2 - 2 Atelectasis

Question 1

56. Which nursing action reduces risk of absorption atelectasis with high-flow oxygen?
    A. Encourage fluid restriction
    B. Keep patient in high Fowler’s only
    C. Increase sedatives to reduce oxygen demand
    D. Use lowest effective FiO₂

Answer 1

Using the lowest FiO₂ possible prevents nitrogen washout and alveolar collapse.

Question 2

57. The nurse is teaching a patient with atelectasis about coughing techniques. Which method is most effective?
    A. Holding breath as long as possible
    B. Shallow, frequent coughing
    C. Huff coughing
    D. Restricting coughing to conserve energy

Answer 2

Huff coughing is effective for mobilizing secretions without airway collapse.

Question 3

58. Which intervention helps prevent atelectasis in a bedridden patient?
    A. Strict bedrest
    B. Continuous high-dose sedation
    C. Restricting fluid intake
    D. Frequent position changes and early ambulation

Answer 3

Repositioning and mobilization expand alveoli, reducing risk of collapse.

Question 4

59. Which equipment is most important in nursing care of a patient with atelectasis?
    A. Bedpan
    B. Cardiac telemetry
    C. Incentive spirometer
    D. Orthopedic traction

Answer 4

The incentive spirometer directly promotes alveolar inflation and prevents collapse.

Question 5

60. Which teaching point should the nurse emphasize for preventing postoperative atelectasis?
    A. Avoid coughing to reduce incision strain
    B. Remain in supine position
    C. Delay ambulation for several days
    D. Perform deep breathing and coughing exercises every 1–2 hours

Answer 5

Regular deep breathing and coughing keep alveoli open and clear secretions.

Question 6

61. The nurse notes a drop in SpO₂ in a patient with suspected atelectasis. What is the first nursing action?
    A. Increase IV fluids immediately
    B. Stop oxygen therapy
    C. Administer sedatives
    D. Reposition and encourage deep breathing

Answer 6

Repositioning and deep breathing can reopen collapsed alveoli before escalating treatment.

Question 7

62. Which intervention should the nurse anticipate for severe atelectasis unresponsive to conservative measures?
    A. Nasogastric decompression
    B. IV diuretics
    C. Bronchoscopy to remove obstruction
    D. Antihistamines

Answer 7

Bronchoscopy can remove mucus plugs or foreign bodies causing obstruction.

Question 8

63. Which intervention is essential after abdominal surgery to prevent atelectasis?
    A. Fluid restriction
    B. Avoiding upright posture
    C. Pain control with analgesia
    D. Withholding coughing exercises

Answer 8

Adequate pain relief enables effective deep breathing and coughing.

Question 9

64. A nurse suspects atelectasis when a patient becomes tachypneic post-op. Which action is most appropriate?
    A. Place patient in supine rest
    B. Administer sedatives
    C. Encourage use of incentive spirometry immediately
    D. Restrict mobility

Answer 9

Incentive spirometry re-expands alveoli and relieves tachypnea from atelectasis.

Question 10

65. Which collaborative intervention may be ordered to assist with atelectasis management?
    A. Bed rest with minimal movement
    B. Sedative therapy
    C. Chest physiotherapy with percussion and postural drainage
    D. Continuous supine positioning

Answer 10

Chest physiotherapy mobilizes secretions and improves lung aeration.

Question 11

66. A patient with atelectasis is placed on supplemental O₂ but hypoxemia persists. Which nursing action is next?
    A. Reduce oxygen to room air
    B. Increase patient sedation
    C. Restrict repositioning
    D. Notify provider for possible CPAP or PEEP therapy

Answer 11

Positive pressure ventilation (CPAP/PEEP) reopens alveoli when oxygen alone is insufficient.

Question 12

67. Which measure best helps the nurse evaluate effectiveness of atelectasis interventions?
    A. Pain reduction
    B. Patient reporting less anxiety
    C. Improvement in SpO₂ and breath sounds
    D. Heart rate stabilization alone

Answer 12

Better oxygenation and auscultation show interventions are effective.

Question 13

68. Which intervention should the nurse avoid in managing atelectasis?
    A. Encouraging coughing
    B. Using incentive spirometer
    C. Providing adequate hydration
    D. Promoting immobility

Answer 13

Immobility worsens secretion stasis and atelectasis progression.

Question 14

69. Which patient teaching is most effective to prevent atelectasis in chronic lung disease?
    A. Rely only on bedrest during exacerbations
    B. Avoid using respiratory aids
    C. Restrict hydration
    D. Practice pursed-lip and diaphragmatic breathing

Answer 14

Breathing techniques improve alveolar expansion and reduce atelectasis risk.

