Lower Respiratory Tract Infections and Disorders Exam
2023 Questions and Answers with complete solution
When a patient is diagnosed with a lung abscess, which does the nurse teach the
patient?
Lobectomy surgery usually is needed to drain the abscess.
IV antibiotic therapy will be used for a prolonged period of time.
Oral antibiotics will be used when the patient and x-ray show evidence of improvement.
No further culture and sensitivity tests are needed if the patient takes the medication as
prescribed.
Oral antibiotics will be used when the patient and x-ray show evidence of improvement
IV antibiotics are used until the patient and x-ray show evidence of improvement. Then
oral antibiotics are used for a prolonged period of time. Lobectomy surgery is needed
only when reinfection of a large cavitary lesion occurs or to establish a diagnosis when
there is evidence of a neoplasm or other underlying problem. Culture and sensitivity
testing is done during the course of antibiotic therapy to ensure that the infecting
organism is not becoming resistant to the antibiotic, as well as at the completion of the
antibiotic therapy
The nurse provides education for a group of nursing students about acute bronchitis
and includes which information?
Typically, there are infiltrates seen on the chest x-ray.
If symptoms last longer than two weeks, patients are advised to see their health care
provider (HCP).
Therapy is mainly supportive.
Egophony may be auscultated
Therapy is mainly supportive
Acute bronchitis is usually self-limiting, and the treatment for acute bronchitis is
supportive. Chest x-rays will differentiate acute bronchitis from pneumonia. With
bronchitis, no consolidation or infiltrates will be seen on an x-ray as there is with
pneumonia. If patients with acute bronchitis develop a fever, have difficulty breathing, or
have symptoms last longer than four weeks, they should see their HCP. Because there
is no consolidation, egophony would not be auscultated. Egophony is an increased
resonance of voice sounds heard when auscultating the lungs, often caused by lung
consolidation and fibrosis. It is caused by the enhanced transmission of high-frequency
sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out
,The health care provider prescribes IV vancomycin for a patient with pneumonia. Which
action does the nurse perform first?
Obtain a full set of vital signs.
Obtain sputum cultures for sensitivity.
Educate the patient about the adverse effects associated with the medication.
Draw a blood specimen to evaluate the white blood cell count
Obtain sputum cultures for sensitivity
The nurse should ensure that the sputum for culture and sensitivity has been sent to the
laboratory before administering the antibiotic. It is important that the organisms be
correctly identified (in the culture) before their numbers are affected by the antibiotic; the
test also will determine whether the proper antibiotic has been prescribed (sensitivity
testing). Vital signs, education, and white blood cell count measurement can be
assessed following the obtainment of sputum cultures
A patient is hospitalized with a diagnosis of pneumonia. When reviewing the patient's
history, the nurse finds that the patient experienced a seizure with profuse vomiting four
days prior to the hospital admission. Which type of pneumonia does the nurse suspect?
Aspiration pneumonia
Opportunistic pneumonia
Hospital-associated pneumonia
Community-acquired pneumonia
Aspiration pneumonia
Aspiration pneumonia results from the abnormal entry of material from the mouth or
stomach into the trachea and lungs. Conditions that increase the risk for aspiration
include decreased level of consciousness (e.g., seizure, anesthesia, head injury, stroke,
alcohol intake), difficulty swallowing, and insertion of nasogastric (NG) tubes with or
without enteral feeding. The aspirated material (food, water, vomitus, oropharyngeal
secretions) triggers an inflammatory response. The history of the patient does not
suggest any exposure to pneumonia in the community. The patient has never been in
the hospital; therefore hospital-associated pneumonia is highly unlikely. The patient
does not have a history of HIV, intake of immunosuppressive drugs, corticosteroids, or
any disorders leading to immunosuppression; therefore opportunistic pneumonia did not
occur in this patient
A patient with a sudden onset of respiratory distress is scheduled for a ventilation-
perfusion scan. Which instruction does the nurse provide to the patient about the
procedure?
