COPD Practice Questions: Respiratory Therapy Board Exam

Chronic obstructive pulmonary disease (COPD) is a common and important topic on the respiratory therapy board exam. Students must understand the pathophysiology, risk factors, clinical signs, diagnostic findings, and treatment strategies associated with this condition.

Questions may test your ability to recognize symptoms, interpret blood gases, analyze pulmonary function results, and select appropriate therapies such as oxygen, bronchodilators, and ventilatory support. Practicing COPD-related questions helps reinforce these key concepts and prepares you to apply your knowledge in exam scenarios.

The following practice questions are designed to help you review essential information and improve your readiness for the respiratory therapy board exam.

Note: We intentionally did not include the correct answers on this page so you can challenge yourself and assess your understanding of the material. If you’d like to access the correct answers and detailed explanations, you can download the digital study guide using the link below.

Why COPD Is an Essential Topic for the Board Exam

Chronic obstructive pulmonary disease (COPD) is one of the most common respiratory disorders encountered in clinical practice, which makes it a frequent topic on the respiratory therapy board exam. Students are expected to understand the underlying pathophysiology, including airflow limitation caused by chronic bronchitis and emphysema.

Exam questions may assess your ability to interpret pulmonary function testing, analyze arterial blood gas results, recognize signs of acute exacerbations, and select appropriate treatments.

You may also be tested on oxygen therapy, bronchodilator use, ventilatory support, and long term disease management. Because COPD affects millions of patients worldwide, mastering this topic is essential for both exam success and safe patient care in real clinical settings.

COPD Board Exam Practice Questions

Review the following COPD practice questions to strengthen your understanding of key concepts that may appear on the respiratory therapy board exam.

Focus on the clinical details, apply your knowledge, and choose the best answer for each scenario.

1. A 66-year-old female presents to the emergency department with dyspnea, shortness of breath, and chest tightness. Lab tests reveal negative troponin and BNP levels, and her ABG results show partially compensated respiratory acidosis. What is the most likely diagnosis for this patient?
A. Pneumonia
B. CHF
C. Exacerbation of COPD
D. Myocardial infarction

2. A 65-year-old male with a 40-year smoking history presents to the hospital with progressive shortness of breath, a chronic dry cough, and recent unintentional weight loss. A chest CT scan reveals hyperinflation of the lungs, flattened diaphragms, and multiple bullae in the upper lung fields. Which of the following conditions is most likely?
A. Pulmonary fibrosis
B. Emphysema
C. Bronchiectasis
D. Chronic pneumonia

3. A 90-year-old patient with advanced COPD and severe osteoarthritis has been using an albuterol MDI at home for years. During a follow-up visit, the patient reports struggling to use the MDI effectively due to worsening arthritis and decreased manual dexterity. Attempts to demonstrate proper use in the clinic are unsuccessful. What should the respiratory therapist recommend as the best alternative for delivering the medication?
A. Attach a valved holding chamber to the MDI
B. Replace the MDI with a small-volume nebulizer
C. Substitute the albuterol MDI with a combination LABA/ICS inhaler
D. Refer the patient for occupational therapy

4. A 67-year-old patient visits a pulmonary clinic after being diagnosed with COPD. Over the past year, the patient experienced one exacerbation, which did not lead to hospitalization. The patient’s Modified Medical Research Council (mMRC) score is 2, and their COPD Assessment Test (CAT) score is 14. Pulmonary function tests confirm moderate airflow obstruction. According to the GOLD 2023 guidelines, which combination of therapies would be the most appropriate for initial long-term management of this patient?
A. LAMA and LABA
B. ICS and LABA
C. LABA and SABA
D. SABA and ICS

5. A 57-year-old female patient who was admitted and diagnosed with emphysema displays the following ABG results:
pH 7.34
PaCO2 65 torr
PaO2 47 torr
HCO3 31 mEq/L
The patient appears to be dyspneic, and inspiratory crackles can be heard during auscultation. Which of the following would you recommend?
A. Nonrebreathing mask at 10 L/min
B. Air-entrainment mask at 28%
C. Albuterol via a small-volume nebulizer
D. Nasal cannula at 4 L/min

