PNR 309 STUDY GUIDE REVIEW SET TEST
PAPER Q&A 2026 VIEW AHEAD
ASSESSMENT.
⫸ Which of the following physical assessment findings in a client
with a lower respiratory problem best supports the nursing diagnosis
of ineffective airway clearance?
a)Basilar crackles
b)Respiratory rate of 28
c)Oxygen saturation of 85%
d)Presence of greenish sputum. Answer: a)Basilar crackles
The presence of adventitious breath sounds indicates that there is
accumulation of secretions in the lower airways. This would be
consistent with a nursing diagnosis of ineffective airway clearance
because the client is retaining secretions.
⫸ Which of the following clinical manifestations should the nurse
expect to find during assessment of a client admitted with
pneumococcal pneumonia?
a)Hyper-resonance on percussion
b)Vesicular breath sounds in all lobes
c)Increased tactile fremitus on palpation
,d)Fine crackles in all lobes on auscultation. Answer: c)Increased
tactile fremitus on palpation
A typical physical examination finding for a client with pneumonia is
increased tactile fremitus on palpation. Other signs of pulmonary
consolidation include dullness to percussion, bronchial breath sounds,
and crackles in the affected area.
⫸ Which of the following is the priority nursing intervention in
helping a client expectorate thick lung secretions?
a)Humidify the oxygen as able
b)Administer cough suppressant q4hr
c)Teach client to splint the affected area
d)Increase fluid intake to 3 L/day if tolerated. Answer: d)Increase
fluid intake to 3 L/day if tolerated
Although several interventions may help the client expectorate mucus,
the highest priority should be on increasing fluid intake, which will
liquefy the secretions so that the client can expectorate them more
easily. Humidifying the oxygen is also helpful, but is not the primary
intervention. Teaching the client to splint the affected area may also
be helpful, but does not liquefy the secretions so that they can be
removed.
⫸ The nurse is providing discharge teaching to an older-adult client
with COPD and pneumonia. Which of the following vaccines should
the nurse recommend that this client receive?
,a)Staphylococcus aureus
b)Haemophilus influenzae
c)Pneumococcal
d)Bacille Calmette-Guérin (BCG). Answer: c)Pneumococcal
The pneumococcal vaccine is important for clients with a history of
heart or lung disease, recovering from a severe illness, age 65 or over,
or living in a long-term care facility.
⫸ The nurse is providing discharge teaching to a client that was
hospitalized with pneumonia. Which of the following client
statements about measures to prevent a relapse indicates that the
teaching has been effective?
a)"I will seek immediate medical treatment for any upper respiratory
infections."
b)"I will increase my food intake to 2 400 calories a day to keep my
immune system well."
c)"I should continue to do deep-breathing and coughing exercises for
at least 6 weeks."
d)"I must use home oxygen therapy for three months and then will
have a chest x-ray to re-evaluate.". Answer: c)"I should continue to do
deep-breathing and coughing exercises for at least 6 weeks."
It is important for the client to continue with coughing and deep-
breathing exercises for 6-8 weeks until all of the infection has cleared
from the lungs. A client should seek medical treatment for upper
respiratory infections that persist for more than 7 days. Increased fluid
, intake, not caloric intake, is required to liquefy secretions. Home O2
is not a requirement unless the client's oxygenation saturation is
below normal.
⫸ The nurse is admitting a client to the medical unit with a diagnosis
of pneumonia. Which of the following prescriptions should the nurse
verify has been completed before administering a dose of
trimethoprim-sulfamethoxazole to the client?
a)Orthostatic blood pressures
b)Sputum culture and sensitivity
c)Pulmonary function evaluation
d)Serum laboratory studies ordered for the morning. Answer:
b)Sputum culture and sensitivity
The nurse should ensure that the sputum for culture and sensitivity
was sent to the laboratory before administering trimethoprim-
sulfamethoxazole. It is important that the organisms are correctly
identified (by the culture) before their numbers are affected by the
antibiotic; the test will also determine whether the proper antibiotic
has been ordered (sensitivity testing). Although antibiotic
administration should not be unduly delayed while waiting for the
client to expectorate sputum, all of the other options will not be
affected by the administration of antibiotics.
⫸ Which of the following nursing interventions is most appropriate
to enhance oxygenation in a client with unilateral malignant lung
disease?
a)Positioning client on right side
PAPER Q&A 2026 VIEW AHEAD
ASSESSMENT.
