Respiratory System | Pneumonia & Tuberculosis NCLEX Quiz 41

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Quizzes Created: 468 | Total Attempts: 2,466,971

Questions: 10 | Attempts: 2,874 | Updated: Aug 19, 2023

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Respiratory System | Pneumonia & Tuberculosis NCLEX Quiz 41 - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.

Questions and Answers

1.

A comatose client needs a nasopharyngeal airway for suctioning. After the airway is inserted. he gags and coughs. Which action should the nurse take?
- A.
  
  Remove the airway and insert a shorter one.
- B.
  
  Reposition the airway.
- C.
  
  Leave the airway in place until the client gets used to it.
- D.
  
  Remove the airway and attempt suctioning without it.
Correct Answer
A. Remove the airway and insert a shorter one.

Explanation
If a client gags or coughs after nasopharyngeal airway placement. the tube may be too long. The nurse should remove it and insert a shorter one. Simply repositioning the airway won’t solve the problem. The client won’t get used to the tube because it’s the wrong size. Suctioning without a nasopharyngeal airway causes trauma to the natural airway.

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2.

An 87-year-old client requires long-term ventilator therapy. He has a tracheostomy in place and requires frequent suctioning. Which of the following techniques is correct?
- A.
  
  Using intermittent suction while advancing the catheter.
- B.
  
  Using continuous suction while withdrawing the catheter.
- C.
  
  Using intermittent suction while withdrawing the catheter.
- D.
  
  Using continuous suction while advancing the catheter.
Correct Answer
C. Using intermittent suction while withdrawing the catheter.

Explanation
Intermittent suction should be applied during catheter withdrawal. To prevent hypoxia. suctioning shouldn’t last more than 10-seconds at a time. Suction shouldn’t be applied while the catheter is being advanced.

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3.

A client’s ABG analysis reveals a pH of 7.18. PaCO2 of 72 mm Hg. PaO2 of 77 mm Hg. and HCO3- of 24 mEq/L. What do these values indicate?
- A.
  
  Metabolic acidosis
- B.
  
  Respiratory alkalosis
- C.
  
  Metabolic alkalosis
- D.
  
  Respiratory acidosis
Correct Answer
D. Respiratory acidosis

Explanation
The ABG analysis results indicate respiratory acidosis. A pH below 7.35 is considered acidic, and a pH of 7.18 falls within this range. PaCO2 above 45 mm Hg suggests retention of carbon dioxide, which is a characteristic of respiratory acidosis. PaO2 of 77 mm Hg is within the normal range, and HCO3- of 24 mEq/L indicates normal bicarbonate levels, which rules out metabolic acidosis or alkalosis. Therefore, the combination of low pH and high PaCO2 points to respiratory acidosis.

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4.

A police officer brings in a homeless client to the ER. A chest x-ray suggests he has TB. The physician orders an intradermal injection of 5 tuberculin units/0.1 ml of tuberculin purified derivative. Which needle is appropriate for this injection?
- A.
  
  5/8” to ½” 25G to 27G needle.
- B.
  
  1” to 3” 20G to 25G needle.
- C.
  
  ½” to 3/8” 26 or 27G needle.
- D.
  
  1” 20G needle.
Correct Answer
C. ½” to 3/8” 26 or 27G needle.

Explanation
Intradermal injections like those used in TN skin tests are administered in small volumes (usually 0.5 ml or less) into the outer skin layers to produce a local effect. A TB syringe with a ½” to 3/8” 26G or 27G needle should be inserted about 1/8” below the epidermis.

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5.

A 76-year old client is admitted for elective knee surgery. Physical examination reveals shallow respirations but no signs of respiratory distress. Which of the following is a normal physiologic change related to aging?
- A.
  
  Increased elastic recoil of the lungs
- B.
  
  Increased number of functional capillaries in the alveoli
- C.
  
  Decreased residual volume
- D.
  
  Decreased vital capacity.
Correct Answer
D. Decreased vital capacity.

Explanation
Reduction in VC is a normal physiologic change in the older adult. Other normal physiologic changes include decreased elastic recoil of the lungs. fewer functional capillaries in the alveoli. and an increase is residual volume.

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6.

A 79-year-old client is admitted with pneumonia. Which nursing diagnosis should take priority?
- A.
  
  Acute pain related to lung expansion secondary to lung infection
- B.
  
  Risk for imbalanced fluid volume related to increased insensible fluid losses secondary to fever.
- C.
  
