Unit 4 NCLEX Practice Questions PDF

Here are 50 NCLEX-style questions based on the provided document, aligned with the specified Unit Student Learning Outcomes (CSLOs). Remember, NCLEX questions often assess critical thinking and application of knowledge, not just rote memorization. **Instructions:** Choose the single best answer for...

Here are 50 NCLEX-style questions based on the provided document, aligned with the specified Unit Student Learning Outcomes (CSLOs). Remember, NCLEX questions often assess critical thinking and application of knowledge, not just rote memorization. **Instructions:** Choose the single best answer for each multiple-choice question. **Questions:** 1. A patient with COPD presents with increased dyspnea. Which initial nursing intervention is MOST important? a) Administer bronchodilators. b) Assess oxygen saturation. c) Encourage pursed-lip breathing. d) Provide emotional support. 2. A patient on oxygen therapy via nasal cannula reports nasal dryness. What's the BEST nursing intervention? a) Increase oxygen flow rate. b) Use a humidifier. c) Apply petroleum jelly to the nostrils. d) Switch to a face mask. 3. Which medication is NOT typically used for the treatment of acute asthma exacerbation? a) Albuterol (SABA) b) Ipratropium bromide (anticholinergic) c) Montelukast (leukotriene modifier)  d) Methylprednisolone (corticosteroid) 4. A patient with cystic fibrosis (CF) is receiving chest physiotherapy. What is the PRIMARY goal of this intervention? a) Improve oxygen saturation. b) Reduce inflammation. c) Mobilize mucus secretions. d) Increase lung capacity. 5. What is a common complication of long-term oxygen therapy? a) Hypoxia b) Hypercapnia c) Oxygen toxicity d) Respiratory acidosis 6. A patient with pneumonia is receiving intravenous antibiotics. When should the nurse expect to see improvement in the patient's condition? a) Within 24 hours b) Within 48 hours c) Within 72 hours d) After several days of treatment 7. Which of the following is NOT a sign of respiratory distress? a) Tachypnea b) Bradycardia c) Use of accessory muscles d) Nasal flaring 8. What is the PRIMARY purpose of a peak flow meter? a) To measure lung capacity. b) To monitor airflow obstruction. c) To assess oxygen saturation. d) To determine the need for hospitalization. 9. A patient with sleep apnea is prescribed CPAP therapy. What is a common side effect of CPAP? a) Hypotension b) Bradycardia c) Dry mouth and nose d) Increased appetite 10. What is the most important aspect of teaching a patient how to use a metered dose inhaler (MDI)? a) Inhaling deeply after actuating the MDI. b) Holding their breath for 10 seconds after each inhalation. c) Coordinating actuation with inhalation. d) Using a spacer device every time. 11. A patient with tuberculosis (TB) is started on a multi-drug regimen. What is the MOST important aspect of patient teaching? a) The importance of completing the entire course of antibiotics. b) The potential side effects of the medication. c) The need for follow-up appointments.  d) The contagious nature of the disease. 12. Which of the following is a priority assessment for a patient with suspected pulmonary embolism? a) Temperature b) Blood pressure c) Respiratory rate and effort d) Oxygen saturation 13. What is the BEST way to prevent healthcare-associated pneumonia (HAP)? a) Administering antibiotics prophylactically. b) Elevating the head of the bed. c) Frequent suctioning. d) Strict adherence to hand hygiene. 14. A patient with cystic fibrosis (CF) is experiencing a respiratory exacerbation. What is the expected treatment? a) Bronchodilators only b) Antibiotic therapy c) Oxygen therapy only d) Chest physiotherapy only 15. A patient with asthma uses a peak flow meter daily. What does a low reading indicate? a) Improved lung function b) Increased airflow c) Worsening asthma symptoms d) No change in asthma status 16. What is the most effective way to reduce the risk of ventilator-associated pneumonia (VAP)? a) Daily sedation vacations. b) Elevating the head of the bed. c) Prophylactic antibiotics. d) Frequent oral care. 17. What is the purpose of incentive spirometry? a) To improve oxygen saturation. b) To strengthen respiratory muscles. c) To measure lung volume. d) To prevent atelectasis. 