⫸ Which of the following physical assessment findings in a client
with a lower respiratory problem best supports the nursing diagnosis
of ineffective airway clearance?
a)Basilar crackles
b)Respiratory rate of 28
c)Oxygen saturation of 85%
d)Presence of greenish sputum. Answer: a)Basilar crackles
The presence of adventitious breath sounds indicates that there is
accumulation of secretions in the lower airways. This would be
consistent with a nursing diagnosis of ineffective airway clearance
because the client is retaining secretions.
⫸ Which of the following clinical manifestations should the nurse
expect to find during assessment of a client admitted with
pneumococcal pneumonia?
a)Hyper-resonance on percussion
b)Vesicular breath sounds in all lobes
c)Increased tactile fremitus on palpation
,d)Fine crackles in all lobes on auscultation. Answer: c)Increased
tactile fremitus on palpation
A typical physical examination finding for a client with pneumonia is
increased tactile fremitus on palpation. Other signs of pulmonary
consolidation include dullness to percussion, bronchial breath sounds,
and crackles in the affected area.
⫸ Which of the following is the priority nursing intervention in
helping a client expectorate thick lung secretions?
a)Humidify the oxygen as able
b)Administer cough suppressant q4hr
c)Teach client to splint the affected area
d)Increase fluid intake to 3 L/day if tolerated. Answer: d)Increase
fluid intake to 3 L/day if tolerated
Although several interventions may help the client expectorate mucus,
the highest priority should be on increasing fluid intake, which will
liquefy the secretions so that the client can expectorate them more
easily. Humidifying the oxygen is also helpful, but is not the primary
intervention. Teaching the client to splint the affected area may also
be helpful, but does not liquefy the secretions so that they can be
removed.
⫸ The nurse is providing discharge teaching to an older-adult client
with COPD and pneumonia. Which of the following vaccines should
the nurse recommend that this client receive?
,a)Staphylococcus aureus
b)Haemophilus influenzae
c)Pneumococcal
d)Bacille Calmette-Guérin (BCG). Answer: c)Pneumococcal
The pneumococcal vaccine is important for clients with a history of
heart or lung disease, recovering from a severe illness, age 65 or over,
or living in a long-term care facility.
⫸ The nurse is providing discharge teaching to a client that was
hospitalized with pneumonia. Which of the following client
statements about measures to prevent a relapse indicates that the
teaching has been effective?
a)"I will seek immediate medical treatment for any upper respiratory
infections."
b)"I will increase my food intake to 2 400 calories a day to keep my
immune system well."
c)"I should continue to do deep-breathing and coughing exercises for
at least 6 weeks."
d)"I must use home oxygen therapy for three months and then will
have a chest x-ray to re-evaluate.". Answer: c)"I should continue to do
deep-breathing and coughing exercises for at least 6 weeks."
It is important for the client to continue with coughing and deep-
breathing exercises for 6-8 weeks until all of the infection has cleared
from the lungs. A client should seek medical treatment for upper
respiratory infections that persist for more than 7 days. Increased fluid
, intake, not caloric intake, is required to liquefy secretions. Home O2
is not a requirement unless the client's oxygenation saturation is
below normal.
⫸ The nurse is admitting a client to the medical unit with a diagnosis
of pneumonia. Which of the following prescriptions should the nurse
verify has been completed before administering a dose of
trimethoprim-sulfamethoxazole to the client?
a)Orthostatic blood pressures
b)Sputum culture and sensitivity
c)Pulmonary function evaluation
d)Serum laboratory studies ordered for the morning. Answer:
b)Sputum culture and sensitivity
The nurse should ensure that the sputum for culture and sensitivity
was sent to the laboratory before administering trimethoprim-
sulfamethoxazole. It is important that the organisms are correctly
identified (by the culture) before their numbers are affected by the
antibiotic; the test will also determine whether the proper antibiotic
has been ordered (sensitivity testing). Although antibiotic
administration should not be unduly delayed while waiting for the
client to expectorate sputum, all of the other options will not be
affected by the administration of antibiotics.
⫸ Which of the following nursing interventions is most appropriate
to enhance oxygenation in a client with unilateral malignant lung
disease?
a)Positioning client on right side
