Pneumonia NCLEX Questions

Pneumonia NCLEX Questions Leave the first rating Students also studied Terms in this set (25) Science MedicinePulmonology Save asthma NCLEX questions 22 terms sandy_jacob5Preview Pneumonia NCLEX Questions 20 terms mary_g_mcdaniel Preview Appendicitis 25 terms Miyah0903Preview Pneum Teacher Sma A 74-year-old male patient with a history of COPD presents with increased shortness of breath, fever, and a productive cough. A chest X-ray confirms pneumonia.Which antibiotic choice is most appropriate considering his comorbid condition?

• Amoxicillin.
• Ceftriaxone.
• Azithromycin.
• Vancomycin.
• Azithromycin.

Rationale: Azithromycin is preferred in patients with COPD exacerbations that

result in pneumonia due to its coverage for typical and atypical pathogens and its anti-inflammatory properties beneficial in COPD management.A nurse is caring for a patient diagnosed with aspiration pneumonia. What is a critical nursing intervention for this patient?

• Encouraging ambulation four times a day.
• Positioning the patient to lie flat for comfort.
• Performing frequent oral care.
• Restricting fluid intake.
• Performing frequent oral care.

Rationale: Frequent oral care helps prevent the proliferation of bacteria in the mouth, reducing the risk of further aspiration of pathogens into the lungs.Which clinical finding would a nurse anticipate when assessing a patient with lobar pneumonia?

• Diffuse wheezing.
• Unilateral chest pain.
• Bilateral crackles.
• Peaked T waves on EKG.
• Unilateral chest pain.

Rationale: Lobar pneumonia typically affects a specific lobe of the lung, leading to localized inflammatory responses, what can cause unilateral chest pain due to pleural irritation.

The nurse assesses a patient with pneumonia who is coughing and appears cyanotic. The oxygen saturation is 85% on room air. What is the most appropriate next step in management?

• Increase fluid intake.
• Administer supplemental oxygen.
• Encourage deep breathing exercises.
• Prepare for intubation.
• Administer supplemental oxygen.

Rationale: Immediate administration of supplemental oxygen saturation and

prevent hypoxia-related complications.When educating a patient on the prevention of pneumococcal pneumonia, which vaccine should the nurse discuss?

• Influenza vaccine.
• Pneumococcal polysaccharide vaccine (PPSV23).
• Bacillus Calmette-Guerin (BCG) vaccine.
• Hepatitis B vaccine.
• Pneumococcal polysaccharide vaccine (PPSV23).

Rationale: PPSV23 is indicated for the prevention of pneumococcal pneumonia,

particularly in older adults and those with chronic health conditions.A nurse is evaluating a patient with suspected viral pneumonia. Which laboratory test would best help differentiate viral from bacterial pneumonia?

• White blood cell count.
• Blood cultures.
• C-reactive protein (CRP).
• Procalcitonin.
• Procalcitonin.

Rationale: Procalcitonin levels are typically lower in viral infections compared to bacterial infections, making this test useful in differentiating the type of pnuemonia.Which symptom is most indicative of sever pneumonia in a pediatric patient?

• Coughing that improves with expectorants.
• Mild fever persisting for two days.
• Nasal flaring and intercostal retractions.
• Occasional vomiting.
• Nasal flaring and intercostal retractions.

Rationale: Nasal flaring and intercostal retractions are signs of respiratory distress, indicating sever pneumonia that requires immediate medical attention.A patient with pneumonia develops sepsis. What is the priority nursing intervention?

• Administering broad-spectrum antibiotics.
• Providing thermal comfort.
• Monitoring urine output.
• Scheduled chest physiotherapy.
• Administering broad-spectrum antibiotics.

Rationale: Immediate administration of broad-spectrum antibiotics is crucial for treating sepsis in pneumonia patients to combat the underlying infection aggressively.Which finding on a chest X-ray would suggest a diagnosis of pneumocystis pneumonia (PCP) in an immunocompromised patient?

• Cavitary lesions.
• Kerley B lines.
• Bilateral interstitial infiltrates.
• Pleural effusion.
• Bilateral interstitial infiltrates.

Rationale: PCP often presents with bilateral interstitial infiltrates on chest X-ray, a pattern that is characteristic of this type of pneumonia in immuncompromised patients.In a patient with pneumonia, which arterial blood has (ABG) finding is most concerning?

• PaO2 of 80 mmHg.
• PaCO2 of 30 mmHg.
• pH of 7.32.
• Bicarbonate (HCO3) of 24 mEq/L.
• pH of 7.32.

Rationale: A pH of 7.32 indicates acidosis, which can occur due to hypoventilation in severe pneumonia.This finding requires urgent intervention to correct respiratory failure.

What is the most effective preventive strategy for reducing the incidence of ventilator-associated pneumonia (VAP)?

• Routine use of systemic antibiotics.
• Daily chlorhexidine oral rinses.
• Regular changes of ventilator tubing.
• Supine positioning.
• Daily chlorhexidine oral rinses.

