NCLEX ACTUAL EXAM 2024
PREDICTION (WITH 100% CORRECT
QUESTIONS AND ANSWERS)
TEST BANK
,Airway – Obstruction and Asthma
1. An elderly client with pneumonia may appear with which of the following symptoms
first?
A. Altered mental status and dehydration
B. fever and chills
C. Hemoptysis and dyspnea
D. Pleuretic chest pain and cough
Ans-1. 1. Fever, chills, hemoptysis, dyspnea, cough, and pleuric chest pain are the common
symptoms of pneumonia, but elderly clients may first appear with only an altered mental status
and dehydration due to a blunted immune response.
2. Which of the following pathophysiological mechanisms that occurs in the lung
parenchyma allows pneumonia to develop?
1. Atelectasis
2. Bronchiectasis
3. Effusion
4. Inflammation
Ans-2. 4. the most common feature of all types of pneumonia is an inflammatory pulmonary
response to the offending organism or agent. Atelectasis and bronchiectasis indicate a collapse of
a portion of the airway that doesn’t occur with pneumonia. An effusion is an accumulation of
excess pleural fluid in the pleural space, which may be a secondary response to pneumonia.
3. A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a
respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold.
From his history, the client may have which of the following?
1. Acute asthma
2. Bronchial pneumonia
3. Chronic obstructive pulmonary disease (COPD)
4. Emphysema
,Ans-3. 1. Based on the client’s history and symptoms, acute asthma is the most likely diagnosis.
He’s unlikely to have bronchial pneumonia without a productive cough and fever and he’s too
young to have developed COPD or emphysema.
4. Which of the following assessment findings would help confirm a diagnosis of asthma in a
client suspected of having the disorder?
1. Circumoral cyanosis
2. Increased forced expiratory volume
3. Inspiratory and expiratory wheezing
4. Normal breath sounds
Ans-4. 3. Inspiratory and expiratory wheezes are typical findings in asthma. Circumoral cyanosis
may be present in extreme cases of respiratory distress. The nurse would expect the client to have
a decreased forced expiratory volume because asthma is an obstructive pulmonary disease.
Breath sounds will be “tight” sounding or markedly decreased; they won’t be normal.
5. Which of the following types of asthma involves an acute asthma attack brought on by an
upper respiratory infection?
1. Emotional
2. Extrinsic
3. Intrinsic
4. Mediated
Ans-5. 1. Intrinsic asthma doesn’t have an easily identifiable allergen and can be triggered by the
common cold. Asthma caused be emotional reasons is considered to be in the extrinsic category.
Extrinsic asthma is caused by dust, molds, and pets; easily identifiable allergens. Mediated
asthma doesn’t exist.
6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased
expiratory volume should be treated with which of the following classes of medication right
away?
1. Beta-adrenergic blockers
2. Bronchodilators
, 3. Inhaled steroids
4. Oral steroids
Ans-6. 2. Bronchodilators are the first line of treatment for asthma because bronchoconstriction
is the cause of reduced airflow. Beta-adrenergic blockers aren’t used to treat asthma and can
cause bronchoconstriction. Inhaled or oral steroids may be given to reduce the inflammation but
aren’t used for emergency relief.
7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate
is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the
following actions should be taken first?
1. Take a full medication history
2. Give a bronchodilator by nebulizer
3. Apply a cardiac monitor to the client
4. Provide emotional support to the client.
Ans-7. 2. The client is having an acute asthma attack and needs to increase oxygen delivery to
the lung and body. Nebulized bronchodilators open airways and increase the amount of oxygen
delivered. First resolve the acute phase of the attack ad how to prevent attacks in the future. It
may not be necessary to place the client on a cardiac monitor because he’s only 19-years-old,
unless he has a past medical history of cardiac problems.
8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day
has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based
on this information, he most likely has which of the following conditions?
1. Adult respiratory distress syndrome (ARDS)
2. Asthma
3. Chronic obstructive bronchitis
4. Emphysema
Ans-8. 3. Because of his extensive smoking history and symptoms, the client most likely has
chronic obstructive bronchitis. Clients with ARDS have acute symptoms of and typically need
large amounts of oxygen. Clients with asthma and emphysema tend not to have a chronic cough
or peripheral edema.
PREDICTION (WITH 100% CORRECT
QUESTIONS AND ANSWERS)
TEST BANK
,Airway – Obstruction and Asthma
1. An elderly client with pneumonia may appear with which of the following symptoms
first?
