NU NUR 330 Module 6 (pdf) | 2026/2027 | Nursing Care of Adults and
Older Adults I Q&A | Nursing
1. A nurse is caring for an older adult patient who has been hospitalized for
an acute exacerbation of chronic obstructive pulmonary disease (COPD). The
patient's arterial blood gas (ABG) results show a pH of 7.31, PaCO2 of 58
mmHg, and HCO3 of 26 mEq/L. The nurse interprets these findings as:
A) Uncompensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Fully compensated respiratory acidosis
D) Uncompensated metabolic acidosis
Correct Answer: Partially compensated respiratory acidosis
Rationale: The pH is low (acidosis), and the PaCO2 is elevated, indicating a
respiratory cause. The HCO3 is slightly elevated, suggesting the kidneys are
attempting to compensate; however, because the pH remains below normal,
this is a partially compensated respiratory acidosis.
2. A nurse is developing a teaching plan for a patient with COPD. Which of
the following statements by the patient indicates an accurate understanding
of the disease process?
A) "I should limit my fluid intake to prevent excess mucus production."
B) "My condition is completely reversible with proper treatment."
C) "I should use pursed-lip breathing during times of shortness of breath."
D) "I will only need to use my inhalers when I feel short of breath."
Correct Answer: "I should use pursed-lip breathing during times of shortness
of breath."
,Rationale: Pursed-lip breathing helps keep airways open longer, which is
beneficial for patients with COPD. The disease is not completely reversible,
fluids should be encouraged to thin secretions, and inhalers are often used
regularly, not just as needed.
3. A nurse is assessing a patient with an acute asthma exacerbation. Which
of the following findings is most indicative of a severe attack?
A) Use of accessory muscles and inability to speak in full sentences
B) Expiratory wheezes audible without a stethoscope
C) Respiratory rate of 24 breaths per minute
D) Oxygen saturation of 94% on room air
Correct Answer: Use of accessory muscles and inability to speak in full
sentences
Rationale: The use of accessory muscles and an inability to speak in full
sentences are signs of severe respiratory distress. While expiratory wheezing
is common, it may be absent in a severe attack ("silent chest"). A respiratory
rate of 24 is elevated but not as critical.
4. A patient with COPD is receiving oxygen via nasal cannula at 2 L/min. The
nurse should monitor the patient for which complication related to oxygen
therapy?
A) Oxygen toxicity
B) Carbon dioxide narcosis
C) Respiratory alkalosis
D) Pulmonary fibrosis
Correct Answer: Carbon dioxide narcosis
,Rationale: In some patients with COPD, the drive to breathe is stimulated by
hypoxia rather than hypercapnia. High-flow oxygen can eliminate this
hypoxic drive, leading to hypoventilation and carbon dioxide retention, which
can progress to carbon dioxide narcosis.
5. A nurse is preparing to administer a bronchodilator via metered-dose
inhaler (MDI) to a patient with asthma. Which of the following actions is most
important to ensure proper medication delivery?
A) Instruct the patient to exhale completely before activating the inhaler
B) Administer two puffs with a single inhalation
C) Have the patient hold the breath for 10 seconds after inhalation
D) Shake the inhaler vigorously for 30 seconds before use
Correct Answer: Have the patient hold the breath for 10 seconds after
inhalation
Rationale: Holding the breath for 10 seconds after inhalation allows the
medication to be deposited in the airways. Shaking the inhaler for a few
seconds is sufficient, and the patient should inhale slowly. Only one puff
should be inhaled at a time.
6. A patient with a history of smoking is diagnosed with community-acquired
pneumonia. The nurse anticipates that the patient's sputum culture will most
likely reveal which organism?
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Legionella pneumophila
Correct Answer: Streptococcus pneumoniae
, Rationale: Streptococcus pneumoniae is the most common cause of
community-acquired pneumonia in adults. While the other organisms can
cause pneumonia, S. pneumoniae is the most frequently identified pathogen.
7. A nurse is caring for a patient with active tuberculosis (TB). Which of the
following precautions is most important to prevent the transmission of
infection?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
Correct Answer: Airborne precautions
Rationale: Tuberculosis is transmitted via airborne droplet nuclei, requiring
airborne precautions, including a negative-pressure room and the use of an
N95 respirator. Contact and droplet precautions are for other types of
infections.
