CNUR 203 NCLEX Review Questions With
Complete Solutions ( Plus Rationales)
An asthmatic patient who has a new prescription for Advair Diskus
|| || || || || || || || || || ||
(combined fluticasone and salmeterol) asks the nurse the purpose of using
|| || || || || || || || || || ||
two drugs. The nurse explains that
|| || || || ||
a.) Advair is a combination of long-acting and slow-acting bronchodilators.
|| || || || || || || || ||
b.) the two drugs work together to block the effects of histamine on the
|| || || || || || || || || || || || || ||
bronchioles.
c.) one drug decreases inflammation, and the other is a bronchodilator.
|| || || || || || || || || ||
d.) the combination of two drugs works more quickly in an acute asthma
|| || || || || || || || || || || || ||
attack. - CORRECT ANSWER✔✔-C
|| || ||
Rationale: Salmeterol is a long-acting bronchodilator, and fluticasone is a
|| || || || || || || || || ||
corticosteroid; they work together to prevent asthma attacks. Neither
|| || || || || || || || ||
medication is an antihistamine. Advair is not used during an acute attack
|| || || || || || || || || || || ||
because the medications do not work rapidly.
|| || || || || ||
When preparing a patient with possible asthma for pulmonary function
|| || || || || || || || || ||
testing, the nurse will teach the patient to
|| || || || || || ||
a.) avoid eating or drinking for 4 hours before the forced expiratory volume
|| || || || || || || || || || || || ||
in 1 second (FEV1)/forced expiratory volume (FEV) test.
|| || || || || || ||
b.) take oral corticosteroids at least 2 hours before the examination.
|| || || || || || || || || ||
c.) withhold bronchodilators for 6 to 12 hours before the examination.
|| || || || || || || || || ||
d.) use rescue medications immediately before the FEV1/FEV testing. -
|| || || || || || || || || ||
CORRECT ANSWER✔✔-C ||
,Rationale: Bronchodilators are held before pulmonary function testing so that
|| || || || || || || || ||
a baseline assessment of airway function can be determined. Testing is
|| || || || || || || || || || || ||
repeated after bronchodilator use to determine whether the decrease in lung
|| || || || || || || || || ||
function is reversible. There is no need for the patient to be NPO. Oral
|| || || || || || || || || || || || || || ||
corticosteroids should also be held before the examination and corticosteroids
|| || || || || || || || ||
given 2 hours before the examination would be at a high level. Rescue
|| || || || || || || || || || || || || ||
medications (which are bronchodilators) would not be given until after the
|| || || || || || || || || || ||
baseline pulmonary function was assessed.
|| || || ||
When teaching a patient with chronic obstructive pulmonary disease (COPD)
|| || || || || || || || || ||
about reasons to quit smoking, the nurse will explain that long-term
|| || || || || || || || || || ||
exposure to tobacco smoke leads to a
|| || || || || ||
a.) weakening of the smooth muscle lining the airways.
|| || || || || || || ||
b.) decrease in the area available for oxygen absorption.
|| || || || || || || ||
c.) lesser number of red blood cells for oxygen delivery.
|| || || || || || || || ||
d.) decreased production of protective respiratory secretions. - CORRECT
|| || || || || || || || ||
ANSWER✔✔-B
Rationale: Tobacco smoke leads to an increase in proteolytic enzymes, which
|| || || || || || || || || || ||
break down alveolar walls and lead to less alveolar surface area for gas
|| || || || || || || || || || || || ||
exchange. Bronchial smooth muscle is not weakened by chronic smoking.
|| || || || || || || || || ||
Polycythemia is a common compensatory mechanism for patients with COPD.
|| || || || || || || || ||
The quantity of respiratory secretions increases as a result of smoking.
|| || || || || || || || || || ||
Which of these is the best goal for the patient admitted with chronic
|| || || || || || || || || || || || ||
bronchitis who has a nursing diagnosis of ineffective airway clearance?
|| || || || || || || || ||
a.) Patient denies having dyspnea.
|| || || ||
b.) Patient's mental status is improved.
|| || || || ||
c.) Patient has a productive cough.
|| || || || ||
,d.) Patient's O2 saturation is 90%. - CORRECT ANSWER✔✔-C
|| || || || || || || ||
Rationale: The goal for the nursing diagnosis of ineffective airway clearance is
|| || || || || || || || || || ||
to maintain a clear airway by coughing effectively. The other goals may be
|| || || || || || || || || || || || || ||
appropriate for the patient with COPD, but they do not address the problem
|| || || || || || || || || || || ||
of ineffective airway clearance.
|| || || ||
The nurse identifies the nursing diagnosis of imbalanced nutrition: less than
|| || || || || || || || || || ||
body requirements for a patient with COPD. An appropriate intervention for
|| || || || || || || || || || ||
this problem is to:
|| || ||
a.) have the patient exercise for 10 minutes before meals.
|| || || || || || || || ||
b.) offer high calorie snacks between meals and at bedtime.
|| || || || || || || || ||
c.) assist the patient in choosing foods with a lot of texture.
|| || || || || || || || || || ||
d.) increase the patient's intake of fruits and fruit juices. - CORRECT
|| || || || || || || || || || || ||
ANSWER✔✔-B
Rationale: Eating small amounts more frequently (as occurs with snacking)
|| || || || || || || || || ||
will increase caloric intake by decreasing the fatigue and feelings of fullness
|| || || || || || || || || || || ||
associated with large meals. Patients with COPD should rest before meals.
|| || || || || || || || || || ||
Foods that have a lot of texture may take more energy to eat and lead to
|| || || || || || || || || || || || || || || ||
decreased intake. Although fruits and juices are not contraindicated, foods
|| || || || || || || || || ||
high in protein are a better choice.
|| || || || || ||
A patient is seen in the clinic with COPD. Which information given by the
|| || || || || || || || || || || || || ||
patient would help most in confirming a diagnosis of chronic bronchitis?
|| || || || || || || || || ||
a.) The patient tells the nurse about a family history of bronchitis.
|| || || || || || || || || || ||
b.) The patient denies having any respiratory problems until the last 6
|| || || || || || || || || || || ||
months.
c.) The patient's history indicates a 40 pack-year cigarette history.
|| || || || || || || || ||
, d.) The patient complains about having a productive cough every winter for
|| || || || || || || || || || || ||
2 months. - CORRECT ANSWER✔✔-D
|| || || ||
Rationale: A diagnosis of chronic bronchitis is based on a history of having a
|| || || || || || || || || || || || || ||
productive cough for several months for at least 2 consecutive years. There is
|| || || || || || || || || || || ||
no familial tendency for chronic bronchitis. Although smoking is the major
|| || || || || || || || || || || ||
risk factor for chronic bronchitis, a smoking history does not confirm the
|| || || || || || || || || || || ||
diagnosis.
The nurse teaches a patient with COPD how to perform pursed-lip breathing,
|| || || || || || || || || || ||
explaining that this technique will assist respiration by
|| || || || || || || ||
a.) loosening secretions so that they may be coughed up more easily.
|| || || || || || || || || || ||
b.) promoting maximal inhalation for better oxygenation of the lungs.
|| || || || || || || || ||
c.) preventing airway collapse and air trapping in the lungs during expiration.
|| || || || || || || || || || ||
d.) decreasing anxiety by giving the patient control of respiratory patterns. -
|| || || || || || || || || || || ||
CORRECT ANSWER✔✔-C ||
Rationale: Pursed-lip breathing increases the airway pressure during the
|| || || || || || || || ||
expiratory phase and prevents collapse of the airways, allowing for more
|| || || || || || || || || || ||
complete exhalation. Although loosening of secretions, improving inhalation,
|| || || || || || || ||
and decreasing anxiety are desirable outcomes for the patient with COPD,
|| || || || || || || || || || ||
pursed-lip breathing does not directly impact these.
|| || || || || ||
The nurse makes a diagnosis of impaired gas exchange for a patient with
|| || || || || || || || || || || || ||
COPD in acute respiratory distress, based on the assessment finding of
|| || || || || || || || || ||
a.) a pulse oximetry reading of 86%.
|| || || || || ||
b.) dyspnea and respiratory rate of 36.
|| || || || || ||
c.) use of the accessory respiratory muscles.
|| || || || || ||
d.) the presence of crackles in both lungs. - CORRECT ANSWER✔✔-A
|| || || || || || || || || ||
Complete Solutions ( Plus Rationales)
An asthmatic patient who has a new prescription for Advair Diskus
|| || || || || || || || || || ||
(combined fluticasone and salmeterol) asks the nurse the purpose of using
|| || || || || || || || || || ||
two drugs. The nurse explains that
|| || || || ||
a.) Advair is a combination of long-acting and slow-acting bronchodilators.
|| || || || || || || || ||
b.) the two drugs work together to block the effects of histamine on the
|| || || || || || || || || || || || || ||
bronchioles.
c.) one drug decreases inflammation, and the other is a bronchodilator.
|| || || || || || || || || ||
d.) the combination of two drugs works more quickly in an acute asthma
|| || || || || || || || || || || || ||
attack. - CORRECT ANSWER✔✔-C
|| || ||
Rationale: Salmeterol is a long-acting bronchodilator, and fluticasone is a
|| || || || || || || || || ||
corticosteroid; they work together to prevent asthma attacks. Neither
|| || || || || || || || ||
medication is an antihistamine. Advair is not used during an acute attack
|| || || || || || || || || || || ||
because the medications do not work rapidly.
|| || || || || ||
When preparing a patient with possible asthma for pulmonary function
|| || || || || || || || || ||
testing, the nurse will teach the patient to
|| || || || || || ||
a.) avoid eating or drinking for 4 hours before the forced expiratory volume
|| || || || || || || || || || || || ||
in 1 second (FEV1)/forced expiratory volume (FEV) test.
|| || || || || || ||
b.) take oral corticosteroids at least 2 hours before the examination.
|| || || || || || || || || ||
c.) withhold bronchodilators for 6 to 12 hours before the examination.
|| || || || || || || || || ||
d.) use rescue medications immediately before the FEV1/FEV testing. -
|| || || || || || || || || ||
CORRECT ANSWER✔✔-C ||
,Rationale: Bronchodilators are held before pulmonary function testing so that
|| || || || || || || || ||
a baseline assessment of airway function can be determined. Testing is
|| || || || || || || || || || || ||
repeated after bronchodilator use to determine whether the decrease in lung
|| || || || || || || || || ||
function is reversible. There is no need for the patient to be NPO. Oral
|| || || || || || || || || || || || || || ||
corticosteroids should also be held before the examination and corticosteroids
|| || || || || || || || ||
given 2 hours before the examination would be at a high level. Rescue
|| || || || || || || || || || || || || ||
medications (which are bronchodilators) would not be given until after the
|| || || || || || || || || || ||
baseline pulmonary function was assessed.
|| || || ||
When teaching a patient with chronic obstructive pulmonary disease (COPD)
|| || || || || || || || || ||
about reasons to quit smoking, the nurse will explain that long-term
|| || || || || || || || || || ||
exposure to tobacco smoke leads to a
|| || || || || ||
a.) weakening of the smooth muscle lining the airways.
|| || || || || || || ||
b.) decrease in the area available for oxygen absorption.
|| || || || || || || ||
c.) lesser number of red blood cells for oxygen delivery.
|| || || || || || || || ||
d.) decreased production of protective respiratory secretions. - CORRECT
|| || || || || || || || ||
ANSWER✔✔-B
Rationale: Tobacco smoke leads to an increase in proteolytic enzymes, which
|| || || || || || || || || || ||
break down alveolar walls and lead to less alveolar surface area for gas
|| || || || || || || || || || || || ||
exchange. Bronchial smooth muscle is not weakened by chronic smoking.
|| || || || || || || || || ||
Polycythemia is a common compensatory mechanism for patients with COPD.
|| || || || || || || || ||
The quantity of respiratory secretions increases as a result of smoking.
|| || || || || || || || || || ||
Which of these is the best goal for the patient admitted with chronic
|| || || || || || || || || || || || ||
bronchitis who has a nursing diagnosis of ineffective airway clearance?
|| || || || || || || || ||
a.) Patient denies having dyspnea.
|| || || ||
b.) Patient's mental status is improved.
|| || || || ||
c.) Patient has a productive cough.
