Shadowing Practice: Live NCLEX® Respiratory Question Drill - Vertical - Learn English Speaking with Video

Thank you.

Hello and good morning future nurses.

Welcome back to UWorld's Next Gen NCLEX review.

I'm Nurse Jasmine and today's topic is respiratory question drill.

So if you haven't joined us before this is what you can expect.

We're going to read the question together

and then you'll have 30 seconds to drop your answers in the comments

and don't be shy this is the best time to practice.

Remember this is just for your own learning this is not for a grade or punishment or anything.

And then we're going to review the rationales and then reminders.

Just share this session.

You know, the more the merrier.

Share it with all your nursing buddies.

Again, don't be shy to leave your comments or questions in the chat.

We have Nurse and Coley moderating our chat.

So if you have any questions, don't feel, don't be hesitant to ask.

And then again, follow us so you don't miss any content.

So starting with our question one, the nurse is assessing a client who has bacterial pneumonia,

which of the following findings would be a priority to follow up.

Then we have headache and fever, sore throat and nasal congestion, use of accessory muscles, and then we have purulent futum.

So what is concerning here?

What pushes you to check on this patient?

And then I see also we have our chat going on.

Again, don't be shy, don't be scared to put your answers.

You know, this is where we learn.

Sometimes we learn more from our mistakes.

Again, this is going to be a respiratory question drill.

Don't forget to like, share.

We have a goal on TikTok to reach 150,000 followers, and we're pretty close.

So if you guys don't mind helping us reach that goal, and let me know where everybody is joining us from.

Let us know.

Today we have a sunny day.

It's been raining here in Dallas, but today is hot.

All right.

So the correct answer for this one is going to be option number three, which a lot of you guys put.

So great job.

The use of accessory muscles is going to be a priority to follow up.

So bacterial pneumonia is an inflammatory reaction in the lungs.

So it's usually caused by an infection.

So this is going to result in the production of cellular debris and purulent secretions.

It also obstructs the alveoli and impairs gas exchange.

So when we see the use of accessory muscles, this means that the client is breathing with more than just their diaphragm.

So it's going to alert us that the client needs oxygen and we're going to focus on airway, breathing, and circulations.

And then we have the other options, one, two, and four.

These are all expected findings with bacterial pneumonia.

The one that we're going to be concerned about is the use of accessory muscles, which tells us that the client is working harder to breathe.

So we're going to assess this client first.

Great job.

All right, question number two.

The nurse is planning care for a client with chronic obstructive pulmonary disease or COPD.

Which of the following interventions should the nurse include in the client's plan of care?

And here we have a select all that apply.

So remember, we're going to have multiple correct answers.

And then we have option one, recommend that the client sleep in the supine position.

Option two, tell the client to eat two to three large meals each day.

Option three, encourage the client to receive the influenza vaccine annually.

Option four, demonstrate the cuff technique for the client.

And then we have option five, instruct the client to limit physical activity.

Let me know.

Let me see where you guys are all joining us from.

We got Portland, Oregon.

We got Maryland.

We got Pittsburgh.

We got Germany and India.

Hello.

We got Turkey, Nigeria, Manchester, Ghana.

How exciting.

We have Kansas City.

How crazy.

How cool, guys.

Thank you for joining us this morning.

And then another question that I'd like to ask you guys, has anybody passed their NCLEX recently or is anybody getting ready to test?

This is where we want to send you all the good luck or celebrate with you.

All right, we got more peeps.

We got South Africa, we got Mexico, we got Seattle, Australia, Arizona, DC.

Hello, hello, welcome.

Emily on TikTok has a year left, but it's going to be amazing, you know, take advantage of this year.

This is your last chance to be a student then you'll

enter the nursing world we have kenya virginia oh my gosh we got a two days

and then clicks in two days so we're gonna send prayers for sure someone's testing on the 23rd

nice oh we got people from republica dominicana welcome welcome 86

and yes you're going to pass

so we're sending you all the good vibes okay good job guys

so the correct answers for this ones are going to be three and four.

So we have the interventions that we should include in the client's plan of care.

So to start, what is COPD, right?

This is going to be a progressive and irreversible lower respiratory condition characterized by chronic inflammation.

