SELECT ALL THAT APPLY NCLEX
PRACTICE QUESTIONS QUIZ #2 (50
ITEMS)
1. 1. Question
A nurse is admitting a client with a possible diagnosis of chronic
bronchitis. The nurse collects data from the client and notes
which of the following signs supports this diagnosis? Select all
that apply.
o A. Scant mucus
o B. Early onset cough
o C. Marked weight loss
o D. Purulent mucus production
o E. Mild episodes of dyspnea
Incorrect
Correct Answer: B, D, & E.
Key features of pulmonary emphysema include dyspnea that is
often marked, late cough (after the onset of dyspnea), scant
mucus production, and marked weight loss. By contrast, chronic
bronchitis is characterized by an early onset of cough (before
dyspnea), copious purulent mucus production, minimal weight
loss, and milder severity of dyspnea.
Option A: Most patients with emphysema present
with very nonspecific symptoms of chronic shortness
of breath and cough with or without sputum
production. As the disease process advances, the
shortness of breath and cough progressively get
worse.
Option B: The most common symptom of patients
with chronic bronchitis is a cough. The history of a
cough typical of chronic bronchitis is characterized to
be present for most days in a month lasting for 3
months with at least 2 such episodes occurring for 2
, years in a row. The characteristic cough of bronchitis
is caused by the copious secretion of mucus in chronic
bronchitis.
Option C: As COPD advances, patients can lose
significant body weight due to systemic inflammation
and increased energy spent in the work of breathing.
Also, there are frequent intermittent exacerbations as
the obstruction of the airways increases.
Option D: The airways become clogged by debris and
this further increases the irritation. A productive cough
with sputum is present in about 50% of patients. The
sputum color may vary from clear, yellow, green, or at
times blood-tinged. The color of the sputum may be
dependent on the presence of secondary bacterial
infection.
Option E: During an acute exacerbation of chronic
bronchitis, the bronchial mucous membrane becomes
hyperemic and edematous with diminished bronchial
mucociliary function. This, in turn, leads to airflow
impediment because of luminal obstruction to small
airways.
2. 2. Question
A nurse, assigned to a client with emphysema, is providing shift
report. Which nursing interventions would be appropriate to
include? Select all that apply.
A. The nurse should reduce fluid intake to less than 850
ml per shift.
B. The nurse should teach diaphragmatic, pursed-
lip breathing.
C. The nurse should administer low-flow oxygen.
D. The nurse should keep the client in a supine position
as much as possible.
E. The nurse should encourage alternating
activity with rest periods.
, F. The nurse should teach the use of postural
drainage and chest physiotherapy.
Incorrect
Correct Answer: B, C, E, & F.
Emphysema is the most severe form of COPD, characterized by
recurrent inflammation that damages and eventually destroys
alveolar walls to create large blebs or bullae (air spaces) and
collapsed bronchioles on expiration (air-trapping).
Option A: Fluid intake should be increased to 3,000
ml/day, if not contraindicated, to liquefy secretions
and facilitate their removal. Provide warm or tepid
liquids. Recommend the intake of fluids between,
instead of during, meals. Using warm liquids may
decrease bronchospasm. Fluids during meals can
increase gastric distension and pressure on the
diaphragm.
Option B: Diaphragmatic, pursed-lip breathing
strengthens respiratory muscles and enhances
oxygenation in clients with emphysema. This provides
the client with some means to cope with or control
dyspnea and reduce air-trapping.
Option C: Low-flow oxygen should be administered
because a client with emphysema has chronic
hypercapnia and a hypoxic respiratory drive.
Administering humidified oxygen prevents drying out
the airways, decreases convective moisture losses,
and improves compliance.
Option D: The client should be placed in a high
Fowler’s position to improve ventilation. Elevation of
the head of the bed facilitates respiratory function by
use of gravity; however, the client in severe distress
will seek the position that most eases breathing.
Option E: Alternating activity with rest allows to
perform activities without excessive distress. During
severe, acute, or refractory respiratory distress, the
patient may be totally unable to perform basic self-
care activities because of hypoxemia and dyspnea.
Rest interspersed with care activities remains an
important part of the treatment regimen.
Option F: If the client has difficulty mobilizing copious
secretions, the nurse should teach the client and
, family members how to perform postural drainage and
chest physiotherapy. These techniques will prevent
possible aspirations and prevent any untoward
complications.
3. 3. Question
A nurse is assigned to care for a client with a peripheral IV
infusion. The nurse is providing hygiene care to the client and
would avoid which of the following while changing the client’s
hospital gown?
A. Using a hospital gown with snaps at the sleeves
B. Disconnecting the IV tubing from the catheter
in the vein
C. Checking the IV flow rate immediately after changing
the hospital gown
D. Putting the bag and tubing through the sleeve,
followed by the client's arm
E. Keeping splint soiled by blood or fluid leakage
Incorrect
Correct Answer: B & E.
Changing a patient’s hospital gown is needed to maintain their
cleanliness and the feeling of freshness.
Option A: A kimono-inspired gown opens in the front
and uses a system of ties and snaps at essential
access points for easy treatment and monitoring.Top
snaps offer upper back access. Wide sleeves and side
snaps provide easy access for an I.V., and are MRI-
compatible.
Option B: The tubing should not be removed from the
IV catheter. With each break in the system, there is an
increased chance of introducing bacteria into the
system, which can lead to infection.
