Pneumonia

Text Mode – Text version of the exam

1) In a recumbent, immobilized patient, lung ventilation can become altered, leading to such
respiratory complications as:

A. Respiratory acidosis, ateclectasis, and hypostatic pneumonia

B. Appneustic breathing, atypical pneumonia and respiratory alkalosis

C. Cheyne-Strokes respirations and spontaneous pneumothorax

D. Kussmail’s respirations and hypoventilation

2) The nurse is preparing her plan of care for her patient diagnosed with pneumonia. Which is
the most appropriate nursing diagnosis for this patient?

A. Fluid volume deficit

B. Decreased tissue perfusion.

C. Impaired gas exchange.

D. Risk for infection

3) A 65-year-old patient with pneumonia is receiving garamycin (Gentamicin). It would be MOST

important for a nurse to monitor which of the following laboratory values in this patient?

A. Hemoglobin and hematocrit.

B. BUN and creatinine.

C. Platelet count and clotting time.

D. Sodium and potassium.

4) A client with bacterial pneumonia is admitted to the pediatric unit. What would the nurse
expect the admitting assessment to reveal?

A. High fever

B. Nonproductive cough

C. Rhinitis

D. Vomiting and diarrhea

5) A firefighter who was involved in extinguishing a house fire is being treated for smoke
inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and
mechanical ventilation. Which of the following conditions has he most likely developed?

A. Acute respiratory distress syndrome (ARDS).

B. Atelectasis.

C. Bronchitis.

D. Pneumonia.

6) Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best
management for the child?

A. Prescribe an antibiotic.

B. Refer him urgently to the hospital.

C. Instruct the mother to increase fluid intake.

D. Instruct the mother to continue breastfeeding.

7) Which order can be associated with the prevention of atelectasis and pneumonia in a client
with amyotrophic lateral sclerosis?

A. Active and passive range of motion exercises twice a day

B. Every 4 hours incentive spirometer

C. Chest physiotherapy twice a day

D. Repositioning every 2 hours around the clock

8) A client with pneumacystis carini pneumonia is receiving trimetrexate. The rationale for
administering leucovorin calcium to a client receiving Methotrexate is to:

A. Treat anemia.

B. Create a synergistic effect.

C. Increase the number of white blood cells.

D. Reverse drug toxicity.

9) Which of the following community-acquired pneumonias demonstrates the highest

occurrence during summer and fall?

A. Legionnaires’ disease
B. Streptococcal (pneumococcal) pneumonia

C. Mycoplasma pneumonia

D. Viral pneumonia

10) Braguda brought her 5-month old daughter in the nearest RHU because her baby sleeps
most of the time, with decreased appetite, has colds and fever for more than a week. The
physician diagnosed pneumonia. Based on this data given by Braguda, you can classify Braguda’s
daughter to have:

A. Pneumonia: cough and colds

B. Severe pneumonia

C. Very severe pneumonia

D. Pneumonia moderate

11) A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type
of isolation is MOST appropriate for this client?

A. Reverse isolation

B. Respiratory isolation

C. Standard precautions

D. Contact isolation

12) The home health nurse is planning for the day’s visits. Which client should be seen first?

A. The 78-year-old who had a gastrectomy 3 weeks ago and has a PEG tube

B. The 5-month-old discharged 1 week ago with pneumonia who is being treated with
amoxicillin liquid suspension

C. The 50-year-old with MRSA being treated with Vancomycin via a PICC line

D. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone
via a centrally placed venous catheter

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

A. Altered mental status and dehydration

B. fever and chills

C. Hemoptysis and dyspnea

D. Pleuretic chest pain and cough

14) While caring for an HIV-positive patient who is hospitalized with Pneumocystis carinii
pneumonia, you note that all of these drug therapies are scheduled for 10:00 AM. Which
nursing action is most essential to accomplish at the scheduled time?

A. Administer the protease inhibitor indinavir (Crixivan) 800 mg PO.

B. Infuse pentamidine (Pentam-300) 300 mg IV over 60 minutes.

C. Have the patient “swish and swallow” nystatin (Mycostatin) 5 mL.

D. Apply acyclovir (Zovirax) cream to oral herpes simplex lesions.

15) Which of the following signs will indicate that a young child is suffering from severe
pneumonia?