We have airway remodeling, and then we also have reduced expiratory airflow.

So option three, we want to encourage the client to receive their flu vaccine because they're going to be immunocompromised, right?

They're at risk for significant complications.

If they do get the disease, if they contact the virus, they're going to be at higher risk for complications.

So we're going to encourage them to receive their vaccine annually.

And then option four, demonstrate the cough cough.

This is also true.

So clients with COPD, they develop ineffective coughing patterns due to that weakened muscles or their airway remodeling.

Remember, the airway is changing.

And this is prone to collapse under pressure.

So to help this, we're going to teach our clients how to huff-cuff through clear secutions.

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So huff-cuff is composed of low-pressure coughs to loosen and help clear out those secretions.

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So to do this, the client should sit upright, inhale deeply, and perform a forceful exhalation that makes a huff sound.

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So that's going to help them clear their secretions.

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And then the incorrect answers are 1, 2, and 5.

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So instead of a supine position, we're going to recommend a semi-fowler position to help test expansion.

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And the client will breathe easier rather than laying on their belly, which is the supine position.

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And then we have option 2, large meals take a lot of energy.

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You know, if you're short of breath and you're trying to eat a large meal, that's hard.

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So imagine a client with COPD.

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It's the same thing, you know.

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So we're going to recommend smaller protein or smaller meals or increased protein snacks.

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We want them to still take care of their nutrition.

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We don't want their shortness of breath to interfere with their condition, with their nutrition.

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And then we have option five, instruct the client to limit physical activity.

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This is incorrect.

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We want them to move to prevent pneumonia infection.

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So great job, guys, on that one.

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And then we have question number three the nurse has attended a staff education program about cystic fibrosis.

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Which are the following should the nurse recognize as a complication of cystic fibrosis?

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And again, select all that apply.

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So we have one, malnutrition, osteoporosis, uterine fibroids, diabetes mellitus, and portal hypertension.

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So which of these are complications?

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let's see okay looking at your comments someone's about to schedule that's exciting

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and we have more peeps joining us we have miami miami brazil canada nice welcome guys welcome

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okay and i like that you guys are dropping your answers great job okay so the correct answers

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i'm going to give you just a couple more to select select

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that apply uh in the meantime i'm going to tell you guys

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so you can find at uworldnursing.com

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so you can see our live schedule we go live several

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times a week uh tuesdays wednesdays thursdays fridays we have nurse Andrew, Nurse Nkoly, Nurse Samantha, myself.

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So if you guys want to prepare and see what topics we're talking about ahead of time, go ahead and check out UWorldNursing.com.

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And then my favorite part about UWorldNursing.com is the free trial so you can try 50 questions with rationales, which is what makes UWorld special.

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And we have a NCLEX study schedule.

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So we have examples from like one month to six months.

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So if you guys are completely like, oh my gosh, where do I start?

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Go ahead and visit UWorldNursing.com.

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All right, guys, so this one is going to be all of them except option three.

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So these are complications of cystic fibrosis.

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So what is cystic fibrosis?

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This is a genetic condition that causes thickening of the mucoid secretions, and this is due to impaired chloride and sodium channel regulation.

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So this leads to exocrine gland dysfunction, obstruction of the digestive, reproductive,

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and respiratory tracts, which can give us a lot of the information that we need for the complications.

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So complications are going to include malnutrition due to malabsorption of nutrients in the GI tract.

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So that's our option one.

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Option two, osteoporosis.

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This is a complication related to the malabsorption in clients with cystic fibrosis.

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Think about the vitamins A, D, E, and K, inflammation and infection, medications, reduced physical activity.

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So this is also a complication.

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And then we have option four, diabetes mellitus, which is also a complication.

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Pancreatic injury from the thick mucus secretions can lead to insufficient insulin production.

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So that's another one.

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And then we have option five, portal hypertension.

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So it can lead to liver disease.

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Cystic fibrosis can lead to liver disease or cirrhosis, which is the hardening of the liver.

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So that hardening is going to cause pressure to increase in that portal vein, which can cause portal hypertension.

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So the only incorrect one is uterine fibroids.

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So specific fibrosis can cause infertility due to those thick cervical mucus and nutrition deficiencies.

