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VSIM QUESTIONS ADVANCED FUND FINAL
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VSIM QUESTIONS ADVANCED FUND FINAL
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VSIM QUESTIONS ADVANCED FUND FINALExpected assessment findings of a patient with pneumonia may include which of the
following? (SATA)
a. Use of accessory muscles
b. Fever
c. Malaise
d. Tachypnea
e. Enuresis - Answers -a b c d
A patient in semi-Fowler's position is having difficulty breathing. What is the priority
action of the nurse?
a. Raise the HOB.
b. Auscultate the lungs
c. Call respiratory therapy
d. Conduct a pain assessment - Answers -a
A patient demonstrates correct use of the incentive spirometer when the patient places
the mouthpiece in the mouth and does which of the following?
a. Inhales quickly and forcefully
b. Inhales slowly and deeply
c. Exhales slowly and deeply
d. Exhales quickly and forcefully - Answers -b
A patient with newly diagnosed pneumonia has an oxygen saturation of 94% on room
air, an increased respiratory rate, and an increased pulse. The patient is pale and
anxious. The nurse questions the oxygen saturation results and looks up which of the
following test results?
a. WBC count
b. Hemoglobin
c. Gram stain
d. Chest X-ray - Answers -b
Mona Hernandez's laboratory work indicates an elevated WBC count with a left shift in
the differential. The nurse interprets this to mean which of the following?
a. There is a high number of WBCs and immature WBCs present to fight the infection
b. There is a high number of WBCs to fight the infection, and the RBCs are
compensating.
c. A left shift in the differential means that there is no infection present
d. There is a high number of WBCs, but not immature WBCs, present in the circulation -
Answers -a
Mona Hernandez's blood gas results indicate respiratory acidosis. Her oxygen
saturation is 95% per the pulse oximeter. Which interventions should the nurse provide?
(SATA)
a. Ensure the patient is well hydrated
,b. Assist the patient with adequate ventilation
c. None; the patient has a 95% oxygenation
d. Provide supplemental oxygen as ordered
e. Promote voluntary coughing activities to clear secretions - Answers -a b d e
Identify the following potential problems or actual problems that the nurse should
include when planning care for the patient diagnosed with pneumonia? (SATA)
a. Metabolic acidosis
b. Not able to tolerate activity
c. Ineffective respiratory gas exchange
d. Acute pain
e. Difficulty breathing - Answers -b c d e
Mona Hernandez asks the nurse why it is necessary to use the incentive spirometer
when she is already having difficulty breathing. What is the best response by the nurse?
a. It decreases cardiac workload during inspiration
b. It increases the oxygen taken in by the lungs when you inhale
c. It helps prevent atelectasis or collapsing of the alveoli in the lungs
d. It was ordered by your provider - Answers -c
A nurse rounding on a patient with pneumonia notices the patient is more confused than
at the beginning of the shift. What is the best response by the nurse?
a. Check oxygen saturation level
b. Ensure a sitter is available to watch the patient
c. Document findings in the medical record
d. Notify the provider - Answers -a
As the nurse administers Mona Hernandez's prescribed medication, guaifenesin, the
patient states: "I don't like this medication. it makes me cough too much." How should
the nurse respond?
a. When you cough out secretions, oxygenation is more effective
b. I will let your provider know you have questions about your medications
c. This medication is given to you because of your pneumonia
d. This mediation will help make your breathing easier - Answers -a
Mona Hernandez complains of SOB with activity and does not want to exacerbate her
condition by moving to the chair or ambulating three times a day as ordered. How
should the nurse respond?
a. You should wait until your breathing improves to try to get out of bed again, because
it makes you SOB
b. Even short activities such as moving to the chair will help you cough mucus out of
your lungs
c. Pneumonia causes thick secretions in your lungs, making it difficult to breathe
d. You really need to walk as much as possible in order to prevent your pneumonia from
getting worse - Answers -b
, Upon entering the room, the nurse observes Mona Hernandez slumped over in a semi-
Fowler's position, struggling to catch her breath. What is the priority nursing action at
this time?
a. Obtain vital signs
b. Assist the patient into a high Fowler's position
c. Titrate her oxygen so that her oxygen is greater than or equal to 95%
d. Obtain an oxygen saturation level - Answers -b
The nurse is preparing to discharge Mona Hernandez from the hospital. Which of the
following instructions should the nurse include in the discharge education? (SATA).
a. Stop taking your antibiotics once you are feeling better
b. Take your antibiotics as directed, even if you are feeling better
c. Continue to focus on ambulating several times per day
d. Quitting smoking will improve your recovery
e. Use the incentive spirometer every one to two hours to move secretions out of your
lungs - Answers -b c d e
A patient states he does not want to use the incentive spirometer because it makes the
patient cough up too much sputum, and it is difficult to breathe. What is the correct
information to teach the patient about the incentive spirometer?
a. You should wait to use your incentive spirometer until you are not coughing up so
much sputum
b. The incentive spirometer helps you to maximize lung function and minimize the risk of
atelectasis
c. You have to use your incentive spirometer because your provider has ordered it for
you
d. The incentive spirometer will cause you to cough less because you are moving more
air through your lungs - Answers -b
The nurse titrates the patient's oxygen to 3L per nasal cannula in order to maintain an
oxygen saturation of at least 94%, per the provider's orders. What is the rationale for
this order? (SATA)
a. Promotes a decrease in myocardial workload
b. Prevents atelectasis in a patient with pneumonia
c. Promotes a decrease in respiratory effort
d. Allows the body to meet metabolic demands
e. Allows the patient to receive 100% oxygen - Answers -a c d
While completing discharge instructions with a patient, the nurse notices the patient is
SOB. What is the priority nursing action at this time?
a. Listen to the patient's lungs
b. Ask if the patient has support at home
c. Reassure the patient
d. Determine if the patient has any questions - Answers -a
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