,"The test involves the injection of a radioisotope and the inhalation of a radioactive gas."
"You will be sedated during the test to prevent you from moving."
"It is important to verify that there is no metal in your body before performing the test."
"You will feel a sensation of chest pressure as the dye circulates through your body."
"The test involves the injection of a radioisotope and the inhalation of a radioactive gas."
A ventilation-perfusion scan has two parts. In the perfusion portion, a radioisotope is
injected into the blood, and the pulmonary vasculature is outlined. In the ventilation part,
the patient inhales a radioactive gas that outlines the alveoli. Sedation is not required;
magnetic imaging is not a component of the examination, so the patient can have the
test even if there is metal in the body. Chest pressure may indicate an adverse reaction
and is not normal
When caring for a patient with pertussis, which intervention does the nurse prioritize?
Administering antibiotic therapy
Administering an antihistamine at bedtime
Teaching the patient how to use a bronchodilator
Instructing the patient to use cough suppressants
Administering antibiotic therapy
The treatment is macrolide (erythromycin, azithromycin [Zithromax]) antibiotics to
minimize symptoms and prevent the spread of the disease. For the patient who cannot
take macrolides, trimethoprim/sulfamethoxazole is used. Cough suppressants and
antihistamines should not be used because they are ineffective and may induce
coughing episodes. Corticosteroids and bronchodilators are not useful in reducing
symptoms.
The nurse is caring for a patient admitted to the hospital with pneumonia. Upon
assessment, the nurse notes a temperature of 101.4° F, a productive cough with yellow
sputum, and a respiratory rate of 20 breaths/minute. Which is an appropriate nursing
diagnosis?
Hyperthermia related to infectious illness
Ineffective thermoregulation related to chilling
Ineffective breathing pattern related to pneumonia
Ineffective airway clearance related to thick secretions
Hyperthermia related to infectious illness
, Because the patient has spiked a temperature and has a diagnosis of pneumonia, the
logical nursing diagnosis is hyperthermia related to infectious illness. There is no
evidence of a chill, and the patient's breathing pattern is within normal limits at 20
breaths/minute. There is no evidence of ineffective airway clearance from the
information given because the patient is expectorating sputum
Which nursing intervention assists a patient with pneumonia in managing thick
secretions and fatigue?
Performing postural drainage every hour
Providing analgesics as prescribed to promote patient comfort
Administering oxygen as prescribed to maintain optimal oxygen saturation levels
Teaching the patient how to cough effectively and expectorate secretions
Teaching the patient how to cough effectively and expectorate secretions
Although several interventions may help the patient expectorate mucus, the nursing
interventions should focus on teaching the patient how to cough effectively and
expectorate secretions. Postural drainage may help to loosen the secretions.
Administering analgesics does not help to manage thick secretions. Administering
oxygen also does not help the patient manage secretions
A pediatric patient presents with a 2-week history of cough, clear sputum, headache,
hoarseness, and myalgias. The patient has no significant medical history. The patient's
parent asks why there is no plan to administer an antibiotic. How does the nurse
respond?
Explain that antibiotics are not required for the patient.
Advise the parent to see another health care provider for a second opinion.
Explain that pertussis is suspected and that bronchodilators are the treatment of choice.
Clarify that antibiotics will be prescribed if the cough persists for another week
Explain that antibiotics are not required for the patient
The symptoms and signs indicate that the patient may have acute bronchitis, which is a
viral disorder. Therefore the nurse should explain to the parent that antibiotics will not
help in viral infections. If they are prescribed, antibiotics may cause side effects and
may also lead to antibiotic resistance. It is incorrect to advise the parent to see another
health care provider, who will likely prescribe a similar course of treatment. The
symptoms are not indicative of pertussis. Bronchodilators are not used to treat
pertussis. Acute bronchitis is a self-limiting disorder, and the cough may last up to 3
weeks. Informing the parent that antibiotics will be prescribed if the cough persists for
another week is not correct.
