Georgia Military College

PATHO HCR 240

Ch 30 Quiz

1)A client is admitted to the hospital suspected to have Legionnaire disease after a cruise. What type of specimen should the nurse collect that is a rapid test to detect the antigens of Legionella pneumophila?

2. The school nurse is providing education to parents of school-age children during flu season. What should the nurse teach about the importance of early diagnosis of influenza?

3. A client has just been admitted with a chronic cough, shortness of breath, and wheezing with associated irritation of his airway, producing hemoptysis and diffuse pain in the chest area. He is diagnosed with large cell carcinoma. What is causing the symptoms that are listed?

4. A 65-year-old man has just been diagnosed with hypercalcemia with a chronic cough and hemoptysis. The physician suspects cancer. Which cancer is most likely?

5. Following a dust storm, the health care provider suspects coccidioidomycosis, a fungal infection, when several clients present to the clinic reporting productive cough, fever, and night sweats. Which manifestations lead the provider to suspect the infection has progressed outside the lung?
   1. Generalized lymph node enlargement
   2. An enlarged liver via palpation
   3. A headache and reports of stiff neck with movement

6. A mother rushes her toddler into the emergency department stating, “My baby can’t breathe.” Initial assessment reveals the child is struggling to breathe in an upright position. He has both inspiratory and expiratory stridor and is using his chest muscles to breathe. The nurse suspects the child has which acute respiratory infection?

7. What does the destructive nature of tuberculosis cause in a previously unexposed immunocompetent person?

8. A client with a history of hypertension and type 2 diabetes mellitus has developed a cold and tells the nurse he purchased an OTC (over-the-counter) nasal decongestant. The most important information for the nurse to provide would be:

9. The nurse is assessing several clients in an outpatient clinic. Which client is most likely to have chronic histoplasmosis?

10. What diagnostic test does the nurse explain to the client will assist with the diagnosis of disseminated histoplasmosis?

11. A pregnant client has experienced episodes of premature labor and is concerned about her unborn child’s lung development. Which nursing response would answer the client's question about time frame when the fetus begins to produce sufficient surfactant?

12. Select the statement that is most accurate in terms of colonization and pneumococcal infection.

13. Which acute respiratory infection in children poses the greatest threat of severe hypoxia caused by inflammatory edema?

14. At an influenza vaccination clinic, a nurse is screening clients who are requesting the vaccine. The nurse determines that which client is unable to receive the vaccine?
15. Diagnostic testing has resulted in a diagnosis of small cell lung cancer (SCLC) in an older adult client. When
16. exploring the etiology of the client's disease, what assessment question is most relevant?

17. Non–small cell lung cancers (NSCLCs) mimic small cell lung cancers (SCLCs) through their abilities to:

18. Older adults are very susceptible to pneumonia in all its varieties. The symptoms that older adults exhibit can be very different than those of other age groups who have pneumonia. What signs and symptoms are older adults with pneumonia less likely to experience than people with pneumonia in other age groups?

19. A client is diagnosed with early pneumococcal pneumonia. What does the nurse recognize occurs during the first stage of pneumococcal pneumonia?

20. The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections?

21. A child is brought to the emergency department with a respiratory infection. The child is struggling to breathe and is very anxious. The health care providers suspect epiglottitis. Which intervention would be a priority?

22. A client tells the nurse he was diagnosed with a sinus infection about 7 days ago. He is now experiencing facial swelling and has also had periods of confusion. His family told him he is not remembering things. The best response by the nurse would be:

23. A 32-year-old client has had a positive reaction to a tuberculin skin test and the duration of exposure is unknown. What education about medications will the nurse provide to the client?

24. A client has developed community-acquired pneumonia and is being treated at home. What does the nurse recognize are the methods in the diagnosis of community-acquired pneumonia?
    1. Severity of illness
    2. Age
    3. Coexisting health problems

25. Which classification of medications used to self-treat the common cold should be avoided by those with a history of hypertension?

26. A client is preparing to travel for business and has developed the common cold. The client informs the nurse that she will be flying and does not want to give it to anyone else. When should the nurse inform the client is the most highly contagious period?

27. Which respiratory infection in children is associated with the poorest outcomes?

28. A college student has developed a cold. Which statement shows that the student has an accurate understanding of the upper respiratory infection?

29. Which problem in neonates can result in increased upper airway resistance and decreased airflow into the lungs?

30. Which organism is a common cause of bacterial pneumonia in both community and hospital settings?

31. A client has been diagnosed with an advanced tumor that has invaded the mediastinum. The client would most likely manifest:

32. A 3-year-old boy has been diagnosed with croup (acute laryngotracheobronchitis). The nurse anticipates the plan of care to include:

33. A parent of a toddler is concerned about possible side effects of influenza immunizations. What will the nurse teach the parent regarding the flu vaccine?

