Pneumonia Practice NCLEX Questions

11. Bed rest is prescribed for a client with pneumonia during the acute phase of the illness. Bed rest serves which of the following purposes? A) It reduces cellular demand for oxygen B) It decreases the episodes of coughing C) It promotes safety D) It promotes clearance of secretions

A) It reduces cellular demand for oxygen

16. Which of the following mental status changes may occur when a client with pneumonia is first experiencing hypoxia? A) Coma B) Apathy C) Irritability D) Depression

C) Irritability

34. A nurse is caring for a client diagnosed with pneumonia. The nurse plans which of the following as the best time to take the client for a short walk? A) After the client uses the meter-dosed inhaler B) After recording the oxygen saturation on the bedside flow sheet C) After the client eats lunch D) After the client has a brief nap

A) After the client uses the meter-dosed inhaler

13. A client with pneumonia is experiencing pleuritic chest pain. Which of the following describes pleuritic chest pain? A) A mild but constant aching in the chest B) Severe midsternal chest pain C) Moderate pain that worsens on inspiration D) Muscle spasm pain that accompanies coughing

C) Moderate pain that worsens on inspiration

6. A 79 year old female client is admitted to the hospital with a diagnosis of bacterial pneumonia. While obtaining the client's health history, the nurse learns that the client has osteoarthritis, a vegetarian diet, and is very concerned about cleanliness. Which of the following would most likely be a predisposing factor for the diagnosis of pneumonia? A) Age B) Osteoarthritis C) Vegetarian diet D) Daily bathing

A) Age

17. The client with pneumonia develops mild constipation, and the nurse administers docusate sodium (Colace) as ordered. The drug works by: A) Softening the stool B) Lubricating the stool C) Increasing stool bulk D) Stimulating peristalsis

A) Softening the stool

23. A client with pneumococcal pneumonia is admitted to an acute care facility. The client in the next room is being treated foe mycoplasmal pneumonia. Despite the different causes of various types of pneumonia, all of them share which feature? A) Inflamed lung tissue B) Suddenonset C) Responsiveness to penicillin D) Elevated white blood cell count

A) Inflamed lung tissue

12. The cyanosis that accompanies bacterial pneumonia is primarily caused by which of the following? A) Decreased cardiac output B) Pleural effusion C) Inadequate peripheral circulation D) Decreased oxygenation of the blood

D) Decreased oxygenation of the blood

20. The nurse is caring for a patient with atypical pneumonia. When conducting a client assessment, which of the following symptoms should the nurse anticipate observing? A) High fever B) Tachypnea C) Dry cough D) Severe chills

C) Dry cough

10. A client with pneumonia has a temperature of 102.6, is diaphoretic, and has a productive cough. The nurse should include which of the following measures in the plan of care? A) Position changes every 4 hours B) Nasotracheal suctioning to clear secretions C) Frequent linen changes D) Frequent offering of the bedpan

C) Frequent linen changes

4. A nurse notes that a client with kyphosis and generalized muscle atrophy. Which of the following problems is a priority when the nurse develops a nursing care plan? A) Infection B) Confusion C) Ineffective coughing and deep breathing D) Difficulty chewing solid foods

C) Ineffective coughing and deep breathing

25. 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 lower left lobe. The nurse determines that the client requires which of the following treatments first? A) Antibiotics B) Bed rest C) Oxygen D) Nutritional intake

C) Oxygen

9. When caring for a client who is receiving an aminoglycoside antibiotic, the nurse monitors which of the following laboratory values? A) Serum sodium B) Serum potassium C) Serum creatinine D) Serum calcium

C) Serum creatinine

36. A client is listening to the lungs of a client who has left lower lobe pneumonia. The nurse interprets that the pneumonia is resolving of which of the following os heard over the affected lung? A) Bronchophony B) Egophony C) Vesicular breath sounds D) Whispered pectorilquy

C) Vesicular breath sounds

27. A 20 year old client is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. What type of instruction would be given to help the client reduce the discomfort he is having? A) "Hold your cough as much as possible" B) "Place the head of the 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"