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So that's infertility, not uterine fibroids.

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So great job on that one, everybody.

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That was a little bit of a long one.

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Our next question, the nurse is checking a client who has a chest tube attached to a closed chest drainage system.

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Which of the following findings would be a priority for the nurse to follow up?

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And then we have our options.

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One, serosanguinous drainage in the collection chamber.

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Option two, crepitus around the insertion site.

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Tiling in the water seal chamber.

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And then we have collection chamber attached to the head of the client's bed.

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Let me see.

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Let me look at your answers, guys.

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Someone's scheduling their test later today.

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That's exciting.

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Yep, you guys answered.

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Sisyphagbrosid affects the sodium chloride pump.

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Great job.

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Yeah, good job, good job.

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You passed the NCLEX on Instagram.

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Good job.

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Congratulations.

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You guys, your comments come so fast.

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I got to read faster.

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And yes, we have NCOLI on our chat.

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Expected versus complication.

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Yes, great job.

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Thank you.

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All right, so the answer for this one is going to be option four.

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It's going to be a priority for us to follow up

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if we see the collection chamber attached to the head of the bed.

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So the chest tube, this is a closed system,

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and it can be used to generate the negative pressure to re-expand a collapsed lung or it also helps drain pleural fluid.

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So we do not want the collection chamber above the lungs because we need it to drain dependent drainage.

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We want to use gravity in our favor to help drain the contents into the collection chamber.

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So the other answers are incorrect.

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This option one is an expected finding.

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We're going to assess for the color, the amount and consistency, but a zero sanguinous drainage is expected.

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And then we have option two, crepitus.

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The crepitus can be expected around the site and only a little bit.

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However, we do want to keep a close eye if the crepitus is increasing, if the area is larger, or if extending to the neck.

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So we're going to immediately assess that one.

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And then we have option three, titling and the wider seal.

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This means it's working correctly.

200

That is exactly what we want to see.

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So great job on that one.

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That one can be a little tricky if you don't know much about the chest tubes, but you guys did amazing on that one.

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All right.

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And I'm going to take this moment just to pause.

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If we have any retakers in our chat today, you know, we know that retaking the NCLEX and all the study materials can be expensive.

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So we want to offer you guys this $20 off the review.

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So if you guys want to upload your CPR or your candidate's performance report, and then you're going to get an email with the offer.

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Or I know they changed our social media, so you should also be able to click on the link if it pops up.

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Or you can also find it at uworldnursing.com.

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So there's several options to find this code.

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So you guys don't forget to take advantage of this.

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And this is for retakers only.

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All right.

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Next question.

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And the nurse is assessing a client who is experiencing an acute exacerbation of asthma.

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Which of the following findings would require immediate follow-up?

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We have option one, abrupt discontinuation of wheezing.

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Option two, use of accessory muscles.

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Option three, non-productive cuffs.

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And we have option four, difficulty speaking.

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So here we have an acute exacerbation of asthma.

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And also let us know how you guys like to study, if there's any specific topics you guys need extra help in

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in your free time go feel free to explore our all

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our channels we do post all our old videos we have

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some great videos on heart failure abgs chronic kidney disease we just did a video yesterday

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so if you guys have time go ahead

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and check out those lectures the lectures are my favorite

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because you learn a lot and even

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if you already know it's just a nice review you know all right

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so this one is going to be option one An abrupt discontinuation of wheezing is our immediate follow-up.

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This is silent chest and it's life-threatening.

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So it typically requires mechanical ventilation or being in a ventilator.

233

So this is our immediate follow-up.

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Wheezing is caused by air movement through the narrow airway, and that's what's happening in asthma and acute exacerbation of asthma.

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So this is a common finding in clients due to the bronchoconstriction, wheezing.

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However, a sudden decrease in wheezing indicates the lack of airflow.

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So also the silent chest.

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So this is an ominous sign that requires emergency interventions to prevent respiratory failure.

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So anytime we see this, that's going to alert you.

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Wait a minute.

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That's not expected.

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And then the options two to four, these are expected findings.

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We have used accessory muscles.

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They are having an acute exacerbation of asthma.

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So they are going to be breathing harder.

