NCLEX : NCLEX
Study concepts, example questions & explanations for NCLEX
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Example Questions
Example Question #1 : Causes And Treatments Of Respiratory Conditions
A young male presents to the emergency department after a motor vehicle accident. Upon examination it is found that the client will require a chest tube to re-inflate his collapsed lung.
All of the following correctly describe how a chest tube is placed except which of these?
If air is to be removed the chest tube is placed inferiorly and posteriorly.
If performed at bedside sterile technique must be utilized.
During insertion the tubes are to be clamped, once in the plural space they are connected and unclamped at that time.
After placement, the tube is sutured to the chest wall and a dressing applied.
A common location utilized for insertion is the fifth intercostal - midaxillary line.
If air is to be removed the chest tube is placed inferiorly and posteriorly.
The correct placement of tubing includes directing a tube apically to remove air from the pleural space, and to direct the tube that will drain fluids in an inferior and posterior orientation.
Example Question #2 : Causes And Treatments Of Respiratory Conditions
A 45 year old male with COPD presents to the hospital with an exacerbation of his lung condition. He is in respiratory distress and the physician recommends he sit leaning forward. What is the purpose of sitting like this?
To prevent falling
To help exhale air
To help inhale air
To prevent loss of consciousness
To easily cough out secretions
To help exhale air
COPD is a chronic lung condition marked by air trapping. Patients with COPD are instructed to sit in the "tripod" position to help them exhale air. Patients sit and lean forward to help maximize air exiting from the lungs.
Example Question #3 : Causes And Treatments Of Respiratory Conditions
Which of the following best describes the mechanism of albuterol inhalers during an asthma exacerbation?
Beta adrenergic antagonist
Alpha adrenergic agonist
Beta adrenergic agonist
None of these
Alpha adrenergic antagonist
Beta adrenergic agonist
Albuterol is a beta adrenergic agonist. It helps to open up the airways during an asthma exacerbation by activating the beta adrenergic receptors, part of the sympathetic nervous system. Side effects include increased heart rate.
Example Question #1 : Causes And Treatments Of Respiratory Conditions
What is the inspiratory reserve volume?
The amount of air that can be exhaled after normal inhalation
The amount of air available in the lungs after exhalation
The amount of air that can be inhaled after normal inhalation
The normal amount of air that is inhaled with each breath
The total amount of air the lung can contain
The amount of air that can be inhaled after normal inhalation
The inspiratory reserve volume for the average adult is roughly 3100mL. It is tested using pulmonary function tests. The inspiratory reserve volume is the amount of air able to be inhaled after a regular inhalation. This is in contrast to the expiratory reserve volume, which is the amount of air that can be exhaled after a regular exhalation.
Example Question #11 : Causes And Treatments Of Respiratory Conditions
Which of the following side effects would you most likely expect when providing an asthmatic patient with continuous nebulizer therapy?
Tachycardia
Pinpoint pupils
Hyperthermia
Hypothermia
Bradycardia
Tachycardia
Asthma is treated with albuterol. This drug is a beta-2 agonist, which works to relax smooth muscle in the lungs, and open up the airways. A consequence of this drug is the beta-2 effects on the heart. Beta-2 on the heart causes an increase in heart rate (tachycardia) and is a common side effect seen in the treatment of asthmatics.
Example Question #871 : Nclex
You are a pulmonology nurse taking care of a patient who complains of episodic wheezing. You perform a diagnostic test in which you perform pulmonary function tests on the patient before, and after administering albuterol, a beta-2 adrenergic agonist. You note that the patient's symptoms and FEV1 readings improve drastically with bronchodilator administration. Based upon these findings, the patient most likely has which of the following?
Lung Cancer
Sarcoidosis
Chronic Obstructive Pulmonary Disease
Throat Cancer
Asthma
Asthma
The correct answer is "Asthma." This answer is correct because asthma is an inflammatory airway condition that is characteristically improved symptomatically and quantitatively (in terms of pulmonary function tests, including FEV1 readings) with bronchodilator administration (e.g. albuterol, the beta-2 adrenergic agonist administered in this patient). In this patient who presented for evaluation of wheezing, a characteristic symptom of asthma, his substantial response to bronchodilator administration makes the likelihood of an asthma diagnosis very high.
Chronic Obstructive Pulmonary Disease (COPD) is an obstructive physiology of the airways often due to chronic tobacco smoking. While bronchodilators may be of some clinical value in these patients, their FEV1 readings characteristically do not correct after bronchodilator administration, as this is a major method in which COPD can be distinguished from asthma and other inflammatory airway conditions.
Sarcoidosis, lung cancer, and throat cancer symptoms would not necessarily improve with bronchodilator administration, nor would pulmonary function test readings in patients with these conditions.
Example Question #877 : Nclex
A 45-year old obese male with a history of obstructive sleep apnea, hypertension, diabetes, and coronary artery disease presents to your primary care clinic for help in managing his fatigue due to his sleep apnea. He is not a candidate for tonsillectomy and adenoidectomy. Which of the following interventions would be the best recommendation to treat his obstructive sleep apnea?
Insulin
Tamsulosin
Metoprolol
Metformin
Continuous positive airway pressure mask (CPAP)
Continuous positive airway pressure mask (CPAP)
The correct answer is "continuous positive airway pressure mask (CPAP)." This is the correct answer as a CPAP mask helps to force airway into the lungs that is otherwise obstructed by the patient's oropharyngeal anatomy at standard breathing pressures due to obstructive sleep apnea. When wearing a CPAP mask (typically when sleeping), snoring is reduced, and oxygenation is improved, allowing patients to have a more restful sleep and feel less fatigued the following day.
While medications like metoprolol, insulin, and metformin may be beneficial to the patient in treating his conditions co-morbid to obstructive sleep apnea, they do not have a direct effect on treating his sleep apnea or the resultant fatigue.
Tamsulosin is an alpha-adrenergic blocker and can be used to treat benign prostatic hyperplasia among other conditions, but not obstructive sleep apnea.
Example Question #871 : Nclex
Example Question #872 : Nclex
A 63 year old female client is newly admitted to the hospital for pneumococcal pneumonia. The nurse recognizes that this patient will most likely exhibit certain symptoms associated with this condition.
Which clinical findings are most commonly consistent with pneumococcal pneumonia?
Headache, muscle aches, and a cough with frothy pink sputum.
Fever, chills, and a non-productive cough.
Sudden onset of fever, chills, with a productive cough with rust colored sputum.
Slow onset of cough, nasal congestion, sore throat, and fever.
Dry cough with fatigue, nausea and vomiting.
Sudden onset of fever, chills, with a productive cough with rust colored sputum.
Pneumococcal (bacterial) pneumonia typically presents with an abrupt onset of fever, shaking chills, and a productive cough (usually rust in color). Usually viral pneumonias will present with a dry non productive cough and associated with other viral infections.
Example Question #873 : Nclex
What population is most at risk during pertussis infection?
Pregnant women
Infants
Elderly
Adolescents
Infants
Due to their susceptibility to suffocation, infants are more at risk of mortality than older children, pregnant women, or the elderly during pertussis infection. Mortality in infants with this condition can be as high as 2%. There is also an increase in infant co-moridities such as pneumonia, encephalopathy, seizures, and failure to thrive.
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