PN2 FINAL 117 ACTUAL TEST SCRIPT 2026
VERIFIED SOLUTIONS
◉ What should the nurse include when teaching health maintenance
strategies to the client with COPD? Select all that apply.
a. Yearly influenza immunizations
b. Immunization against pneumonia
c. Limitation of physical activity
d. Oral fluid restriction
e. Adequate caloric intake. Answer: Answer: A, B, E; Clients with
COPD are highly susceptible to respiratory infections such as
influenza, so they should be immunized yearly. Clients with COPD
are highly susceptible to respiratory infections such as pneumonia
so they should be immunized as prescribed by their healthcare
provider. Clients with COPD use a large amount of calories because
of labored respiratory function; increased caloric intake is necessary
to maintain a healthy weight. Clients with COPD should undergo a
progressive rehabilitation program to increase their activity
tolerance. Fluid restriction is not needed with COPD unless there is
fluid retention from another etiology.
◉ Pnuemonia. Answer: Infection of lungs that results in fluid build
up in alveoli.
Result of virus, bacteria, fungi, parasites, or chemical agents.
,- Culture before treating so we know how to treat.
◉ Pneumonia (S/S). Answer: Chest pain*
Tachypnea
Hemoptysis
Sputum production
Crackles
Fever
Chills
Cough
◉ CAP, HAP, and VAP?
- What are they?
Hint: Related to pneumonia acquisition.. Answer: Community
Acquired Pneumonia
Hospital Acquired Pneumonia
Ventilator Acquired Pneumonia
- To prevent VAP, mouth care is essential!!
◉ Population at risk for pneumonia. Answer: Young
Elderly
Immunocomprimised
, ◉ A client is hospitalized with a diagnosis of pneumonia. Which
findings, based on the nurse's knowledge, are indicative of a
deteriorating clinical state? Select all that apply.
a. Increased respiratory rate
b. Tachycardia
c. Agitation
d. Cyanosis
e. Increased urinary output. Answer: Answer: A, B, C, D; Increased
respiratory rate, tachycardia, and agitation are early signs of
respiratory distress, and can be interpreted by the nurse as
deteriorating clinical state. Cyanosis develops later in the
progression of respiratory distress, but is still an indication of client
deterioration. Increased urinary output is the opposite of what the
nurse would expect in a client with respiratory distress whose
condition is deteriorating.
◉ A client is scheduled for a partial nephrectomy. In teaching the
client about postoperative care, the nurse uses which rationale to
explain why aggressive measures are needed to prevent atelectasis
and pneumonia?
a. Nephrectomy involves paralyzing the intercostal muscles.
b. Intraoperative surgical contamination of the pulmonary
structures is unavoidable.
c. The client must be maintained in a flat position for 24 hours.
VERIFIED SOLUTIONS
◉ What should the nurse include when teaching health maintenance
strategies to the client with COPD? Select all that apply.
a. Yearly influenza immunizations
b. Immunization against pneumonia
c. Limitation of physical activity
d. Oral fluid restriction
e. Adequate caloric intake. Answer: Answer: A, B, E; Clients with
COPD are highly susceptible to respiratory infections such as
influenza, so they should be immunized yearly. Clients with COPD
are highly susceptible to respiratory infections such as pneumonia
so they should be immunized as prescribed by their healthcare
provider. Clients with COPD use a large amount of calories because
of labored respiratory function; increased caloric intake is necessary
to maintain a healthy weight. Clients with COPD should undergo a
progressive rehabilitation program to increase their activity
tolerance. Fluid restriction is not needed with COPD unless there is
fluid retention from another etiology.
◉ Pnuemonia. Answer: Infection of lungs that results in fluid build
up in alveoli.
Result of virus, bacteria, fungi, parasites, or chemical agents.
,- Culture before treating so we know how to treat.
◉ Pneumonia (S/S). Answer: Chest pain*
Tachypnea
Hemoptysis
Sputum production
Crackles
Fever
Chills
Cough
◉ CAP, HAP, and VAP?
- What are they?
Hint: Related to pneumonia acquisition.. Answer: Community
Acquired Pneumonia
Hospital Acquired Pneumonia
Ventilator Acquired Pneumonia
- To prevent VAP, mouth care is essential!!
◉ Population at risk for pneumonia. Answer: Young
Elderly
Immunocomprimised
, ◉ A client is hospitalized with a diagnosis of pneumonia. Which
findings, based on the nurse's knowledge, are indicative of a
deteriorating clinical state? Select all that apply.
a. Increased respiratory rate
b. Tachycardia
c. Agitation
d. Cyanosis
e. Increased urinary output. Answer: Answer: A, B, C, D; Increased
respiratory rate, tachycardia, and agitation are early signs of
respiratory distress, and can be interpreted by the nurse as
deteriorating clinical state. Cyanosis develops later in the
progression of respiratory distress, but is still an indication of client
deterioration. Increased urinary output is the opposite of what the
nurse would expect in a client with respiratory distress whose
condition is deteriorating.
◉ A client is scheduled for a partial nephrectomy. In teaching the
client about postoperative care, the nurse uses which rationale to
explain why aggressive measures are needed to prevent atelectasis
and pneumonia?
a. Nephrectomy involves paralyzing the intercostal muscles.
b. Intraoperative surgical contamination of the pulmonary
structures is unavoidable.
c. The client must be maintained in a flat position for 24 hours.