Question 1

Which of the following pulmonary infections is most commonly seen in patients with AIDS?&#10;A) Anaerobic&#10;B) Pneumocystis jiroveci&#10;C) Streptococcus pneumoniae (Diplococcus pneumoniae)&#10;D) Legionella pneumophila

Accepted Answer

Historically, the fungus Pneumocystis jiroveci has caused most cases of pneumonia in AIDS patients. Because AIDS patients have a compromised immune system, they are prone to many other infectious organisms.

Question 2

Ventilator-acquired pneumonia (VAP) is defined as pneumonia that develops:&#10;A) between 24 and 48 hours after endotracheal intubation.&#10;B) more than 48 to 72 hours after endotracheal intubation.&#10;C) less than 24 hours after mechanical ventilation is started.&#10;D) more than 48 to 72 hours after mechanical ventilation is started.

Accepted Answer

When a patient is intubated and develops pneumonia more than 48 to 72 hours later, he or she is found to have VAP. The patient may not actually need mechanical ventilation. The likely cause of the pneumonia is microaspiration of oral secretions around the endotracheal tube cuff.

Question 3

All of the following are considered to be normal causative agents for community-acquired pneumonia (CAP) EXCEPT:&#10;A) staphylococcal pneumonia.&#10;B) Haemophilus influenza.&#10;C) Legionella pneumophila.&#10;D) Candida albicans.

Accepted Answer

Staphylococcal pneumonia, Haemophilus influenza, and Legionella pneumophila are all causes of community-acquired pneumonia. Candida albicans is an opportunistic yeast infection.

Question 4

A 28-year-old patient who has dogs, parakeets, and cats as pets has been admitted with pneumonia. It is suspected that she acquired the infection from one of her pets. What organism is likely to be found in her sputum?

A) Bacteroides melaninogenicus
B) Staphylococcus aureus
C) Chlamydia psittaci
D) Haemophilus influenzae

Accepted Answer

C. psittaci bacteria are found in the feces of parakeets and other birds. When parakeet feces are dried, aerosolized, and inhaled, pneumonia can result. Although the other organisms can cause pneumonia, they are not associated with household pets.

Question 5

Overall, most cases of pneumonia are caused by:&#10;A) viruses.&#10;B) gram-negative bacteria.&#10;C) protozoa.&#10;D) fungi.

Accepted Answer

About half of all pneumonia cases are caused by viruses.

Question 6

When a patient has pneumonia, which of the following would be found in the alveolar effusion fluids?
1) Mucus
2) Serum fluid
3) Saliva
4) Red blood cells

A) 1, 3
B) 2, 4
C) 2, 3
D) 1, 2, 3, 4

Accepted Answer

During the inflammatory processes found with pneumonia, the effusion fluids in the alveoli will contain serum fluid, red blood cells, and polymorphonuclear leukocytes and macrophages. Saliva is found in the mouth, and mucus is found in the airways. Neither will be found in the alveoli.

Question 7

A patient has bilateral pneumonia. What findings can be expected on the CT scan?
1) Depressed diaphragms
2) Elongated heart
3) Air bronchograms
4) Consolidation

A) 3, 4
B) 1, 2
C) 2, 3, 4
D) 1, 2, 3, 4

Accepted Answer

Frequently, the CT scan results on a patient with pneumonia will show air bronchograms and consolidation because the alveoli are filled with fluids while the airways are patent. Depressed diaphragms and elongated heart are seen in patients with COPD because of air trapping.

Question 8

Which of the following can cause pneumonia?&#10;1) Bacteria&#10;2) Viruses&#10;3) Prions&#10;4) Fungi&#10;A) 1, 2&#10;B) 2, 3&#10;C) 1, 2, 4&#10;D) 1, 2, 3, 4

Accepted Answer

Many types of bacteria, viruses, and fungi can cause pneumonia. Prions are associated with some neurologic conditions, but not pneumonia.

Question 9

Physical assessment findings on a patient with pneumonia would include all of the following EXCEPT:&#10;A) bradycardia.&#10;B) whispered pectoriloquy.&#10;C) dull percussion note.&#10;D) increased vocal fremitus.

Accepted Answer

Patients with pneumonia usually have tachycardia, not bradycardia. Whispered pectoriloquy, dull percussion note, and increased vocal fremitus are all the result of alveolar consolidation.

Question 10

A patient has a pleural effusion related to her pneumonia. Which of the following should the respiratory therapist recommend to treat the pleural effusion?&#10;A) Hyperinflation therapy&#10;B) Supplemental oxygen&#10;C) Thoracentesis&#10;D) Percussion and postural drainage

Accepted Answer

The thoracentesis procedure involves placing a needle through the chest wall to withdraw the pleural effusion fluid. This allows the lung to reexpand. Although the other listed options may be used in the care of a patient with pneumonia, they will not help to remove the pleural fluid.

Question 11

If a patient has pneumonia, which of the following can increase the risk of life-threatening illness or death?
1) Weakened immune system
2) COPD
3) Marfan's syndrome
4) Heart disease

A) 1, 3
B) 2, 4
C) 1, 2, 3
D) 1, 2, 4

Accepted Answer

The answer of If a patient has pneumonia, which of...

Question 12

A patient has a bacterial pneumonia. What kills the invading bacteria?&#10;A) Macrophages&#10;B) Red blood cells&#10;C) Polymorphonuclear leukocytes&#10;D) Serum fluid

Accepted Answer

The answer of A patient has a bacterial pneumonia. What...

Deck 16: Pneumonia