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We do have a nonproductive cuff and difficulty speaking.

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So those are expected except the abrupt discontinuation of wheezing.

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So good job.

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All right, next question.

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The nurse is observing a staff member caring for a client with chronic obstructive pulmonary disease or COPD.

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The nurse should intervene if the staff member is observed.

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And then we have our options.

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Option one, demonstrating per slip breathing for the client, providing the client with information about smoking cessation.

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Option three, administering albuterol to the client before meals.

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And option four, hyperoxygenating the client before assisting the client to ambulate?

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Looking at your answers.

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We're almost there.

258

We got two more questions to go.

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Silent lungs, danger.

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Yes.

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If you're going to remember anything, remember that.

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Silent lungs, danger.

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We don't like that.

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That was for our old question.

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All right, guys.

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Great job.

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Great job.

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And we did talk a little bit about COPD earlier.

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So these answers should relate to that.

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Okay, okay.

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I like the rationale, Steph Marie on TikTok.

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Thank you.

273

All right, guys.

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Okay, so the correct answer for this one is going to be option four.

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So like I said, we did talk a little bit about COPD.

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But just to remind you guys, this is a progressive, irreversible, lower respiratory condition that's characterized by chronic inflammation,

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airway remodeling, and reduced expiratory airflow.

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So the long-term carbon dioxide retention, it actually decreases the body's sensitivity to elevated carbon dioxide levels.

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So these clients are getting accustomed to their new normal.

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So they're going to rely more heavily on decreased oxygen levels to help them stimulate breathing, right?

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We still need to breathe.

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So too much oxygen can reduce this stimulus.

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So it slows respiration and can worsen carbon dioxide retention.

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So we're not going to hyper oxygenate our client with COPD because this takes away their stimulus to breathe.

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So and I saw you guys put that in the rationale.

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So great job.

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And then we have options one, two and three.

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These are appropriate for the client with COPD.

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The first lip breathing is appropriate.

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It prolongs exhalation.

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It prevents premature airway collapse and it helps improve airway exchange.

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Oxygen two, yes, smoking cessation is very important for clients with COPD.

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And option three, we talked about, you know, client with that short of breath trying to eat a large meal.

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So if we can help them, we would administer an albuterol before the meal so that we can, so the client can eat more comfortably and eat more.

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Great job.

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All right, guys, we're almost there.

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We have the nurse's caring for a client who has a chest tube attached.

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We have another chest tube to a closed chest drainage system.

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Which of the following actions should the nurse take?

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And here we have a select all that apply.

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Option one, avoid stripping or milking the client's chest tube option two climb the chest tube while the client is ambulating

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option three withhold analgesics to prevent respiratory depression option four monitor the insertion site for subcutaneous emphysema

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and then we have option five instruct the client to avoid coughing

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and deep breathing let me know what you guys think we're

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so happy to have you guys here you guys have been doing amazing today within especially with rationale

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so everybody gets bonus points everybody here gets bonus points and that is your price for wednesday wednesday morning

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great job and remember we're going to have multiple correct answers for this one guys

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all right somebody is done with nclix used your world question structure is exactly the same as nclix

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so great job congratulations thank you for using us thank you for trusting us Nice.

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All right, guys.

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So the correct answers for this one are one in four, which I saw a lot in our comments.

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So we did talk a little bit about chest tubes.

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Just to remind you guys again, a chest tube is a closed chest system, closed chest drainage system.

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So it's used to generate negative pressure to help re-expand a collapsed lung

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or to help us drain a fluid in that pleural space.

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So option one is correct.

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We do not want to strip the tubing because it could dislodge or we can injure the lungs.

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So we're not going to do that.

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And then option four, we have monitor the insertion sites.

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Yes, which of the following should the nurse take?

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So yes, we are going to monitor the insertion site for subcutaneous emphysema.

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This is part of our assessment, guys.

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We're going to assess the client, their breathing, the output on the chest tube, what everything looks like and it's part of the focus assessment like I said.

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So if we see any subcutaneous emphysema,

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this can indicate that the tube is dislodged or that air is leaking into that subcutaneous tissue and this needs follow-up.

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The other options are incorrect.

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We do not clamp the chest tube.