34. Which individual should have priority for receiving a seasonal influenza vaccination?

35. Which description of the onset of symptoms is most characteristic of epiglottitis?

36. The nurse is preparing to educate a client with HIV-related histoplasmosis about the lifelong medication he will be taking. What medication will the nurse discuss with the client?

37. The nurse is performing a health history for a male client who is having a series of diagnostic tests to determine the presence of squamous cell carcinoma. What question would be most beneficial for the nurse to ask that would correlate with this suspicion?

38. An 8-year-old child develops pneumonia with physical exam revealing intercostal retractions and difficulty breathing. The nurse anticipates the need for prompt treatment based on which facts about pneumonia?

39. A client presents to the physician’s office with a chronic cough, shortness of breath, and wheezing that has gotten progressively worse, with recent episodes of hemoptysis. Diagnostic tests reveal a lung mass. Based on these symptoms, the nurse anticipates which of the following has occurred?

40. A nurse is assessing a 2-week-old infant with pulmonary edema. Which symptom indicates the infant is experiencing respiratory distress?

41. An older adult client recently had a cerebrovascular accident that resulted in dysphagia. What is the nurse’s greatest concern while feeding this client?

42. An older adult client admitted to the hospital with tuberculosis becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. What is the most likely diagnosis?

43. An infant born 10 weeks premature was placed on mechanical ventilation. Eight weeks later a nursing assessment reveals a barrel chest, tachycardia, rapid and shallow breathing, hypoxemia, hypercapnia, and poor weight gain. Based on this assessment, which diagnosis is most likely?

44. Which clients would be considered at high risk for developing pneumonia (both community and hospital setting)?
    1.                 A young adult in motorcycle accident with head injury requiring tracheostomy and mechanical ventilation
    2.                 A HIV-positive client with a WBC count of 2000 who has been camping near a commercial farm raising chickens for food
    3. A school-aged child with severe asthma controlled by steroids admitted for an exacerbation

45. A 6-hour-old newborn develops a critical respiratory problem and is rushed to the ICU. The ICU nurses suspect the infant has respiratory distress syndrome (RDS) based on which findings?
    1. Bluish discoloration of the skin and mucous membranes (central cyanosis)
    2. Substernal retractions with each breath
    3. Expiratory grunting

46. Influenza A subtype H5N1 (avian flu) has been documented in poultry in both East and Southeast Asian countries. This form of avian flu is highly contagious from bird to bird but rarely is passed from human to

47. human. There is a large amount of concern that the H5N1 strain might mutate, making it easier to be passed from human to human, carrying with it a high mortality rate. What is the main concern if the H5N1 strain does mutate?

48. Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD?

49. What is the underlying cause of respiratory failure in a child with bronchiolitis?

50. A client comes to an urgent care center. The nurse notes that the client has a fever of 103.2°F (39.5°C), pleuritic pain with each breath, and enlarged lymph nodes in the neck and axilla area. The client also has a productive cough. The nurse should consider tuberculosis if the client's history includes:

51. When talking to a group of homeless women living in a shelter, the nurse should educate about risk for developing tuberculosis. The nurse should emphasize which lab/diagnostic test as considered to be the "gold" standard for diagnosing tuberculosis?

52. A 66-year-old man presents in the emergency room accompanied by his wife, who claims that he has been acting confused. The man reports a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 39.3°C, and his blood work indicates his sodium level is at 126 mEq/L (126 mmol/L). The normal level is 135-145 mEq/L (135 to 145 mmol/L). What will be the assessing physician's most likely suspicion?

53. The nurse has administered a Mantoux (tuberculin) test to four clients. Select the client who will most likely have a suppressed response.

54. How is the organism causing Legionnaire disease, a form of bronchopneumonia, usually transmitted?

55. Most respiratory disorders in infants make it difficult to get air into their lungs. This is due to a decrease in which factor?

56. A client has presented to a clinic reporting a persistent headache. What assessment should the clinician conduct to differentiate between rhinosinusitis and other health problems?

57. Which characteristic of the lungs of infants and small children creates an increased risk of respiratory disorders?

58. A child has developed respiratory stridor and is displaying a crowing sound. The parents ask the nurse what is causing this sound. The best response would be:

59. A client diagnosed with the common cold has been taking an over-the-counter antihistamine for the control of symptoms. What should the client be aware may occur if the drugs are used too frequently over too many days?

60. The nurse is assessing a client who states he felt fine all day and then, within 5 minutes, began to feel extremely weak and tired and began having a fever. What do these symptoms indicate that the client may be experiencing?

