Exam 1 Practice PDF

Exam 1 Practice:\ **1. A patient with pneumonia is experiencing dyspnea and a productive cough. What is the most appropriate initial nursing intervention?**\ a. Perform postural drainage.\ b. Administer prescribed antibiotics.\ c. Position the patient in high Fowler's position.\ d. Initiate oxygen t...

Exam 1 Practice:\ **1. A patient with pneumonia is experiencing dyspnea and a productive cough. What is the most appropriate initial nursing intervention?**\ a. Perform postural drainage.\ b. Administer prescribed antibiotics.\ c. Position the patient in high Fowler's position.\ d. Initiate oxygen therapy at 6L/min. *Answer: c.*\ **Rationale:** High Fowler's position promotes lung expansion and reduces dyspnea. Antibiotics and oxygen are important but require specific orders and further assessment. **2. Which of the following is a hallmark sign of community-acquired pneumonia?**\ a. Night sweats\ b. Hemoptysis\ c. Acute onset of fever and chills\ d. Persistent dry cough *Answer: c.*\ **Rationale:** Community-acquired pneumonia typically presents with an acute onset of fever, chills, and a productive cough. **3. What is a priority diagnostic test for pneumonia?**\ a. Sputum culture\ b. Chest X-ray\ c. ABG analysis\ d. Pulmonary function test *Answer: b.*\ **Rationale:** A chest X-ray confirms the presence and location of pneumonia, while a sputum culture helps identify the causative agent. **4. Which intervention is most appropriate to prevent hospital-acquired pneumonia?**\ a. Encourage hourly use of an incentive spirometer.\ b. Limit ambulation to conserve energy.\ c. Provide a high-calorie diet.\ d. Perform daily chest physiotherapy. *Answer: a.*\ **Rationale:** Using an incentive spirometer prevents atelectasis and promotes lung expansion, reducing the risk of hospital-acquired pneumonia. **5. What is a common early sign of sepsis in a patient with pneumonia?**\ a. Hypotension\ b. Fever\ c. Bradycardia\ d. Mottled skin *Answer: b.*\ **Rationale:** Fever is a common early sign of systemic infection, indicating potential sepsis. **6. The nurse understands that a patient with pneumonia may have which abnormal laboratory finding?**\ a. Decreased WBC count\ b. Increased WBC count\ c. Decreased hemoglobin\ d. Increased hematocrit *Answer: b.*\ **Rationale:** An elevated WBC count indicates an inflammatory or infectious process like pneumonia. **7. A patient with pneumonia reports worsening symptoms despite antibiotic therapy. What should the nurse assess first?**\ a. Compliance with medication\ b. Drug allergies\ c. Blood glucose levels\ d. Lung sounds *Answer: a.*\ **Rationale:** Noncompliance with antibiotic therapy can lead to ineffective treatment and worsening symptoms. **Section 2: Tuberculosis (6 Questions)** **8. What is the primary mode of transmission for tuberculosis (TB)?**\ a. Contaminated surfaces\ b. Inhalation of airborne droplets\ c. Direct contact with bodily fluids\ d. Consumption of undercooked meat *Answer: b.*\ **Rationale:** TB spreads through airborne droplets when an infected person coughs or sneezes. **9. A patient with a positive TB skin test (PPD) asks what this means. What is the best response?**\ a. \"You have active TB and require treatment.\"\ b. \"Further tests are needed to determine if you have active or latent TB.\"\ c. \"You are immune to tuberculosis.\"\ d. \"You must be placed in isolation immediately.\" *Answer: b.*\ **Rationale:** A positive PPD test indicates TB exposure, but further testing (e.g., chest X-ray) is needed to confirm active infection. **10. Which medication is commonly prescribed for latent TB?**\ a. Rifampin\ b. Isoniazid\ c. Ethambutol\ d. Streptomycin *Answer: b.*\ **Rationale:** Isoniazid (INH) is commonly used to treat latent TB to prevent progression to active disease. **11. What type of isolation precautions should be implemented for a patient with suspected TB?**\ a. Droplet precautions\ b. Contact precautions\ c. Airborne precautions\ d. Standard precautions *Answer: c.*\ **Rationale:** Airborne precautions prevent the spread of TB via respiratory droplets. **12. A nurse is caring for a patient taking rifampin. What side effect should the patient be informed about?**\ a. Red-orange discoloration of body fluids\ b. Severe hypotension\ c. Metallic taste in the mouth\ d. Photosensitivity *Answer: a.*\ **Rationale:** Rifampin commonly causes red-orange discoloration of body fluids such as urine and tears. **13. What is the purpose of the BCG vaccine?**\ a. Treat latent TB infections.