Question 15

70. Which priority nursing diagnosis fits a patient with acute atelectasis?
    A. Risk for electrolyte imbalance
    B. Disturbed body image
    C. Impaired gas exchange
    D. Risk for fluid overload

Answer 15

Atelectasis impairs oxygen delivery, making gas exchange the priority diagnosis.

Question 16

71. Which immediate nursing action should follow auscultation of absent breath sounds over a lobe?
    A. Reassure the patient and do nothing
    B. Restrict fluids
    C. Encourage the patient to remain supine
    D. Notify provider, as this may indicate lobar atelectasis

Answer 16

Absent breath sounds suggest lobar collapse, requiring immediate provider notification.

Question 17

72. Which collaborative treatment may nurses assist with in severe atelectasis due to secretions?
    A. IV corticosteroids
    B. Oral antihistamines
    C. NG tube insertion
    D. Therapeutic bronchoscopy

Answer 17

Bronchoscopy clears secretions or obstruction, restoring ventilation.

Question 18

73. A patient with atelectasis is anxious and dyspneic. Which nursing intervention helps most?
    A. Administer sedatives immediately
    B. Place in supine rest
    C. Restrict incentive spirometry
    D. Provide calm reassurance while encouraging slow, deep breathing

Answer 18

Anxiety worsens dyspnea; reassurance and guided breathing improve outcomes.

Question 19

74. Which discharge teaching reduces recurrence of atelectasis at home?
    A. Avoid physical activity
    B. Use oxygen only at night without exercises
    C. Take frequent sedatives for comfort
    D. Continue deep breathing, coughing, and ambulation daily

Answer 19

Continued breathing exercises and daily activity prevent recurrence.

Question 20

75. Which nursing intervention best supports secretion clearance in atelectasis?
    A. Continuous supine positioning
    B. Sedation for comfort
    C. Restricting fluid intake
    D. Humidified oxygen therapy

Answer 20

Humidified oxygen loosens secretions, aiding clearance and alveolar expansion.

Question 21

76. Which early clinical manifestation of atelectasis should the nurse monitor for?
    A. Increased respiratory rate (tachypnea)
    B. Peripheral edema
    C. Clubbing of fingers
    D. Cyanosis only in late stage

Answer 21

Tachypnea is an early sign as the body attempts to compensate for reduced gas exchange.

Question 22

77. Which diagnostic tool is most useful to confirm atelectasis?
    A. Pulmonary angiography
    B. Sputum culture
    C. CT scan of the chest
    D. Chest X-ray

Answer 22

Chest X-ray is the standard initial tool, showing volume loss, opacity, or mediastinal shift.

Question 23

78. Which breath sound change is most associated with atelectasis?
    A. Vesicular sounds over the collapsed area
    B. High-pitched wheezing
    C. Absent or markedly diminished breath sounds
    D. Hyperresonance on percussion

Answer 23

Collapsed alveoli produce diminished or absent breath sounds on auscultation.

Question 24

79. A nurse suspects atelectasis in a patient post-op. Which bedside finding supports the diagnosis?
    A. Fever with tachypnea
    B. Hypotension
    C. Loud cardiac murmurs
    D. Hepatomegaly

Answer 24

Low-grade fever and tachypnea are common bedside findings due to inflammation and impaired ventilation.

Question 25

80. Which ABG change is expected in significant atelectasis? A. Respiratory alkalosis B. Normal PaO₂ and PaCO₂ C. Hypoxemia with low PaO₂ D. Metabolic alkalosis

Answer 25

Atelectasis produces hypoxemia due to ventilation-perfusion mismatch and shunting.

Question 26

81. Which chest X-ray finding indicates lobar atelectasis? A. Hyperinflation with flat diaphragms B. Reticulonodular infiltrates C. Homogenous opacity with volume loss D. Multiple cystic lesions

Answer 26

Homogenous opacity and volume loss are classic for lobar atelectasis.

Question 27

82. Which sign may indicate severe atelectasis in children? A. Intercostal retractions B. Pedal edema C. Peripheral clubbing D. Nasal congestion

Answer 27

Intercostal retractions reflect increased work of breathing from alveolar collapse.

Question 28

83. Which lab finding may indirectly suggest atelectasis? A. Elevated WBC count with retained secretions B. Low serum sodium C. Hyperkalemia D. Anemia

Answer 28

Retained secretions can lead to infection, raising WBC count in association with atelectasis.

Question 29

84. A patient has tracheal deviation toward the right. Which interpretation is most consistent? A. Right-sided atelectasis B. Left-sided pleural effusion C. Left-sided pneumothorax D. Pulmonary hypertension

Answer 29

Volume loss from right-sided atelectasis pulls the trachea toward the affected side.