2023 Questions and Answers with complete solution
When a patient is diagnosed with a lung abscess, which does the nurse teach the
patient?
Lobectomy surgery usually is needed to drain the abscess.
IV antibiotic therapy will be used for a prolonged period of time.
Oral antibiotics will be used when the patient and x-ray show evidence of improvement.
No further culture and sensitivity tests are needed if the patient takes the medication as
prescribed.
Oral antibiotics will be used when the patient and x-ray show evidence of improvement
IV antibiotics are used until the patient and x-ray show evidence of improvement. Then
oral antibiotics are used for a prolonged period of time. Lobectomy surgery is needed
only when reinfection of a large cavitary lesion occurs or to establish a diagnosis when
there is evidence of a neoplasm or other underlying problem. Culture and sensitivity
testing is done during the course of antibiotic therapy to ensure that the infecting
organism is not becoming resistant to the antibiotic, as well as at the completion of the
antibiotic therapy
The nurse provides education for a group of nursing students about acute bronchitis
and includes which information?
Typically, there are infiltrates seen on the chest x-ray.
If symptoms last longer than two weeks, patients are advised to see their health care
provider (HCP).
Therapy is mainly supportive.
Egophony may be auscultated
Therapy is mainly supportive
Acute bronchitis is usually self-limiting, and the treatment for acute bronchitis is
supportive. Chest x-rays will differentiate acute bronchitis from pneumonia. With
bronchitis, no consolidation or infiltrates will be seen on an x-ray as there is with
pneumonia. If patients with acute bronchitis develop a fever, have difficulty breathing, or
have symptoms last longer than four weeks, they should see their HCP. Because there
is no consolidation, egophony would not be auscultated. Egophony is an increased
resonance of voice sounds heard when auscultating the lungs, often caused by lung
consolidation and fibrosis. It is caused by the enhanced transmission of high-frequency
sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out
,The health care provider prescribes IV vancomycin for a patient with pneumonia. Which
action does the nurse perform first?
Obtain a full set of vital signs.
Obtain sputum cultures for sensitivity.
Educate the patient about the adverse effects associated with the medication.
Draw a blood specimen to evaluate the white blood cell count
Obtain sputum cultures for sensitivity
The nurse should ensure that the sputum for culture and sensitivity has been sent to the
laboratory before administering the antibiotic. It is important that the organisms be
correctly identified (in the culture) before their numbers are affected by the antibiotic; the
test also will determine whether the proper antibiotic has been prescribed (sensitivity
testing). Vital signs, education, and white blood cell count measurement can be
assessed following the obtainment of sputum cultures
A patient is hospitalized with a diagnosis of pneumonia. When reviewing the patient's
history, the nurse finds that the patient experienced a seizure with profuse vomiting four
days prior to the hospital admission. Which type of pneumonia does the nurse suspect?
Aspiration pneumonia
Opportunistic pneumonia
Hospital-associated pneumonia
Community-acquired pneumonia
Aspiration pneumonia
Aspiration pneumonia results from the abnormal entry of material from the mouth or
stomach into the trachea and lungs. Conditions that increase the risk for aspiration
include decreased level of consciousness (e.g., seizure, anesthesia, head injury, stroke,
alcohol intake), difficulty swallowing, and insertion of nasogastric (NG) tubes with or
without enteral feeding. The aspirated material (food, water, vomitus, oropharyngeal
secretions) triggers an inflammatory response. The history of the patient does not
suggest any exposure to pneumonia in the community. The patient has never been in
the hospital; therefore hospital-associated pneumonia is highly unlikely. The patient
does not have a history of HIV, intake of immunosuppressive drugs, corticosteroids, or
any disorders leading to immunosuppression; therefore opportunistic pneumonia did not
occur in this patient
A patient with a sudden onset of respiratory distress is scheduled for a ventilation-
perfusion scan. Which instruction does the nurse provide to the patient about the
procedure?
