MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
NR 511 FINAL Exam
PREPARATION TEST BANK
LATEST 2025 UPDATE:(
Respiratory Conditions Diagnosis
and Management Guide) ALREADY
GRADED A+
MEDBOOST STUVIA
,MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
An adult has upper respiratory symptoms & cough for The past 14 dys. What should be
considered?
(Pertussis)
Pertussis should always be considered in adults who present with acute cough of greater than 5
dys’ duration. The incubation period for pertussis is about 7-10 dys. Clients present with URI
symptoms for 1-2 weeks. The classic paroxysmal cough usually begins in The second week of
The illness. The duration of symptoms & cough are about 3 months even when treated with
antibiotics. This is highly infectious & is a reportable disease.
Mycoplasma pneumoniae is: (a disease with extrapulmonary manifestations)
Mycoplasma is an atypical pathogen & produces atypical pneumonia. It can be difficult to
diagnose because symptoms can be varied & involve multiple body systems (extra pulmonary
manifestations). Infection with Mycoplasma may present with a normal white blood cell count,
maculopapular rash, GI symptoms, tender joints & aches, &, though rare, cardiac rhythm
disturbances. Respiratory symptoms may not be pronounced. On chest X-ray The are some
unique findings (per bronchial pattern) with Mycoplasma. These include thickened bronchial
shadow, streaks of interstitial infiltration, & atelectasis. These are more likely to occur in The
lower lobes.
Which medication below is contraindicated in an asthma client because it may increase risk of
sudden death if used alone? (Long-acting bronchodilator)
A long-acting bronchodilator can be used to treat asthma when it is used in combination with an
inhaled steroid. Otherwise, using a long-acting bronchodilator like salmeterol is contraindicated.
The is an increased risk of sudden death with asthma exacerbations when this class is used solo
to treat asthma. The oTher choices can be used to treat asthma. Choices vary depending on The
client.
A 75year-old female with emphysema who has been treated with inhaled steroids for many
years should: (should be screened for osteoporosis)
Older females are at higher risk than oThers for osteoporosis. This female client, who has used
inhaled steroids & smokes, has multiple risk factors for osteoporosis. Additionally, she probably
has emphysema because she smoked (or still smokes). If she is Asian or Caucasian, she has still
anoTher risk factor. Screening for osteoporosis should be considered when managing clients
with multiple risk factors.
A client received The pneumonia immunization at age 60 years. He is 65 years old & presents
to your clinic today. What recommendation should be made about The pneumococcal
immunization? (He should receive anoTher one today)
This client should receive anoTher one today because he is 65 years old & at least 5 years has
elapsed since his last one. The CDC does not recommend immunizing this client every 5 years.
Two immunizations are available, PCV13 & PPSV23. He needs both, but PCV13 should be
administered today. PPSV23 should be administered at least 1 year later.
MEDBOOST STUVIA
,MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
Which of The following medications should be used cautiously in a client who has asthma?
(Timolol ophthalmic drops)
Timolol is a beta blocker. This class of medications can precipitate bronchoconstriction in clients
who have asthma. Even though timolol is being administered in The eye, it is absorbed through
mucous membranes & can exert systemic effects. Beta blockers should be avoided in clients
with asthma & used cautiously in clients with COPD. The oTher medications listed have no
specific contraindications for clients with asthma.
The most common symptom associated with acute bronchitis is: (Cough)
Fever (temp > 101°F) is an unusual symptom associated with acute bronchitis. Cough is The
most common symptom associated with acute bronchitis. Purulent sputum is identified in more
than 50% of clients with acute bronchitis. The color imparted to The sputum is usually due to
sloughing of epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are
typical of acute bronchitis. Pharyngitis is common.
Mild persistent asthma is characterized by: (symptoms occurring more than twice weekly)
Mild persistent asthma is characterized by symptoms that occur more than twice weekly but not
daily; or 3-4 nocturnal awakenings per month due to asthma. It is treated with an inhaled
steroid daily, & a bronchodilator PRN for exacerbations. If symptoms occur more than twice
weekly, Therapy should be stepped up. Generally, a long-acting bronchodilator is added to The
steroid when Therapy is stepped up.
