NCLEX Deck

Respiratory

NCLEX Clinical Study Booklet · 11 cards

Contents

Asthma.

Airway
What is Asthma?
  • Chronic reversible airway inflammation with bronchospasm.
  • Narrowed airways trap air → wheezing and difficulty exhaling.
What are the Causes / Risk Factors?
  • Allergens (dust, pollen, dander)
  • Respiratory infections
  • Cold air, exercise
  • Smoke, pollution
  • Stress
  • Aspirin/NSAIDs (some)
What are the Symptoms?
  • Expiratory wheezing
  • Dyspnea, chest tightness
  • Cough, prolonged expiration
  • Accessory muscle use
  • Anxiety
  • Silent chest = ominous
How is it Diagnosed?
  • ↓Peak expiratory flow rate
  • Spirometry (reversible obstruction)
  • Pulse oximetry, ABG
  • History of triggers
What is the Treatment?
  • Rescue: short-acting beta agonist (albuterol)
  • Controllers: inhaled corticosteroids, LABA
  • Avoid triggers
  • High Fowler's, O₂; teach inhaler/spacer
NCLEX TipA silent chest with no wheezing during an attack is an emergency — airflow is severely limited.
© NCLEX Deck1 / 11

COPD.

Chronic
What is COPD?
  • Progressive, irreversible airflow limitation (chronic bronchitis + emphysema).
  • Air trapping → CO₂ retention.
What are the Causes / Risk Factors?
  • Smoking (primary)
  • Occupational/pollutant exposure
  • Alpha-1 antitrypsin deficiency
  • Recurrent infections
What are the Symptoms?
  • Chronic productive cough
  • Dyspnea, prolonged expiration
  • Barrel chest
  • Pursed-lip breathing
  • Wheezes/crackles
  • Clubbing, hypoxia
How is it Diagnosed?
  • Spirometry (↓FEV1/FVC)
  • ABG: chronic respiratory acidosis
  • CXR: hyperinflation
  • Pulse oximetry
What is the Treatment?
  • Bronchodilators, inhaled corticosteroids
  • LOW-flow O₂ (1–2 L)
  • Smoking cessation
  • Pursed-lip breathing; flu/pneumococcal vaccines
NCLEX TipGive COPD patients LOW-flow oxygen — high O₂ can suppress their hypoxic drive to breathe.
© NCLEX Deck2 / 11

Pneumonia.

Infection
What is Pneumonia?
  • Infection and inflammation of lung tissue with alveolar consolidation.
  • Impairs gas exchange.
What are the Causes / Risk Factors?
  • Bacterial (S. pneumoniae), viral, fungal
  • Aspiration
  • Immobility, immunosuppression
  • Older age, smoking
What are the Symptoms?
  • Fever, chills
  • Productive cough (rusty/purulent sputum)
  • Pleuritic chest pain
  • Dyspnea, tachypnea
  • Crackles, ↓breath sounds
  • Confusion (elderly)
How is it Diagnosed?
  • CXR (consolidation)
  • Sputum culture
  • ↑WBC
  • Pulse oximetry, ABG
What is the Treatment?
  • Antibiotics (bacterial)
  • O₂, hydration, rest
  • Incentive spirometer, deep breathing, ambulation
  • Antipyretics; vaccines
NCLEX TipPush fluids, deep breathing, and early mobility. In the elderly, confusion may be the only sign.
© NCLEX Deck3 / 11

Tuberculosis.

