Comprehensive MDC III Exam 2 Study
Guide: NCLEX-Style Questions with
Detailed Rationales
1. A client with chronic bronchitis often shows signs of hypoxia. Which
of the following is the priority to monitor for in this client?
A. O2 levels
B. Barrel chest
C. Nutritional status
D. Clubbing of fingers
Answer: A. O2 levels
Rationale: In chronic bronchitis, hypoxia is a primary concern due to chronic
inflammation and mucus production obstructing airways. Monitoring
oxygen saturation is the priority to prevent complications like respiratory
failure. Barrel chest and clubbing are late findings, while nutritional status is
important but not the priority.
2. Which of the following positions offers NO benefit to relieve
dyspnea in a client with chronic airflow limitation?
A. Sitting at the edge of the chair, leaning forward with arms folded
and resting on a table
B. Low semi-reclining positions with shoulders back and neck apart
, C. Leaning forward in a chair with feet spread apart and elbows placed
on knees
D. Upright with head slightly flexed, feet spread apart, and shoulders
relaxed
Answer: B. Low semi-reclining positions with shoulders back and neck
apart
Rationale: The tripod position (A, C, D) helps relieve dyspnea by allowing
accessory muscles to assist with breathing. A low semi-reclining position
does not provide the same mechanical advantage and may actually impede
diaphragmatic movement.
3. A nurse is helping a client learn about managing their asthma. What
should the nurse instruct the client to do?
A. Keep a symptom diary to identify what triggers asthma attacks
B. Make an appointment with an allergist for allergies
C. Take low-dose aspirin daily for anti-inflammatory action
D. Drink large amounts of clear fluid to keep mucus thin
Answer: A. Keep a symptom diary to identify what triggers asthma
attacks
Rationale: Identifying triggers is fundamental to asthma self-management.
A symptom diary helps clients recognize patterns and avoid triggers.
Aspirin can trigger asthma in some patients. Fluid intake is helpful but not
the priority teaching point.
,4. A patient with cystic fibrosis is admitted to the medical-surgical unit
for elective surgery. Which infection control measure is best?
A. Place 2 clients with CF in the same room
B. Standard precautions, including handwashing, are sufficient
C. Client placed on contact isolation
D. Measures that limit close contact between 2 people with CF are
needed
Answer: D. Measures that limit close contact between 2 people with CF
are needed
Rationale: Patients with cystic fibrosis are at risk for cross-infection with
Burkholderia cepacia and Pseudomonas aeruginosa. They should not share
rooms or have close contact with other CF patients.
5. What precautions are used for a patient with tuberculosis? (Select all
that apply)
A. Airborne precautions
B. N95 respirator
C. Negative pressure room
D. Contact precautions
E. Standard precautions
Answer: A, B, C
Rationale: TB requires airborne precautions, including an N95 respirator and
a negative pressure room. Contact precautions are not required for TB.
, 6. Which medications are used to treat tuberculosis? (Select all that
apply)
A. Isoniazid
B. Rifampin
C. Pyrazinamide
D. Ethambutol
E. Acyclovir
Answer: A, B, C, D
Rationale: The first-line anti-TB medications include isoniazid, rifampin,
pyrazinamide, and ethambutol. These are typically taken for 6-9 months.
7. A patient with TB asks how long they will need to take their
medications. What is the correct response?
A. 2-4 weeks
B. 6-9 months
C. 1 year
D. Lifelong
Answer: B. 6-9 months
Rationale: TB treatment typically requires 6-9 months of multidrug therapy
to completely eradicate the bacteria and prevent drug resistance.
8. What patient education should be provided to a client taking anti-
TB medications? (Select all that apply)
Guide: NCLEX-Style Questions with
Detailed Rationales
1. A client with chronic bronchitis often shows signs of hypoxia. Which
of the following is the priority to monitor for in this client?
A. O2 levels
B. Barrel chest
C. Nutritional status
D. Clubbing of fingers
Answer: A. O2 levels
Rationale: In chronic bronchitis, hypoxia is a primary concern due to chronic
inflammation and mucus production obstructing airways. Monitoring
oxygen saturation is the priority to prevent complications like respiratory
failure. Barrel chest and clubbing are late findings, while nutritional status is
important but not the priority.
2. Which of the following positions offers NO benefit to relieve
dyspnea in a client with chronic airflow limitation?
A. Sitting at the edge of the chair, leaning forward with arms folded
and resting on a table
B. Low semi-reclining positions with shoulders back and neck apart
, C. Leaning forward in a chair with feet spread apart and elbows placed
on knees
D. Upright with head slightly flexed, feet spread apart, and shoulders
relaxed
Answer: B. Low semi-reclining positions with shoulders back and neck
apart
Rationale: The tripod position (A, C, D) helps relieve dyspnea by allowing
accessory muscles to assist with breathing. A low semi-reclining position
does not provide the same mechanical advantage and may actually impede
diaphragmatic movement.
3. A nurse is helping a client learn about managing their asthma. What
should the nurse instruct the client to do?
A. Keep a symptom diary to identify what triggers asthma attacks
B. Make an appointment with an allergist for allergies
C. Take low-dose aspirin daily for anti-inflammatory action
D. Drink large amounts of clear fluid to keep mucus thin
Answer: A. Keep a symptom diary to identify what triggers asthma
attacks
Rationale: Identifying triggers is fundamental to asthma self-management.
A symptom diary helps clients recognize patterns and avoid triggers.
Aspirin can trigger asthma in some patients. Fluid intake is helpful but not
the priority teaching point.
,4. A patient with cystic fibrosis is admitted to the medical-surgical unit
for elective surgery. Which infection control measure is best?
A. Place 2 clients with CF in the same room
B. Standard precautions, including handwashing, are sufficient
C. Client placed on contact isolation
D. Measures that limit close contact between 2 people with CF are
needed
Answer: D. Measures that limit close contact between 2 people with CF
are needed
Rationale: Patients with cystic fibrosis are at risk for cross-infection with
Burkholderia cepacia and Pseudomonas aeruginosa. They should not share
rooms or have close contact with other CF patients.
5. What precautions are used for a patient with tuberculosis? (Select all
that apply)
A. Airborne precautions
B. N95 respirator
C. Negative pressure room
D. Contact precautions
E. Standard precautions
Answer: A, B, C
Rationale: TB requires airborne precautions, including an N95 respirator and
a negative pressure room. Contact precautions are not required for TB.
, 6. Which medications are used to treat tuberculosis? (Select all that
apply)
A. Isoniazid
B. Rifampin
C. Pyrazinamide
D. Ethambutol
E. Acyclovir
Answer: A, B, C, D
Rationale: The first-line anti-TB medications include isoniazid, rifampin,
pyrazinamide, and ethambutol. These are typically taken for 6-9 months.
7. A patient with TB asks how long they will need to take their
medications. What is the correct response?
A. 2-4 weeks
B. 6-9 months
C. 1 year
D. Lifelong
Answer: B. 6-9 months
Rationale: TB treatment typically requires 6-9 months of multidrug therapy
to completely eradicate the bacteria and prevent drug resistance.
8. What patient education should be provided to a client taking anti-
TB medications? (Select all that apply)
