Last updated June 20, 2026

nclex-rn practice

NCLEX respiratory questions, built around what to assess first

Respiratory questions on the NCLEX-RN reward one habit: assess before you act, and protect the airway and oxygenation before anything else. The exam wants to see that you can spot a failing airway, position the client, and pick the intervention that keeps them breathing.

Most tested
  • COPD and asthma management
  • Pneumonia and oxygenation
  • Chest tubes and what each finding means
  • Oxygen therapy and ABG basics
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what to know

The high-yield points, in one place.

  • Airway and breathing come first. On any priority question, a client with a compromised airway or a falling oxygen level outranks everyone else.
  • COPD runs on a lower oxygen target. Aim for an SpO2 of about 88 to 92 percent, not 100. Over-oxygenating can raise their CO2 and depress breathing.
  • Position upright to breathe. High Fowler's or a tripod position eases the work of breathing for most respiratory distress.
  • Know your chest-tube findings. Gentle tidaling is normal. Continuous bubbling in the water seal means an air leak. Never clamp without an order.
  • Match the oxygen device to the need. A nasal cannula for low-flow needs, a non-rebreather for emergencies. Humidify the higher flow rates.
real practice questions

Try a few respiratory questions right now.

These are real NCLEX-format questions with full rationales. Open each one to see why every option is right or wrong.

Physiological AdaptationMultiple choice

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD) receiving oxygen at 2 L/min by nasal cannula. The client's oxygen saturation is 90 percent. Which action by the nurse is most appropriate?

  1. Increase the oxygen to 6 L/min to reach a saturation of 100 percent
  2. Maintain the current oxygen flow and continue to monitor
  3. Remove the oxygen and reassess in 30 minutes
  4. Notify the provider that the saturation is dangerously low
show the rationale
Why B is correct: an SpO2 of 88 to 92 percent is the therapeutic target for a client with COPD, so 90 percent is acceptable and the nurse maintains the current flow and keeps monitoring. Why the others are wrong: pushing the saturation toward 100 percent with high-flow oxygen can raise CO2 and depress the client's respiratory effort, removing oxygen risks hypoxia, and 90 percent is within the goal range so it is not an emergency.
Reduction of Risk PotentialMultiple choice

A nurse is monitoring a client with a chest tube connected to a water-seal drainage system and notes continuous bubbling in the water-seal chamber. Which is the nurse's priority action?

  1. Document the bubbling as an expected finding
  2. Assess the tubing and connections for an air leak
  3. Clamp the chest tube immediately
  4. Increase the wall suction to clear the bubbling
show the rationale
Why B is correct: continuous bubbling in the water-seal chamber signals an air leak, so the nurse first assesses the tubing and connections from the client to the device for a loose or disconnected site. Why the others are wrong: continuous bubbling is not expected (gentle tidaling is), clamping a chest tube without an order can cause a tension pneumothorax, and raising the suction does not fix a leak.
Physiological AdaptationSATA

A nurse is assessing a client during an acute asthma exacerbation. Which findings indicate the client is worsening and needs immediate intervention? Select all that apply.

  1. Audible wheezing that suddenly becomes a silent chest
  2. Use of accessory muscles to breathe
  3. Oxygen saturation dropping to 89 percent
  4. A productive cough with clear sputum
  5. A respiratory rate that slows as the client becomes drowsy
show the rationale
Why A, B, C, E are correct: a silent chest is ominous because airflow is too low to make a wheeze, accessory-muscle use shows increased work of breathing, a falling saturation reflects worsening gas exchange, and a slowing rate with drowsiness signals fatigue and impending respiratory failure. Why D is wrong: a productive cough with clear sputum is not, by itself, a sign of deterioration.

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common questions

Respiratory on the NCLEX, answered.

What respiratory topics show up most on the NCLEX-RN?
COPD and asthma, pneumonia, oxygen therapy, chest tubes, and the basics of reading an ABG appear most often. Most are written as assess-first or what-to-do-first questions, since airway and breathing sit at the top of nearly every priority.
What is the oxygen target for a client with COPD?
About 88 to 92 percent, not 100 percent. Over-oxygenating a client with COPD can raise their carbon dioxide and depress their drive to breathe, so the goal is enough oxygen to stay safe without overshooting.
How do I answer chest-tube questions?
Learn what each chamber shows. Gentle tidaling in the water seal is normal, continuous bubbling means an air leak, and bubbling in the suction-control chamber means the suction is working. Never clamp a chest tube without an order, since trapped air can cause a tension pneumothorax.
Can I make respiratory questions from my own notes?
Yes. Upload your respiratory lecture or a chapter, and the app generates NCLEX-format questions on exactly that material, each with a rationale that explains every option. A built-in question bank is there to start with too.
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