D) "Splint your chest wall with a pillow for comfort"

24. An elderly client with pneumonia may appear with which of the following symptoms? A) Altered mental status and dehydration B) Fever and chills C) Hemoptysis and dsypnea D) Pleuritic chest pain and cough

A) Altered mental status and dehydration

15. Aspirin is administered to clients with pneumonia because if its antipyretic and: A) Analgesic effects B) Anticoagulant effects C) Adrenergic effects D) Antihistamine effects

A) Analgesic effects

31. A client with pneumonia is admitted to an acute care facility and is receiving supplemental oxygen, 2 L/min via nasal cannula. The client's history includes 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) Aginal pain C) Respiratory alkalosis D) Metabolic acidosis

A) Apnea

40. A patient who was admitted to the hospital with pneumococcal pneumonia has a temperature of 101.6 with a frequent cough and is complaining of chest pain rated a 7 on a 10 point scale with deep inspiration. Which of these ordered medications should the nurse give first? A) Azithromycin (Zithromax) B) Acetominophen (Tylenol) C) Guaifenesin (Robitussin) D) Codiene sulfate (Codiene)

A) Azithromycin (Zithromax)

33. A client is admitted to the hospital with a diagnosis of right lower lobe pneumonia. The nurse auscultates the right lower lobe, expecting to note which of the following types of breath sounds? A) Bronchial B) Bronchovesicular C) Vesicular D) Absent

A) Bronchial

22. A nurse is performing a respiratory assessment on a client with pneumonia. She asks the client to say "ninety-nine" several times. Through the stethoscope, she hears the words clearly over his left lower lobe. What term should the nurse use to document this finding? A) Bronchophony B) Tactile fremitus C) Crepitation D) Egophony

A) Bronchophony

5. A client with a deep vein thrombosis suddenly develops dyspnea, tachypnea, and chest discomfort. What should the nurse do first? A) Elevate the head of the bed 30 to 45 degrees B) Encourage the client to cough and deep breathe C) Auscultate the lungs to detect abnormal breath sounds D) Contact the physician

A) Elevate the head of the bed 30 to 45 degrees

21. Which of the following assessment findings should the nurse expect to find a client with bacterial pneumonia? A) Increase fremitus B) Bilateral expiratory wheezing C) Resonance on percussion D) Vesicular breath sounds

A) Increase fremitus

29. A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's conditions? A) The client has a PaO2 value of 90 mm Hg or higher B) The client has a PaCO2 value of 65 mm Hg or higher C) The client exhibits restlessness and confusion D) The client exhibits bronchial breath sounds over the affected area

A) The client has a PaO2 value of 90 mm Hg or higher

1. Which of the following clients should the nurse most encourage to receive the pneumoccocal and influenza vaccination? A) A 30 year old pregnant women B) A 75 year old with diabetes C) A 5 year old entering school D) A 60 year old man with benign prostatic hypertrophy

B) A 75 year old with diabetes

3. A client with bacterial pneumonia is coughing up tenacious, purulent sputum. Which of the following measures would most likely help liquefy these viscous secretions? A) Performing postural drainage B) Breathing humidified air C) Clapping and percussing over the affected lung D) Performing coughing and deep breathing exercises

B) Breathing humidified air

37. A nurse is caring for a client with pneumonia who suddenly becomes restless and has a PaO2 of 60 mm Hg. Which of the following nursing diagnosis would be the most appropriate for this client? A) Fatigue related to debilitated state B) Impaired gas exchange related to increased pulmonary secretions C) Ineffective airway clearance related to dilated bronchioles D) Impaired gas exchange related to pneumonia

B) Impaired gas exchange related to increased pulmonary secretions

8. A client with bacterial pneumonia is to be started on IV antibiotics. Which of the following diagnostic tests must be completed before antibiotic therapy begins? A) Urinalysis B) Sputum culture C) Chest radiograph D) Red blood cell count

B) Sputum culture

19. Which of the following would be an appropriate expected outcome for an elderly client recovering from bacterial pneumonia? A) A respiratory rate of 25 to 30 breaths/minute B) The ability to perform activities of daily living C) A maximum loss of 5 to 10 lbs of body weight D) Chest pain that is minimized by splinting the rib cage