Rationale: Daily chlorhexidine oral rinses have been shown to significantly reduce the incidence of VAP by decreasing oral bacterial colonization.A nurse is caring for a patient with bacterial pneumonia and notes a sudden increase in temperature to 102.5F (39.2C) and a decrease in blood pressure to 90/60 mmHg. What is the most likely cause of these findings?

• Septic shock.
• Pulmonary embolism.
• Myocardial infarction.
• Acute respiratory distress syndrome (ARDS).
• Septic shock.

Rationale: The combination of fever and hypotension in a patient with pneumonia

is indicative of septic shock, likely resulting form systemic bacterial infection spreading beyond the lungs.Which assessment finding would differentiate a diagnosis of viral pneumonia from bacterial pneumonia in a young adult?

• Elevated white blood cell count.
• Crackles heard on auscultation.
• Dry, non-productive cough.
• Sharp, pleuritic chest pain.
• Dry, non-productive cough.

Rationale: Viral pneumonia is often associated with a dry, non-productive cough, while bacterial pneumonia typically presents with a productive cough and possibly purulent sputum.In a patient with pneumonia, which complication is indicated by the presence of dullness to percussion over the affected area of the lung?

• Pleural effusion.
• Pneumothorax.
• Bronchopleural fistula.
• Atelectasis.
• Pleural effusion.

Rationale: Dullness to percussion over an area of the lung is typical of pleural effusion, which can occur as a complication of pneumonia due to inflammation extending into the pleural space.A nurse is caring for an elderly patient who has been diagnosed with pneumonia. Which of the following would be an atypical symptom of pneumonia in this age group?

• Confusion.
• High fever.
• Productive cough.
• Chest pain.
• Confusion.

Rationale: Elderly patients may exhibit atypical symptoms of pneumonia such as

confusion or altered mental status, which can be mistaken for other conditions common in this population.Which intervention is most critical for a patient with pneumonia and a history of chronic alcoholism?

• Thiamine supplementation.
• Administration of corticosteroids.
• High-calorie diet.
• Stress ulcer prophylaxis.
• Thiamine supplementation.

Rationale: Thiamine supplementation is crucial in patients with a history of chronic alcoholism to prevent Wernicke-Korsakoff syndrome, especially when they are at increased metabolic demand due to infections like pneumonia.

A patient with pneumonia has a respiratory rate of 28 breaths per minute, oxygen saturation of 92% on room air, and is using accessory muscles to breathe. What is the priority nursing action?

• Administer anxiolytics.
• Start non-invasive ventilation.
• Increase oral fluid intake.
• Perform chest physiotherapy.
• Start non-invasive ventilation.

Rationale: Non-invasive ventilation can assist in reducing the work of breathing, improving oxygenation, and preventing further respiratory distress.When educating a group of nursing students about pneumonia, which information should the nurse emphasize about the transmission of pneumonia in healthcare settings?

• It is primarily transmitted through indirect contact.
• Airborne precautions should always be used.
• Hand hygiene is the most effective way to prevent

transmission.

• Patients should be isolated in negative pressure rooms.
• Hand hygiene is the most effective way to prevent transmission.

Rationale: Hand hygiene is critical in preventing the spread of pneumonia and

other respiratory infections within healthcare settings.A patient with HIV and a CD4 count of less than 200 cells/mm3 is diagnosed with pneumonia. Which organism is most likely responsible for the pneumonia in this patient?

• Streptococcus pneumoniae.
• Haemophilus influenzae.
• Pneumocystis jirovecii.
• Mycoplasma pneumoniae.
• Pneumocystis jirovecii.

Rationale: Pneumocystis jirovecii pneumonia (PCP) is a common opportunistic

infection in patients with HIV, especially when the CD4 count falls below 200 cells/mm3.For a patient recovering from pneumonia, which outcome indicates that treatment has been effective?

• Normalization of white blood cell count.
• Improvement in chest X-ray.
• Resolution of symptoms.
• All of the above.
• All of the above.

Rationale: Effective treatment of pneumonia is indicated by a combination of

clinical improvement (resolution of symptoms), radiological improvement (chest X-ray), and normalization of laboratory markers such as white blood cell count.A nurse is assessing a patient with atypical pneumonia.What symptom is most characteristic of atypical pneumonia?

• High fever.
• Wey cough with yellow sputum.
• Slow onset with dry cough.
• Rapid onset with shaking chills.
• Slow onset with dry cough.

Rationale: Atypical pneumonia, often caused by pathogens like Mycoplasma

pneumoniae, typically presents with a slow onset and a dry cough, differing from the acute presentations seen in typical bacterial pneumonia.Which of the following is a risk factor for healthcare- associated pneumonia (HCAP)?

• Recent antibiotic use.
• Attendance at a large public gathering.
• Smoking in the past year.
• Having pets at home.
• Recent antibiotic use.

Rationale: Recent antibiotic use is a risk factor for HCAP due to the potential for developing resistance to common antibiotics, making the patient more susceptible to pneumonia caused by resistant organisms.