NUR 317 Pneumonia & TB NCLEX
practice questions Med Surg I with
ANSWERS All correct 2022/2023
A nurse is caring for an 89-year-old client admitted with pneumonia. He has an IV of
normal saline running at 100 mL/hr and antibiotics that were initiated in the emergency
department 3 hours ago. He has oxygen at 2 liters/nasal cannula. What assessment
finding by the nurse indicates that goals for a priority diagnosis have been met for this
client?
A) The client is alert and oriented to person, place, and time.
B) Blood pressure is within normal limits and client's baseline.
C) Skin behind the ears demonstrates no redness or irritation.
D) Urine output has been >30 mL/hr per Foley catheter - ✔ A) The client is alert and
oriented to person, place, and time.
A client has been admitted to the hospital with suspected TB. What drugs should the
nurse plan to teach the client about before discharge? Select all that apply.
A) Rifampin (Rifadin); contact lenses can become stained orange
B) Isoniazid (INH); report yellowing of the skin or darkened urine
C) Pyrazinamide (PZA); maintain a fluid restriction of 1200 mL/day
D) Ethambutol (Myambutol); report any changes in vision
E) Amoxicillin (Amoxil); take this drug with food or milk - ✔ A) Rifampin (Rifadin);
contact lenses can become stained orange
B) Isoniazid (INH); report yellowing of the skin or darkened urine
D) Ethambutol (Myambutol); report any changes in vision
Which of these clients should the charge nurse assign to the LPN/LVN working on the
medical-surgical unit?
A) Client with group A beta-hemolytic streptococcal pharyngitis who has stridor
B) Client with pulmonary tuberculosis who is receiving multiple medications
C) Client with sinusitis who has just arrived after having endoscopic sinus surgery
D) Client with tonsillitis who has a thick-sounding voice and difficulty swallowing - ✔ B)
Client with pulmonary tuberculosis who is receiving multiple medications
A client with pneumonia caused by aspiration after alcohol intoxication has just been
admitted. The client is febrile and agitated. Which health care provider order should the
nurse implement first?
,A) Administer levofloxacin (Levaquin) 500 mg IV.
B) Draw aerobic and anaerobic blood cultures.
C) Give lorazepam (Ativan) as needed for agitation.
D) Refer to social worker for alcohol counseling. - ✔ B) Draw aerobic and anaerobic
blood cultures.
The medical-surgical unit has one negative-airflow room. Which of these four clients
who have just arrived on the unit should the charge nurse admit to this room?
A) Client with bacterial pneumonia and a cough productive of green sputum
B) Client with neutropenia and pneumonia caused by Candida albicans
C) Client with possible pulmonary tuberculosis who currently has hemoptysis
D) Client with right empyema who has a chest tube and a fever of 103.2° F - ✔ C)
Client with possible pulmonary tuberculosis who currently has hemoptysis
An older adult resident in a long-term-care facility becomes confused and agitated,
telling the nurse, "Get out of here! You're going to kill me!" Which action will the nurse
take first?
A) Check the resident's oxygen saturation.
B) Do a complete neurologic assessment.
C) Give the prescribed PRN lorazepam (Ativan).
D) Notify the resident's primary care provider. - ✔ A) Check the resident's oxygen
saturation.
The community health nurse is planning tuberculosis treatment for a client who is
homeless and heroin-addicted. Which action will be most effective in ensuring that the
client completes treatment?
A) Arrange for a health care worker to watch the client take the medication.
B) Give the client written instructions about how to take prescribed medications.
C) Have the client repeat medication names and side effects.
D) Instruct the client about the possible consequences of nonadherence. - ✔ A)
Arrange for a health care worker to watch the client take the medication.
An older client presents to the emergency department with a 2-day history of cough,
pain on inspiration, shortness of breath, and dyspnea. The client never had a
pneumococcal vaccine. The client's chest x-ray shows density in both bases. The client
has wheezing upon auscultation of both lungs. Would a bronchodilator be beneficial for
this client?
A) It would not be beneficial for this client.
B) It would help decrease the bronchospasm.
C) It would clear up the density in the bases of the client's lungs.
D) It would decrease the client's pain on inspiration. - ✔ B) It would help decrease the
bronchospasm.