6. An ABG was collected from a 71-year-old female patient with a history of chronic COPD. Which of the following values would most accurately reflect the severity of her chronic condition?
A. pH
B. PaCO2
C. HCO3-
D. PaO2

7. A COPD patient is being discharged, and the doctor wants to prescribe a controller-type bronchodilator for home use. Which of the following medications would you recommend?
A. Albuterol
B. Levalbuterol
C. Metaproterenol
D. Brovana

8. A 59-year-old female patient with COPD is receiving supplemental oxygen via nasal cannula at 2 L/min. Her ABG results are as follows:
pH 7.37
PaCO2 58 torr
HCO3- 32 mEq/L
PaO2 58 torr
SaO2 85%
Based on this data, which of the following would you recommend?
A. Increase the oxygen flow to 3 L/min
B. Switch to BiPAP with an FiO2 of 100%
C. Switch to a nonrebreathing mask at 10 L/min
D. Switch to an air entrainment mask at 24%

9. While assessing a 51-year-old male patient, you observe significant use of neck muscles during normal breathing. This finding is consistent with which of the following?
A. Pulmonary embolism
B. Myasthenia gravis
C. COPD
D. Orthopnea

10. A 69-year-old female patient with advanced COPD is receiving supplemental oxygen. Which of the following is a problem that could arise under such circumstances?
A. Hypoventilation
B. Hyperventilation
C. Retinopathy of prematurity
D. The development of pulmonary edema

11. A 65-year-old male patient undergoing bronchodilator therapy is suspected of having COPD. His pulmonary function test (PFT) results are as follows:
FEV1/FVC ratio = 64%
FEV1 = 86% predicted
Which of the following best describes this patient?
A. Normal
B. Mild COPD
C. Moderate COPD
D. Severe COPD

12. A 59-year-old male patient with COPD, weighing 145 lbs., is receiving volume-controlled SIMV ventilation. The following data is available:
Ventilator settings:
Tidal volume 450 mL
Rate 10
FiO2 30%
PEEP 5 cm H2O
ABG results:
pH 7.38
PaCO2 59 torr
HCO3 34 mEq/L
PaO2 62 torr
SaO2 90%
Which of the following would you recommend?
A. Increase the FiO2
B. Increase the SIMV rate
C. Increase the tidal volume
D. Maintain the current settings

13. While reviewing the chart of a 65-year-old patient diagnosed with COPD and chronic hypoxemia, you would expect to find which of the following?
A. Chronic respiratory alkalosis
B. Secondary polycythemia
C. A decreased A-P chest diameter
D. An FRC less than predicted

14. You are called to check the VD/VT ratio of a 59-year-old female patient with advanced COPD. Which of the following would you expect to find?
A. Normal
B. Increased
C. Decreased
D. Not affected by the patient’s condition

15. A 61-year-old male patient with emphysema is receiving oxygen via an air-entrainment mask set at 45%. One hour after initiating oxygen therapy, the patient appears lethargic and obtunded. What is the most likely cause of this change in condition?
A. Hypotension
B. Refractory hypoxemia
C. Respiratory muscle fatigue
D. Oxygen-induced hypoventilation

16. A 64-year-old male with a long history of COPD is admitted to the emergency department with worsening dyspnea and fatigue. On examination, he has a barrel-shaped chest, audible wheezing, and mild cyanosis. ABG results reveal:
pH: 7.30
PaCO2: 72 torr
PaO2: 55 torr
HCO3-: 36 mEq/L
BE: +8
Which of the following interventions would be most appropriate at this time?
A. Noninvasive ventilation with BiPAP
B. Administer a bronchodilator via MDI
C. Place the patient on a nonrebreather mask at 15 L/min
D. Initiate intubation and mechanical ventilation

17. A 62-year-old male patient with a history of advanced COPD presents to the clinic with worsening dyspnea, fatigue, and pedal edema. Physical examination reveals jugular venous distention (JVD), and an echocardiogram confirms right ventricular hypertrophy. Which of the following is the most likely cause of these findings?
A. Pulmonary embolism
B. Cor pulmonale
C. Acute exacerbation of COPD
D. Congestive heart failure