Question 30

85. Which finding on physical assessment is common in atelectasis? A. Dullness to percussion over collapsed area B. Tympany over affected lobe C. Increased tactile fremitus D. Hyperresonance on percussion

Answer 30

Dullness to percussion is found over collapsed lung tissue.

Question 31

86. Which symptom is often the first sign of atelectasis in post-op patients? A. Dyspnea B. Productive cough C. Hemoptysis D. Weight loss

Answer 31

Dyspnea (difficulty breathing) is an early and common presentation.

Question 32

87. Which condition is a complication of untreated atelectasis seen on imaging? A. Pneumonia B. Pulmonary embolism C. Pleural calcification D. Diaphragmatic paralysis

Answer 32

Collapsed alveoli predispose to infection, often progressing to pneumonia.

Question 33

88. Which noninvasive diagnostic test monitors oxygenation in atelectasis? A. Capnography B. Spirometry C. Pulse oximetry D. Bronchoscopy

Answer 33

Pulse oximetry continuously tracks SpO₂, helping evaluate severity.

Question 34

89. Which auscultatory finding suggests improvement of atelectasis? A. Return of normal vesicular breath sounds B. Persistent absent sounds C. Loud wheezes D. Pleural rub

Answer 34

Return of vesicular breath sounds indicates re-expansion of alveoli.

Question 35

90. Which chest CT finding is more specific than X-ray for atelectasis? A. Air bronchograms with volume loss B. Flattened diaphragms C. Patchy interstitial thickening D. Ground-glass opacity

Answer 35

CT shows air bronchograms with volume loss, confirming collapsed lung regions.

Question 36

91. Which finding differentiates atelectasis from pleural effusion on chest X-ray? A. Mediastinal shift toward opacity B. Blunting of costophrenic angle C. Large homogeneous opacity with fluid level D. Opacity without mediastinal shift

Answer 36

Atelectasis causes mediastinal shift toward opacity, unlike effusion which pushes away.

Question 37

92. Which assessment would the nurse expect in a patient with moderate atelectasis? A. Cyanosis and tachycardia B. Bradycardia C. Frothy sputum D. Subcutaneous emphysema

Answer 37

Cyanosis and tachycardia reflect hypoxemia due to impaired oxygen exchange.

Question 38

93. Which pulmonary function test finding is expected in atelectasis? A. Decreased vital capacity B. Increased total lung capacity C. Increased residual volume D. Normal FEV1/FVC

Answer 38

Atelectasis reduces vital capacity due to collapsed alveoli.

Question 39

94. Which nursing assessment finding is most concerning in atelectasis? A. Rapid desaturation on pulse oximetry B. Low-grade fever C. Mild cough D. Slight tachypnea

Answer 39

Rapid SpO₂ drop signals worsening hypoxemia, requiring urgent action.

Question 40

95. Which chest finding is consistent with severe atelectasis? A. Asymmetrical chest expansion B. Symmetrical excursion C. Bilateral crackles D. Increased tactile fremitus only

Answer 40

Asymmetrical expansion occurs when one lung fails to expand properly.

Question 41

96. Which diagnostic sign suggests obstructive atelectasis? A. Mediastinal shift toward affected side B. Pleural plaques C. Bilateral effusion D. Flattened diaphragm

Answer 41

Obstructive atelectasis causes mediastinal shift toward the collapsed lobe.

Question 42

97. Which classic triad of symptoms suggests atelectasis in a post-op patient? A. Dyspnea, tachypnea, and diminished breath sounds B. Hemoptysis, chest pain, and fever C. Clubbing, weight loss, and hypoxemia D. Stridor, wheezing, and dysphagia

Answer 42

The triad of dyspnea, tachypnea, and diminished breath sounds is strongly suggestive.

Question 43

98. Which diagnostic test can directly visualize airway obstruction causing atelectasis? A. Bronchoscopy B. Pulse oximetry C. Chest ultrasound D. Spirometry

Answer 43

Bronchoscopy allows visualization and potential removal of the obstruction.

Question 44

99. Which ABG abnormality reflects progression of atelectasis with hypoventilation? A. Respiratory acidosis with elevated PaCO₂ B. Metabolic alkalosis C. Normal gases D. Increased bicarbonate alone

Answer 44

Severe atelectasis may progress to respiratory acidosis as hypoventilation retains CO₂.

Question 45

100. Which physical exam finding helps distinguish atelectasis from COPD? A. Dullness to percussion with reduced expansion B. Hyperresonance and prolonged expiration C. Diffuse wheezing D. Clubbing of fingers

Answer 45

Dullness with reduced chest expansion suggests volume loss, unlike COPD which shows hyperinflation.