Infection
What is Tuberculosis?
  • Infection by Mycobacterium tuberculosis, primarily the lungs.
  • Airborne; may be latent or active.
What are the Causes / Risk Factors?
  • Airborne droplet nuclei (coughing)
  • Crowded/close contact
  • Immunosuppression (HIV)
  • Homelessness, incarceration
What are the Symptoms?
  • Productive cough >3 weeks
  • Hemoptysis
  • Night sweats
  • Low-grade fever
  • Weight loss, fatigue, anorexia
How is it Diagnosed?
  • Positive TST (Mantoux) / IGRA
  • Sputum AFB smear & culture (confirms)
  • CXR (upper-lobe cavities)
What is the Treatment?
  • Airborne precautions (negative-pressure, N95)
  • RIPE: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
  • Emphasize adherence (DOT)
  • Rifampin turns secretions orange
NCLEX TipTB needs airborne precautions and months of combination therapy — adherence prevents drug resistance.
© NCLEX Deck4 / 11

Pulmonary Embolism.

Emergency
What is Pulmonary Embolism?
  • A clot (usually from a DVT) lodges in the pulmonary artery.
  • Blocks pulmonary blood flow — life-threatening.
What are the Causes / Risk Factors?
  • DVT (most common source)
  • Immobility, recent surgery
  • Hypercoagulability
  • Fractures (fat embolism), long travel
What are the Symptoms?
  • Sudden dyspnea & pleuritic chest pain
  • Tachypnea, tachycardia
  • Anxiety, restlessness
  • Hypoxia, hemoptysis
  • Hypotension (massive PE)
How is it Diagnosed?
  • CT pulmonary angiography (definitive)
  • D-dimer
  • ABG (hypoxemia, respiratory alkalosis)
  • V/Q scan
What is the Treatment?
  • O₂, high Fowler's
  • Anticoagulation (heparin → warfarin/DOAC)
  • Thrombolytics for massive PE
  • Prevent DVT (mobility, prophylaxis)
NCLEX TipSudden dyspnea + chest pain + tachycardia after surgery/immobility = suspect PE. Oxygenate and anticoagulate.
© NCLEX Deck5 / 11

ARDS.

Emergency
What is ARDS?
  • Acute severe lung injury with non-cardiogenic pulmonary edema.
  • Refractory hypoxemia despite oxygen.
What are the Causes / Risk Factors?
  • Sepsis (common)
  • Aspiration
  • Trauma, near-drowning
  • Pancreatitis
  • Massive transfusion
What are the Symptoms?
  • Severe dyspnea, tachypnea
  • Refractory hypoxemia (low O₂ despite high FiO₂)
  • Crackles
  • Restlessness, cyanosis
  • Accessory muscle use
How is it Diagnosed?
  • ABG: severe hypoxemia
  • CXR: bilateral 'white-out' infiltrates
  • Rule out cardiac cause (normal PCWP)
What is the Treatment?
  • Mechanical ventilation with PEEP
  • Low tidal volume; prone positioning
  • Treat underlying cause (e.g., sepsis)
  • Sedation; monitor hemodynamics
NCLEX TipARDS = refractory hypoxemia (no improvement with O₂) + bilateral infiltrates. Treat with PEEP and the cause.
© NCLEX Deck6 / 11

Pneumothorax.

Emergency
What is Pneumothorax?
  • Air in the pleural space collapses the lung.
  • Tension pneumothorax shifts the mediastinum — emergency.
What are the Causes / Risk Factors?
  • Chest trauma / rib fracture
  • Central line insertion
  • Ruptured bleb (spontaneous)
  • Barotrauma (ventilation)
What are the Symptoms?
  • Sudden sharp pleuritic chest pain
  • Dyspnea
  • ↓/absent breath sounds on affected side
  • Tracheal deviation (tension — away from side)
  • Hypotension, distended neck veins (tension)
How is it Diagnosed?
  • CXR (definitive)
  • Hyperresonance, absent breath sounds
  • Assess for tension (emergency)
What is the Treatment?
  • Chest tube with water-seal drainage
  • Tension: emergent needle decompression
  • O₂, high Fowler's
  • Monitor tube & lung re-expansion
NCLEX TipTracheal deviation + hypotension + absent breath sounds = tension pneumothorax → immediate needle decompression.
© NCLEX Deck7 / 11

Pleural Effusion.