A. Dyspnea

B. Wheezing

C. Fast breathing

D. Chest indrawing

16) A client with AIDS develops bacterial pneumonia is admitted in the emergency department.
The client’s arterial blood gases is drawn and the result is PaO2 80mmHg. then arterial blood
gases are drawn again and the level is reduced from 80 mmHg to 65 mmHg. The nurse should;

A. Have arterial blood gases performed again to check for accuracy.

B. Increase the oxygen flow rate.

C. Notify the physician.

D. Decrease the tension of oxygen in the plasma.

17) The nurse is caring for four clients on a stepdown intensive care unit. The client at the
highest risk for developing nosocomial pneumonia is the one who:

A. has a respiratory infection

B. is intubated and on a ventilator

C. has pleural chest tubes

D. is receiving feedings through a jejunostomy tube

18) You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a
treatment for Pneumocystis carinii pneumonia. Which information is most important to
communicate to the physician?

A. The blood pressure decreased to 104/76 during administration.

B. The patient is complaining of pain at the site of the infusion.

C. The patient is not taking in an adequate amount of oral fluids.

D. Blood glucose is 55 mg/dL after the medication administration.

19) For a 3-month old child to be classified to have Pneumonia (not severe), you would expect to
find RR of:

A. 60 bpm

B. 40 bpm

C. 70 bpm

D. 50 pbm

20) Nurse Betty is assessing tactile fremitus in a client with pneumonia. For this examination,
nurse Betty should use the:

A. Fingertips

B. Finger pads

C. Dorsal surface of the hand

D. Ulnar surface of the hand

21) A 20-year-old patient is being treated for pneumonia. He has a persistent cough and
complains of severe pain on coughing. What could you tell him to help him reduce his
discomfort?

A. “Hold your cough as much as possible.”

B. “Place the head of your bed flat to help with coughing.”

C. “Restrict fluids to help decrease the amount of sputum.”

D. “Splint your chest wall with a pillow for comfort.”

22) A male client with pneumonia develops respiratory failure and has a partial pressure of
arterial oxygen of 55 mm Hg. He’s placed on mechanical ventilation with a fraction of inspired
oxygen (FIO2) of 0.9. The nursing goal should be to reduce the FIO2 to no greater than:
A. 0.21

B. 0.35

C. 0.5

D. 0.7

23) Mr. Jose is admitted to the hospitalwith a diagnosis of pneumonia and COPD. The physician
orders an oxygen therapy for him. The most comfortable method of delivering oxygen to Mr.
Jose is by:

A. Croupette

B. Nasal Cannula

C. Nasal catheter

D. Partial rebreathing mask

24) A male client with pneumococcal pneumonia is admitted to an acute care facility. The client
in the next room is being treated for mycoplasmal pneumonia. Despite the different causes of
the various types of pneumonia, all of them share which feature?

A. Inflamed lung tissue

B. Sudden onset

C. Responsiveness to penicillin.

D. Elevated white blood cell (WBC) count

25) The priority is postoperative respiratory toilet. This client will quickly develop profound
atelectasis and eventually pneumonia without adequate gas exchange. This will only be
achieved with the appropriate pain management.

A. Pallor

B. Increased temperature

C. Dyspnea

D. Involuntary muscle spasms

26) A client with pneumonia is receiving supplemental oxygen, 2 L/min via nasal cannula. The
client’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery
disease. Because of these findings, the nurse closely monitors the oxygen flow and the client’s
respiratory status. Which complication may arise if the client receives a high oxygen
concentration?

A. Apnea

B. Anginal pain

C. Respiratory alkalosis

D. Metabolic acidosis

27) A male elderly client is admitted to an acute care facility with influenza. The nurse monitors
the client closely for complications. What is the most common complication of influenza?

A. Septicemia

B. Pneumonia

C. Meningitis

D. Pulmonary edema

28) An 80-year-old male client is admitted to the hospital with a diagnosis of pneumonia. Nurse
Oliver learns that the client lives alone and hasn’t been eating or drinking. When assessing him
for dehydration, nurse Oliver would expect to find:

A. Hypothermia

B. Hypertension

C. Distended neck veins

D. Tachycardia

29) A male client admitted to an acute care facility with pneumonia is receiving supplemental
oxygen, 2 L/minute via nasal cannula. The client’s history includes chronic obstructive
pulmonary disease (COPD) and coronary artery disease. Because of these history findings, the
nurse closely monitors the oxygen flow and the client’s respiratory status. Which complication
may arise if the client receives a high oxygen concentration?

A. Apnea

B. Anginal pain

C. Respiratory alkalosis

D. Metabolic acidosis
30) Which of the following would be an appropriate nursing diagnosis for a hospitalized client
with bacterial pneumonia and shortness of breath?

A. Ineffective cardiopulmonary tissue perfusion related to myocardial damage

B. Risk for self-care deficit related to fatigue

C. Deficient fluid volume related to nausea and vomiting

D. Disturbed thought processes related to inadequate relief of chest pain