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Problems Lewis et al.: Medical-Surgical Nursing in Canada, 3rd Edition exam questions and answer
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Problems Lewis et al.: Medical-Surgical Nursing in Canada, 3rd Edition exam questions and answer
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Problems Lewis et al.: Medical-Surgical Nursing inCanada, 3rd Edition exam 2024-2025 questions and
answer
1 During assessment of the chest in a patient with pneumococcal pneumonia, what would the
nurse expect to find?
a. Hyperresonance on percussion
b. Increased tactile fremitus on palpation
c. Fine crackles in all lobes on auscultation
d. Asymmetrical chest expansion on inspection - answer>>>ANS: B
Pneumonias caused by Streptococcus pneumoniae are typically lobar or segmental. The nurse
would expect to find increased tactile fremitus over the affected area of the lungs. The area
would be dull to percussion.
PTS: 1 DIF: Cognitive Level: Application
REF: page 666, Table 30-5 OBJ: 1
TOP: Nursing Process: Assessment MSC: CRNE: CH-4
2. Four days after admission, a patient with chronic obstructive lung disease is diagnosed with
hospital-acquired pneumonia (HAP). Which of the following organisms does the nurse
recognize is a common cause of this type of pneumonia?
a. Pneumocystis carinii
b. Haemophilus influenzae
c. Pseudomonas aeruginosa
d. Mycoplasma pneumoniae - answer>>>ANS: C
Bacteria are responsible for the majority of HAP infections, including Pseudomonas,
Enterobacter, Staphylococcus aureus, methicillin-resistant S. aureus, and S. pneumoniae.
PTS: 1 DIF: Cognitive Level: Comprehension REF: pages 660-662
,OBJ: 1 TOP: Nursing Process: Assessment MSC: CRNE: CH-8
3. During assessment of the patient with pneumonia, what does the nurse understand about
the disease?
a. All patients with pneumonia will have a productive cough.
b. Manifestations of pneumonia vary, depending on the causative organism.
c. The typical pneumonia symptoms are usually caused by M. pneumoniae.
d. The pathophysiology of the disease is the same, regardless of the causative microorganism. -
answer>>>ANS: B
Manifestations of pneumonia vary according to their causative agent.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 660
OBJ: 1 TOP: Nursing Process: Assessment MSC: CRNE: CH-8
4. To promote airway clearance in a patient with pleurisy, what should the nurse instruct the
patient to do?
a. Splint the chest when coughing.
b. Maintain a semi-Fowler's position.
c. Wear the nasal oxygen cannula at all times.
d. Use relaxation techniques to reduce anxiety. - answer>>>ANS: A
Coughing is less painful and more likely to be effective when the patient splints the chest during
coughing.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 699
OBJ: 11 TOP: Nursing Process: Implementation MSC: CRNE: CH-32
5. . Following assessment of a patient with pneumonia, the nurse documents a nursing
diagnosis of ineffective airway clearance. On which of the following data would the nurse base
this nursing diagnosis?
, a. SpO2 of 85%
b. Respiratory rate of 28 breaths/min
c. Presence of greenish sputum
d. Weak, nonproductive cough - answer>>>ANS: D
The weak, nonproductive cough indicates that the patient is unable to clear the airway
effectively.
PTS: 1 DIF: Cognitive Level: Application
REF: page 667, Nursing Care Plan 30-1 OBJ: 2
TOP: Nursing Process: Diagnosis MSC: CRNE: CH-15
8. Following discharge teaching, the nurse evaluates that the patient with pneumonia
understands measures to prevent a relapse of the pneumonia when the patient gives which of
the following responses?
a. "I will increase my food intake to 2400 calories a day."
b. "I must use home oxygen therapy for 3 months."
c. "I will seek medical treatment for any upper respiratory infections."
d. "I should continue to do deep breathing and coughing exercises for at least 6 weeks." -
answer>>>ANS: D
Patients at risk for recurrent pneumonia should use the incentive spirometer or do deep
breathing and coughing exercises or both for 6 to 8 weeks after discharge.
PTS: 1 DIF: Cognitive Level: Application REF: page 668
OBJ: 2 TOP: Nursing Process: Evaluation MSC: CRNE: NCP-14
6. The nurse is preparing a patient with a diagnosis of bronchiectasis for chest physiotherapy
with postural drainage. Which one of the following will the nurse implement?
a. Position the patient supine.
b. Elevate the head of the bed by 20 cm.
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