18. Which respiratory assessment finding warrants IMMEDIATE attention? a) Mild wheezing b) Productive cough c) Use of accessory muscles d) Decreased breath sounds in one lung field 19. What is the most common cause of community-acquired pneumonia (CAP)? a) *Streptococcus pneumoniae* b) *Haemophilus influenzae* c) *Legionella pneumophila* d) *Mycoplasma pneumoniae* 20. What is the PRIMARY goal of treatment for a patient with pulmonary arterial hypertension (PAH)? a) Cure the disease b) Improve quality of life c) Reduce pulmonary vascular resistance d) Prevent right-sided heart failure 21. What is the most significant risk factor for developing lung cancer? a) Family history b) Exposure to asbestos c) Cigarette smoking d) Air pollution 22. Which nursing intervention is MOST important for a patient with a tracheostomy? a) Maintaining the tracheostomy tube. b) Monitoring the patient's oxygen saturation. c) Providing frequent oral care. d) Suctioning the tracheostomy tube as needed. 23. What is the most common symptom of idiopathic pulmonary fibrosis (IPF)? a) Cough b) Wheezing c) Dyspnea d) Chest pain 24. Which of the following is a hallmark sign of severe asthma? a) Wheezing b) Silent chest c) Tachycardia d) Use of accessory muscles 25. What is the purpose of postural drainage? a) To remove excess fluid from the lungs. b) To improve oxygenation. c) To promote drainage of mucus secretions. d) To strengthen respiratory muscles. 26. A patient is experiencing an acute asthma exacerbation. Which intervention is the priority? a) Administer oxygen. b) Administer bronchodilators. c) Assess respiratory status. d) Obtain arterial blood gas (ABG) levels. 27. What is the most reliable indicator of effective oxygen therapy? a) Increased pulse oximetry reading. b) Improved respiratory rate. c) Decreased shortness of breath. d) Improved mental status. 28. A patient with COPD is experiencing a worsening respiratory infection. Which finding is most concerning? a) Increased sputum production. b) Increased shortness of breath. c) Decreased oxygen saturation. d) Increased heart rate. 29. What is the most important nursing intervention for a patient with a pneumothorax? a) Administer oxygen. b) Monitor respiratory status. c) Insert a chest tube. d) Prepare for surgery. 30. What is the most common complication following a lung biopsy? a) Infection b) Pneumothorax c) Hemorrhage d) Pain 31. Which assessment finding is MOST concerning in a patient with a newly diagnosed nasal fracture? a) Epistaxis b) Nasal deformity c) Clear rhinorrhea d) Periorbital ecchymosis 32. What is the MOST effective method to prevent the spread of tuberculosis (TB)? a) Handwashing b) Airborne precautions c) Vaccination d) Prophylactic antibiotics 33. What is the PRIMARY nursing intervention for a patient experiencing an upper airway obstruction? a) Administer oxygen. b) Perform a tracheostomy. c) Establish an airway. d) Call a rapid response team. 34. What is the most common type of lung cancer? a) Small cell lung cancer b) Non-small cell lung cancer c) Adenocarcinoma d) Squamous cell carcinoma 35. Which teaching point is MOST important for a patient with OSA who is prescribed CPAP? a) The importance of using the machine every night. b) How to clean and maintain the machine. c) The potential side effects of the therapy. d) The purpose of the therapy. 36. A patient with a chest tube is experiencing sudden cessation of bubbling in the water- seal chamber. What is the MOST likely cause? a) The lung has re-expanded. b) The chest tube is kinked. c) The patient Here are 50 NCLEX-style questions based on the provided text, focusing on the listed conditions and aligning with the Unit Student Learning Outcomes. Note that the provided text does not directly cover migraines, seizures, Parkinson's disease, multiple sclerosis, transient ischemic attack (TIA), ischemic stroke, or asthma. Therefore, these questions will rely on general nursing knowledge regarding these conditions. The text *does* extensively cover respiratory issues; thus, a significant portion of the questions will address oxygenation problems from that perspective. **Instructions:** Choose the single best answer for each multiple-choice question. **Questions:** 1. A patient with COPD is experiencing dyspnea. Which nursing intervention is MOST important? a) Administer oxygen at 10 L/min via nasal cannula. b) Encourage pursed-lip breathing. c) Place the patient in Trendelenburg position. d) Restrict fluids to prevent fluid overload. 2. A patient with cystic fibrosis (CF) is admitted with a respiratory exacerbation. What is a priority nursing assessment?  a) Apical pulse b) Breath sounds c) Bowel sounds d) Blood pressure 3. Which medication is NOT typically used to treat acute asthma exacerbation? a) Albuterol (Proventil) b) Ipratropium bromide (Atrovent) c) Methylprednisolone (Solu-Medrol) d) Morphine sulfate 4. A patient with suspected pulmonary embolism (PE) is admitted. What is the priority nursing intervention? a) Administer oxygen. b) Assess for calf pain. c) Monitor for signs of heart failure. d) All of the above. 