including the wrong ones.

Question 1 · Multiple choice
Which is an early sign of hypoxia in an adult client?
  1. Cyanosis
  2. Restlessness
  3. Bradycardia
  4. Decreased level of consciousness
Show answer and rationale

Answer: B

A. Cyanosis is a late sign.

B. Correct. Restlessness, anxiety and tachycardia are early signs.

C. Bradycardia is a late sign.

D. Decreased consciousness is late.

Question 2 · Multiple choice
A client with an asthma exacerbation is prescribed both albuterol and fluticasone inhalers. Which should the client use first?
  1. Fluticasone, then albuterol
  2. Albuterol, then fluticasone
  3. Either order is fine
  4. Only fluticasone during an attack
Show answer and rationale

Answer: B

A. The steroid works better once the airways are opened.

B. Correct. The bronchodilator opens the airways so the inhaled corticosteroid reaches deeper.

C. Order matters for deposition.

D. Inhaled steroids are maintenance therapy and do not relieve an acute attack.

Question 3 · Select all that apply
Which actions are appropriate for a client with a chest tube connected to a water-seal drainage system? Select all that apply.
  1. Keep the drainage system below the level of the chest
  2. Clamp the tube routinely during ambulation
  3. Expect gentle tidaling in the water-seal chamber
  4. Report continuous bubbling in the water-seal chamber
  5. Keep sterile gauze or petroleum gauze at the bedside
Show answer and rationale

Answer: A, C, D, E

A. Correct. Gravity prevents backflow into the pleural space.

B. Routine clamping can cause a tension pneumothorax.

C. Correct. Tidaling with breathing shows the system is patent.

D. Correct. Continuous bubbling suggests an air leak.

E. Correct. Needed if the tube becomes dislodged.

Question 4 · Multiple choice
A client with COPD is short of breath. Which position helps most?
  1. Supine
  2. Sitting upright, leaning forward on the over-bed table
  3. Trendelenburg
  4. Prone
Show answer and rationale

Answer: B

A. Lying flat restricts lung expansion.

B. Correct. Tripod positioning helps the diaphragm and accessory muscles work.

C. Head-down positioning worsens breathing.

D. Prone is not used for routine COPD dyspnea.

Question 5 · Select all that apply
Which findings suggest pneumonia? Select all that apply.
  1. Fever
  2. Productive cough
  3. Crackles over the affected area
  4. Bradypnea
  5. Pleuritic chest pain
Show answer and rationale

Answer: A, B, C, E

A. Correct. Infection causes fever.

B. Correct. Purulent or rust-colored sputum is common.

C. Correct. Fluid in alveoli causes crackles.

D. Pneumonia usually causes tachypnea, not slow breathing.

E. Correct. Inflamed pleura hurt on inspiration.

How to study respiratory for the NCLEX

  1. Memorise early versus late hypoxia signs; it decides many priority questions.
  2. In COPD, give the prescribed oxygen and titrate to the target saturation (often 88 to 92%), while watching for rising CO2.
  3. Bronchodilator before steroid is a favourite question.

Frequently asked questions

What respiratory topics are on the NCLEX?

COPD, asthma, pneumonia, tuberculosis, pulmonary embolism, oxygen therapy, chest tubes and arterial blood gases are the most tested.

How do I answer respiratory priority questions?

Use airway, breathing, circulation. A client with a breathing problem usually comes first unless another client has a more immediate threat.

Can I make respiratory questions from my notes?

Yes. Upload your respiratory unit to NurseQuizAI and practise on questions written from it.

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