NR324/NR 324 Exam 2 V3 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
receiving oxygen at 2 L/min via nasal cannula. Which finding is most important for the nurse
to report to the provider?
A. Oxygen saturation of 89%
B. Bilateral crackles in the lung bases
C. Presence of a productive cough
D. Respiratory rate of 10 breaths/min
Correct Answer: D
Rationale: A respiratory rate of 10 breaths/min in a COPD patient receiving oxygen may
indicate respiratory depression due to the loss of the hypoxic drive. While an SpO2 of 89%
is often normal for chronic lung patients, a significant drop in respiratory effort is a priority
concern. The nurse must monitor the patient closely for CO2 narcosis and possible
respiratory failure.
2. A patient is prescribed Albuterol via a metered-dose inhaler (MDI) for the management of
asthma. What is the primary purpose of this medication?
A. To reduce airway inflammation over time
,B. To thin respiratory secretions for easier expectoration
C. To provide rapid relief of acute bronchospasm
D. To prevent the release of histamine from mast cells
Correct Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts quickly to relax
bronchial smooth muscle during an asthma flare-up. It is classified as a rescue medication
and is not used for long-term inflammatory control like inhaled corticosteroids. Patients
should be taught to use this medication first during an acute episode of shortness of breath.
3. Which nursing intervention is a priority for a patient suspected of having active pulmonary
tuberculosis (TB)?
A. Administering the prescribed multi-drug regimen
B. Obtaining a sputum culture for acid-fast bacilli
C. Educating the patient on the importance of long-term therapy
D. Placing the patient in a negative-pressure private room
Correct Answer: D
Rationale: Public health safety and infection control require immediate isolation of any
patient suspected of having active TB. Airborne precautions, including a negative-pressure
room and N95 mask usage by staff, are essential to prevent the spread of the bacteria. Once
, the patient is safely isolated, diagnostic testing and treatment can proceed according to
protocol.
4. A nurse is assessing a patient with bacterial pneumonia. Which clinical manifestation
should the nurse expect to find?
A. Increased tactile fremitus over the affected area
B. Vesicular breath sounds throughout all lung fields
C. Hyperresonance upon percussion of the chest wall
D. Decreased heart rate and low-grade fever
Correct Answer: A
Rationale: Pneumonia causes lung consolidation, which results in increased tactile
fremitus because sound and vibration travel better through solid or fluid-filled tissue than
through air. The nurse would also expect to hear crackles or bronchial breath sounds over
the area of consolidation. Dullness to percussion, rather than hyperresonance, is also a
classic sign of pneumonia.
5. A patient with hypertension is started on Lisinopril. Which side effect should the nurse
instruct the patient to report immediately?
A. Swelling of the lips, face, or tongue
B. A persistent dry, non-productive cough
C. Occasional dizziness when standing up quickly
Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
receiving oxygen at 2 L/min via nasal cannula. Which finding is most important for the nurse
to report to the provider?
A. Oxygen saturation of 89%
B. Bilateral crackles in the lung bases
C. Presence of a productive cough
D. Respiratory rate of 10 breaths/min
Correct Answer: D
Rationale: A respiratory rate of 10 breaths/min in a COPD patient receiving oxygen may
indicate respiratory depression due to the loss of the hypoxic drive. While an SpO2 of 89%
is often normal for chronic lung patients, a significant drop in respiratory effort is a priority
concern. The nurse must monitor the patient closely for CO2 narcosis and possible
respiratory failure.
2. A patient is prescribed Albuterol via a metered-dose inhaler (MDI) for the management of
asthma. What is the primary purpose of this medication?
A. To reduce airway inflammation over time
,B. To thin respiratory secretions for easier expectoration
C. To provide rapid relief of acute bronchospasm
D. To prevent the release of histamine from mast cells
Correct Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that acts quickly to relax
bronchial smooth muscle during an asthma flare-up. It is classified as a rescue medication
and is not used for long-term inflammatory control like inhaled corticosteroids. Patients
should be taught to use this medication first during an acute episode of shortness of breath.
3. Which nursing intervention is a priority for a patient suspected of having active pulmonary
tuberculosis (TB)?
A. Administering the prescribed multi-drug regimen
B. Obtaining a sputum culture for acid-fast bacilli
C. Educating the patient on the importance of long-term therapy
D. Placing the patient in a negative-pressure private room
Correct Answer: D
Rationale: Public health safety and infection control require immediate isolation of any
patient suspected of having active TB. Airborne precautions, including a negative-pressure
room and N95 mask usage by staff, are essential to prevent the spread of the bacteria. Once
, the patient is safely isolated, diagnostic testing and treatment can proceed according to
protocol.
4. A nurse is assessing a patient with bacterial pneumonia. Which clinical manifestation
should the nurse expect to find?
A. Increased tactile fremitus over the affected area
B. Vesicular breath sounds throughout all lung fields
C. Hyperresonance upon percussion of the chest wall
D. Decreased heart rate and low-grade fever
Correct Answer: A
Rationale: Pneumonia causes lung consolidation, which results in increased tactile
fremitus because sound and vibration travel better through solid or fluid-filled tissue than
through air. The nurse would also expect to hear crackles or bronchial breath sounds over
the area of consolidation. Dullness to percussion, rather than hyperresonance, is also a
classic sign of pneumonia.
5. A patient with hypertension is started on Lisinopril. Which side effect should the nurse
instruct the patient to report immediately?
A. Swelling of the lips, face, or tongue
B. A persistent dry, non-productive cough
C. Occasional dizziness when standing up quickly