, A client who has been homeless and has spent the past 6 months living in shelters has
been diagnosed with confirmed tuberculosis (TB). Which medications does the nurse
expect to be ordered for the client?
A) Isoniazid (INH), rifampin (Rifadin), pyrazinamide (Zinamide), ethambutol (Myambutol)
B) Metronidazole (Flagyl), acyclovir (Zovirax), flunisolide (AeroBid), rifampin (Rifadin)
C) Prednisone (Prednisone), guaifenesin (Organidin), ketorolac (Toradol), pyrazinamide
(Zinamide)
D) Salmeterol (Serevent), cromolyn sodium (Intal), dexamethasone (Decadron),
isoniazid (INH) - ✔ A) Isoniazid (INH), rifampin (Rifadin), pyrazinamide (Zinamide),
ethambutol (Myambutol)
A client is taking isoniazid, rifampin, pyrazinamide, and ethambutol for tuberculosis. The
client calls to report visual changes, including blurred vision and reduced visual fields.
Which medication may be causing these changes?
A) Ethambutol
B) Isoniazid
C) Pyrazinamide
D) Rifampin - ✔ A) Ethambutol
A client is being discharged home with active tuberculosis. Which information does the
nurse include in the discharge teaching plan?
A) "You are not contagious unless you stop taking your medication."
B) "You will not be contagious to the people you have been living with."
C) "You will have to take these medications for at least 1 year."
D) "Your sputum may turn a rust color as your condition gets better." - ✔ B) "You will
not be contagious to the people you have been living with."
A client who has recently traveled to Vietnam comes to the emergency department with
fatigue, lethargy, night sweats, and a low-grade fever. What is the nurse's first action?
A) Contact the health care provider for tuberculosis (TB) medications.
B) Perform a TB skin test.
C) Place a respiratory mask on the client.
D) Test all family members for TB. - ✔ C) Place a respiratory mask on the client.
pneumonia may present differently in the older adult than in the younger adult?
A) Crackles on auscultation
B) Fever
C) Headache
D) Wheezing - ✔ B) Fever
practice questions Med Surg I with
ANSWERS All correct 2022/2023
A nurse is caring for an 89-year-old client admitted with pneumonia. He has an IV of
normal saline running at 100 mL/hr and antibiotics that were initiated in the emergency
department 3 hours ago. He has oxygen at 2 liters/nasal cannula. What assessment
finding by the nurse indicates that goals for a priority diagnosis have been met for this
client?
A) The client is alert and oriented to person, place, and time.
B) Blood pressure is within normal limits and client's baseline.
C) Skin behind the ears demonstrates no redness or irritation.
D) Urine output has been >30 mL/hr per Foley catheter - ✔ A) The client is alert and
oriented to person, place, and time.
A client has been admitted to the hospital with suspected TB. What drugs should the
nurse plan to teach the client about before discharge? Select all that apply.
A) Rifampin (Rifadin); contact lenses can become stained orange
B) Isoniazid (INH); report yellowing of the skin or darkened urine
C) Pyrazinamide (PZA); maintain a fluid restriction of 1200 mL/day
D) Ethambutol (Myambutol); report any changes in vision
E) Amoxicillin (Amoxil); take this drug with food or milk - ✔ A) Rifampin (Rifadin);
contact lenses can become stained orange
B) Isoniazid (INH); report yellowing of the skin or darkened urine
D) Ethambutol (Myambutol); report any changes in vision
Which of these clients should the charge nurse assign to the LPN/LVN working on the
medical-surgical unit?
A) Client with group A beta-hemolytic streptococcal pharyngitis who has stridor
B) Client with pulmonary tuberculosis who is receiving multiple medications
C) Client with sinusitis who has just arrived after having endoscopic sinus surgery
D) Client with tonsillitis who has a thick-sounding voice and difficulty swallowing - ✔ B)
Client with pulmonary tuberculosis who is receiving multiple medications
A client with pneumonia caused by aspiration after alcohol intoxication has just been
admitted. The client is febrile and agitated. Which health care provider order should the
nurse implement first?
,A) Administer levofloxacin (Levaquin) 500 mg IV.