8. A patient with active TB is prescribed a four-drug regimen. The nurse
should instruct the patient that the treatment will last for at least:
A) 2 weeks
B) 6 to 12 months
C) 6 weeks
D) 2 years
Correct Answer: 6 to 12 months
Older Adults I Q&A | Nursing
1. A nurse is caring for an older adult patient who has been hospitalized for
an acute exacerbation of chronic obstructive pulmonary disease (COPD). The
patient's arterial blood gas (ABG) results show a pH of 7.31, PaCO2 of 58
mmHg, and HCO3 of 26 mEq/L. The nurse interprets these findings as:
A) Uncompensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Fully compensated respiratory acidosis
D) Uncompensated metabolic acidosis
Correct Answer: Partially compensated respiratory acidosis
Rationale: The pH is low (acidosis), and the PaCO2 is elevated, indicating a
respiratory cause. The HCO3 is slightly elevated, suggesting the kidneys are
attempting to compensate; however, because the pH remains below normal,
this is a partially compensated respiratory acidosis.
2. A nurse is developing a teaching plan for a patient with COPD. Which of
the following statements by the patient indicates an accurate understanding
of the disease process?
A) "I should limit my fluid intake to prevent excess mucus production."
B) "My condition is completely reversible with proper treatment."
C) "I should use pursed-lip breathing during times of shortness of breath."
D) "I will only need to use my inhalers when I feel short of breath."
Correct Answer: "I should use pursed-lip breathing during times of shortness
of breath."
,Rationale: Pursed-lip breathing helps keep airways open longer, which is
beneficial for patients with COPD. The disease is not completely reversible,
fluids should be encouraged to thin secretions, and inhalers are often used
regularly, not just as needed.
3. A nurse is assessing a patient with an acute asthma exacerbation. Which
of the following findings is most indicative of a severe attack?
A) Use of accessory muscles and inability to speak in full sentences
B) Expiratory wheezes audible without a stethoscope
C) Respiratory rate of 24 breaths per minute
D) Oxygen saturation of 94% on room air
Correct Answer: Use of accessory muscles and inability to speak in full
sentences
Rationale: The use of accessory muscles and an inability to speak in full
sentences are signs of severe respiratory distress. While expiratory wheezing
is common, it may be absent in a severe attack ("silent chest"). A respiratory
rate of 24 is elevated but not as critical.
4. A patient with COPD is receiving oxygen via nasal cannula at 2 L/min. The
nurse should monitor the patient for which complication related to oxygen
therapy?
A) Oxygen toxicity
B) Carbon dioxide narcosis
C) Respiratory alkalosis
D) Pulmonary fibrosis
Correct Answer: Carbon dioxide narcosis
,Rationale: In some patients with COPD, the drive to breathe is stimulated by
hypoxia rather than hypercapnia. High-flow oxygen can eliminate this
hypoxic drive, leading to hypoventilation and carbon dioxide retention, which
can progress to carbon dioxide narcosis.
5. A nurse is preparing to administer a bronchodilator via metered-dose
inhaler (MDI) to a patient with asthma. Which of the following actions is most
important to ensure proper medication delivery?
A) Instruct the patient to exhale completely before activating the inhaler
B) Administer two puffs with a single inhalation
C) Have the patient hold the breath for 10 seconds after inhalation
D) Shake the inhaler vigorously for 30 seconds before use
Correct Answer: Have the patient hold the breath for 10 seconds after
inhalation
Rationale: Holding the breath for 10 seconds after inhalation allows the
medication to be deposited in the airways. Shaking the inhaler for a few
seconds is sufficient, and the patient should inhale slowly. Only one puff
should be inhaled at a time.
6. A patient with a history of smoking is diagnosed with community-acquired
pneumonia. The nurse anticipates that the patient's sputum culture will most
likely reveal which organism?
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Legionella pneumophila
Correct Answer: Streptococcus pneumoniae
, Rationale: Streptococcus pneumoniae is the most common cause of
community-acquired pneumonia in adults. While the other organisms can
cause pneumonia, S. pneumoniae is the most frequently identified pathogen.
7. A nurse is caring for a patient with active tuberculosis (TB). Which of the
following precautions is most important to prevent the transmission of
infection?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
Correct Answer: Airborne precautions
Rationale: Tuberculosis is transmitted via airborne droplet nuclei, requiring
airborne precautions, including a negative-pressure room and the use of an
N95 respirator. Contact and droplet precautions are for other types of
infections.
8. A patient with active TB is prescribed a four-drug regimen. The nurse
should instruct the patient that the treatment will last for at least:
A) 2 weeks
B) 6 to 12 months
C) 6 weeks
D) 2 years
Correct Answer: 6 to 12 months