B) The ability to perform activities of daily living

30. A client undergone a left hemicolectomy. Which activities prevent the occurrence of postoperative pneumonia in this client? A) Administer oxygen, coughing, breathing deeply, and maintaining bed rest B) Coughing, breathing deeply, maintaining bed rest, and using incentive spirometer C) Coughing, breathing deeply, frequent repositioning, and using incentive spirometer D) Administering

C) Coughing, breathing deeply, frequent repositioning, and using incentive spirometer

38. A nurse is preparing a client with pneumonia for discharge to home. Which statement made by the client would alert the nurse to the fact that the client is in need of further discharge teaching? A) "I will take all of my antibiotics even if I do feel 100% better" B) "I understand that it may be weeks before my usual sense of well being returns" C) "It is a good idea for me to take a nap every afternoon for the next couple of weeks" D) "You can toss out the incentive spirometer as soon as I leave for home"

D) "You can toss out the incentive spirometer as soon as I leave for home"

28. The nurse is assessing a client who comes to the clinic for care. Which of the following findings in this client suggest bacterial pneumonia? A) Nonproductive cough and normal temperature B) Sore throat and abdominal pain C) Hemoptysis and dysuria D) Dyspnea and wheezing

D) Dyspnea and wheezing

32. The nurse is caring for a client with pneumonia. As part of prescribed therapy, the client must use a bedside incentive spirometer to promote maximal deep breathing. The nurse checks to make sure the client is using the spirometer properly. During each hour, the client should perform a minimum of how many sustained, voluntary inflation maneuvers? A) One to Two B) Three to Four C) Five to Seven D) Eight to Ten

D) Eight to Ten

39. A nurse is assigned to care for a client with pneumonia. The nurse reviews the nursing care plan and notes documentation of a nursing diagnosis if Activity Intolerance. The nurse implements which of the following in the client's care? A) Provides stimulation in the environment to maintain client alertness B) Encourages deep, rapid breathing during activity C) Schedules activities before giving respiratory medication or treatments D) Observes vital signs and oxygen saturation periodically during activity

D) Observes vital signs and oxygen saturation periodically during activity

2. Which of the following would be most important to teach a client older than 65 years to prevent recurrence of bacterial pneumonia? A) Change current diet habits B) Seek prompt antibiotic therapy for viral infections C) Receive prophylactic antibiotic therapy D) Obtain influenza and pneumonia vaccines

D) Obtain influenza and pneumonia vaccines

18. A client with pneumonia has a temperature ranging between 101 and 102 and periods of diaphoresis. Based on the information, which of the following nursing interventions would be a priority? A) Maintain complete bed rest B) Administer oxygen therapy C) Provide frequent linen changes D) Provide fluid intake of 3 liters per day

D) Provide fluid intake of 3 liters per day

35. A client with pneumonia has anorexia caused by the effort required for eating while dyspneic and decreased taste sensation. Which of the following actions by the nurse would be most helpful in increasing the client's appetite? A) Encourage drinking fluids up to 3 liters per day B) Keep fresh water at the bedside C) Provide three large meals daily D) Provide mouth care before meals

D) Provide mouth care before meals

14. Which of the following measures would most likely be successful in reducing pleuritic chest pain in a client with pneumonia? A) Encourage the client to breathe shallowly B) Have the client practice abdominal breathing C) Offer the client incentive spirometry D) Teach the client to splint the rib cage when coughing

D) Teach the client to splint the rib cage when coughing

26. 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 the client? A) Continued dyspnea B) Fever of 102 C) Respiratory rate of 32 breaths/minute D) Vesicular breath sounds in the right base

D) Vesicular breath sounds in the right base

7. Which of the following would be a priority assessment data to gather from a client who has been diagnosed with pneumonia? Select all that apply. A) Auscultation of breath sounds B) Auscultation of bowel sounds C) Presence of chest pain D) Presence of peripheral edema E) Color of nail beds

a,c,e