Chronic
What is Pleural Effusion?
  • Excess fluid in the pleural space.
  • Compresses the lung and impairs expansion.
What are the Causes / Risk Factors?
  • Heart failure
  • Pneumonia / infection
  • Malignancy
  • Cirrhosis, nephrotic syndrome
What are the Symptoms?
  • Dyspnea
  • Pleuritic chest pain
  • ↓breath sounds & dullness to percussion
  • Decreased chest expansion
  • Cough
How is it Diagnosed?
  • CXR / ultrasound
  • Thoracentesis (diagnostic & therapeutic)
  • Fluid analysis (exudate vs transudate)
What is the Treatment?
  • Thoracentesis to drain fluid
  • Treat underlying cause
  • O₂; position for comfort
  • Chest tube if large/recurrent
NCLEX TipDullness to percussion with diminished breath sounds at the base suggests effusion; thoracentesis drains it.
© NCLEX Deck8 / 11

Atelectasis.

Post-op
What is Atelectasis?
  • Collapse of alveoli → reduced gas exchange.
  • Common after surgery and with immobility.
What are the Causes / Risk Factors?
  • Post-op hypoventilation
  • Immobility, shallow breathing
  • Mucus plugging
  • Pain limiting deep breaths
What are the Symptoms?
  • Dyspnea, tachypnea
  • ↓breath sounds over the area
  • Low-grade fever (early post-op)
  • Hypoxia, cough
How is it Diagnosed?
  • CXR
  • Auscultation (diminished sounds)
  • Pulse oximetry
What is the Treatment?
  • Incentive spirometer
  • Deep breathing & coughing, splinting
  • Early ambulation
  • Adequate pain control; reposition
NCLEX TipAtelectasis is the top cause of fever in the first 24–48h post-op — prevent with incentive spirometry and mobility.
© NCLEX Deck9 / 11

Chest Tube Management.

Post-op
Purpose
  • Removes air (pneumothorax) or fluid (effusion/hemothorax) from the pleural space
  • Restores negative pressure so the lung re-expands
Normal Findings
  • Gentle tidaling (fluctuation) in the water-seal chamber
  • Gentle bubbling in the suction-control chamber (if on suction)
  • Drainage marked and monitored over time
Red Flags & Actions
  • Continuous bubbling in water-seal = AIR LEAK
  • Sudden bright-red or ↑ drainage = hemorrhage — notify provider
  • No tidaling = obstruction OR lung re-expanded
  • If it disconnects: place end in sterile water. If it dislodges: sterile dressing taped on 3 sides
NCLEX TipTube disconnects → submerge end in sterile water. Tube dislodges from chest → occlusive dressing taped on 3 sides.
© NCLEX Deck10 / 11

Respiratory Failure.

Emergency
What is Respiratory Failure?
  • Inadequate gas exchange: hypoxemia (PaO₂ <60) and/or hypercapnia (PaCO₂ >50).
  • Type 1 (oxygenation) vs Type 2 (ventilation).
What are the Causes / Risk Factors?
  • COPD, asthma, pneumonia, ARDS
  • Opioid overdose (hypoventilation)
  • Neuromuscular disease
  • Pulmonary embolism
What are the Symptoms?
  • Dyspnea, tachypnea → later bradypnea
  • Restlessness → confusion → ↓LOC
  • Cyanosis
  • Accessory muscle use
  • Tachycardia, dysrhythmias
How is it Diagnosed?
  • ABG (hypoxemia / hypercapnia)
  • Pulse oximetry
  • CXR; identify cause
What is the Treatment?
  • O₂ therapy; support airway
  • Mechanical ventilation / BiPAP if needed
  • Treat underlying cause
  • Upright position; monitor closely
NCLEX TipEarly hypoxia shows as restlessness/agitation; cyanosis and bradycardia are late. Act on the early signs.
© NCLEX Deck11 / 11
No topics match your search.