\ b. Prevent progression of active TB.\ c. Provide immunity against TB.\ d. Reduce drug resistance in TB. *Answer: c.*\ **Rationale:** The Bacille Calmette-Guérin (BCG) vaccine offers some protection against TB, particularly in high-prevalence areas. **Section 3: Obstructive Sleep Apnea (5 Questions)** **14. Which diagnostic tool is most effective for diagnosing obstructive sleep apnea?**\ a. Chest X-ray\ b. Polysomnography (sleep study)\ c. CT scan\ d. Pulmonary function test *Answer: b.*\ **Rationale:** A polysomnography evaluates sleep patterns, oxygen levels, and breathing interruptions. **15. What lifestyle change can reduce the risk of obstructive sleep apnea?**\ a. Reducing fluid intake before bed\ b. Maintaining a healthy weight\ c. Avoiding exercise before sleep\ d. Using sedatives at bedtime *Answer: b.*\ **Rationale:** Obesity is a significant risk factor for sleep apnea; weight loss can reduce airway obstruction. **16. A patient with sleep apnea is prescribed a CPAP machine. What is the primary purpose of this device?**\ a. Prevent upper airway collapse during sleep.\ b. Provide supplemental oxygen.\ c. Induce a deeper stage of sleep.\ d. Reduce the risk of aspiration. *Answer: a.*\ **Rationale:** A CPAP machine maintains positive airway pressure to prevent airway collapse. **17. What is a classic symptom of obstructive sleep apnea?**\ a. Frequent urination at night\ b. Morning headaches\ c. Chest pain\ d. Nausea *Answer: b.*\ **Rationale:** Morning headaches result from nocturnal hypoxia and poor sleep quality. **18. Which patient is at highest risk for obstructive sleep apnea?**\ a. A 20-year-old college athlete with asthma\ b. A 40-year-old obese male smoker\ c. A 55-year-old female with COPD\ d. A 70-year-old male with Parkinson's disease *Answer: b.*\ **Rationale:** Obesity, smoking, and being male increase the risk of obstructive sleep apnea. **Section 4: Pleural Disorders and Chest Tubes (7 Questions)** **19. Which symptom is most commonly associated with a pneumothorax?**\ a. Fever and chills\ b. Sudden onset of chest pain and dyspnea\ c. Persistent productive cough\ d. Cyanosis and bradycardia *Answer: b.*\ **Rationale:** A pneumothorax causes sudden chest pain and dyspnea due to air in the pleural space collapsing the lung. **20. What is the priority nursing action when caring for a patient with a chest tube?**\ a. Clamp the tube during patient transport.\ b. Ensure the drainage system is upright and below chest level.\ c. Strip the chest tube every hour to prevent clots.\ d. Disconnect the chest tube system to replace it. *Answer: b.*\ **Rationale:** The drainage system must remain upright and below the chest to prevent backflow and maintain proper functioning. **21. During chest tube care, the nurse notices continuous bubbling in the water seal chamber. What does this indicate?**\ a. Normal functioning of the chest tube\ b. An air leak in the system\ c. The chest tube has become dislodged\ d. Fluid accumulation in the pleural cavity *Answer: b.*\ **Rationale:** Continuous bubbling in the water seal chamber indicates an air leak that must be addressed. **22. What is the primary purpose of thoracentesis?**\ a. Remove air from the pleural space.\ b. Obtain a sample of pleural fluid for analysis.\ c. Instill medication into the pleural space.\ d. Inflate a collapsed lung. *Answer: b.*\ **Rationale:** Thoracentesis is used to remove pleural fluid for diagnostic or therapeutic purposes. **23. A patient with a pleural effusion is scheduled for a thoracentesis. What is the nurse\'s priority action during the procedure?**\ a. Assist the patient to lie flat.\ b. Encourage deep breathing during the procedure.\ c. Monitor for signs of pneumothorax.\ d. Administer a sedative. *Answer: c.*\ **Rationale:** Pneumothorax is a potential complication of thoracentesis due to lung injury. **24. A patient has a hemothorax. What clinical manifestation should the nurse expect?**\ a. Decreased lung sounds on the affected side\ b. Crepitus around the chest tube site\ c. Tracheal deviation toward the unaffected side\ d. Crackles and wheezes in both lungs *Answer: a.*\ **Rationale:** Hemothorax causes blood accumulation in the pleural space, leading to diminished lung sounds. **25. What intervention is necessary to maintain a closed chest tube drainage system?**\ a. Disconnect and reconnect the system as needed.\ b. Keep the system open to air for continuous drainage.\ c. Secure all connections to prevent air leaks.\ d. Clamp the chest tube routinely to prevent backflow. *Answer: c.