NR324/NR 324 Exam 2 V1 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD). Which
physical assessment finding should the nurse expect to observe?
A. Increased tactile fremitus
B. Inspiratory wheezing
C. Narrowed intercostal spaces
D. Barrel chest
Correct Answer: D
Rationale: A barrel chest is a classic clinical manifestation of COPD caused by chronic air
trapping and lung hyperinflation. The nurse must recognize that this change in the
anteroposterior diameter is indicative of long-standing disease. Education on energy
conservation techniques is also essential for these patients to manage daily activities.
2. Which medication should the nurse instruct a patient with asthma to use for an acute
attack of shortness of breath?
A. Salmeterol
B. Albuterol
C. Fluticasone
,D. Montelukast
Correct Answer: B
Rationale: Albuterol is a short-acting beta-agonist (SABA) that acts as a rescue medication
to provide rapid bronchodilation during an acute asthma exacerbation. Long-acting
agonists and corticosteroids are used for maintenance therapy rather than immediate
relief. The nurse must ensure the patient understands the difference between rescue and
controller inhalers.
3. A patient is admitted with community-acquired pneumonia. Which nursing intervention is
the highest priority?
A. Obtaining a sputum culture
B. Administering oral fluids
C. Administering the first dose of antibiotics
D. Teaching the patient how to use an incentive spirometer
Correct Answer: C
Rationale: Administering the first dose of antibiotics is critical for treating the underlying
infection and improving patient outcomes in pneumonia. However, the nurse must ensure
the sputum culture is collected before the first dose if possible without delaying treatment.
Rapid initiation of therapy is a key quality indicator in clinical practice for pneumonia care.
, 4. The nurse reviews the arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52,
HCO3 26. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the imbalance. Since the bicarbonate level is within the normal range,
the condition is uncompensated respiratory acidosis. This often occurs in conditions where
gas exchange is impaired, such as COPD or sedation.
5. A patient with iron deficiency anemia is prescribed oral ferrous sulfate. What instruction
should the nurse provide to enhance absorption?
A. Take the medication with a glass of milk
B. Take the medication with orange juice
C. Take the medication immediately after a heavy meal
D. Take the medication with an antacid
Correct Answer: B
Q&A with Rationale | Chamberlain
University
1. A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD). Which
physical assessment finding should the nurse expect to observe?
A. Increased tactile fremitus
B. Inspiratory wheezing
C. Narrowed intercostal spaces
D. Barrel chest
Correct Answer: D
Rationale: A barrel chest is a classic clinical manifestation of COPD caused by chronic air
trapping and lung hyperinflation. The nurse must recognize that this change in the
anteroposterior diameter is indicative of long-standing disease. Education on energy
conservation techniques is also essential for these patients to manage daily activities.
2. Which medication should the nurse instruct a patient with asthma to use for an acute
attack of shortness of breath?
A. Salmeterol
B. Albuterol
C. Fluticasone
,D. Montelukast
Correct Answer: B
Rationale: Albuterol is a short-acting beta-agonist (SABA) that acts as a rescue medication
to provide rapid bronchodilation during an acute asthma exacerbation. Long-acting
agonists and corticosteroids are used for maintenance therapy rather than immediate
relief. The nurse must ensure the patient understands the difference between rescue and
controller inhalers.
3. A patient is admitted with community-acquired pneumonia. Which nursing intervention is
the highest priority?
A. Obtaining a sputum culture
B. Administering oral fluids
C. Administering the first dose of antibiotics
D. Teaching the patient how to use an incentive spirometer
Correct Answer: C
Rationale: Administering the first dose of antibiotics is critical for treating the underlying
infection and improving patient outcomes in pneumonia. However, the nurse must ensure
the sputum culture is collected before the first dose if possible without delaying treatment.
Rapid initiation of therapy is a key quality indicator in clinical practice for pneumonia care.
, 4. The nurse reviews the arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52,
HCO3 26. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the imbalance. Since the bicarbonate level is within the normal range,
the condition is uncompensated respiratory acidosis. This often occurs in conditions where
gas exchange is impaired, such as COPD or sedation.
5. A patient with iron deficiency anemia is prescribed oral ferrous sulfate. What instruction
should the nurse provide to enhance absorption?
A. Take the medication with a glass of milk
B. Take the medication with orange juice
C. Take the medication immediately after a heavy meal
D. Take the medication with an antacid
Correct Answer: B