61. A client arrives in the clinic with a cough, fever, and chest discomfort and is diagnosed with community- acquired pneumonia. What education does the nurse anticipate providing prior to discharging the client from the clinic?

62. A client from Texas is suspected of being infected with coccidioidomycosis and has been admitted to the hospital with fever, cough, pleuritic chest pain, and skin lesions. When performing a health history, which question would be most valuable to assist with diagnosis?

63. An adult client recently had a cerebrovascular accident that resulted in dysphagia. What is the nurse’s priority action to prevent the aspiration of gastric contents?

64. A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that the most likely cause of this infection is:

65. A client diagnosis with tuberculosis asks the nurse how long the antitubercular medication will need to be taken. What is the best response?

66. A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which factor most likely had the greatest impact on development of the lung cancer?

67. A client with an 80-pack-year history of tobacco smoking has presented to the clinic complaining of “bronchitis” cough for the past 5 months, weight loss, and shortness of breath. Today, this client “got scared” when he coughed up blood in his sputum. The health care provider is concerned this client may have which possible diagnosis?

68. An immunocompromised host is open to pneumonia from all types of organisms. There is, however, a correlation between specific types of immunologic deficits and specific invading organisms. What organism is most likely to cause pneumonia in an immunocompromised host with neutropenia and impaired granulocyte function?

69. A client has been diagnosed with pneumococcal infection. The nurse shares with the client which statement about the spread of the disease?

70. While educating a smoking cessation class, a client asks the nurse, "If I can still get lung cancer, what should I be looking for?" Which response by the nurse is best?

71. A social worker is counseling the family of an 85-year-old woman who has just been diagnosed with non-small cell lung cancer. What concerns should she convey to the family regarding the unintended effects of treating the disease?:

72. A 3-year-old child has been admitted to the pediatric unit for the treatment of croup. The nurse should include which action in the child's plan of care?

73. In assessing the infant’s respiratory system, which finding confirms to the nurse that the infant is having trouble breathing?

74. A parent of a toddler is concerned about possible side effects of influenza immunizations. What will the nurse teach the parent regarding the flu vaccine?

75. A client was admitted 3 days ago and is developing signs and symptoms of pneumonia. Select the correct documentation of the diagnosis.

76. A client has been admitted to a medical unit of a hospital for the treatment of pneumonia that is attributable to S. pneumonia. Which consideration is the priority in this client's treatment?

77. A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?

78. Which diagnosis places a child at the greatest risk for airway obstruction?

79. The nurse is performing a physical assessment on a client who is suspected to have sinusitis. What assessment findings does the nurse correlate with this infection?
    1. Turbinate edema
    2. Nasal crusts
    3. Purulence of the nasal cavity

80. A client asks the nurse if it is possible to contract influenza by being exposed to wound secretions. On what knowledge should the nurse base her response to the client?

81. A client has developed bacterial pneumonia and is admitted to the hospital. The nurse obtains sputum cultures upon admission. What bacteria does the nurse anticipate finding when the results are complete?

82. A client with coccidioidomycosis has developed a severe headache with neck stiffness, has a fever, and states he feels very ill. What does the nurse recognize these symptoms may indicate?

83. The nurse is developing a community program since a recent increase in admissions to the acute care facility with tuberculosis infection. What is the most frequent form of tuberculosis that the nurse should focus on?

84. An infant who was born prematurely and developed respiratory distress syndrome was placed on mechanical ventilation for several weeks. What condition should the nurse monitor the infant for related to the long-term ventilatory support?

85. A nurse is assessing a 1-year-old child diagnosed with croup. Which manifestation would most likely be present?

86. A parent calls 911 and states her child is having trouble breathing. The child is rushed to the emergency department. Upon assessment, the child appears pale, toxic, and lethargic and assumes a distinctive position— sitting up with the mouth open and the chin thrust forward. The parent states that the child just developed a sore throat and fever today. The health care provider determines that the child is experiencing:

87. A client calls the health care provider’s office and frantically tells the nurse his TB test is red, and he is afraid this means he has tuberculosis. The best response by the nurse would be:

88. A client with newly diagnosed squamous cell carcinoma of the lung asks, “So how do we treat this cancer?” Which response from the health care provider is most accurate?
    1. Surgery to remove tumor
    2. Radiation therapy
    3. Chemotherapy

89. An adult comes to the urgent care clinic reporting facial pain, headache, and copious amounts of thick purulent nasal discharge. Based on these symptoms, the nurse practitioner suspects the client is experiencing which condition?

90. A client presents with atypical pneumonia signs/symptoms and is diagnosed with Mycoplasma pneumoniae. For which characteristics of the cough should the nurse assess this client?
    1. Dry
    2. Hacking
    3. Nonproductive

91. A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that: