Pneumonia (NCLEX) Assessment & Treatment Quiz

1. A patient with pneumonia develops a sudden sharp pleuritic chest pain and dyspnea. What complication should you suspect?

Sepsis

Acute respiratory distress syndrome (ARDS)

Empyema or pleural effusion

Myocardial infarction

2. A patient recovering from pneumonia asks when they can return to work. What is the appropriate guidance?

Immediately after discharge

After fever resolves and symptoms improve significantly

Only after repeat chest X-ray shows complete resolution

At least 6 weeks post-discharge

3. Which of the following patients would be appropriate for outpatient treatment of community-acquired pneumonia?

Patient with SpO2 < 90% and altered mental status

Patient with CURB-65 score of 0-1, reliable follow-up

Patient with sepsis and hemodynamic instability

Patient requiring mechanical ventilation

4. A patient with pneumonia is prescribed a macrolide antibiotic. What is the most common side effect you should monitor for?

Nephrotoxicity

Gastrointestinal disturbance

Photosensitivity

Ototoxicity

5. Which finding on physical examination suggests pneumonia rather than bronchitis?

Dry cough

Rhonchi

Dullness to percussion and crackles

Wheezing

6. A patient with pneumonia has a sputum culture growing Streptococcus pneumoniae resistant to penicillin. What adjustment to therapy is necessary?

Continue current penicillin therapy

Switch to fluoroquinolone or higher-dose cephalosporin

Discontinue antibiotics

Add only supportive care

7. What is the primary mechanism by which pneumonia causes hypoxemia?

Airway obstruction

Ventilation-perfusion (V/Q) mismatch

Hypoventilation

Decreased cardiac output

8. Which nursing diagnosis is most appropriate for a patient with pneumonia and oxygen saturation of 88%?

Ineffective airway clearance

Impaired gas exchange

Risk for infection

Activity intolerance

9. A patient receiving mechanical ventilation develops fever, purulent sputum, and new infiltrates on chest X-ray. What is this condition?

Community-acquired pneumonia

Ventilator-associated pneumonia (VAP)

Aspiration pneumonia

Fungal pneumonia

10. Which laboratory value would indicate a severe systemic response to pneumonia?

White blood cell count 6,000/μL

Creatinine 0.8 mg/dL

Lactate > 4 mmol/L

Hemoglobin 13 g/dL

11. Which of the following is the most common causative organism of community-acquired pneumonia (CAP) in immunocompetent adults?

Streptococcus pneumoniae

Haemophilus influenzae

Legionella pneumophila

Pseudomonas aeruginosa

12. What is the expected duration of antibiotic therapy for uncomplicated community-acquired pneumonia?

3 days

5-7 days

10-14 days

28 days

13. Which patient population is at highest risk for developing aspiration pneumonia?

Young athletes

Patients with impaired swallowing or altered consciousness

Patients on prophylactic antibiotics

Patients with normal immune function

14. A patient develops pneumonia 48 hours after hospital admission. What is this type of infection called?

Community-acquired pneumonia (CAP)

Hospital-acquired pneumonia (HAP)

Ventilator-associated pneumonia (VAP)

Healthcare-associated pneumonia (HCAP)

15. Atypical pneumonia is characterized by which finding?

Lobar consolidation on chest X-ray

Minimal findings on chest X-ray despite significant symptoms

High fever and purulent sputum

Pleural effusion in most cases

16. Which antibiotic is first-line empiric therapy for community-acquired pneumonia in hospitalized patients without severe disease?

Ceftriaxone or cefotaxime with azithromycin

Vancomycin alone

Fluoroquinolone alone

Amoxicillin-clavulanate

17. A patient with pneumonia has a respiratory rate of 28 breaths/min and oxygen saturation of 92% on room air. What is the priority nursing intervention?

Administer supplemental oxygen

Start IV antibiotics immediately

Obtain blood cultures

Encourage deep breathing exercises

18. The CURB-65 scoring system is used to assess pneumonia severity. Which factor is NOT part of this score?

Confusion

Urea > 7 mmol/L

Respiratory rate > 30

Oxygen saturation < 90%

19. Which chest X-ray finding is characteristic of bacterial pneumonia?

Hyperinflation

Lobar or segmental consolidation

Bilateral hilar lymphadenopathy

Pleural effusion only

20. A 65-year-old patient presents with fever, productive cough, and pleuritic chest pain. What classic clinical finding would you expect on auscultation?

Vesicular breath sounds throughout

Crackles and bronchial breath sounds

Absent breath sounds bilaterally

Wheezing in all lung fields

Pneumonia Quiz: Can You Assess and Treat It?