©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Chapter 30: Nursing Management:
Lower Respiratory Problems Lewis et al.:
Medical-Surgical Nursing in Canada, 3rd
Edition Exam Practice Questions and
Answers
1. Following assessment of a patient with pneumonia, the nurse documents a nursing diagnosis of
ineffective airway clearance. On which of the following data would the nurse base this nursing diagnosis?
a. SpO2 of 85%
b. Respiratory rate of 28 breaths/min
c. Presence of greenish sputum
d. Weak, nonproductive cough - Ans:✔✔-ANS: D
The weak, nonproductive cough indicates that the patient is unable to clear the airway effectively.
Page 1/36
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
PTS: 1 DIF: Cognitive Level: Application
REF: page 667, Nursing Care Plan 30-1 OBJ: 2
TOP: Nursing Process: Diagnosis MSC: CRNE: CH-15
2. A 56-year-old normally healthy patient at the clinic is diagnosed with community-acquired
pneumonia. The nurse anticipates that empirical treatment of the patient could include the
administration of which of the following medications?
a. Ciprofloxacin (Cipro)
b. Azithromycin (Zithromax)
c. Trimethoprim-sulfamethoxazole (Bactrim)
d. A second- or third-generation cephalosporin - Ans:✔✔-ANS: B
Early initiation of appropriate antibiotic therapy has been demonstrated to reduce mortality. The
treatment of choice is a macrolide (erythromycin, azithromycin, or clarithromycin).
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 665
OBJ: 1 TOP: Nursing Process: Planning MSC: CRNE: CH-44
Page 2/36
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
3. During assessment of the chest in a patient with pneumococcal pneumonia, what would the nurse
expect to find?
a. Hyperresonance on percussion
b. Increased tactile fremitus on palpation
c. Fine crackles in all lobes on auscultation
d. Asymmetrical chest expansion on inspection - Ans:✔✔-ANS: B
Pneumonias caused by Streptococcus pneumoniae are typically lobar or segmental. The nurse would
expect to find increased tactile fremitus over the affected area of the lungs. The area would be dull to
percussion.
PTS: 1 DIF: Cognitive Level: Application
REF: page 666, Table 30-5 OBJ: 1
TOP: Nursing Process: Assessment MSC: CRNE: CH-4
4. To promote airway clearance in a patient with pleurisy, what should the nurse instruct the patient to
do?
a. Splint the chest when coughing.
Page 3/36
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. Maintain a semi-Fowler's position.
c. Wear the nasal oxygen cannula at all times.
d. Use relaxation techniques to reduce anxiety. - Ans:✔✔-ANS: A
Coughing is less painful and more likely to be effective when the patient splints the chest during
coughing.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 699
OBJ: 11 TOP: Nursing Process: Implementation MSC: CRNE: CH-32
5. Four days after admission, a patient with chronic obstructive lung disease is diagnosed with hospital-
acquired pneumonia (HAP). Which of the following organisms does the nurse recognize is a common
cause of this type of pneumonia?
a. Pneumocystis carinii
b. Haemophilus influenzae
c. Pseudomonas aeruginosa
d. Mycoplasma pneumoniae - Ans:✔✔-ANS: C
Page 4/36
FIRST PUBLISH OCTOBER 2024
Chapter 30: Nursing Management:
Lower Respiratory Problems Lewis et al.:
Medical-Surgical Nursing in Canada, 3rd
Edition Exam Practice Questions and
Answers
1. Following assessment of a patient with pneumonia, the nurse documents a nursing diagnosis of
ineffective airway clearance. On which of the following data would the nurse base this nursing diagnosis?
a. SpO2 of 85%
b. Respiratory rate of 28 breaths/min
c. Presence of greenish sputum
d. Weak, nonproductive cough - Ans:✔✔-ANS: D
The weak, nonproductive cough indicates that the patient is unable to clear the airway effectively.
Page 1/36
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
PTS: 1 DIF: Cognitive Level: Application
REF: page 667, Nursing Care Plan 30-1 OBJ: 2
TOP: Nursing Process: Diagnosis MSC: CRNE: CH-15
2. A 56-year-old normally healthy patient at the clinic is diagnosed with community-acquired
pneumonia. The nurse anticipates that empirical treatment of the patient could include the
administration of which of the following medications?
a. Ciprofloxacin (Cipro)
b. Azithromycin (Zithromax)
c. Trimethoprim-sulfamethoxazole (Bactrim)
d. A second- or third-generation cephalosporin - Ans:✔✔-ANS: B
Early initiation of appropriate antibiotic therapy has been demonstrated to reduce mortality. The
treatment of choice is a macrolide (erythromycin, azithromycin, or clarithromycin).
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 665
OBJ: 1 TOP: Nursing Process: Planning MSC: CRNE: CH-44
Page 2/36
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
3. During assessment of the chest in a patient with pneumococcal pneumonia, what would the nurse
expect to find?
a. Hyperresonance on percussion
b. Increased tactile fremitus on palpation
c. Fine crackles in all lobes on auscultation
d. Asymmetrical chest expansion on inspection - Ans:✔✔-ANS: B
Pneumonias caused by Streptococcus pneumoniae are typically lobar or segmental. The nurse would
expect to find increased tactile fremitus over the affected area of the lungs. The area would be dull to
percussion.
PTS: 1 DIF: Cognitive Level: Application
REF: page 666, Table 30-5 OBJ: 1
TOP: Nursing Process: Assessment MSC: CRNE: CH-4
4. To promote airway clearance in a patient with pleurisy, what should the nurse instruct the patient to
do?
a. Splint the chest when coughing.
Page 3/36
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. Maintain a semi-Fowler's position.
c. Wear the nasal oxygen cannula at all times.
d. Use relaxation techniques to reduce anxiety. - Ans:✔✔-ANS: A
Coughing is less painful and more likely to be effective when the patient splints the chest during
coughing.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 699
OBJ: 11 TOP: Nursing Process: Implementation MSC: CRNE: CH-32
5. Four days after admission, a patient with chronic obstructive lung disease is diagnosed with hospital-
acquired pneumonia (HAP). Which of the following organisms does the nurse recognize is a common
cause of this type of pneumonia?
a. Pneumocystis carinii
b. Haemophilus influenzae
c. Pseudomonas aeruginosa
d. Mycoplasma pneumoniae - Ans:✔✔-ANS: C
Page 4/36
