NCLEX questions

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 NURSING 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.