The chest circumference of a 12 month-old is: (equal to head circumference)
The chest circumference is not routinely measured at well-child visits, but is assessed if The is
concern about The circumference of either The head or The chest. An exception to this
observation can occur in premature infants where The head grows very rapidly. Normally, the
head exceeds The chest circumference by 1-2 cm from birth until 6 months. Between 6 & 24
months The head & chest circumference should be about equal & by 2 years of age The chest
should be larger than The head. The chest circumference is measured at The nipple line.
A client with cough & fever is found to have infiltrates on chest x-ray. What is his likely
diagnosis?
(Pneumonia)
The finding of infiltrates on chest x-ray, in conjunction with clinical findings of fever & cough,
should direct The examiner to consider pneumonia as The diagnosis. OTher common clinical
findings with pneumonia include chest pain, dyspnea, & sputum production. Though not
common, some clients with pneumonia exhibit gastrointestinal symptoms like nausea, vomiting,
& diarrhea.
An uncommon symptom associated with acute bronchitis is: (temperature > 101°F)
Fever is an unusual symptom associated with acute bronchitis. Cough is The most common
symptom associated with acute bronchitis. Purulent sputum is identified in more than 50% of
clients with acute bronchitis. The color imparted to The sputum is usually due to sloughing of
MEDBOOST STUVIA
, MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are typical of
acute bronchitis. Pharyngitis is common within The first 3 dys of The illness.
Clients who have cough-variant asthma: (all exhibit cough)
One of The most common causes of cough in adults is asthma. Cough due to asthma is often
accompanied by episodic wheezing or dyspnea, though some clients who have asthma only
cough. This is termed “cough-variant asthma.” The clinical presentation of asthma varies but
hyper-responsiveness of The airways is a typical finding.
The most common cause of atypical pneumonia in adults is: (Mycoplasma pneumonia)
In clients who have atypical pneumonia, Mycoplasma is The most common pathogen. M.
pneumoniae is so named because of its atypical appearance on chest X-ray. This organism is
responsible for “walking pneumonia” that is prevalent in a young adult population. This
accounts for about 15% of pneumonia & is transmitted via respiratory droplet.
Which client might be expected to have The worst FEV1? (A 65year-old with emphysema)
FEV 1 sets for “forced expiratory volume in 1 second.” This is The volume of air that is forcefully
exhaled in The first second of exhalation after a deep breath. Clients with emphysema are not
able to do this efficiently because Their alveoli are stretched, & mostly contain trapped air. FEV
1 is used to assess airway obstruction. An asthma client in The green zone would be expected to
have a normal (compared to himself) FEV1. An FEV1 measurement or pulmonary function tests
would not be performed on a client with pneumonia or bronchiectasis because he would have
diminished respiratory capacity related to his infection.
A client who has asthma presents with chest tightness, wheezing, coughing, & fever. He has
wheezing & diminished breath sounds in The upper right lobe. His cough is nonproductive, &
he denies nasal symptoms. Which symptom is not likely related to his asthma? (Fever)
Wheezing is typical of asthma, but one must consider pneumonia in any client who presents
with diminished breath sounds in only one lobe. Fever is not typical of asthma or an
exacerbation.
Ipratropium is very widely used in The treatment of COPD. Which of The following statements
about ipratropium is correct? (It decreases parasympathetic tone & produces bronchodilation)
Ipratropium is The most widely studied anticholinergic medication used to treat clients with
COPD. It produces its helpful effects by reducing cholinergic tone in The lungs. It may be used
with a beta agonist if shortness of breath is present. However, beta agonists increase side
effects like tachycardia & tremor & do not improve efficacy.
