NCLEX-PN
NCLEX Respiratory Questions Questions
Extract:
Question 1 of 5
The nurse is discharging the client diagnosed with bronchiolitis obliterans. Which priority intervention should the nurse include?
Correct Answer: C
Rationale: Bronchiolitis obliterans causes irreversible airway obstruction, often requiring home oxygen therapy (
C) to manage hypoxemia, a priority for discharge planning. Referrals (
A), physical therapy (
B), and advance directives (
D) are important but secondary to ensuring oxygenation.
Question 2 of 5
The client is admitted to the emergency department with chest trauma. Which signs/symptoms indicate to the nurse the diagnosis of pneumothorax?
Correct Answer: B
Rationale: Pneumothorax causes unequal lung expansion and dyspnea (
B) from collapsed lung. Bronchovesicular sounds/bradypnea (
A), frothy sputum (
C), and barrel chest (
D) suggest other conditions.
Question 3 of 5
The client diagnosed with tuberculosis has been treated with antitubercular medications for six (6) weeks. Which data would indicate the medications have been effective?
Correct Answer: B
Rationale: Improved symptoms (
B) after six weeks of TB treatment (e.g., reduced cough, fever) indicate medication efficacy. WBCs in sputum (
A) are not a standard measure. Chest X-ray changes (
C) lag behind clinical improvement. The skin test (
D) remains positive post-exposure, regardless of treatment.
Question 4 of 5
The nurse instructs the client's spouse to empty and thoroughly clean the vaporizer after each use. Which rationale provides the basis for the nurse's instruction?
Correct Answer: B
Rationale: A cool-mist vaporizer can harbor pathogens like bacteria and mold if not cleaned properly, potentially worsening respiratory symptoms.
Question 5 of 5
A patient, who is receiving continuous IV Heparin for the treatment of a DVT, has an aPTT of 110 seconds. What is your next nursing action per protocol?
Correct Answer: D
Rationale: The aPTT is 110 seconds, which is too high. Any aPTT value greater than 80 seconds places the patient at risk for bleeding. Most Heparin protocols dictate that the nurse would hold the infusion for 1 hour and to decrease the rate of infusion. If the aPTT is less than 60 seconds, the dose would need to be increased and a bolus may be needed. aPTT values should be around 60-80 seconds to achieve a therapeutic response for Heparin.