Respiratory System | Pneumonia & Tuberculosis NCLEX Quiz 38

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  • 1/10 Questions

    A client has been treated with antibiotic therapy for right lower-lobe pneumonia for 10 days and will be discharged today. Which of the following physical findings would lead the nurse to believe it is appropriate to discharge this client?

    • Continued dyspnea
    • Fever of 102*F
    • Respiratory rate of 32 breaths/minute
    • Vesicular breath sounds in right base
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Respiratory System | Pneumonia & Tuberculosis NCLEX Quiz 38 - Quiz

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  • 2. 

    A client with pneumonia develops dyspnea with a respiratory rate of 32 breaths/minute and difficulty expelling his secretions. The nurse auscultates his lung fields and hears bronchial sounds in the left lower lobe. The nurse determines that the client requires which of the following treatments first?

    • Antibiotics

    • Bed rest

    • Oxygen

    • Nutritional intake

    Correct Answer
    A. Oxygen
    Explanation
    The client is having difficulty breathing and is probably becoming hypoxic. As an emergency measure. the nurse can provide oxygen without waiting for a physicians order. Antibiotics may be warranted. but this isn’t a nursing decision. The client should be maintained on bedrest if he is dyspneic to minimize his oxygen demands. but providing additional will deal more immediately with his problem. The client will need nutritional support. but while dyspneic. he may be unable to spare the energy needed to eat and at the same time maintain adequate oxygenation.

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  • 3. 

    Which of the following organisms most commonly causes community-acquired pneumonia in adults?

    • Haemiphilus influenzae

    • Klebsiella pneumoniae

    • Streptococcus pneumoniae

    • Staphylococcus aureus

    Correct Answer
    A. Streptococcus pneumoniae
    Explanation
    Pneumococcal or streptococcal pneumonia. caused by streptococcus pneumoniae. is the most common cause of community-acquired pneumonia. H. influenzae is the most common cause of infection in children. Klebsiella species is the most common gram-negative organism found in the hospital setting. Staphylococcus aureus is the most common cause of hospital-acquired pneumonia.

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  • 4. 

      A client with primary TB infection can expect to develop which of the following conditions?

    • Active TB within 2 weeks

    • Active TB within 1 month

    • A fever that requires hospitalization

    • A positive skin test

    Correct Answer
    A. A positive skin test
    Explanation
    A primary TB infection occurs when the bacillus has successfully invaded the entire body after entering through the lungs. At this point. the bacilli are walled off and skin tests read positive. However. all but infants and immunosuppressed people will remain asymptomatic. The general population has a 10% risk of developing active TB over their lifetime. in many cases because of a break in the body’s immune defenses. The active stage shows the classic symptoms of TB: fever. hemoptysis. and night sweats.

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  • 5. 

    Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop?

    • Atelectasis

    • Bronchiectasis

    • Effusion

    • Inflammation

    Correct Answer
    A. Inflammation
    Explanation
    The common feature of all type of pneumonia is an inflammatory pulmonary response to the offending organism or agent. Atelectasis and bronchiectasis indicate a collapse of a portion of the airway that doesn’t occur in pneumonia. An effusion is an accumulation of excess pleural fluid in the pleural space. which may be a secondary response to pneumonia.

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  • 6. 

    Clients with chronic illnesses are more likely to get pneumonia when which of the following situations is present?

    • Dehydration

    • Group living

    • Malnutrition

    • Severe periodontal disease

    Correct Answer
    A. Group living
    Explanation
    Clients with chronic illnesses generally have poor immune systems. Often. residing in group living situations increases the chance of disease transmission.

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  • 7. 

    The right forearm of a client who had a purified protein derivative (PPD) test for tuberculosis is reddened and raised about 3mm where the test was given. This PPD would be read as having which of the following results?

    • Indeterminate

    • Needs to be redone

    • Negative

    • Positive

    Correct Answer
    A. Negative
    Explanation
    This test would be classed as negative. A 5 mm raised area would be a positive result if a client was HIV+ or had recent close contact with someone diagnosed with TB. Indeterminate isn’t a term used to describe results of a PPD test. If the PPD is reddened and raised 10mm or more. it’s considered positive according to the CDC.

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  • 8. 

    An elderly client with pneumonia may appear with which of the following symptoms first?

    • Altered mental status and dehydration

    • Fever and chills

    • Hemoptysis and dyspnea

    • Pleuritic chest pain and cough

    Correct Answer
    A. Altered mental status and dehydration
    Explanation
    Fever. chills. hemoptysis. dyspnea. cough. and pleuritic chest pain are common symptoms of pneumonia. but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response.

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  • 9. 

    When auscultating the chest of a client with pneumonia. the nurse would expect to hear which of the following sounds over areas of consolidation?

    • Bronchial

    • Bronchovesicular

    • Tubular

    • Vesicular

    Correct Answer
    A. Bronchial
    Explanation
    Chest auscultation reveals bronchial breath sounds over areas of consolidation. Bronchovesicular are normal over midlobe lung regions. tubular sounds are commonly heard over large airways. and vesicular breath sounds are commonly heard in the bases of the lung fields.

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  • 10. 

    A diagnosis of pneumonia is typically achieved by which of the following diagnostic tests?

    • ABG analysis

    • Chest x-ray

    • Blood cultures

    • Sputum culture and sensitivity

    Correct Answer
    A. Sputum culture and sensitivity
    Explanation
    Sputum C & S is the best way to identify the organism causing the pneumonia. Chest x-ray will show the area of lung consolidation. ABG analysis will determine the extent of hypoxia present due to the pneumonia. and blood cultures will help determine if the infection is systemic.

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  • Apr 29, 2024
    Quiz Edited by
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  • Sep 26, 2017
    Quiz Created by
    Santepro
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