NCLEX-PN
Respiratory System NCLEX Questions Questions
Extract:
Question 1 of 5
You are about to hang a bag of intravenous Vancomycin for a patient who has severe pneumonia. Which statement by the patient causes you to hold the bag of Vancomycin and notify the doctor immediately?
Correct Answer: D
Rationale: Ringing in the ears indicates potential ototoxicity, a serious vancomycin side effect requiring immediate cessation and physician notification. Other symptoms (A, B,
C) are less specific and not immediately alarming.
Question 2 of 5
The client diagnosed with asthma is admitted to the emergency department with difficulty breathing and a blue color around the mouth. Which diagnostic test will be ordered to determine the status of the client?
Correct Answer: B
Rationale: Pulmonary function tests (
B) assess airway obstruction in acute asthma. CBC (
A), allergy testing (
C), and cortisol levels (
D) are not immediate diagnostic tools.
Question 3 of 5
A patient was admitted to the intensive care unit 48 hours ago for treatment of a gunshot wound. The patient has recently developed a productive cough and a fever of 104.3 ' $F$. The patient is breathing on their own and doesn't require mechanical ventilation. On assessment, you note coarse crackles in the right lower lobe. A chest x-ray shows infiltrates with consolidation in the right lower lobe. Based on this specific patient scenario, this is known as what type of pneumonia?
Correct Answer: C
Rationale: Hospital-acquired pneumonia (HAP) develops 48 hours or more after hospital admission, as seen in this patient. Aspiration pneumonia is linked to inhaling foreign material, ventilator-acquired pneumonia requires mechanical ventilation, and community-acquired pneumonia occurs outside healthcare settings.
Question 4 of 5
The influenza vaccine is in short supply. Which group of clients would the public health nurse consider priority when administering the vaccine?
Correct Answer: A
Rationale: Elderly and chronically ill (
A) are at highest risk for flu complications, prioritizing them. Child-care workers/children (
B), chaplains/HCWs (
C), and teachers/students (
D) are secondary.
Question 5 of 5
The nurse and an unlicensed assistive personnel (UAP) are caring for an elderly client diagnosed with emphysema. Which nursing tasks could be delegated to the UAP to improve gas exchange? Select all that apply.
Correct Answer: A,C
Rationale: UAPs can keep the head of the bed elevated (1) to improve lung expansion and record pulse oximetry (3), a non-invasive task. Encouraging deep breathing (2) requires teaching, a nursing role. Assessing consciousness (4) and auscultating breath sounds (5) are assessment tasks reserved for nurses.