5. Which oxygen delivery system provides the most precise FiO2? a) Nasal cannula b) Simple face mask c) Venturi mask d) Non-rebreather mask 6. A patient with COPD is receiving oxygen therapy. What is a crucial assessment finding to monitor? a) Heart rate  b) Respiratory rate c) Oxygen saturation d) All of the above 7. What is a common side effect of inhaled corticosteroids? a) Bronchospasm b) Tachycardia c) Oral thrush d) Hypotension 8. Which statement about post-operative care for a patient who underwent a laryngectomy is FALSE? a) Careful suctioning is required. b) The patient will require a tracheostomy. c) Speech therapy will be necessary. d) Nutritional support may be needed. 9. A patient with a tracheostomy is experiencing copious secretions. What is the appropriate nursing intervention? a) Suction the tracheostomy tube. b) Increase the oxygen flow rate. c) Encourage coughing. d) Both A and C. 10. Which of these is NOT a typical sign or symptom of pneumonia? a) Cough b) Fever  c) Bradycardia d) Shortness of breath 11. What is the most common cause of chronic respiratory problems? a) Asthma b) Pneumonia c) Smoking d) Air pollution 12. What is the most effective method for preventing the spread of respiratory infections? a) Handwashing b) Wearing a mask c) Vaccination d) All of the above 13. What is a key element of patient education for managing asthma? a) Identifying and avoiding triggers b) Using a peak flow meter c) Proper inhaler technique d) All of the above 14. What is a common sign of a pneumothorax? a) Decreased breath sounds on one side b) Increased respiratory rate c) Chest pain d) All of the above 15. A patient presents with sudden onset of unilateral weakness and slurred speech. What condition should the nurse suspect? a) Migraine b) Seizure c) Ischemic stroke d) Asthma exacerbation 16. A patient with Parkinson's disease is experiencing difficulty swallowing. What nursing intervention is most appropriate? a) Encourage large, infrequent meals b) Assist the patient with meals and provide thickened liquids c) Place the patient in Trendelenburg position while eating d) Administer antiemetics as needed 17. Which of the following is NOT a common symptom of multiple sclerosis (MS)? a) Muscle weakness b) Fatigue c) Shortness of breath d) Cognitive changes 18. A patient experiencing a TIA is at risk for developing which condition? a) Multiple sclerosis b) Ischemic stroke c) Parkinson's disease d) Asthma 19. What is the priority nursing intervention for a patient experiencing a seizure? a) Restrain the patient b) Place a tongue depressor in the patient's mouth c) Protect the patient from injury d) Administer oxygen 20. Which of the following is NOT a typical sign of a migraine? a) Unilateral headache b) Nausea and vomiting c) Photophobia and phonophobia d) Sudden loss of consciousness 21. What is a common medication used to treat migraine headaches? a) Triptans (e.g., sumatriptan) b) NSAIDs (e.g., ibuprofen) c) Anti-emetics (e.g., ondansetron) d) All of the above 22. A patient with asthma is using a metered-dose inhaler (MDI). What should the nurse teach the patient to do after each puff? a) Rinse their mouth b) Drink water c) Hold their breath for 10 seconds d) All of the above 23. What is the cornerstone of managing COPD long-term? a) Oxygen therapy b) Bronchodilators c) Smoking cessation d) Pulmonary rehabilitation 24. What is a priority nursing assessment for a patient with suspected pneumonia? a) Oxygen saturation b) Breath sounds c) Temperature d) All of the above 25. What is the most important teaching point for a patient with newly diagnosed tuberculosis (TB)? a) Importance of completing the entire course of antibiotics. b) Need for frequent handwashing. c) Importance of avoiding crowds. d) All of the above. 26. A patient with a new tracheostomy is at risk for which complication? a) Infection b) Bleeding c) Airway obstruction d) All of the above 27. What is a key assessment for a patient receiving oxygen therapy?  a) Respiratory rate and depth b) Oxygen saturation c) Skin color and capillary refill d) All of the above 28. A patient with COPD has a chronic cough producing thick sputum. What nursing intervention is most helpful? a) Increase fluid intake b) Encourage deep breathing exercises c) Provide chest physiotherapy d) All of the above 29. What is a common side effect of anticholinergic bronchodilators? a) Dry mouth b) Tachycardia c) Tremors d) Nausea 30. Which type of respiratory medication should be used first in an asthma exacerbation? a) Inhaled corticosteroids b) Long-acting beta-agonists c) Short-acting beta-agonists d) Leukotriene modifiers 31. What is the best way to confirm a diagnosis of Tuberculosis (TB)?  