B) Draw aerobic and anaerobic blood cultures.
C) Give lorazepam (Ativan) as needed for agitation.
D) Refer to social worker for alcohol counseling. - ✔ B) Draw aerobic and anaerobic
blood cultures.
The medical-surgical unit has one negative-airflow room. Which of these four clients
who have just arrived on the unit should the charge nurse admit to this room?
A) Client with bacterial pneumonia and a cough productive of green sputum
B) Client with neutropenia and pneumonia caused by Candida albicans
C) Client with possible pulmonary tuberculosis who currently has hemoptysis
D) Client with right empyema who has a chest tube and a fever of 103.2° F - ✔ C)
Client with possible pulmonary tuberculosis who currently has hemoptysis
An older adult resident in a long-term-care facility becomes confused and agitated,
telling the nurse, "Get out of here! You're going to kill me!" Which action will the nurse
take first?
A) Check the resident's oxygen saturation.
B) Do a complete neurologic assessment.
C) Give the prescribed PRN lorazepam (Ativan).
D) Notify the resident's primary care provider. - ✔ A) Check the resident's oxygen
saturation.
The community health nurse is planning tuberculosis treatment for a client who is
homeless and heroin-addicted. Which action will be most effective in ensuring that the
client completes treatment?
A) Arrange for a health care worker to watch the client take the medication.
B) Give the client written instructions about how to take prescribed medications.
C) Have the client repeat medication names and side effects.
D) Instruct the client about the possible consequences of nonadherence. - ✔ A)
Arrange for a health care worker to watch the client take the medication.
An older client presents to the emergency department with a 2-day history of cough,
pain on inspiration, shortness of breath, and dyspnea. The client never had a
pneumococcal vaccine. The client's chest x-ray shows density in both bases. The client
has wheezing upon auscultation of both lungs. Would a bronchodilator be beneficial for
this client?
A) It would not be beneficial for this client.
B) It would help decrease the bronchospasm.
C) It would clear up the density in the bases of the client's lungs.
D) It would decrease the client's pain on inspiration. - ✔ B) It would help decrease the
bronchospasm.
, A client who has been homeless and has spent the past 6 months living in shelters has
been diagnosed with confirmed tuberculosis (TB). Which medications does the nurse
expect to be ordered for the client?
A) Isoniazid (INH), rifampin (Rifadin), pyrazinamide (Zinamide), ethambutol (Myambutol)
B) Metronidazole (Flagyl), acyclovir (Zovirax), flunisolide (AeroBid), rifampin (Rifadin)
C) Prednisone (Prednisone), guaifenesin (Organidin), ketorolac (Toradol), pyrazinamide
(Zinamide)
D) Salmeterol (Serevent), cromolyn sodium (Intal), dexamethasone (Decadron),
isoniazid (INH) - ✔ A) Isoniazid (INH), rifampin (Rifadin), pyrazinamide (Zinamide),
ethambutol (Myambutol)
A client is taking isoniazid, rifampin, pyrazinamide, and ethambutol for tuberculosis. The
client calls to report visual changes, including blurred vision and reduced visual fields.
Which medication may be causing these changes?
A) Ethambutol
B) Isoniazid
C) Pyrazinamide
D) Rifampin - ✔ A) Ethambutol
A client is being discharged home with active tuberculosis. Which information does the
nurse include in the discharge teaching plan?
A) "You are not contagious unless you stop taking your medication."
B) "You will not be contagious to the people you have been living with."
C) "You will have to take these medications for at least 1 year."
D) "Your sputum may turn a rust color as your condition gets better." - ✔ B) "You will
not be contagious to the people you have been living with."
A client who has recently traveled to Vietnam comes to the emergency department with
fatigue, lethargy, night sweats, and a low-grade fever. What is the nurse's first action?
A) Contact the health care provider for tuberculosis (TB) medications.
B) Perform a TB skin test.
C) Place a respiratory mask on the client.
D) Test all family members for TB. - ✔ C) Place a respiratory mask on the client.
pneumonia may present differently in the older adult than in the younger adult?
A) Crackles on auscultation
B) Fever
C) Headache
D) Wheezing - ✔ B) Fever