18. A 73-year-old male patient with moderate COPD presents to the clinic for a routine follow-up. He reports stable symptoms, including occasional dyspnea with exertion but no recent exacerbations. His pulmonary function test (PFT) results show:
FEV1/FVC ratio: 62%
FEV1: 65% of predicted
He is currently using a short-acting beta-agonist (SABA) as needed. According to the GOLD guidelines, which of the following would be the most appropriate adjustment to his treatment plan?
A. Add a long-acting beta-agonist (LABA)
B. Add a combination LABA/ICS inhaler
C. Initiate long-term oxygen therapy (LTOT)
D. Increase the use of his short-acting beta-agonist

19. A 62-year-old female patient with COPD arrives at the clinic for a follow-up visit. She reports increased dyspnea and a persistent cough with yellow sputum production over the past three days. She has had one hospitalization for a COPD exacerbation in the past year. Her current medications include a long-acting beta-agonist (LABA) and a short-acting beta-agonist (SABA) as needed. Which of the following would be the most appropriate addition to her treatment plan?
A. Add a long-acting muscarinic antagonist (LAMA)
B. Add an inhaled corticosteroid (ICS)
C. Prescribe a short course of oral antibiotics and corticosteroids
D. Switch the LABA to a combination LABA/LAMA inhaler

20. A 72-year-old male patient reports a productive cough that has persisted for at least four months per year over the past two years. This clinical history most likely describes which of the following conditions?
A. Chronic bronchitis
B. Status asthmaticus
C. Panlobular emphysema
D. Centrilobular emphysema

21. A 58-year-old female patient with a history of COPD presents with shortness of breath, lightheadedness, and cyanosis of the lips. Upon auscultation, bilateral bronchial breath sounds with inspiratory crackles are noted. ABG results are as follows:
pH 7.35
PaCO2 65 torr
PaO2 49 torr
HCO3 31 mEq/L
BE +6
Which of the following would you recommend?
A. Volume-controlled A/C mechanical ventilation
B. Albuterol aerosol via SVN
C. Air-entrainment mask at 28%
D. Nonrebreathing mask at 12 L/min

22. While assessing a 71-year-old male patient, you observe that his chest has a barrel-shaped appearance. This finding most likely indicates which of the following?
A. Pectus excavatum
B. Pectus carinatum
C. Air trapping
D. Tension pneumothorax

23. A 72-year-old female patient with severe COPD is showing signs of pulmonary hypertension and cor pulmonale. Which of the following would you recommend?
A. Corticosteroid therapy
B. Systemic vasodilators
C. Long-term oxygen therapy
D. Long-acting beta-agonist therapy

24. A 65-year-old male patient receiving bronchodilator therapy is undergoing pulmonary function testing to confirm a suspected diagnosis of COPD. His PFT results are as follows: FEV1/FVC ratio = 64% and FEV1 = 38% predicted. Which of the following best describes this patient?
A. Normal
B. Mild COPD
C. Moderate COPD
D. Severe COPD

25. A 69-year-old male patient arrives in the emergency department complaining of difficulty breathing. His medical history includes both COPD and CHF. To aid in the differential diagnosis, the doctor orders blood tests for bacteremia, CK-MB, cTnI, cTnT, and BNP. All results return negative. What is the most likely cause of the patient’s dyspnea?
A. CHF
B. Myocardial infarction
C. Exacerbation of COPD
D. Pneumonia

Final Thoughts

COPD is a critical topic for the respiratory therapy board exam because it requires a strong understanding of disease mechanisms, patient assessment, diagnostic interpretation, and treatment strategies.

By reviewing and practicing questions on this topic, you can strengthen your knowledge and improve your ability to recognize key clinical patterns. Consistent practice helps reinforce important concepts and prepares you to confidently answer COPD-related questions on the exam.

Keep studying, review the explanations carefully, and continue testing your knowledge to build the confidence needed to succeed on the respiratory therapy board exam.