Option C: The flow rate should be checked
immediately after changing the hospital gown,
because the position of the roller clamp may have
PRACTICE QUESTIONS QUIZ #2 (50
ITEMS)
1. 1. Question
A nurse is admitting a client with a possible diagnosis of chronic
bronchitis. The nurse collects data from the client and notes
which of the following signs supports this diagnosis? Select all
that apply.
o A. Scant mucus
o B. Early onset cough
o C. Marked weight loss
o D. Purulent mucus production
o E. Mild episodes of dyspnea
Incorrect
Correct Answer: B, D, & E.
Key features of pulmonary emphysema include dyspnea that is
often marked, late cough (after the onset of dyspnea), scant
mucus production, and marked weight loss. By contrast, chronic
bronchitis is characterized by an early onset of cough (before
dyspnea), copious purulent mucus production, minimal weight
loss, and milder severity of dyspnea.
Option A: Most patients with emphysema present
with very nonspecific symptoms of chronic shortness
of breath and cough with or without sputum
production. As the disease process advances, the
shortness of breath and cough progressively get
worse.
Option B: The most common symptom of patients
with chronic bronchitis is a cough. The history of a
cough typical of chronic bronchitis is characterized to
be present for most days in a month lasting for 3
months with at least 2 such episodes occurring for 2
, years in a row. The characteristic cough of bronchitis
is caused by the copious secretion of mucus in chronic
bronchitis.
Option C: As COPD advances, patients can lose
significant body weight due to systemic inflammation
and increased energy spent in the work of breathing.
Also, there are frequent intermittent exacerbations as
the obstruction of the airways increases.
Option D: The airways become clogged by debris and
this further increases the irritation. A productive cough
with sputum is present in about 50% of patients. The
sputum color may vary from clear, yellow, green, or at
times blood-tinged. The color of the sputum may be
dependent on the presence of secondary bacterial
infection.
Option E: During an acute exacerbation of chronic
bronchitis, the bronchial mucous membrane becomes
hyperemic and edematous with diminished bronchial
mucociliary function. This, in turn, leads to airflow
impediment because of luminal obstruction to small
airways.
2. 2. Question
A nurse, assigned to a client with emphysema, is providing shift
report. Which nursing interventions would be appropriate to
include? Select all that apply.
A. The nurse should reduce fluid intake to less than 850
ml per shift.
B. The nurse should teach diaphragmatic, pursed-
lip breathing.
C. The nurse should administer low-flow oxygen.
D. The nurse should keep the client in a supine position
as much as possible.
E. The nurse should encourage alternating
activity with rest periods.
, F. The nurse should teach the use of postural
drainage and chest physiotherapy.
Incorrect
Correct Answer: B, C, E, & F.
Emphysema is the most severe form of COPD, characterized by
recurrent inflammation that damages and eventually destroys
alveolar walls to create large blebs or bullae (air spaces) and
collapsed bronchioles on expiration (air-trapping).
Option A: Fluid intake should be increased to 3,000
ml/day, if not contraindicated, to liquefy secretions
and facilitate their removal. Provide warm or tepid
liquids. Recommend the intake of fluids between,
instead of during, meals. Using warm liquids may
decrease bronchospasm. Fluids during meals can
increase gastric distension and pressure on the
diaphragm.
Option B: Diaphragmatic, pursed-lip breathing
strengthens respiratory muscles and enhances
oxygenation in clients with emphysema. This provides
the client with some means to cope with or control
dyspnea and reduce air-trapping.
Option C: Low-flow oxygen should be administered
because a client with emphysema has chronic
hypercapnia and a hypoxic respiratory drive.
Administering humidified oxygen prevents drying out
the airways, decreases convective moisture losses,
and improves compliance.
Option D: The client should be placed in a high
Fowler’s position to improve ventilation. Elevation of
the head of the bed facilitates respiratory function by
use of gravity; however, the client in severe distress
will seek the position that most eases breathing.
Option E: Alternating activity with rest allows to
perform activities without excessive distress. During
severe, acute, or refractory respiratory distress, the
patient may be totally unable to perform basic self-
care activities because of hypoxemia and dyspnea.
Rest interspersed with care activities remains an
important part of the treatment regimen.
Option F: If the client has difficulty mobilizing copious
secretions, the nurse should teach the client and
, family members how to perform postural drainage and
chest physiotherapy. These techniques will prevent
possible aspirations and prevent any untoward
complications.
3. 3. Question
A nurse is assigned to care for a client with a peripheral IV
infusion. The nurse is providing hygiene care to the client and
would avoid which of the following while changing the client’s
hospital gown?
A. Using a hospital gown with snaps at the sleeves
B. Disconnecting the IV tubing from the catheter
in the vein
C. Checking the IV flow rate immediately after changing
the hospital gown
D. Putting the bag and tubing through the sleeve,
followed by the client's arm
E. Keeping splint soiled by blood or fluid leakage
Incorrect
Correct Answer: B & E.
Changing a patient’s hospital gown is needed to maintain their
cleanliness and the feeling of freshness.
Option A: A kimono-inspired gown opens in the front
and uses a system of ties and snaps at essential
access points for easy treatment and monitoring.Top
snaps offer upper back access. Wide sleeves and side
snaps provide easy access for an I.V., and are MRI-
compatible.
Option B: The tubing should not be removed from the
IV catheter. With each break in the system, there is an
increased chance of introducing bacteria into the
system, which can lead to infection.
Option C: The flow rate should be checked
immediately after changing the hospital gown,
because the position of the roller clamp may have