a) Chest x-ray b) Tuberculin skin test (TST) c) Sputum culture d) Blood test 32. Which of these is a sign of respiratory distress in a child? a) Nasal flaring b) Grunting c) Retractions d) All of the above 33. What is a common complication of long-term oxygen therapy in patients with COPD? a) Oxygen toxicity b) Dependence on oxygen c) Dry nose and mouth d) All of the above 34. A patient with cystic fibrosis (CF) is experiencing difficulty maintaining adequate nutrition. What is the most likely cause? a) Lack of appetite b) Pancreatic insufficiency c) Frequent respiratory infections 1. **b) Assess oxygen saturation.** Assessing oxygen saturation is the priority initial intervention to determine the severity of the dyspnea and guide further treatment. 2. **b) Use a humidifier.** A humidifier adds moisture to the air, alleviating nasal dryness. 3. **c) Montelukast (leukotriene modifier).** Montelukast is a preventative medication, not used for acute exacerbations. 4. **c) Mobilize mucus secretions.** Chest physiotherapy helps loosen and remove mucus from the airways. 5. **c) Oxygen toxicity.** Long-term high oxygen concentrations can damage lung tissue. 6. **d) After several days of treatment.** Antibiotic effectiveness varies, and improvement may take several days. 7. **b) Bradycardia.** Bradycardia is not a sign of respiratory distress; the others are. 8. **b) To monitor airflow obstruction.** Peak flow meters measure the speed of air exhaled, indicating airway narrowing. 9. **c) Dry mouth and nose.** The air pressure from CPAP can dry mucous membranes. 10. **c) Coordinating actuation with inhalation.** This ensures medication reaches the lungs effectively. 11. **a) The importance of completing the entire course of antibiotics.** This prevents drug resistance and ensures eradication of the bacteria. 12. **c) Respiratory rate and effort.** These are crucial indicators of respiratory compromise in a suspected PE. 13. **d) Strict adherence to hand hygiene.** Hand hygiene is the most effective measure to prevent HAP transmission. 14. **b) Antibiotic therapy.** Respiratory exacerbations in CF often require antibiotics to treat bacterial infections. 15. **c) Worsening asthma symptoms.** A low peak flow reading indicates decreased airflow and worsening asthma control. 16. **d) Frequent oral care.** Oral care reduces bacterial load and risk of VAP. 17. **d) To prevent atelectasis.** Incentive spirometry encourages deep breathing to prevent lung collapse. 18. **d) Decreased breath sounds in one lung field.** This suggests a potential collapse or obstruction requiring immediate attention. 19. **a) *Streptococcus pneumoniae*.** This is the most common bacterial cause of CAP. 20. **c) Reduce pulmonary vascular resistance.** This improves heart function and quality of life. 21. **c) Cigarette smoking.** This is the leading cause of lung cancer. 22. **a) Maintaining the tracheostomy tube.** Maintaining a patent airway is the highest priority. 23. **c) Dyspnea.** Shortness of breath is the most common and debilitating symptom of IPF. 24. **b) Silent chest.** Absence of wheezing in a severe attack is ominous, indicating complete airway obstruction. 25. **c) To promote drainage of mucus secretions.** Positioning assists in gravity-aided mucus drainage. 26. **c) Assess respiratory status.** A complete assessment is paramount before initiating treatment. 27. **a) Increased pulse oximetry reading.** Pulse oximetry is the most direct measure of oxygenation. 28. **c) Decreased oxygen saturation.** This indicates worsening oxygenation and potential respiratory failure. 29. **c) Insert a chest tube.** This procedure relieves pressure from the lung. 30. **b) Pneumothorax.** Accidental lung puncture during the procedure is a common complication. 31. **d) Periorbital ecchymosis.** This (raccoon eyes) suggests possible orbital fracture, a serious complication. 32. **b) Airborne precautions.** TB is spread through airborne droplets. 33. **c) Establish an airway.** Maintaining a patent airway is the immediate priority. 34. **b) Non-small cell lung cancer.** This accounts for the vast majority of lung cancers. 35. **a) The importance of using the machine every night.** Consistent use is crucial for treatment efficacy. 36. **b) The chest tube is kinked.** This would prevent air from escaping, halting bubbling. (Note: A lung re-expansion would be expected to be a *gradual* decrease in bubbling, not sudden cessation.) **(Note: Questions 37-50 were not provided in the original prompt.)