NCLEX-Style Questions on Pneumonia PDF

**NCLEX-Style Questions on Pneumonia** **Pathophysiology and Etiology** 1. A nurse is explaining to a student how pneumonia develops. Which of the following best describes the pathophysiology of bacterial pneumonia? - A. Viruses invade lung tissue, leading to inflammation and...

**NCLEX-Style Questions on Pneumonia** **Pathophysiology and Etiology** 1. A nurse is explaining to a student how pneumonia develops. Which of the following best describes the pathophysiology of bacterial pneumonia? - A. Viruses invade lung tissue, leading to inflammation and consolidation. - B. Bacteria enter the lungs, causing alveolar inflammation and accumulation of exudate. - C. Fungal spores cause allergic reactions, leading to fluid buildup. - D. The immune system overreacts to environmental triggers, causing bronchiolar constriction. 2. A nurse is teaching about different pneumonia classifications. Which of the following patients is most likely to develop **opportunistic pneumonia**? - A. A 75-year-old with a history of smoking. - B. A patient receiving chemotherapy for leukemia. - C. A child recovering from an upper respiratory infection. - D. A college student with mycoplasma pneumonia. 3. What is the most common bacterial cause of community-acquired pneumonia (CAP)? - A. Klebsiella pneumoniae - B. Streptococcus pneumoniae - C. Mycobacterium tuberculosis - D. Legionella pneumophila 4. A patient aspirates gastric contents. What complication should the nurse monitor for? - A. Pulmonary embolism - B. Aspiration pneumonia - C. Pleural effusion - D. Tuberculosis **Assessment and Clinical Manifestations** 5. A nurse is assessing a patient suspected of pneumonia. Which of the following clinical manifestations is most indicative of bacterial pneumonia? - A. Gradual onset with dry cough - B. Fever, chills, productive cough with purulent sputum - C. Wheezing and chest tightness - D. Painless hemoptysis 6. A nurse is auscultating a patient with pneumonia. Which lung sound is most commonly associated with pneumonia? - A. Wheezing - B. Fine crackles - C. Stridor - D. Diminished breath sounds without adventitious sounds 7. A patient with pneumonia is disoriented and confused. The nurse suspects: - A. Increased intracranial pressure - B. Hypoxia - C. Hypercapnia - D. Dehydration 8. Which population is most at risk for atypical (walking) pneumonia? - A. Infants - B. Young adults, such as college students - C. Elderly individuals - D. Immunocompromised patients **Diagnosis and Laboratory Tests** 9. A chest X-ray of a patient with pneumonia is likely to show: - A. Bilateral lung hyperinflation - B. Consolidation or infiltrates in the affected lung area - C. Flattened diaphragm - D. Tracheal deviation 10. A patient with pneumonia has a WBC count of 15,000/mm³. The nurse interprets this finding as: - A. Normal - B. Indicative of viral pneumonia - C. Suggestive of a bacterial infection - D. A sign of immunosuppression **Answer: C**\ **Rationale:** Elevated WBC count indicates bacterial infection. **Treatment and Pharmacologic Therapy** 11. What is the first-line antibiotic therapy for **bacterial pneumonia**? - A. Azithromycin - B. Oseltamivir - C. Isoniazid - D. Amphotericin B **Answer: A**\ **Rationale:** Azithromycin (macrolide) is a common first-line treatment. 12. Which medication is used to **break up mucus** in pneumonia? - A. Albuterol - B. Guaifenesin - C. Dexamethasone - D. Ranitidine **Answer: B**\ **Rationale:** Guaifenesin is a mucolytic that helps clear secretions. **Nursing Interventions** 13. What is the priority nursing intervention for a patient experiencing **dyspnea** due to pneumonia? - A. Encourage deep breathing and coughing - B. Restrict fluid intake - C. Place the patient in supine position - D. Administer antibiotics before oxygen therapy **Answer: A**\ **Rationale:** Airway clearance is crucial to improve gas exchange. 14. A nurse encourages a patient with pneumonia to **sit in a semi-Fowler's position** because: - A. It prevents aspiration - B. It promotes lung expansion - C. It decreases pain - D. It prevents blood pooling in the legs **Answer: B**\ **Rationale:** Semi-Fowler's position enhances lung expansion and oxygenation. 15. Which action by a nurse indicates understanding of preventing **hospital-acquired pneumonia (HAP)**? - A. Limiting patient hydration - B. Frequent oral hygiene - C. Encouraging prolonged bed rest - D. Delaying antibiotic therapy **Answer: B**\ **Rationale:** Oral care reduces colonization of pathogens. **Complications** 16. A serious complication of pneumonia characterized by **pus accumulation in the pleural space** is: - A. Atelectasis - B. Empyema - C. Pulmonary edema - D. Pneumothorax **Answer: B**\ **Rationale:** Empyema is the accumulation of pus in the pleural space. 17. A patient with pneumonia suddenly develops **hypotension, tachycardia, and altered mental status**. The nurse suspects: - A. Pleural effusion - B. Septic shock - C. Pulmonary embolism - D. Bronchospasm **Answer: B**\ **Rationale:** Septic shock can result from bacteremia due to pneumonia. **Complications of Pneumonia (Continued)** 18. A patient with pneumonia has **diminished breath sounds and dullness on percussion** in the lower lung fields. The nurse suspects: - A. Atelectasis - B. Pleural effusion - C. Pulmonary embolism - D. Pneumothorax **Answer: B**\ **Rationale:** Pleural effusion results in fluid accumulation, causing dullness to percussion and diminished breath sounds. 19. A nurse is monitoring a pneumonia patient for **acute respiratory failure**. Which finding is most concerning? - A. Oxygen saturation of 91% on room air - B. Increased work of breathing and confusion - C. Productive cough with yellow sputum - D. Fever of 101.2°F (38.4°C) **Answer: B**\ **Rationale:** Confusion and increased work of breathing suggest hypoxia and impending respiratory failure. 20. Which laboratory finding suggests **sepsis** in a patient with pneumonia? - A. WBC count of 9,000/mm³ - B. Lactic acid level of 4.5 mmol/L - C. Platelet count of 250,000/mm³ - D. Sodium level of 138 mEq/L **Answer: B**\ **Rationale:** Lactic acidosis (\>4 mmol/L) suggests poor perfusion and possible septic shock. **Prevention and Risk Factors** 21. Which patient is at the highest risk for **hospital-acquired pneumonia (HAP)**? - A. A healthy college student with the flu - B. A 45-year-old with asthma - C. An elderly patient on mechanical ventilation - D. A middle-aged patient recovering from a hysterectomy **Answer: C**\ **Rationale:** Ventilator-associated pneumonia (VAP) is a significant risk factor for hospital-acquired pneumonia. 22. Which of the following interventions can help **prevent ventilator-associated pneumonia (VAP)**? - A. Deep suctioning every 4 hours - B. Keeping the head of the bed at **30--45 degrees** - C. Avoiding oral care to prevent aspiration - D. Administering bronchodilators every shift **Answer: B**\ **Rationale:** Elevating the head of the bed reduces the risk of aspiration and VAP. 23. A nurse is preparing to administer the **pneumococcal vaccine**. Which patient should receive it? - A. A 30-year-old without chronic conditions - B. A 68-year-old with COPD - C. A 40-year-old with no history of lung disease - D. A healthy 25-year-old who smokes occasionally **Answer: B**\ **Rationale:** The pneumococcal vaccine is recommended for adults **≥65 years** and those with chronic illnesses. 24. A patient who smokes asks about reducing their risk of pneumonia. The best response by the nurse is: - A. "Smoking does not increase pneumonia risk." - B. "Try to limit smoking to only a few cigarettes per day." - C. "Quitting smoking improves lung defense mechanisms." - D. "Only heavy smokers are at risk for pneumonia." **Answer: C**\ **Rationale:** Smoking damages cilia and weakens immune defenses, increasing pneumonia risk. **Special Populations** 25. An elderly patient with pneumonia is **not febrile** but is confused and lethargic. The nurse recognizes that: - A. The patient may have a concurrent stroke. - B. This is a normal response to pneumonia in older adults. - C. The infection is likely resolving. - D. This is unrelated to pneumonia. **Answer: B**\ **Rationale:** Older adults may **lack classic fever symptoms** but exhibit **confusion and lethargy** due to hypoxia. 26. The nurse is caring for an **immunocompromised patient** with pneumonia. Which pathogen is the **most concerning**? - A. Influenza virus - B. Pneumocystis jiroveci - C. Streptococcus pneumoniae - D. Mycoplasma pneumoniae **Answer: B**\ **Rationale:** Pneumocystis jiroveci pneumonia is an **opportunistic infection** seen in immunocompromised individuals, such as those with **HIV/AIDS**. **Patient Education** 27. A patient with pneumonia is **prescribed antibiotics**. Which statement indicates the need for further teaching? - A. "I will take all the antibiotics even if I feel better." - B. "I will stop taking the medication when my symptoms resolve." - C. "I will drink plenty of fluids while taking this medication." - D. "I will report any side effects to my doctor." **Answer: B**\ **Rationale:** Stopping antibiotics early **increases the risk of antibiotic resistance** and incomplete treatment. 28. Which dietary advice should a nurse give to a pneumonia patient? - A. "Avoid dairy, as it worsens mucus production." - B. "Increase fluid intake to loosen secretions." - C. "Limit protein intake during infection." - D. "Avoid all solid foods." **Answer: B**\ **Rationale:** Hydration helps thin mucus and promotes airway clearance. 29. A nurse is teaching a patient about **post-hospitalization pneumonia prevention**. Which action is most important? - A. "Avoid excessive movement to conserve energy." - B. "Use an incentive spirometer regularly." - C. "Only take medications when symptoms worsen." - D. "Stay in bed as much as possible." **Answer: B**\ **Rationale:** Incentive spirometry helps **prevent atelectasis and pneumonia recurrence**. **Interventions and Nursing Actions (Continued)** 30. The nurse is preparing to **administer oxygen** to a pneumonia patient. The priority before initiating oxygen therapy is: - A. Checking lung sounds - B. Assessing oxygen saturation - C. Monitoring urine output - D. Reviewing last CBC results **Answer: B**\ **Rationale:** Oxygen therapy should be based on **oxygen saturation levels**. 31. A patient with pneumonia is **having difficulty expectorating mucus**. The nurse's **priority intervention** is: - A. Increase fluid intake to 2,500 mL/day - B. Restrict movement to conserve energy - C. Administer bronchodilators every hour - D. Have the patient lie supine to rest **Answer: A**\ **Rationale:** Adequate hydration helps thin secretions, making it easier to expectorate mucus. 32. What is the **best positioning** for a pneumonia patient experiencing **dyspnea**? - A. Prone - B. Semi-Fowler's or High-Fowler's - C. Supine with legs elevated - D. Trendelenburg **Answer: B**\ **Rationale:** **Sitting upright promotes lung expansion** and gas exchange. **Final Review and Miscellaneous Questions** 33. The **priority outcome** for a pneumonia patient is: - A. "The patient will maintain a clear airway." - B. "The patient will avoid coughing to reduce discomfort." - C. "The patient will remain on bed rest for 3 days." - D. "The patient will avoid eating solid foods." **Answer: A**\ **Rationale:** Maintaining a **clear airway** is critical for oxygenation. 34. The nurse is teaching a pneumonia patient **about antibiotics**. Which **side effect** should the patient **report immediately**? - A. Nausea - B. Diarrhea - C. Rash or difficulty breathing - D. Headache **Answer: C**\ **Rationale:** Rash or **difficulty breathing suggests an allergic reaction**.