|| || || || ||
,d.) Patient's O2 saturation is 90%. - CORRECT ANSWER✔✔-C
|| || || || || || || ||
Rationale: The goal for the nursing diagnosis of ineffective airway clearance is
|| || || || || || || || || || ||
to maintain a clear airway by coughing effectively. The other goals may be
|| || || || || || || || || || || || || ||
appropriate for the patient with COPD, but they do not address the problem
|| || || || || || || || || || || ||
of ineffective airway clearance.
|| || || ||
The nurse identifies the nursing diagnosis of imbalanced nutrition: less than
|| || || || || || || || || || ||
body requirements for a patient with COPD. An appropriate intervention for
|| || || || || || || || || || ||
this problem is to:
|| || ||
a.) have the patient exercise for 10 minutes before meals.
|| || || || || || || || ||
b.) offer high calorie snacks between meals and at bedtime.
|| || || || || || || || ||
c.) assist the patient in choosing foods with a lot of texture.
|| || || || || || || || || || ||
d.) increase the patient's intake of fruits and fruit juices. - CORRECT
|| || || || || || || || || || || ||
ANSWER✔✔-B
Rationale: Eating small amounts more frequently (as occurs with snacking)
|| || || || || || || || || ||
will increase caloric intake by decreasing the fatigue and feelings of fullness
|| || || || || || || || || || || ||
associated with large meals. Patients with COPD should rest before meals.
|| || || || || || || || || || ||
Foods that have a lot of texture may take more energy to eat and lead to
|| || || || || || || || || || || || || || || ||
decreased intake. Although fruits and juices are not contraindicated, foods
|| || || || || || || || || ||
high in protein are a better choice.
|| || || || || ||
A patient is seen in the clinic with COPD. Which information given by the
|| || || || || || || || || || || || || ||
patient would help most in confirming a diagnosis of chronic bronchitis?
|| || || || || || || || || ||
a.) The patient tells the nurse about a family history of bronchitis.
|| || || || || || || || || || ||
b.) The patient denies having any respiratory problems until the last 6
|| || || || || || || || || || || ||
months.
c.) The patient's history indicates a 40 pack-year cigarette history.
|| || || || || || || || ||
, d.) The patient complains about having a productive cough every winter for
|| || || || || || || || || || || ||
2 months. - CORRECT ANSWER✔✔-D
|| || || ||
Rationale: A diagnosis of chronic bronchitis is based on a history of having a
|| || || || || || || || || || || || || ||
productive cough for several months for at least 2 consecutive years. There is
|| || || || || || || || || || || ||
no familial tendency for chronic bronchitis. Although smoking is the major
|| || || || || || || || || || || ||
risk factor for chronic bronchitis, a smoking history does not confirm the
|| || || || || || || || || || || ||
diagnosis.
The nurse teaches a patient with COPD how to perform pursed-lip breathing,
|| || || || || || || || || || ||
explaining that this technique will assist respiration by
|| || || || || || || ||
a.) loosening secretions so that they may be coughed up more easily.
|| || || || || || || || || || ||
b.) promoting maximal inhalation for better oxygenation of the lungs.
|| || || || || || || || ||
c.) preventing airway collapse and air trapping in the lungs during expiration.
|| || || || || || || || || || ||
d.) decreasing anxiety by giving the patient control of respiratory patterns. -
|| || || || || || || || || || || ||
CORRECT ANSWER✔✔-C ||
Rationale: Pursed-lip breathing increases the airway pressure during the
|| || || || || || || || ||
expiratory phase and prevents collapse of the airways, allowing for more
|| || || || || || || || || || ||
complete exhalation. Although loosening of secretions, improving inhalation,
|| || || || || || || ||
and decreasing anxiety are desirable outcomes for the patient with COPD,
|| || || || || || || || || || ||
pursed-lip breathing does not directly impact these.
|| || || || || ||
The nurse makes a diagnosis of impaired gas exchange for a patient with
|| || || || || || || || || || || || ||
COPD in acute respiratory distress, based on the assessment finding of
|| || || || || || || || || ||
a.) a pulse oximetry reading of 86%.
|| || || || || ||
b.) dyspnea and respiratory rate of 36.
|| || || || || ||
c.) use of the accessory respiratory muscles.
|| || || || || ||
d.) the presence of crackles in both lungs. - CORRECT ANSWER✔✔-A
|| || || || || || || || || ||
