TB and Pneumonia Practice Questions PDF

TB and Pneumonia Practice Questions: **Question 1**\ A nurse is teaching a community group about pneumonia. Which pathogen is most commonly responsible for community-acquired pneumonia (CAP)?\ A. Streptococcus pneumoniae\ B. Mycobacterium tuberculosis\ C. Influenza virus\ D. Klebsiella pneumoniae...

TB and Pneumonia Practice Questions: **Question 1**\ A nurse is teaching a community group about pneumonia. Which pathogen is most commonly responsible for community-acquired pneumonia (CAP)?\ A. Streptococcus pneumoniae\ B. Mycobacterium tuberculosis\ C. Influenza virus\ D. Klebsiella pneumoniae **Answer:** A. Streptococcus pneumoniae\ **Rationale:** Streptococcus pneumoniae is responsible for approximately 50% of pneumonia cases, particularly community-acquired pneumonia. Mycobacterium tuberculosis causes tuberculosis, not pneumonia. Influenza virus and Klebsiella pneumoniae are less common causes of pneumonia. **Question 2**\ A patient with suspected bacterial pneumonia presents with unilateral lung involvement. The nurse recognizes this as:\ A. Bronchopneumonia\ B. Lobar pneumonia\ C. Aspiration pneumonia\ D. Viral pneumonia **Answer:** B. Lobar pneumonia\ **Rationale:** Bacterial pathogens often cause lobar pneumonia, which affects one or more lobes of a single lung. Bronchopneumonia is typically patchy and scattered. Aspiration pneumonia results from the inhalation of substances, and viral pneumonia often shows a mild, scattered pattern. **Question 3**\ The nurse is assessing a patient with tuberculosis (TB). What is the hallmark of a positive Mantoux test?\ A. Redness at the injection site\ B. Induration at the injection site\ C. Presence of a rash\ D. Elevated WBC levels **Answer:** B. Induration at the injection site\ **Rationale:** A positive Mantoux test is identified by induration (a raised, hardened area) at the injection site, not redness. Redness alone is not indicative of a positive result. **Question 4**\ The nurse is reviewing a patient's arterial blood gas (ABG) results. Which finding is most concerning in a patient with pneumonia?\ A. pH: 7.35, PaCO₂: 45 mmHg\ B. pH: 7.28, PaCO₂: 50 mmHg\ C. pH: 7.40, PaCO₂: 40 mmHg\ D. pH: 7.38, PaCO₂: 42 mmHg **Answer:** B. pH: 7.28, PaCO₂: 50 mmHg\ **Rationale:** A pH of 7.28 indicates acidosis, and a PaCO₂ of 50 mmHg reflects hypercapnia, suggesting respiratory acidosis---a critical concern in pneumonia due to impaired gas exchange. **Question 5**\ A nurse is providing care for a patient with active tuberculosis. Which medication regimen is appropriate for the first two months of treatment?\ A. Isoniazid and rifampin\ B. Rifampin, isoniazid, ethambutol, and pyrazinamide\ C. Rifampin and pyrazinamide only\ D. Ethambutol and rifampin **Answer:** B. Rifampin, isoniazid, ethambutol, and pyrazinamide\ **Rationale:** The initial phase of active TB treatment includes a combination of rifampin, isoniazid, ethambutol, and pyrazinamide to effectively reduce bacterial load and prevent resistance. **Question 6**\ The nurse is implementing interventions for a patient with pneumonia. Which intervention is a priority?\ A. Teaching slow abdominal breathing\ B. Ensuring a fluid intake of 2500-3000 mL/day\ C. Administering antibiotics as ordered\ D. Placing the patient in a semi-Fowler's position **Answer:** C. Administering antibiotics as ordered\ **Rationale:** Administering antibiotics is critical to treat the infection. The other interventions support symptom management and patient comfort but do not directly address the underlying cause. **Question 7**\ A patient with aspiration pneumonia is admitted to the unit. Which factor is most likely responsible for the severity of the inflammation?\ A. Volume of aspirated material\ B. Presence of gastric reflux\ C. pH of the aspirated material\ D. Type of bacteria in the aspirate **Answer:** C. pH of the aspirated material\ **Rationale:** Materials with a low pH cause more severe inflammation, increasing the risk of tissue damage and subsequent bacterial invasion. **Question 8**\ Which laboratory test is the gold standard for confirming a tuberculosis diagnosis?\ A. Sputum culture\ B. Chest X-ray\ C. Nucleic acid amplification test (NAA)\ D. Interferon-gamma release assay (IGRA) **Answer:** A. Sputum culture\ **Rationale:** Although other tests like NAA and IGRA are useful, a sputum culture is the definitive diagnostic tool for confirming tuberculosis. **Question 9**\ A nurse is educating a patient about pneumococcal vaccination. Which patient statement indicates the need for further teaching?\ A. \"I will only need one dose of the vaccine for lifetime immunity.\"\ B. \"I should get revaccinated if I'm over 65 and was vaccinated before age 65.\"\ C. \"The vaccine can help prevent severe pneumonia caused by Streptococcus pneumoniae.\"\ D. \"I may need revaccination if I have a weakened immune system.\" **Answer:** A. \"I will only need one dose of the vaccine for lifetime immunity.\"\ **Rationale:** While the pneumococcal vaccine often provides lifetime immunity, revaccination is recommended for individuals who are immunosuppressed or were vaccinated before age 65. **Question 10**\ Which clinical manifestation is most commonly associated with bacterial pneumonia?\ A. Scattered, patchy infiltrates on a chest X-ray\ B. Sudden onset of fever, chills, and productive cough\ C. Non-productive cough with mild dyspnea\ D. Night sweats and weight loss **Answer:** B. Sudden onset of fever, chills, and productive cough\ **Rationale:** Bacterial pneumonia typically presents with acute symptoms like fever, chills, and a productive cough, distinguishing it from viral or atypical forms of pneumonia. **Question 11**\ The nurse is caring for a patient receiving treatment for latent tuberculosis. What is the expected pharmacologic regimen?\ A. Rifampin, isoniazid, ethambutol, and pyrazinamide for 2 months\ B. Isoniazid for 6-9 months\ C. Rifampin for 12 months\ D. Rifampin and pyrazinamide for 6 months **Answer:** B. Isoniazid for 6-9 months\ **Rationale:** Latent TB is typically treated with isoniazid for 6-9 months. Active TB requires combination therapy. **Question 12**\ Which diagnostic test is best for identifying active tuberculosis in a patient with a positive Mantoux test?\ A. Chest X-ray\ B. Sputum culture\ C. QuantiFERON-TB test\ D. Nucleic acid amplification test (NAA) **Answer:** B. Sputum culture\ **Rationale:** A sputum culture is the gold standard for confirming active TB. A chest X-ray and NAA are supportive diagnostic tools but do not definitively confirm active infection. **Question 13**\ The nurse is monitoring a patient with pneumonia for sepsis. Which finding requires immediate intervention?\ A. WBC count of 12,000/mm³\ B. Lactate level of 4.2 mmol/L\ C. Blood pressure of 118/78 mmHg\ D. Arterial pH of 7.38 **Answer:** B. Lactate level of 4.2 mmol/L\ **Rationale:** A lactate level above 4 mmol/L indicates hypoperfusion and requires immediate intervention to prevent septic shock. The other values are within normal or acceptable ranges. **Question 14**\ A patient with pneumonia is experiencing pleuritic chest pain during coughing. What intervention should the nurse prioritize?\ A. Administering prescribed antipyretics\ B. Teaching the patient to splint the chest\ C. Positioning the patient in a semi-Fowler\'s position\ D. Encouraging fluid intake of 3,000 mL/day **Answer:** B. Teaching the patient to splint the chest\ **Rationale:** Splinting helps reduce pain associated with pleuritic chest pain during coughing, promoting better secretion clearance without causing additional discomfort. **Question 15**\ A nurse is caring for an immunocompromised patient with suspected opportunistic pneumonia. Which pathogen is most likely involved?\ A. Pneumocystis jirovecii\ B. Streptococcus pneumoniae\ C. Mycobacterium tuberculosis\ D. Haemophilus influenzae **Answer:** A. Pneumocystis jirovecii\ **Rationale:** Pneumocystis jirovecii is a common cause of opportunistic pneumonia in immunocompromised individuals, particularly those with AIDS or undergoing immunosuppressive therapy. **Question 16**\ The nurse is planning care for a patient with bacterial pneumonia. Which intervention will help maintain airway patency?\ A. Performing endotracheal suctioning as ordered\ B. Placing the patient in a supine position\ C. Limiting fluid intake to reduce congestion\ D. Teaching the patient slow abdominal breathing **Answer:** A. Performing endotracheal suctioning as ordered\ **Rationale:** Endotracheal suctioning is an effective intervention to remove secretions and maintain airway patency. The supine position and fluid restriction are not appropriate in this context. **Question 17**\ The nurse is providing education to a patient newly diagnosed with tuberculosis. Which statement indicates understanding?\ A. \"I will no longer be infectious after two weeks of therapy.\"\ B. \"I must complete the full course of therapy to prevent resistance.\"\ C. \"If I feel better, I can stop taking my medications early.\"\ D. \"A positive skin test means I have active tuberculosis.\" **Answer:** B. \"I must complete the full course of therapy to prevent resistance.\"\ **Rationale:** Completing the full course of TB therapy is essential to prevent resistance. Stopping early, even if symptoms improve, can lead to treatment failure and resistant strains.