NUR 439 FINAL EXAM – PRIMARY CARE
COMPREHENSIVE PRACTICE QUESTIONS &
CORRECT ANSWERS STUDY GUIDE (2026)
A client tells you she had a "positive" tuberculin skin test. The patient is upset and states: "I
can't believe I have TB!" Which statement by the nurse is appropriate?
• "You'll need to put on a mask and wear it whenever you are around other people."
• "The doctor will prescribe Isoniazid (INH) for you to take for the next 9 months."
• "This finding does not confirm TB; it may indicate a recent exposure to tuberculosis."
• "We'll need to do a chest x-ray. This may be falsely positive because of your family
history."
Correct answer: "This finding does not confirm TB; it may indicate a recent exposure to
tuberculosis."
Following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis
of impaired gas exchange based on which finding?
• SpO2 of 86%
• Crackles in both lower lobes
• Temperature of 101.40F (38.60C)
• Production of greenish purulent sputum
Correct answer: SpO2 of 86%
The nurse assesses a client admitted for chest trauma who reports dyspnea. The nurse
finds tracheal deviation and a pulse oximetry reading of 86%. What is the nurse's priority
intervention?
• Notify the health care provider and document the symptoms.
• Intubate the client and prepare for mechanical ventilation.
• Administer oxygen and prepare for chest tube insertion.
• Administer an intermittent positive-pressure breathing treatment.
Correct answer: Administer oxygen and prepare for chest tube insertion.
,A postoperative patient reports sudden onset of shortness of breath and pleuritic chest pain.
Assessment findings include diaphoresis, hypotension, crackles in the left lower lobe and a
pulse ox of 85%. The nurse suspects the patient is experiencing which of the following?
• Atelectasis
• Pulmonary embolism
• Flail chest
• Hemothorax
Correct answer: Pulmonary embolism
A client newly diagnosed with asthma is preparing for discharge. Which point should the
nurse emphasize during the client's teaching?
• Contact the HCP if nighttime wheezing becomes a concern
• Limit exposure to sources that trigger an asthma attack
• Use the peak flow meter only if symptoms are worsening
• Use inhaled steroid medication as the rescue/reliever inhaler
Correct answer: Limit exposure to sources that trigger an asthma attack
Education by the nurse that could reduce the risk of chronic obstructive pulmonary disease
(COPD) in healthy individuals would include?
• Participation in regular aerobic exercise
• Consumption of a high-protein diet
• Abstention from cigarette smoking
• Avoidance of persons with known respiratory infections
Correct answer: Abstention from cigarette smoking
, During an assessment, the nurse knows that expected assessment findings in the normal
adult lung include the presence of:
a.
Adventitious sounds and limited chest expansion. b.
Increased tactile fremitus and dull percussion tones. c.
Muffled voice sounds and symmetric tactile fremitus. d.
Absent voice sounds and hyperresonant percussion tones.
Correct answer: c.
Muffled voice sounds and symmetric tactile fremitus.
During percussion, the nurse knows that a dull percussion note elicited over a lung lobe most
likely results from:
a.
Shallow breathing.
b.
Normal lung tissue.
c.
Decreased adipose tissue.
d.
Increased density of lung tissue.
Correct answer: d.
Increased density of lung tissue.
COMPREHENSIVE PRACTICE QUESTIONS &
CORRECT ANSWERS STUDY GUIDE (2026)
A client tells you she had a "positive" tuberculin skin test. The patient is upset and states: "I
can't believe I have TB!" Which statement by the nurse is appropriate?
• "You'll need to put on a mask and wear it whenever you are around other people."
• "The doctor will prescribe Isoniazid (INH) for you to take for the next 9 months."
• "This finding does not confirm TB; it may indicate a recent exposure to tuberculosis."
• "We'll need to do a chest x-ray. This may be falsely positive because of your family
history."
Correct answer: "This finding does not confirm TB; it may indicate a recent exposure to
tuberculosis."
Following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis
of impaired gas exchange based on which finding?
• SpO2 of 86%
• Crackles in both lower lobes
• Temperature of 101.40F (38.60C)
• Production of greenish purulent sputum
Correct answer: SpO2 of 86%
The nurse assesses a client admitted for chest trauma who reports dyspnea. The nurse
finds tracheal deviation and a pulse oximetry reading of 86%. What is the nurse's priority
intervention?
• Notify the health care provider and document the symptoms.
• Intubate the client and prepare for mechanical ventilation.
• Administer oxygen and prepare for chest tube insertion.
• Administer an intermittent positive-pressure breathing treatment.
Correct answer: Administer oxygen and prepare for chest tube insertion.
,A postoperative patient reports sudden onset of shortness of breath and pleuritic chest pain.
Assessment findings include diaphoresis, hypotension, crackles in the left lower lobe and a
pulse ox of 85%. The nurse suspects the patient is experiencing which of the following?
• Atelectasis
• Pulmonary embolism
• Flail chest
• Hemothorax
Correct answer: Pulmonary embolism
A client newly diagnosed with asthma is preparing for discharge. Which point should the
nurse emphasize during the client's teaching?
• Contact the HCP if nighttime wheezing becomes a concern
• Limit exposure to sources that trigger an asthma attack
• Use the peak flow meter only if symptoms are worsening
• Use inhaled steroid medication as the rescue/reliever inhaler
Correct answer: Limit exposure to sources that trigger an asthma attack
Education by the nurse that could reduce the risk of chronic obstructive pulmonary disease
(COPD) in healthy individuals would include?
• Participation in regular aerobic exercise
• Consumption of a high-protein diet
• Abstention from cigarette smoking
• Avoidance of persons with known respiratory infections
Correct answer: Abstention from cigarette smoking
, During an assessment, the nurse knows that expected assessment findings in the normal
adult lung include the presence of:
a.
Adventitious sounds and limited chest expansion. b.
Increased tactile fremitus and dull percussion tones. c.
Muffled voice sounds and symmetric tactile fremitus. d.
Absent voice sounds and hyperresonant percussion tones.
Correct answer: c.
Muffled voice sounds and symmetric tactile fremitus.
During percussion, the nurse knows that a dull percussion note elicited over a lung lobe most
likely results from:
a.
Shallow breathing.
b.
Normal lung tissue.
c.
Decreased adipose tissue.
d.
Increased density of lung tissue.
Correct answer: d.
Increased density of lung tissue.