Question 46

101. Which medication is most helpful in treating atelectasis caused by bronchospasm? A. Short-acting beta agonists (SABA) B. Mucolytics C. Antibiotics D. Corticosteroids

Answer 46

SABAs (like albuterol) relax airway smooth muscle, relieving obstruction from bronchospasm and reopening alveoli.

Question 47

102. Which treatment is most appropriate for atelectasis caused by mucus plugging? A. Supplemental iron B. Chest physiotherapy C. Bronchodilators only D. Nebulized mucolytics such as acetylcysteine

Answer 47

Nebulized mucolytics thin mucus, helping clear plugs that cause resorptive atelectasis.

Question 48

103. Which intervention is indicated for severe postoperative atelectasis due to retained secretions? A. High-dose corticosteroids B. Chest tube placement C. Therapeutic bronchoscopy D. IV diuretics

Answer 48

Bronchoscopy can directly remove secretions or obstructions, restoring ventilation.

Question 49

104. Which therapy helps prevent alveolar collapse in patients with persistent atelectasis? A. Continuous positive airway pressure (CPAP) B. Diuretic infusion C. High-dose antihistamines D. Blood transfusion

Answer 49

CPAP maintains positive pressure, keeping alveoli open and improving oxygenation.

Question 50

105. Which antibiotic treatment is indicated if atelectasis progresses to pneumonia? A. Empiric broad-spectrum antibiotics B. Antiviral therapy C. Antifungal therapy D. Antipyretics only

Answer 50

Broad-spectrum antibiotics are started empirically when atelectasis-related pneumonia develops.

Question 51

106. Which adjunct therapy is often used alongside bronchodilators in atelectasis due to COPD? A. Mucolytics B. IV fluids C. High-dose opioids D. Sedatives

Answer 51

Mucolytics help reduce secretion viscosity, improving clearance in COPD patients with atelectasis.

Question 52

107. Which oxygen delivery method reduces risk of absorption atelectasis? A. High-flow 100% oxygen B. Hyperbaric oxygen chamber C. Low-flow nasal cannula with lowest effective FiO₂ D. Non-rebreather mask at maximum flow

Answer 52

Using the lowest FiO₂ via nasal cannula avoids nitrogen washout and prevents worsening absorption atelectasis.

Question 53

108. Which medication may be prescribed to reduce inflammation contributing to atelectasis? A. Corticosteroids B. Anticoagulants C. Proton pump inhibitors D. Beta-blockers

Answer 53

Corticosteroids decrease airway inflammation, particularly in obstructive or inflammatory causes of atelectasis.

Question 54

109. Which type of therapy helps re-expand alveoli when conservative measures fail? A. Pulmonary vasodilators B. Surfactant replacement therapy C. Anticoagulation D. Antihypertensives

Answer 54

In neonatal or ARDS-related atelectasis, exogenous surfactant therapy restores alveolar stability.

Question 55

110. Which treatment is most useful for postoperative prevention of atelectasis? A. Incentive spirometry and early ambulation B. Long-term antibiotic therapy C. Antihistamines D. Continuous sedatives

Answer 55

Incentive spirometry with ambulation prevents alveolar collapse after surgery.

Question 56

111. Which nursing intervention supports medication therapy in atelectasis? A. Chest physiotherapy combined with mucolytics B. Bedrest with oxygen therapy only C. Withholding coughing to prevent pain D. Minimal hydration

Answer 56

Physiotherapy with mucolytics enhances secretion clearance and medication effectiveness.

Question 57

112. Which advanced therapy may be considered in refractory atelectasis due to ARDS? A. ECMO (extracorporeal membrane oxygenation) B. Long-term antibiotics C. IV fluids alone D. Antihistamines

Answer 57

In severe ARDS, ECMO provides gas exchange support when mechanical ventilation and PEEP fail.

Question 58

113. Which nebulized treatment helps thin secretions in atelectasis? A. Hypertonic saline B. Corticosteroids C. Bronchodilators D. Antibiotics

Answer 58

Hypertonic saline attracts water into airways, thinning mucus and aiding clearance.

Question 59

114. Which medication combination reduces atelectasis risk in COPD patients? A. Inhaled corticosteroid plus long-acting beta agonist (ICS + LABA) B. Antibiotics plus mucolytic C. Diuretics plus antihypertensives D. Opioids plus benzodiazepines

Answer 59

ICS + LABA improve airway patency and reduce exacerbations, lowering atelectasis risk.

Question 60

115. Which treatment goal is the priority in atelectasis management? A. Restore and maintain adequate ventilation B. Correct electrolyte imbalance C. Manage long-term weight loss D. Prevent pulmonary embolism

Answer 60

The primary goal is to re-expand alveoli and improve gas exchange through ventilation restoration.