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We never clamp.

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This can cause a pneumothorax or a collapsed lung.

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So option two, no, we're not going to do that.

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And then option three, chest tubes are very painful.

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Just imagine having a chest tube literally inserted in your skin.

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So we're not going to withhold analgesics.

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We're going to work with our clients to help them be comfortable with the chest tube

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because they can stay there for a couple of days.

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And then we have option five, instruct the client to avoid coughing and deep breathing.

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So this is not something we're going to instruct them.

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Instead, we want them to cough and we want them to take deep breaths

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so we can help move those secretions and they can breathe easier.

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Great job.

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Alrighty, and this is our last question for today.

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The nurse is caring for a client who is experiencing an acute exacerbation of asthma.

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The nurse should prepare to administer.

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We have albuterol, salmitrol, oh my gosh, lutecasone, and montelicast.

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I feel like I just said a spell.

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But you guys got this.

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So we have here acute exacerbation of asthma.

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What do we think?

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Okay, good job, guys.

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And then how many have you guys gotten correct so far?

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I also want to take this moment to tell you guys about our partnership with NSNA or the National Student Nurses Association.

352

With this partnership, we're hosting virtual webinars throughout the year and the upcoming ones are coming up in the fall.

353

So for more information, you can go to our social media, UWorld Nursing, or you can also check out NSNA's social media so you can sign up for our webinars.

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All righty, guys.

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This is our last question.

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And as most of you, yeah, pretty much all of you guys got this one right.

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We got option one.

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So during an asthma attack, we need a fast-acting medication.

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So that's going to be olibutyl.

360

It's a nebulized short-acting beta-2 agonist.

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And this is going to open the airway and improve hypoxia.

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The other options are incorrect.

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Option two is used to prevent asthma attacks.

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So it's not used for acute exacerbations.

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Emphasis on acute.

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I saw a couple say it was too easy.

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It could be, but imagine if you're reading it too fast and you answer it incorrectly.

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That's where we need to take our time.

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And then we have option three, flotacosone.

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So this inhaled systemic corticosteroids.

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So these are going to help for long term to help that underlying inflammation.

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They take some time to actually work, so they're not going to be used for an acute exacerbation.

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And then lastly, we have that Montelicast.

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So this is a leukotriene inhibitor combined with a short-acting and corticosteroid inhaler like budesonide.

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It can help provide long-term asthma control.

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However, it's not used for an acute exacerbation.

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So great job, you guys.

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That was our last question.

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Again, don't forget to visit youworldnursing.com.

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That is where we have all our good links, all the goodies that you can sign up for.

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Don't forget to like, share and subscribe.

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Help us reach that goal.

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And I'll always leave you with this message.

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You have what it takes to be a safe and compassionate nurse.

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And great job.

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Thank you for watching.

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Thank you.

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Vocabulary and speaking notes for this lesson

This C1 speaking lesson is built on the video “Live NCLEX® Respiratory Question Drill - Vertical”. The speaker keeps coming back to these words: option, client, nurse, chest, answer. This video has 387 sentences and 3964 words to shadow. The speech runs for 24:10. The speaker talks at a natural 164 words per minute, close to everyday conversation. Only 79% of the words are among the 3,000 most common in English, so the vocabulary is demanding.

Key vocabulary in this video

The 15 most advanced words in the video, with pronunciation and meaning:

Word	Pronunciation	Meaning
complication noun	/ˌkɑm.pləˈkeɪ.ʃən/	The act or process of complicating.
asthma noun	/ˈæzmə/	A long-term respiratory condition, in which the airways may unexpectedly and suddenly narrow, often in response to an allergen, cold air, exercise, or…
acute adjective	/əˈkjut/	Brief, quick, short.
airway noun	/ˈɛɚ.weɪ/	The trachea.
exacerbation noun	/ɪɡˈzæsɚˌbeɪʃən/	An increase in the severity of something (such as a disease)
fibrosis noun	/faɪˈbɹoʊsɪs/	The formation of (excess) fibrous connective tissue in an organ.
respiratory adjective	/ɹɪˈspɪ.ɹət.ə.ɹi/	Relating to respiration or the organs of respiration; breathing.
cystic adjective	/ˈsɪstɪk/	Of or pertaining to a cyst.
secretion noun	/sɪˈkriːʃ(ə)n/	Any substance that is secreted by an organism.
wheeze noun	/ʍiːz/	A piping or whistling sound caused by difficult respiration.
accessory noun	/əkˈsɛs.(ə.)ɹi/	Something that belongs to part of another main thing; something additional and subordinate, an attachment.
drainage noun	/ˈdɹeɪnəd͡ʒ/	A natural or artificial means for the removal of fluids from a given area by its draining away.
incorrect adjective	/ˌɪn.kəˈɹɛkt/	Not correct; erroneous or wrong.
cough verb	/kɔf/	Sometimes followed by up: to force (something) out of the lungs or throat by pushing air from the lungs through the glottis (causing a short, explosive sound)…
assess verb	/əˈsɛs/	To determine, estimate or judge the value of; to evaluate; to estimate.

Phrasal verbs you will hear

Word	Pronunciation	Meaning
follow up verb		To take further actions remaining after an event; to continue, revisit, or persist; especially, to maintain communication or verify.
check out verb		To record the departure or withdrawal of someone or something (such as guests, employees, books, etc.).
go ahead verb	/ˌɡoʊ əˈhɛd/	To proceed with; to begin.
clear out verb		To completely empty.
pop up verb		To come up with a "pop" sound.
take away verb	/ˌteɪk əˈweɪ/	To remove something and put it in a different place.

Sentences worth repeating

Short, complete lines from the video that you can reuse in everyday conversation:

What pushes you to check on this patient?
If you're going to remember anything, remember that.
All right, guys, we're almost there.
What do we think?
That's where we need to take our time.

Grammar in this video

The structures the speaker uses most, with the exact words from the video:

Structure	In the video
Passive voice be + past participle — the focus is on what happens, not who does it	be concerned · be immunocompromised · is composed
Relative clauses who / which + clause — extra information about a person or thing	belly, which is · rationales, which is · tracts, which can
Present perfect have/has + past participle — a past action that still matters now	haven't joined · have reduced · has attended

Pronunciation to watch

The speaker uses 64 contractions and reduced forms, such as we're, don't, you're. Say them the short way, as you hear them.

The “th” sounds: withhold /wɪθˈhoʊld/, threaten /ˈθɹɛt.n̩/
The “sh” and “zh” sounds: complication /ˌkɑm.pləˈkeɪ.ʃən/, exacerbation /ɪɡˈzæsɚˌbeɪʃən/, secretion /sɪˈkriːʃ(ə)n/, rationale /ˌɹæʃ.əˈnæl/, insertion /ɪnˈsɝʃən/
Long words — get the stress right: complication /ˌkɑm.pləˈkeɪ.ʃən/, exacerbation /ɪɡˈzæsɚˌbeɪʃən/, respiratory /ɹɪˈspɪ.ɹət.ə.ɹi/, accessory /əkˈsɛs.(ə.)ɹi/, subcutaneous /sʌbkjuːˈteɪnɪəs/

How to practise with this video

Listen to the whole video once without speaking and note the words you do not know.
Start at 0.75× speed, shadow it sentence by sentence, then go back to normal speed once it feels easy.
Record yourself and compare with the original, paying attention to words like complication, asthma, acute.

What is the Shadowing Technique?

Shadowing is a science-backed language learning technique originally developed for professional interpreter training and popularized by polyglot Dr. Alexander Arguelles. The method is simple but powerful: you listen to native English audio and immediately repeat it out loud — like a shadow following the speaker with just a 1–2 second delay. Unlike passive listening or grammar drills, shadowing forces your brain and mouth muscles to simultaneously process and reproduce real speech patterns. Research shows it significantly improves pronunciation accuracy, intonation, rhythm, connected speech, listening comprehension, and speaking fluency — making it one of the most effective methods for IELTS Speaking preparation and real-world English communication.

Shadowing technique: read the full step-by-step guide →

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Vocabulary and speaking notes for this lesson

Key vocabulary in this video

Phrasal verbs you will hear

Sentences worth repeating

Grammar in this video

Pronunciation to watch

How to practise with this video

What is the Shadowing Technique?