** 1. **b) Encourage pursed-lip breathing.** High-flow oxygen can suppress the hypoxic drive in COPD patients. Pursed-lip breathing helps control breathing and improve oxygenation. Trendelenburg is not indicated for dyspnea, and fluid restriction isn't the priority for dyspnea. 2. **b) Breath sounds.** Assessing breath sounds helps identify areas of decreased air entry, wheezes, or crackles, indicative of a respiratory exacerbation. 3. **d) Morphine sulfate.** Morphine is an opioid and respiratory depressant, contraindicated in acute asthma exacerbation. Albuterol, ipratropium, and methylprednisolone are all used in acute asthma treatment. 4. **d) All of the above.** PE is a life-threatening condition. Oxygen is crucial, calf pain is a common symptom, and monitoring for heart failure is necessary due to the potential for right-sided heart strain. 5. **c) Venturi mask.** Venturi masks deliver a precise FiO2 by mixing oxygen with room air through a calibrated valve. 6. **d) All of the above.** All these parameters are crucial in monitoring a COPD patient on oxygen therapy, as changes can indicate respiratory distress or complications. 7. **c) Oral thrush.** Inhaled corticosteroids can cause candidiasis (oral thrush) due to their local effects. 8. **a) Careful suctioning is required.** This is TRUE. The other statements are also true regarding post-operative laryngectomy care. 9. **d) Both A and C.** Suctioning removes secretions, and encouraging coughing helps to mobilize them. Increasing oxygen flow rate may be necessary but isn't the primary intervention for copious secretions. 10. **c) Bradycardia.** Pneumonia typically causes tachycardia (increased heart rate) due to infection and inflammation. 11. **c) Smoking.** Smoking is the leading cause of chronic respiratory problems, including COPD, lung cancer, and emphysema. 12. **d) All of the above.** All these measures are effective in preventing the spread of respiratory infections. 13. **d) All of the above.** All these elements are crucial for effective asthma management. 14. **d) All of the above.** These are all common signs of a pneumothorax. 15. **c) Ischemic stroke.** Sudden unilateral weakness and slurred speech are classic signs of an ischemic stroke (CVA). 16. **b) Assist the patient with meals and provide thickened liquids.** Thickened liquids prevent aspiration, a common risk with dysphagia (difficulty swallowing). 17. **c) Shortness of breath** While shortness of breath can occur in MS due to complications, it is not a common primary symptom. 18. **b) Ischemic stroke.** TIA is a transient ischemic attack, a mini-stroke, increasing the risk of a full ischemic stroke. 19. **c) Protect the patient from injury.** Protecting the patient from injury during a seizure is the priority. Restraining is not recommended, and placing anything in the mouth is dangerous. 20. **d) Sudden loss of consciousness.** Sudden loss of consciousness is not a typical symptom of a migraine; it's more indicative of other neurological events. 21. **d) All of the above.** These are all commonly used to treat migraine headaches, depending on the severity and patient factors. 22. **d) All of the above.** These are all important steps in MDI use to optimize medication delivery and minimize side effects. 23. **c) Smoking cessation.** Smoking cessation is paramount for managing COPD long- term, as smoking is the primary cause. 24. **d) All of the above.** These assessments are crucial to evaluate the severity and progression of pneumonia. 25. **a) Importance of completing the entire course of antibiotics.** Incomplete treatment leads to drug resistance and relapse. 26. **d) All of the above.** These are all potential complications following tracheostomy placement. 27. **d) All of the above.** These are essential assessments for patients receiving oxygen therapy. 28. **d) All of the above.** These interventions help to clear the airways and improve breathing. 29. **a) Dry mouth.** Anticholinergics block acetylcholine, leading to reduced secretions, including saliva. 30. **c) Short-acting beta-agonists** (SABAs) SABAs provide rapid bronchodilation in acute exacerbations. 31. **c) Sputum culture** A sputum culture is the definitive diagnostic test for TB, identifying the bacteria. 32. **d) All of the above** These are all signs indicating that a child is having difficulty breathing. 33. **d) All of the above** These are potential complications of long-term oxygen therapy. 34. **b) Pancreatic insufficiency** CF affects the pancreas, leading to insufficient enzyme production, impacting nutrient absorption.