  Anxiety related to dyspnea and chest pain.
- D.
  
  Ineffective airway clearance related to retained secretions.
Correct Answer
D. Ineffective airway clearance related to retained secretions.

Explanation
Pneumonia is an acute infection of the lung parenchyma. The inflammatory reaction may cause an outpouring of exudate into the alveolar spaces. leading to an ineffective airway clearance related to retained secretions.

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7.

A community health nurse is conducting an educational session with community members regarding TB. The nurse tells the group that one of the first symptoms associated with TB is:
- A.
  
  A bloody. productive cough
- B.
  
  A cough with the expectoration of mucoid sputum
- C.
  
  Chest pain
- D.
  
  Dyspnea
Correct Answer
B. A cough with the expectoration of mucoid sputum

Explanation
One of the first pulmonary symptoms includes a slight cough with the expectoration of mucoid sputum.

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8.

A nurse evaluates the blood theophylline level of a client receiving aminophylline (theophylline) by intravenous infusion. The nurse would determine that a therapeutic blood level exists if which of the following were noted in the laboratory report?
- A.
  
  5 mcg/mL
- B.
  
  15 mcg/mL
- C.
  
  25 mcg/mL
- D.
  
  30 mcg/mL
Correct Answer
B. 15 mcg/mL

Explanation
The therapeutic theophylline blood level range from 10-20 mcg/mL.

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9.

Isoniazid (INH) and rifampin (Rifadin) have been prescribed for a client with TB. A nurse reviews the medical record of the client. Which of the following. if noted in the client’s history. would require physician notification?
- A.
  
  Heart disease
- B.
  
  Allergy to penicillin
- C.
  
  Hepatitis B
- D.
  
  Rheumatic fever
Correct Answer
C. Hepatitis B

Explanation
Isoniazid and rifampin are contraindicated in clients with acute liver disease or a history of hepatic injury.

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10.

A client is experiencing confusion and tremors is admitted to a nursing unit. An initial ABG report indicates that the PaCO2 level is 72 mm Hg. whereas the PaO2 level is 64 mm Hg. A nurse interprets that the client is most likely experiencing:
- A.
  
  Carbon monoxide poisoning
- B.
  
  Carbon dioxide narcosis
- C.
  
  Respiratory alkalosis
- D.
  
  Metabolic acidosis
Correct Answer
B. Carbon dioxide narcosis

Explanation
Carbon dioxide narcosis is a condition that results from extreme hypercapnia. with carbon dioxide levels in excess of 70 mm Hg. The client experiences symptoms such as confusion and tremors. which may progress to convulsions and possible coma.

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Current Version
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Quiz Edited by
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Sep 26, 2017

Quiz Created by
Santepro

Respiratory System | Pneumonia & Tuberculosis NCLEX Quiz 41

A comatose client needs a nasopharyngeal airway for suctioning. After the airway is inserted. he gags and coughs. Which action should the nurse take?

An 87-year-old client requires long-term ventilator therapy. He has a tracheostomy in place and requires frequent suctioning. Which of the following techniques is correct?

A client’s ABG analysis reveals a pH of 7.18. PaCO2 of 72 mm Hg. PaO2 of 77 mm Hg. and HCO3- of 24 mEq/L. What do these values indicate?

A police officer brings in a homeless client to the ER. A chest x-ray suggests he has TB. The physician orders an intradermal injection of 5 tuberculin units/0.1 ml of tuberculin purified derivative. Which needle is appropriate for this injection?

A 76-year old client is admitted for elective knee surgery. Physical examination reveals shallow respirations but no signs of respiratory distress. Which of the following is a normal physiologic change related to aging?

A 79-year-old client is admitted with pneumonia. Which nursing diagnosis should take priority?

A community health nurse is conducting an educational session with community members regarding TB. The nurse tells the group that one of the first symptoms associated with TB is:

A nurse evaluates the blood theophylline level of a client receiving aminophylline (theophylline) by intravenous infusion. The nurse would determine that a therapeutic blood level exists if which of the following were noted in the laboratory report?

Isoniazid (INH) and rifampin (Rifadin) have been prescribed for a client with TB. A nurse reviews the medical record of the client. Which of the following. if noted in the client’s history. would require physician notification?

A client is experiencing confusion and tremors is admitted to a nursing unit. An initial ABG report indicates that the PaCO2 level is 72 mm Hg. whereas the PaO2 level is 64 mm Hg. A nurse interprets that the client is most likely experiencing: