Respiratory Nursing for the NCLEX-RN Exam

Common failure modes

These are the patterns that cause most candidates to lose marks on this topic. Recognising them in advance is half the work.

• !Giving high-flow oxygen to a COPD patient and missing the hypoxic-drive risk (target SpO2 88–92%)
• !Mistaking respiratory acidosis (high PaCO2, low pH) for metabolic acidosis (low HCO3)
• !Disconnecting a chest tube without clamping briefly and submerging in sterile water
• !Forgetting to stop tube feedings 30–60 minutes before suctioning to prevent aspiration

Study tips

• 1Drill ABG interpretation in 4 steps: pH, PaCO2, HCO3, then determine compensation. Practice 50 ABGs.
• 2Memorize asthma severity classifications and stepwise treatment per GINA guidelines.
• 3Know chest tube safety: bubbling in water seal = air leak; tidal swing = correct placement; sudden absence of tidaling = obstruction or lung re-expansion.
• 4Pneumonia: empiric coverage for CAP differs from HAP/VAP — know the priority cultures and antibiotic windows.

Sample NCLEX-RN Respiratory Nursing questions

These sample items mirror the format and difficulty of real NCLEX-RN questions. Practice with thousands more on the free Koydo question bank.

1. 1

   A client with COPD has SpO2 of 88% on room air. Which oxygen delivery method is most appropriate initially?

   • ANon-rebreather mask at 15 L/min
   • BNasal cannula at 2 L/minCorrect
   • CBiPAP
   • DVenturi mask at 50% FiO2
   Why this answer?

   COPD patients rely on hypoxic drive — the target SpO2 is 88–92%, not 100%. Start with low-flow nasal cannula at 1–2 L/min and titrate up. Aggressive oxygen delivery (NRB or 50% Venturi) can suppress the hypoxic drive and cause CO2 retention.