Question 1

When an individual acquires pneumonia <48 hours after hospital admission, it is considered&#10;A) Hospital-acquired pneumonia&#10;B) Health-care-associated pneumonia&#10;C) Community-acquired pneumonia&#10;D) Ventilator-associated pneumonia

Accepted Answer

Pneumonia acquired <48 hours after hospital admission or while living in an assisted or long-term care facility is considered health-care-associated pneumonia. An infection is considered hospital acquired if it occurs >48 hours after hospital admission.

Question 2

Which structure is not part of the lower respiratory tract?&#10;A) Trachea&#10;B) Larynx&#10;C) Bronchi&#10;D) Alveolar ducts

Accepted Answer

The lower respiratory tract consists of the trachea, bronchi, bronchioles, and alveolar ducts. The larynx is part of the upper respiratory tract.

Question 3

The physiological process of respiration is&#10;A) The mechanical movement of air in and out of the lungs&#10;B) The transfer and movement of oxygen and carbon dioxide in the blood&#10;C) The cellular process of oxygen and carbon dioxide exchange&#10;D) The dilation and constriction of airways in the lungs

Accepted Answer

Respiration is the cellular process of oxygen and carbon dioxide exchange. Ventilation is the mechanical movement of air in and out of the lungs.

Question 4

Which type of cell triggers capillary leakage of red blood cells, edema, and the accumulation of exudate in the alveoli during the inflammatory response?&#10;A) T cells&#10;B) B cells&#10;C) Macrophages&#10;D) Neutrophils

Accepted Answer

During the inflammatory response, neutrophils accumulate at the area of inflammation and trigger capillary leakage of red blood cells, edema, and exudate in the alveoli.

Question 5

Which process occurs during the first stage of pneumonia?&#10;A) A solid mass forms as fibrin, neutrophils, and red blood cells consolidate.&#10;B) Alveolar walls thicken, and diffusion of oxygen and carbon dioxide in the alveoli is compromised.&#10;C) Vital capacity is diminished, and atelectasis occurs.&#10;D) Capillaries begin to leak, and fibrin is formed.

Accepted Answer

During the first stage of pneumonia, congestion occurs due to the thickening of alveolar walls, and the diffusion of oxygen and carbon dioxide in the alveoli is compromised, causing hypoxemia.

Question 6

When conducting a physical assessment of the respiratory system, which should be done first?&#10;A) Observe the rate and rhythm of respirations.&#10;B) Auscultate over the bronchial and peripheral lung fields.&#10;C) Palpate the area for deformities.&#10;D) Perform posterior percussion of the lung fields.

Accepted Answer

When conducting any physical assessment, inspection should be the first step. Inspection of the respiratory system includes observing the rate and rhythm of respiration, the effort of breathing, and the depth of inspiration.

Question 7

A patient has a chest x-ray 24 hours after first experiencing symptoms of pneumonia. What would the nurse practitioner expect to see on the chest x-ray?&#10;A) Pulmonary infiltrates and fibrosis&#10;B) Calcified pleural plaques&#10;C) Dense, white area of consolidation&#10;D) Diffuse pleural thickening

Accepted Answer

Pneumonia typically appears as a dense, white area of consolidation on a chest x-ray. The density may not be visible until 12 to 48 hours after the first symptoms of pneumonia.

Question 8

When using the CURB-65 tool, the nurse practitioner determines that a 60-year-old patient who is alert and oriented, has a respiratory rate of 25, BUN of 21 mg/dL, and blood pressure of 95/65 would fall under which category?

A) Score of 0; home management is recommended
B) Score of 1; home management is recommended
C) Score of 2; hospitalization is recommended
D) Score of 3; hospitalization is recommended

Accepted Answer

The CURB-65 tool assigns points if a patient has new onset of confusion, elevated BUN (>20mg/dL), rapid respiratory rate (?30/minute), low blood pressure (<90 mmHg systolic or ?60 mmHg diastolic), and age ?65 years. A score of 0 to 1 indicates home management is safe, and a score ?3 indicates a need for hospitalization.

Question 9

Which results should be obtained before the first dose of antibiotics is administered?&#10;A) Complete blood count&#10;B) Allergy test&#10;C) Basic metabolic panel&#10;D) Culture and sensitivity

Accepted Answer

Culture and sensitivity is a test that identifies the causative bacteria of an infection and confirms which antibiotic would be most effective. It is important that these results are reviewed prior to antibiotic treatment.

Question 10

How often should a patient with pneumonia use their incentive spirometer?&#10;A) Twice a day&#10;B) Three times a day&#10;C) Every hour while awake&#10;D) Every other hour while awake

Accepted Answer

A patient with pneumonia should be encouraged to use their incentive spirometer every hour while awake.

Question 11

The PPSV23 vaccine should be recommended for&#10;A) Individuals 50 and older who have medical conditions&#10;B) Individuals 65 and older who have medical conditions&#10;C) Individuals 65 and older who have not received the PCV13 vaccine&#10;D) Individuals 65 and older regardless of receiving the PCV13 vaccine

Accepted Answer

The answer of The PPSV23 vaccine should be recommended for&#10;A)...

Question 12

Older adults are at higher risk of developing pneumonia due to&#10;A) Increased action of cilia&#10;B) Changes in the function of alveolar macrophages&#10;C) Constriction of the alveolar ducts and bronchioles&#10;D) Increased chest wall elasticity

Accepted Answer

The answer of Older adults are at higher risk of...

Question 13

Which pathogen is associated with hospital-acquired pneumonia?&#10;A) Klebsiella&#10;B) Streptococcus pneumoniae&#10;C) Haemophilus influenzae&#10;D) Pneumocystis jirovecii

Accepted Answer

The answer of Which pathogen is associated with hospital-acquired pneumonia?&#10;A)...

Question 14

Vancomycin should not be administered rapidly due to the potential of causing which side effect?&#10;A) Stevens-Johnson syndrome&#10;B) Red Man syndrome&#10;C) Tendon rupture&#10;D) Clostridium difficile-associated diarrhea (CDAD)

Accepted Answer

The answer of Vancomycin should not be administered rapidly due...

Question 15

When referring to Case Study 5 (Geriatric): Osteoporosis, which is considered an etiology for secondary osteoporosis?&#10;A) Genetics&#10;B) Lack of sunlight exposure&#10;C) Low level of vitamin D&#10;D) Bowel conditions

Accepted Answer

The answer of When referring to Case Study 5 (Geriatric):...

Deck 21: Pneumonia