CMSRN - Pulmonary Exam Questions And
100% Correct Answers
During the admission assessment at the hospital, the nurse identifies that the following
puts the patient at risk for TB
1. Immunosuppresed state
2. Pneumonia and SLE
3. Refusal of the influenza vaccine during the current flu season
4. African American race - ANSWER 1. An immunosuppressed state is a risk factor for
TB. Normal defense mechanisms are not functioning to combat infection.
The nurse is assessing findings of the TB skin test performed with purified protein
derivative. For which of the following clients would the nurse identify a positive reaction
if there is a response of 5mm induration?
1. 32 yo who immigrated from Ecuador last year
2. 30 yo with ESKD
3. 27 yo who uses IV drugs
4. 24 yo with active HIV - ANSWER 4. a pt. with HIV has a positive response to PPD with
an induration of 5mm or more.
anyone who has moved within the last 5 years from a country with prevalence of TB
would have a positive response with induration 10mm or more. for persons at low risk
for TB a positive response is noted with induration of 15mm or more
A patient is newly diagnosed with mild obstructive sleep apnea and asks the nurse if he
can make lifestyle changes to improve his condition. Which of the following changes
does the nurse identify as contributing to improvement in symptoms?
1. Daytime napping
2. Weight loss
,3. Use of sedatives at bedtime
4. decrease in activity level- ANS 2. weight loss. Mild OSA is improved by weight loss. All
sedatives and alcohol are to be avoided 3-4 hr before sleep. Long daytime napping or
decreases in activity level does not affect OSA
The patient is frustrated because she cannot tolerate the mask for her tx with CPAP.
Based on which of the following reasons does the nurse believe that this patient will be
more tolerant of BiPAP tx? 1. Lower inspiratory pressure and higher expiratory pressure
can be used. 2. Bipap provides symptom relief 3. Higher inspiratory pressure and lower
expiratory pressure can be used
4. mean pressure is higher using BiPAP - ANSWER 3. this results in lower mean
pressure that is often tolerated better
in screening a 72 yo to recieve influenza and pneumonia vaccines, the nruse determines
both vaccines are indicated. what would be the correct action by the nurse
1. administer one vaccine and then schedule the other for 3 months later
2. administer both vaccines in the same arm
3. draw up both vaccines in the same syringe for one injection
4. administer each vaccine in a different arm - ANSWER 4. you can wait 1 month in
between
James Cantrell, age 82 is admitted to the medical unit with a dx of bacterial pneumona.
Treatment is initiated with IV Keflex 400 mg every 12 hours.
The Nurse knows Mr. Cantrell's risk for developing the PNA was increased because
admission assessment revealed he also: a. is homebound b. has DM c. is African
American d. has a stage 2 decub ulcer ANSWER B Risk factors for CAP include
diabetes, cardiovascular disorders, alcohol abuse, and immunosuppression. The other
options do not significantly contribute to PNA risk.
James Cantrell, 82 years of age, is admitted to the medical unit with a diagnosis of
bacterial pneumonia. He is started on IV Keflex 400 mg every 12 hours.
Mr. Cantrell develops a pleural effusion that impairs his respiratory functioning. The
physician performs a thoracentesis in the special procedures area and the patient is
returned to his room. Which of the following postprocedure symptoms would the nurse
, notify the physician immediately?.
a. patient complaint of a productive cough
b. RR of 16
c. pt. c/o chest tightness
d. HR of 72 - ANSWER C the pt.'s complaint of chest tightness may suggest a pneumo.
other options are normal for a pt with PNA
After Mr. cantrell is afebrile for 24hrs, the physician recommends a PNA vaccine. in
accordance with admission guidelines, the nurse would deliver the vaccine by:
a. sub Q injection into mid-lateral thigh
b. IM injection into mid lateral thigh
c. IV injection into antecubital space
d. intraderman injection into patients forearm - ANSWER B. manufacturers guidelines
call for IM injection of the PNA vaccine, preferably in the mid lateral thigh or the deltoid
muscle
Rachel Sutton, 55 years old, has been receiving chemo for nonsmall cancer of the lung.
During nursing assessment, the patient reports a sore throat. Her oral mucosa are
swollen and red with ulcers and her saliva is thick and ropy.
The nurse will collaborate with the patient's health care provider to initiate which of the
following as the most appropriate tx for oral symptoms?
a. rinse mough before and after meals and at bedtime with a solution of salt and sodium
bicarb
b. gargle and rinse mouth 4x/day with commercial anticeptic mouth wash
c. maintain a diet of warm, bland liquids until ulcers heal
d. use soft bristle tooth brush dipped in hydrogen peroxide to clean teeth and tongue -
ANSWER A. Oral care for the patient with mucositis should be performed before and
after each meal and at bedtime as a minimum. One tsp of sodium bicarb may be added
to a saline solution to decrease odor, alleviate pain, and dissolve mucin. An antiseptic
mouthwash will likely worsen rather than improve symptoms of mucositis. The other
options will not accomplish these tx goals.
100% Correct Answers
During the admission assessment at the hospital, the nurse identifies that the following
puts the patient at risk for TB
1. Immunosuppresed state
2. Pneumonia and SLE
3. Refusal of the influenza vaccine during the current flu season
4. African American race - ANSWER 1. An immunosuppressed state is a risk factor for
TB. Normal defense mechanisms are not functioning to combat infection.
The nurse is assessing findings of the TB skin test performed with purified protein
derivative. For which of the following clients would the nurse identify a positive reaction
if there is a response of 5mm induration?
1. 32 yo who immigrated from Ecuador last year
2. 30 yo with ESKD
3. 27 yo who uses IV drugs
4. 24 yo with active HIV - ANSWER 4. a pt. with HIV has a positive response to PPD with
an induration of 5mm or more.
anyone who has moved within the last 5 years from a country with prevalence of TB
would have a positive response with induration 10mm or more. for persons at low risk
for TB a positive response is noted with induration of 15mm or more
A patient is newly diagnosed with mild obstructive sleep apnea and asks the nurse if he
can make lifestyle changes to improve his condition. Which of the following changes
does the nurse identify as contributing to improvement in symptoms?
1. Daytime napping
2. Weight loss
,3. Use of sedatives at bedtime
4. decrease in activity level- ANS 2. weight loss. Mild OSA is improved by weight loss. All
sedatives and alcohol are to be avoided 3-4 hr before sleep. Long daytime napping or
decreases in activity level does not affect OSA
The patient is frustrated because she cannot tolerate the mask for her tx with CPAP.
Based on which of the following reasons does the nurse believe that this patient will be
more tolerant of BiPAP tx? 1. Lower inspiratory pressure and higher expiratory pressure
can be used. 2. Bipap provides symptom relief 3. Higher inspiratory pressure and lower
expiratory pressure can be used
4. mean pressure is higher using BiPAP - ANSWER 3. this results in lower mean
pressure that is often tolerated better
in screening a 72 yo to recieve influenza and pneumonia vaccines, the nruse determines
both vaccines are indicated. what would be the correct action by the nurse
1. administer one vaccine and then schedule the other for 3 months later
2. administer both vaccines in the same arm
3. draw up both vaccines in the same syringe for one injection
4. administer each vaccine in a different arm - ANSWER 4. you can wait 1 month in
between
James Cantrell, age 82 is admitted to the medical unit with a dx of bacterial pneumona.
Treatment is initiated with IV Keflex 400 mg every 12 hours.
The Nurse knows Mr. Cantrell's risk for developing the PNA was increased because
admission assessment revealed he also: a. is homebound b. has DM c. is African
American d. has a stage 2 decub ulcer ANSWER B Risk factors for CAP include
diabetes, cardiovascular disorders, alcohol abuse, and immunosuppression. The other
options do not significantly contribute to PNA risk.
James Cantrell, 82 years of age, is admitted to the medical unit with a diagnosis of
bacterial pneumonia. He is started on IV Keflex 400 mg every 12 hours.
Mr. Cantrell develops a pleural effusion that impairs his respiratory functioning. The
physician performs a thoracentesis in the special procedures area and the patient is
returned to his room. Which of the following postprocedure symptoms would the nurse
, notify the physician immediately?.
a. patient complaint of a productive cough
b. RR of 16
c. pt. c/o chest tightness
d. HR of 72 - ANSWER C the pt.'s complaint of chest tightness may suggest a pneumo.
other options are normal for a pt with PNA
After Mr. cantrell is afebrile for 24hrs, the physician recommends a PNA vaccine. in
accordance with admission guidelines, the nurse would deliver the vaccine by:
a. sub Q injection into mid-lateral thigh
b. IM injection into mid lateral thigh
c. IV injection into antecubital space
d. intraderman injection into patients forearm - ANSWER B. manufacturers guidelines
call for IM injection of the PNA vaccine, preferably in the mid lateral thigh or the deltoid
muscle
Rachel Sutton, 55 years old, has been receiving chemo for nonsmall cancer of the lung.
During nursing assessment, the patient reports a sore throat. Her oral mucosa are
swollen and red with ulcers and her saliva is thick and ropy.
The nurse will collaborate with the patient's health care provider to initiate which of the
following as the most appropriate tx for oral symptoms?
a. rinse mough before and after meals and at bedtime with a solution of salt and sodium
bicarb
b. gargle and rinse mouth 4x/day with commercial anticeptic mouth wash
c. maintain a diet of warm, bland liquids until ulcers heal
d. use soft bristle tooth brush dipped in hydrogen peroxide to clean teeth and tongue -
ANSWER A. Oral care for the patient with mucositis should be performed before and
after each meal and at bedtime as a minimum. One tsp of sodium bicarb may be added
to a saline solution to decrease odor, alleviate pain, and dissolve mucin. An antiseptic
mouthwash will likely worsen rather than improve symptoms of mucositis. The other
options will not accomplish these tx goals.