,"The test involves the injection of a radioisotope and the inhalation of a radioactive gas."
"You will be sedated during the test to prevent you from moving."
"It is important to verify that there is no metal in your body before performing the test."
"You will feel a sensation of chest pressure as the dye circulates through your body."
"The test involves the injection of a radioisotope and the inhalation of a radioactive gas."
A ventilation-perfusion scan has two parts. In the perfusion portion, a radioisotope is
injected into the blood, and the pulmonary vasculature is outlined. In the ventilation part,
the patient inhales a radioactive gas that outlines the alveoli. Sedation is not required;
magnetic imaging is not a component of the examination, so the patient can have the
test even if there is metal in the body. Chest pressure may indicate an adverse reaction
and is not normal
When caring for a patient with pertussis, which intervention does the nurse prioritize?
Administering antibiotic therapy
Administering an antihistamine at bedtime
Teaching the patient how to use a bronchodilator
Instructing the patient to use cough suppressants
Administering antibiotic therapy
The treatment is macrolide (erythromycin, azithromycin [Zithromax]) antibiotics to
minimize symptoms and prevent the spread of the disease. For the patient who cannot
take macrolides, trimethoprim/sulfamethoxazole is used. Cough suppressants and
antihistamines should not be used because they are ineffective and may induce
coughing episodes. Corticosteroids and bronchodilators are not useful in reducing
symptoms.
The nurse is caring for a patient admitted to the hospital with pneumonia. Upon
assessment, the nurse notes a temperature of 101.4° F, a productive cough with yellow
sputum, and a respiratory rate of 20 breaths/minute. Which is an appropriate nursing
diagnosis?
Hyperthermia related to infectious illness
Ineffective thermoregulation related to chilling
Ineffective breathing pattern related to pneumonia
Ineffective airway clearance related to thick secretions
Hyperthermia related to infectious illness
, Because the patient has spiked a temperature and has a diagnosis of pneumonia, the
logical nursing diagnosis is hyperthermia related to infectious illness. There is no
evidence of a chill, and the patient's breathing pattern is within normal limits at 20
breaths/minute. There is no evidence of ineffective airway clearance from the
information given because the patient is expectorating sputum
Which nursing intervention assists a patient with pneumonia in managing thick
secretions and fatigue?
Performing postural drainage every hour
Providing analgesics as prescribed to promote patient comfort
Administering oxygen as prescribed to maintain optimal oxygen saturation levels
Teaching the patient how to cough effectively and expectorate secretions
Teaching the patient how to cough effectively and expectorate secretions
Although several interventions may help the patient expectorate mucus, the nursing
interventions should focus on teaching the patient how to cough effectively and
expectorate secretions. Postural drainage may help to loosen the secretions.
Administering analgesics does not help to manage thick secretions. Administering
oxygen also does not help the patient manage secretions
A pediatric patient presents with a 2-week history of cough, clear sputum, headache,
hoarseness, and myalgias. The patient has no significant medical history. The patient's
parent asks why there is no plan to administer an antibiotic. How does the nurse
respond?
Explain that antibiotics are not required for the patient.
Advise the parent to see another health care provider for a second opinion.
Explain that pertussis is suspected and that bronchodilators are the treatment of choice.
Clarify that antibiotics will be prescribed if the cough persists for another week
Explain that antibiotics are not required for the patient
The symptoms and signs indicate that the patient may have acute bronchitis, which is a
viral disorder. Therefore the nurse should explain to the parent that antibiotics will not
help in viral infections. If they are prescribed, antibiotics may cause side effects and
may also lead to antibiotic resistance. It is incorrect to advise the parent to see another
health care provider, who will likely prescribe a similar course of treatment. The
symptoms are not indicative of pertussis. Bronchodilators are not used to treat
pertussis. Acute bronchitis is a self-limiting disorder, and the cough may last up to 3
weeks. Informing the parent that antibiotics will be prescribed if the cough persists for
another week is not correct.
