All NCLEX Resources
Example Questions
Example Question #1 : Identifying Respiratory Conditions
Which of the following organisms causes whooping cough?
Haemophilus influenzae
Human respiratory syncytial virus (RSV)
Klebsiella pneumoniae
Bordetella pertussis
Bordetella pertussis
Whooping cough, a condition that results in severe paroxysmal coughing fits followed by a long wheezing inspiratory gasp (the "whoop") is caused by the bacteria Bordetella pertussis. Haemophilus influenzae and Klebsiella pneumoniae both commonly cause pneumonia, and RSV is a virus that is frequently implicated in lower respiratory infections of infants and children.
Example Question #1 : Identifying Respiratory Conditions
In pertussis, what stage follows the incubation (also known as the catarrhal) stage?
The acute stage
The convalescent stage
The paroxysmal stage
The whooping stage
The paroxysmal stage
After the catarrhal stage, an individual with pertussis will progress into the paroxysmal stage. It's during this stage that they will experience uncontrollable fits of 5-15 forceful coughs, followed by a "whoop" or gasp as they struggle to inhale. The force of these coughs can be such that they can result in vomiting, epistaxis, subconjunctival hemorrhage, or even broken ribs.
Example Question #53 : Conditions And Treatments
How long is the incubation period for pertussis?
4-6 weeks
2-7 days
1-3 weeks
2-3 months
1-3 weeks
The incubation period for pertussis, also known as the catarrhal stage, can last as little as 4 days or as long as 42 days, but a typical period is 1-3 weeks. During this stage the disease looks like a regular upper respiratory infection, with sneezing, mild cough, and runny nose. The infected individual is highly infectious at this time, with bacteria spread by airborne droplets after sneezing or cough.
Example Question #861 : Nclex
You are the nurse taking care of a 40-year old African-American female who complains of fatigue and shortness of breath. Her physical exam is remarkable for erythema nodosum on the bilateral lower extremities. A chest x-ray is performed that demonstrates bilateral hilar infiltrates. She lives and works in a suburb, has not traveled outside of the United States recently, and does not work in a healthcare setting. Which of the following is the most likely diagnosis?
Lung cancer
Meningitis
Tuberculosis
Sarcoidosis
Pharyngitis
Sarcoidosis
The correct answer is "Sarcoidosis." Sarcoidosis is the correct answer as this inflammatory condition is frequently found in African-American women in their 40's who present with fatigue and shortness of breath among other symptoms, who also have erythema nodosum on the lower extremities, and have bilateral hilar infiltrates on chest x-ray. This constellation of findings is highly suggestive of sarcoidosis. Sarcoidosis results in the formation of numerous non-necrotizing granulomas, most commonly found in the lungs, that can play a role in the symptoms experienced by these patients. Other findings suggestive of sarcoidosis include elevated serum calcium levels with normal serum PTH levels.
Tuberculosis can present in a similar manner to sarcoidosis, however given the patient's suburban living environment, lack of a travel history, and lack of healthcare exposure, the likelihood of being exposed to tuberculosis is very low, making sarcoidosis a more likely etiology.
While lung cancer can present as shortness of breath with hilar infiltration in chest x-ray, in a relatively young otherwise healthy patient who also has erythema nodosum and in whom the hilar infiltrates are bilateral, sarcoidosis would be a more likely etiology.
The patient does not have any findings consistent with meningitis (leg rash in meningitis is petechial, not erythema nodosum) or pharyngitis.
Example Question #1 : Causes And Treatments Of Respiratory Conditions
What is the "hygiene hypothesis" in asthma?
Keeping children's hands clean will reduce asthma rates
Frequent bathing can reduce the severity of asthma attacks
Dirty water is responsible for many cases of asthma in the developing world
Exposing children to pathogens at a young age will decrease their risk for asthma
Exposing children to pathogens at a young age will decrease their risk for asthma
Incidence of asthma is lower in populations exposed to an abundance of microbes from a young age. The "hygiene hypothesis" suggests that early immune stimulation by multiple forms of infectious agents may push a Th1 phenotype, reducing the Th2 (allergic) response.
Example Question #61 : Conditions And Treatments
All of the following are common triggers for asthma except __________.
emotional stress or excitement
squatting
exercise
cold air
squatting
The most commonly reported triggers for asthma attacks are cold air, emotional stress or excitement, infection, irritants such as pollen or dust mites, and exercise. Other triggers may include lying down, exposure to cigarette smoke, or acid reflux.
Example Question #2 : Respiratory Conditions
A patient has been administered isoniazid for the treatment of tuberculosis (TB). Which statement made by the nurse would be the most appropriate when teaching the client about this medication?
"This medication is known to cause peripheral neuropathy and therefore it is necessary to give pyridoxine prophylactically."
"This medication must be taken twice daily for 9–12 months."
"This medication must be given by DOT – directly observed therapy."
"This medication is expensive and may only be taken subcutaneously."
"This medication is associated with color blindness."
"This medication is known to cause peripheral neuropathy and therefore it is necessary to give pyridoxine prophylactically."
Isoniazid is a bactericidal drug that is given for tuberculosis that has several adverse effects including peripheral neuropathy. This drug is usually administered in conjunction to other antitubercular drugs. Pyridoxine (vitamin B6) is recommended to be taken in conjunction with isoniazid to prevent neurotoxicity.
Isoniazid is relatively inexpensive and may be taken orally or intravenously. It is not necessary to be taken under direct observation, and is usually dosed according to type of disease (active versus latent). The typical duration of administration is roughly 26 weeks. Color blindness is not associated with isoniazid treatment.
Example Question #3 : Respiratory Conditions
All of the following changes may be seen in chronic asthma except __________.
destruction of alveolar septa and pulmonary capillaries
deposition of subepithelial collagen
destruction of alveolar septa and pulmonary capillaries
Chronic asthma can result in a situation referred to as "airway remodeling," typified by the following changes: increased airway vascularity, epithelial desquamation, deposition of subepithelial collagen, and hypertrophy and hyperplasia of mucus glands and of the underlying muscle layer.
Destruction of alveolar septa and pulmonary capillaries is a common finding in emphysema and does not present in asthma.
Example Question #864 : Nclex
At what stage are antibiotics effective in treatment of pertussis?
Up to 8 weeks
Up to 2 weeks
Up to 6 weeks
Up to 4 weeks
Up to 4 weeks
Antibiotics have been shown to have very little effectiveness in treating a pertussis infection older than four weeks. Because of this, treatment with antibiotics to individuals that have been symptomatic for longer than four weeks is not generally recommended.
Example Question #861 : Nclex
A client is admitted to the ICU with acute respiratory distress syndrome (ARDS). The client has a recent history of bacterial pneumonia that has worsened and is at risk for hypoxemia.
All of the following interventions apply to treatment for acute respiratory distress syndrome (ARDS) except __________.
daily weight should be taken to monitor fluid status
client may be placed in the prone position to increase the PaO2
parenteral or enteral feeding will be necessary to meet high energy demands
an arterial catheter may be inserted to allow for blood pressure monitoring and ABG (arterial blood gas) blood sampling
the client should be given the highest concentration of oxygen that will yield a PaO2 of 60 mmHg or greater
the client should be given the highest concentration of oxygen that will yield a PaO2 of 60 mmHg or greater
The oxygen concentration should be the lowest possible, due to the risk of oxygen toxicity seen in clients with FIO2 (fraction of inspired oxygen) levels exceeding 60% for more than 48 hours.