An 80year-old has Stage 3 COPD. He is most likely to have concomitant: (anxiety or
depression)
MEDBOOST STUVIA
CERTIFIED EXAMINER
NR 511 FINAL Exam
PREPARATION TEST BANK
LATEST 2025 UPDATE:(
Respiratory Conditions Diagnosis
and Management Guide) ALREADY
GRADED A+
MEDBOOST STUVIA
,MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
An adult has upper respiratory symptoms & cough for The past 14 dys. What should be
considered?
(Pertussis)
Pertussis should always be considered in adults who present with acute cough of greater than 5
dys’ duration. The incubation period for pertussis is about 7-10 dys. Clients present with URI
symptoms for 1-2 weeks. The classic paroxysmal cough usually begins in The second week of
The illness. The duration of symptoms & cough are about 3 months even when treated with
antibiotics. This is highly infectious & is a reportable disease.
Mycoplasma pneumoniae is: (a disease with extrapulmonary manifestations)
Mycoplasma is an atypical pathogen & produces atypical pneumonia. It can be difficult to
diagnose because symptoms can be varied & involve multiple body systems (extra pulmonary
manifestations). Infection with Mycoplasma may present with a normal white blood cell count,
maculopapular rash, GI symptoms, tender joints & aches, &, though rare, cardiac rhythm
disturbances. Respiratory symptoms may not be pronounced. On chest X-ray The are some
unique findings (per bronchial pattern) with Mycoplasma. These include thickened bronchial
shadow, streaks of interstitial infiltration, & atelectasis. These are more likely to occur in The
lower lobes.
Which medication below is contraindicated in an asthma client because it may increase risk of
sudden death if used alone? (Long-acting bronchodilator)
A long-acting bronchodilator can be used to treat asthma when it is used in combination with an
inhaled steroid. Otherwise, using a long-acting bronchodilator like salmeterol is contraindicated.
The is an increased risk of sudden death with asthma exacerbations when this class is used solo
to treat asthma. The oTher choices can be used to treat asthma. Choices vary depending on The
client.
A 75year-old female with emphysema who has been treated with inhaled steroids for many
years should: (should be screened for osteoporosis)
Older females are at higher risk than oThers for osteoporosis. This female client, who has used
inhaled steroids & smokes, has multiple risk factors for osteoporosis. Additionally, she probably
has emphysema because she smoked (or still smokes). If she is Asian or Caucasian, she has still
anoTher risk factor. Screening for osteoporosis should be considered when managing clients
with multiple risk factors.
A client received The pneumonia immunization at age 60 years. He is 65 years old & presents
to your clinic today. What recommendation should be made about The pneumococcal
immunization? (He should receive anoTher one today)
This client should receive anoTher one today because he is 65 years old & at least 5 years has
elapsed since his last one. The CDC does not recommend immunizing this client every 5 years.
Two immunizations are available, PCV13 & PPSV23. He needs both, but PCV13 should be
administered today. PPSV23 should be administered at least 1 year later.
MEDBOOST STUVIA
,MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
Which of The following medications should be used cautiously in a client who has asthma?
(Timolol ophthalmic drops)
Timolol is a beta blocker. This class of medications can precipitate bronchoconstriction in clients
who have asthma. Even though timolol is being administered in The eye, it is absorbed through
mucous membranes & can exert systemic effects. Beta blockers should be avoided in clients
with asthma & used cautiously in clients with COPD. The oTher medications listed have no
specific contraindications for clients with asthma.
The most common symptom associated with acute bronchitis is: (Cough)
Fever (temp > 101°F) is an unusual symptom associated with acute bronchitis. Cough is The
most common symptom associated with acute bronchitis. Purulent sputum is identified in more
than 50% of clients with acute bronchitis. The color imparted to The sputum is usually due to
sloughing of epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are
typical of acute bronchitis. Pharyngitis is common.
Mild persistent asthma is characterized by: (symptoms occurring more than twice weekly)
Mild persistent asthma is characterized by symptoms that occur more than twice weekly but not
daily; or 3-4 nocturnal awakenings per month due to asthma. It is treated with an inhaled
steroid daily, & a bronchodilator PRN for exacerbations. If symptoms occur more than twice
weekly, Therapy should be stepped up. Generally, a long-acting bronchodilator is added to The
steroid when Therapy is stepped up.