A. Altered mental status and dehydration
B. fever and chills
C. Hemoptysis and dyspnea
D. Pleuretic chest pain and cough
Ans-1. 1. Fever, chills, hemoptysis, dyspnea, cough, and pleuric chest pain are the common
symptoms of pneumonia, but elderly clients may first appear with only an altered mental status
and dehydration due to a blunted immune response.
2. Which of the following pathophysiological mechanisms that occurs in the lung
parenchyma allows pneumonia to develop?
1. Atelectasis
2. Bronchiectasis
3. Effusion
4. Inflammation
Ans-2. 4. the most common feature of all types of pneumonia is an inflammatory pulmonary
response to the offending organism or agent. Atelectasis and bronchiectasis indicate a collapse of
a portion of the airway that doesn’t occur with pneumonia. An effusion is an accumulation of
excess pleural fluid in the pleural space, which may be a secondary response to pneumonia.
3. A 7-year-old client is brought to the E.R. He’s tachypneic and afebrile and has a
respiratory rate of 36 breaths/minute and a nonproductive cough. He recently had a cold.
From his history, the client may have which of the following?
1. Acute asthma
2. Bronchial pneumonia
3. Chronic obstructive pulmonary disease (COPD)
4. Emphysema
,Ans-3. 1. Based on the client’s history and symptoms, acute asthma is the most likely diagnosis.
He’s unlikely to have bronchial pneumonia without a productive cough and fever and he’s too
young to have developed COPD or emphysema.
4. Which of the following assessment findings would help confirm a diagnosis of asthma in a
client suspected of having the disorder?
1. Circumoral cyanosis
2. Increased forced expiratory volume
3. Inspiratory and expiratory wheezing
4. Normal breath sounds
Ans-4. 3. Inspiratory and expiratory wheezes are typical findings in asthma. Circumoral cyanosis
may be present in extreme cases of respiratory distress. The nurse would expect the client to have
a decreased forced expiratory volume because asthma is an obstructive pulmonary disease.
Breath sounds will be “tight” sounding or markedly decreased; they won’t be normal.
5. Which of the following types of asthma involves an acute asthma attack brought on by an
upper respiratory infection?
1. Emotional
2. Extrinsic
3. Intrinsic
4. Mediated
Ans-5. 1. Intrinsic asthma doesn’t have an easily identifiable allergen and can be triggered by the
common cold. Asthma caused be emotional reasons is considered to be in the extrinsic category.
Extrinsic asthma is caused by dust, molds, and pets; easily identifiable allergens. Mediated
asthma doesn’t exist.
6. A client with acute asthma showing inspiratory and expiratory wheezes and a decreased
expiratory volume should be treated with which of the following classes of medication right
away?
1. Beta-adrenergic blockers
2. Bronchodilators
, 3. Inhaled steroids
4. Oral steroids
Ans-6. 2. Bronchodilators are the first line of treatment for asthma because bronchoconstriction
is the cause of reduced airflow. Beta-adrenergic blockers aren’t used to treat asthma and can
cause bronchoconstriction. Inhaled or oral steroids may be given to reduce the inflammation but
aren’t used for emergency relief.
7. A 19-year-old comes into the emergency department with acute asthma. His respiratory rate
is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the
following actions should be taken first?
1. Take a full medication history
2. Give a bronchodilator by nebulizer
3. Apply a cardiac monitor to the client
4. Provide emotional support to the client.
Ans-7. 2. The client is having an acute asthma attack and needs to increase oxygen delivery to
the lung and body. Nebulized bronchodilators open airways and increase the amount of oxygen
delivered. First resolve the acute phase of the attack ad how to prevent attacks in the future. It
may not be necessary to place the client on a cardiac monitor because he’s only 19-years-old,
unless he has a past medical history of cardiac problems.
8. A 58-year-old client with a 40-year history of smoking one to two packs of cigarettes a day
has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based
on this information, he most likely has which of the following conditions?
1. Adult respiratory distress syndrome (ARDS)
2. Asthma
3. Chronic obstructive bronchitis
4. Emphysema
Ans-8. 3. Because of his extensive smoking history and symptoms, the client most likely has
chronic obstructive bronchitis. Clients with ARDS have acute symptoms of and typically need
large amounts of oxygen. Clients with asthma and emphysema tend not to have a chronic cough
or peripheral edema.