*\ **Rationale:** Secure connections ensure the closed system remains intact, preventing air leaks. **Section 5: Chronic Obstructive Pulmonary Disease (COPD) (6 Questions)** **26. What is the primary risk factor for COPD?**\ a. Exposure to dust and allergens\ b. Smoking tobacco\ c. Alcohol consumption\ d. Sedentary lifestyle *Answer: b.*\ **Rationale:** Smoking is the leading cause of COPD and contributes to airway and alveolar damage. **27. Which clinical manifestation is most consistent with COPD?**\ a. Sudden dyspnea and chest pain\ b. Chronic productive cough and wheezing\ c. Fever and pleuritic chest pain\ d. Night sweats and hemoptysis *Answer: b.*\ **Rationale:** Chronic productive cough, wheezing, and dyspnea are hallmark signs of COPD. **28. What is a priority intervention for a patient with acute COPD exacerbation?**\ a. Restrict fluid intake to prevent edema.\ b. Administer high-flow oxygen via mask.\ c. Position the patient in tripod position.\ d. Encourage frequent deep breathing and coughing. *Answer: c.*\ **Rationale:** The tripod position facilitates lung expansion and reduces dyspnea in COPD patients. **29. The nurse understands that COPD pathophysiology includes which finding?**\ a. Bronchoconstriction and increased airway resistance\ b. Decreased surfactant production\ c. Increased elastic recoil of the alveoli\ d. Overproduction of renin and angiotensin *Answer: a.*\ **Rationale:** COPD involves bronchoconstriction, inflammation, and airway obstruction due to mucus buildup. **30. Which lab value is most important to monitor in a patient with COPD?**\ a. Hemoglobin\ b. Arterial blood gases (ABGs)\ c. Creatinine\ d. Platelet count *Answer: b.*\ **Rationale:** ABGs provide critical information about oxygenation and CO2 retention in COPD patients. **31. What is a common complication of long-term COPD?**\ a. Cor pulmonale\ b. Pneumothorax\ c. Pulmonary embolism\ d. Tuberculosis *Answer: a.*\ **Rationale:** Cor pulmonale (right-sided heart failure) is a common complication due to increased pulmonary vascular resistance. **Section 6: Evidence-Based Practice (EBP) (5 Questions)** **32. What does the \"P\" in the PICOT framework represent?**\ a. Population\ b. Procedure\ c. Practice\ d. Prevention *Answer: a.*\ **Rationale:** The \"P\" in PICOT stands for Population, the group being studied. **33. Which type of research evidence is considered the strongest?**\ a. Case-control study\ b. Randomized controlled trial\ c. Expert opinion\ d. Qualitative study *Answer: b.*\ **Rationale:** Randomized controlled trials (RCTs) are the gold standard for evaluating interventions. **34. How is reliability defined in research?**\ a. The ability to replicate study findings consistently\ b. The appropriateness of the research question\ c. The strength of the intervention effect\ d. The ethicality of the study *Answer: a.*\ **Rationale:** Reliability refers to the consistency and repeatability of study results. **35. A nurse reads a research study about a new intervention. What is the next step in the EBP process?**\ a. Apply the findings to all patients.\ b. Critically appraise the study\'s validity and relevance.\ c. Consult the patient's family for input.\ d. Implement the intervention in a pilot study. *Answer: b.*\ **Rationale:** Appraising the study ensures it is valid and applicable before implementation. **Section 7: Lab Values (5 Questions)** **36. Which lab value is most concerning in a patient with respiratory acidosis?**\ a. pH 7.30\ b. pH 7.45\ c. PaCO2 35 mmHg\ d. HCO3 22 mEq/L *Answer: a.*\ **Rationale:** A pH of 7.30 indicates acidosis, commonly caused by CO2 retention in respiratory conditions. **37. What is the normal range for PaO2 in arterial blood gases?**\ a. 60--80 mmHg\ b. 80--100 mmHg\ c. 50--70 mmHg\ d. 90--110 mmHg *Answer: b.*\ **Rationale:** The normal PaO2 range is 80--100 mmHg, reflecting adequate oxygenation. **38. Which lab value would be expected in a patient with an acute bacterial infection?**\ a. Elevated WBC count\ b. Decreased WBC count\ c. Decreased hematocrit\ d. Elevated hemoglobin *Answer: a.*\ **Rationale:** A bacterial infection triggers an immune response, leading to an elevated WBC count. **39. What is the priority nursing intervention for a patient with a potassium level of 2.9 mEq/L?**\ a. Administer potassium chloride as prescribed.\ b. Encourage increased fluid intake.\ c. Administer calcium gluconate.\ d. Monitor for signs of hyperkalemia. *Answer: a.*\ **Rationale:** Hypokalemia (K+ \