The chest circumference of a 12 month-old is: (equal to head circumference)
The chest circumference is not routinely measured at well-child visits, but is assessed if The is
concern about The circumference of either The head or The chest. An exception to this
observation can occur in premature infants where The head grows very rapidly. Normally, the
head exceeds The chest circumference by 1-2 cm from birth until 6 months. Between 6 & 24
months The head & chest circumference should be about equal & by 2 years of age The chest
should be larger than The head. The chest circumference is measured at The nipple line.
A client with cough & fever is found to have infiltrates on chest x-ray. What is his likely
diagnosis?
(Pneumonia)
The finding of infiltrates on chest x-ray, in conjunction with clinical findings of fever & cough,
should direct The examiner to consider pneumonia as The diagnosis. OTher common clinical
findings with pneumonia include chest pain, dyspnea, & sputum production. Though not
common, some clients with pneumonia exhibit gastrointestinal symptoms like nausea, vomiting,
& diarrhea.
An uncommon symptom associated with acute bronchitis is: (temperature > 101°F)
Fever is an unusual symptom associated with acute bronchitis. Cough is The most common
symptom associated with acute bronchitis. Purulent sputum is identified in more than 50% of
clients with acute bronchitis. The color imparted to The sputum is usually due to sloughing of
MEDBOOST STUVIA
, MEDBOOSTSTUVIA YOUR
CERTIFIED EXAMINER
epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are typical of
acute bronchitis. Pharyngitis is common within The first 3 dys of The illness.
Clients who have cough-variant asthma: (all exhibit cough)
One of The most common causes of cough in adults is asthma. Cough due to asthma is often
accompanied by episodic wheezing or dyspnea, though some clients who have asthma only
cough. This is termed “cough-variant asthma.” The clinical presentation of asthma varies but
hyper-responsiveness of The airways is a typical finding.
The most common cause of atypical pneumonia in adults is: (Mycoplasma pneumonia)
In clients who have atypical pneumonia, Mycoplasma is The most common pathogen. M.
pneumoniae is so named because of its atypical appearance on chest X-ray. This organism is
responsible for “walking pneumonia” that is prevalent in a young adult population. This
accounts for about 15% of pneumonia & is transmitted via respiratory droplet.
Which client might be expected to have The worst FEV1? (A 65year-old with emphysema)
FEV 1 sets for “forced expiratory volume in 1 second.” This is The volume of air that is forcefully
exhaled in The first second of exhalation after a deep breath. Clients with emphysema are not
able to do this efficiently because Their alveoli are stretched, & mostly contain trapped air. FEV
1 is used to assess airway obstruction. An asthma client in The green zone would be expected to
have a normal (compared to himself) FEV1. An FEV1 measurement or pulmonary function tests
would not be performed on a client with pneumonia or bronchiectasis because he would have
diminished respiratory capacity related to his infection.
A client who has asthma presents with chest tightness, wheezing, coughing, & fever. He has
wheezing & diminished breath sounds in The upper right lobe. His cough is nonproductive, &
he denies nasal symptoms. Which symptom is not likely related to his asthma? (Fever)
Wheezing is typical of asthma, but one must consider pneumonia in any client who presents
with diminished breath sounds in only one lobe. Fever is not typical of asthma or an
exacerbation.
Ipratropium is very widely used in The treatment of COPD. Which of The following statements
about ipratropium is correct? (It decreases parasympathetic tone & produces bronchodilation)
Ipratropium is The most widely studied anticholinergic medication used to treat clients with
COPD. It produces its helpful effects by reducing cholinergic tone in The lungs. It may be used
with a beta agonist if shortness of breath is present. However, beta agonists increase side
effects like tachycardia & tremor & do not improve efficacy.
An 80year-old has Stage 3 COPD. He is most likely to have concomitant: (anxiety or
depression)
MEDBOOST STUVIA
