NCLEX-PN
NCLEX Questions Respiratory Questions
Extract:
Question 1 of 5
A 52-year old female patient is receiving medical treatment for a possible tuberculosis infection. The patient is a U.S. resident but grew up in a foreign country. She reports that as a child she received the BCG vaccine (bacille Calmette-Guerin vaccine). Which physician's order below would require the nurse to ask the doctor for an order clarification?
Correct Answer: A
Rationale: The BCG vaccine can cause false-positive PPD (Mantoux) test results, making it unreliable in patients with a BCG history. The nurse should clarify this order, as an IGRA test (e.g., QuantiFERON-TB Gold) or other diagnostics are preferred.
Question 2 of 5
The unlicensed assistive personnel (UAP) assists the client with a chest tube to ambulate to the bathroom. Which situation warrants immediate intervention from the nurse?
Correct Answer: B
Rationale: Suction during ambulation (
B) restricts mobility and risks dislodgement, requiring intervention. Below chest level (
A), ambulation (
C), and commode (
D) are appropriate.
Question 3 of 5
An alarm beeps notifying you that one of your patient's oxygen saturation is reading $89 \%$. You arrive to the patient's room, and see the patient comfortably resting in bed watching television. The patient is already on $2 \mathrm{~L}$ of oxygen via nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing action would be:
Correct Answer: A
Rationale: In COPD, oxygen saturation of 88-92% is acceptable to avoid suppressing the hypoxic drive. Since the patient is comfortable, continue monitoring . Increasing oxygen or notifying the doctor is unnecessary unless symptoms worsen.
Question 4 of 5
Because of this client's impaired speech, which nursing action facilitates communication?
Correct Answer: D
Rationale: Providing paper and pencil allows the client with impaired speech post-laryngectomy to communicate effectively through writing.
Question 5 of 5
The nurse is caring for the client diagnosed with pneumonia. Which information should the nurse include in the teaching plan? Select all that apply.
Correct Answer: B,E
Rationale: Rest periods (
B) conserve energy, and pulse oximetry (E) monitors oxygenation in pneumonia. Oxygen (
A) depends on SpO2, fluid restriction (
C) is inappropriate, and smoking (
D) must stop.